Monday, July 30, 2012

Affordable Care Act Update



William, Paul and James Newland and their sister, Christine Ketterhagen, who together own Hercules Industries, have no right to conduct their family business in a manner that comports with their Catholic faith.

The federal government can and will compel them to either surrender their business or to engage in activities the Catholic faith teaches are intrinsically immoral.

This is exactly what President Barack Obama's Justice Department told a U.S. district court in a formal filing last week. (The Patriot Post)

A federal judge disagreed...

A coalition of civil rights group has persuaded a Denver, Colo. judge that Obamacare’s preventive care coverage provides a “substantial burden” on a Colorado company’s free exercise of religion.

Judge John Kane, who was appointed by President Jimmy Carter, granted a “preliminary injunction” barring enforcement of the law against the family-owned company, pending a full trial.

“This is the very first ruling on whether Obamacare can violate religious freedom and the judge said no,” said Matt Bowman, a lawyer for legal advocacy group Alliance Defending Freedom, formerly known as the Alliance Defense Fund. (The Daily Caller)

The mandate forces employers, regardless of their religious or moral convictions, to provide insurance coverage for abortion-inducing drugs, sterilization, and contraception under threat of heavy penalties.

Alliance Defending Freedom attorneys obtained the first-ever order against the mandate on behalf of Hercules Industries and the Catholic family that owns it. The administration opposed the order, arguing, contrary to the U.S. Constitution, that people of faith forfeit their religious liberty once they engage in business. (Alliance Defending Freedom)

Judge John Kane emphasized that his ruling only applies to the specific company whose lawsuit he considered—Colorado-based Hercules Industries.

“Every American, including family business owners, should be free to live and do business according to their faith. For the time being, Hercules Industries will be able to do just that,” attorney Matt Bowman said in a statement. (Healthwatch)

The Thomas More Law Center, a national public interest law firm based in Ann Arbor, Michigan, announced it has filed an emergency motion asking that Federal District Judge Robert H. Cleland of the Eastern District of Michigan stop the HHS Mandate which goes into effect on August 1, 2012. (Christian Newswire, Thomas More Law Center)

- Father, we thank you for this huge victory for Hercules Industries. We ask that you make it complete for all Americans.

- "...being confident of this very thing, that He who has begun a good work in you will complete it until the day of Jesus Christ." (Philippians 1:6)


The nonpartisan Congressional Budget Office said repealing President Obama’s healthcare reform would increase the deficit by $109 billion over 10 years. This is in light of June’s Supreme Court ruling that upheld most of the law, and it is a smaller deficit increase than CBO previously had linked to the repeal.

CBO said the ruling added uncertainty to its estimates but it has put forward a number that comes down in the middle of possible outcomes. It estimates that the ruling will save the government $84 billion because fewer people would be covered by Medicaid.

In March 2011, CBO said that the law would reduce the deficit by $210 billion over 10 years, despite increasing spending by $1.042 trillion over 10 years, from 2012 until 2021. The new estimate covers 2022. Using the same time frame, repeal would only add $65 billion, CBO said. (On The Money)

There is a $145 billion difference between $210 billion and $65 billion which amounts to a 69 percent loss of effectiveness in how much the Affordable Care Act will reduce the deficit. (Pray for Congress)

House Republican Policy Committee Chairman Tom Price, M.D. (R-GA) statement: The "nearly $1.7 trillion price tag and the taxes that will be imposed on individuals and businesses are only one part of the cost of this law. What cannot be fully expressed in a CBO score is how the American people, under the president’s plan, will lose access to affordable, quality health care choices."

Former CBO Director Douglas Holtz-Eakin: This does not constitute a comprehensive re-estimate of the cost of the ACA.

An interesting feature of the report is that the CBO estimates that the ACA will cut Medicare spending by $741 billion over the next 10 years, up from the roughly $500 billion advertised at passage. This change reflects both the fact that the budget window is different, and that in the absence of cuts, Medicare is growing quite rapidly. Accordingly, the size of the cuts are growing rapidly as well.

The final aspect of the CBO analysis, contained in a letter to Speaker Boehner, is that repeal of the ACA will increase the deficit by $109 billion over 10 years. Interestingly, $95 billion is “off-budget” savings—CBO parlance for Social Security taxes. Put differently, the ACA is budgetarily “sound” only because of higher taxes—no health-care savings in sight. (NRO)

As reinterpreted by the Court, the mandate is not “a provision requiring most individuals to obtain insurance coverage or pay a penalty tax” but is rather just a tax. By the CBO’s own prior reckoning, the fact of the requirement was a significant driver of compliance, so if it’s not a requirement then compliance would be diminished. The agency’s health-care analysts were aware of the problem in the course of this re-scoring, but in the end evidently decided they would do best to pretend it did not exist and report no significant effect on compliance. (NRO)

- Father, we thank you for the "nonpartisan" though still incomplete picture from the Congressional Budget Office and for the clear voices that can help us complete the picture of this health care law. We ask that the truth would continue to prevail, for a clear fiscal picture as a whole, and for leaders willing to speak hard truth to the public about how to fix the problem instead of just things that sound good and actually make the problem worse.

- "You be watchful in all things, endure afflictions, do the work of an evangelist, fulfill your ministry." (2 Timothy 4:5)


A large bloc of House Republicans urged their leaders to hold more votes to block funding for the healthcare law. Joined by roughly half of the House GOP, Reps. Michele Bachmann (R-Minn.) and Jim Jordan (R-Ohio) stated that efforts to subvert "ObamaCare" must continue "until we are successful."

"We urge you not to bring to the House floor ... any legislation that provides or allows fund to implement ObamaCare," they wrote in a letter, adding that all current implementation funds should be rescinded. The letter was addressed to Speaker John Boehner (R-Ohio) and Majority Leader Eric Cantor (R-Va.).

The current House GOP has held more than 30 votes to undermine the Affordable Care Act, which the Supreme Court largely upheld on June 28. Republicans most recently led the chamber in a second vote to repeal the law in full. The measure passed 244-185 but will go nowhere in the Democrat-controlled Senate, like most of the others.

Democrats responded by seeking to portray the GOP as myopically focused on healthcare at the expense of other national problems. (Healthwatch) put the question of "whether the House Republicans would permit or not permit funding for Obamacare in whatever legislation is enacted to fund the government after Sept. 30—when the current funding legislation runs out" to House Speaker John Boehner and Majority Whip Kevin McCarthy.

The Speaker responded that "our goal would be to make sure the government is funded." concluded the "House Republicans do plan to fund implementation of Obamacare past Sept. 30."

This is one possible scenario if a separate bill for funding the Department of Health and Human Services is not enacted by then. As reported last week, HHS Appropriations Subcommittee Chairman Rep. Rehberg (R-Montana) has introduced an excellent bill that cuts the HHS budget by $1.3 billion, blocks implementation of the health care law, and defunds abortion provider Planned Parenthood.

Insisting on all that in a continuing resolution that temporarily keeps the government funded past September 30, likely until after the election, would be a heavy lift.

Less difficult would be to include in a continuing resolution language that, as puts it, "expressly prohibits funding specifically for the Obamacare regulation that requires health-care plans to cover, without cost-sharing, sterilizations, artificial contraceptives and abortifacients."

That's the same regulation that is under court challenge as discussed in the first item above. That mandate is set to go into effect in two days, Wednesday, August 1, 2012.

- Father, we know that the health care law is one of our largest domestic national problems, and it's aggravating other challenges we face in our economy and our moral state as a country. We ask that you would help our leaders match their priorities to Your priorities, give them strategies for enactment, and make them effective.

- "And Elisha prayed, and said, “LORD, I pray, open his eyes that he may see.” Then the LORD opened the eyes of the young man, and he saw. And behold, the mountain was full of horses and chariots of fire all around Elisha." (2 Kings 6:17)


Re-electing President Obama is really important to President Obama, which isn't news. What is news are the out-of-liberal-character acts that his Administration is committing to serve this political goal. Most remarkable is Mr. Obama's decision to flout his own health-care law to temporarily protect private insurance inside Medicare. ObamaCare slashes about $145 billion from Medicare Advantage. (WSJ)

The Patient Protection and Affordable Care Act substantially alters Medicare Advantage (MA) and, as a consequence, reduces the access of senior citizens and the disabled to quality health care by restricting and worsening the health care plan options available to them. Lower-income beneficiaries, Hispanics, and African–Americans will bear a disproportionate share of the act’s Medicare Advantage payment reductions.

The MA changes are structured in ways that will make almost all beneficiaries who would have chosen MA under prior law worse off. The “lucky” ones will lose only money. The rest will lose both money and their chosen method of obtaining health care, and the changes may also adversely affect the health of some beneficiaries. (Heritage Foundation)

CBO estimates that the ACA will cut Medicare spending by $741 billion over the next 10 years, up from the roughly $500 billion advertised at passage. (NRO)

HHS has a program "to implement an $8.35 billion demonstration program to isolate Medicare Advantage from those cuts—at least through the election." (Docs4PatientCare)

GAO’s General Counsel advised HHS Secretary Kathleen Sebelius that the Centers for Medicare & Medicaid Services (CMS) has not established that the agency’s Medicare Advantage (MA) Quality Bonus Payment Demonstration is within its legal authority under section 402 of the Social Security Amendments of 1967 as amended.

In March 2012, GAO issued a report recommending that CMS terminate the $8 billion demonstration because of the demonstration’s high cost and significant design shortcomings. (GAO)

- Father, we ask that this demonstration project be terminated because it is illegal. May our leaders live by the laws they have passed. May all of our leaders turn from laws, no matter who passed them, that do not honor you.

- "Just as you presented your members as slaves of uncleanness, and of lawlessness leading to more lawlessness, so now present your members as slaves of righteousness for holiness." (Romans 6:19)


While most uninsured children will qualify for coverage under the federal health law, a small percentage—6.6 percent of the total, or at least 460,000—may be shut out because of how the government proposes to define “affordable” coverage, says a report from the U.S. Government Accountability Office.

The proposed Treasury Department rule says workers and their families are ineligible for federal subsidies for coverage if an employer offers them affordable coverage at work. An employer’s offer is considered affordable if the worker’s share is less than 9.5 percent of household income.

But the rule bases affordability on what a worker would have to pay to cover himself or herself, not on the cost of covering the entire family, which is generally higher.

- Father, whatever the greater injustices of the law at large, this law is on track to be implemented for many, and rules like this add pressure on the disintegration of the family, your holy institution, in this country. We ask that our laws and regulations would not further undermine the family.

- "If anyone does not provide for his own, and especially for those of his household, he has denied the faith and is worse than an unbeliever." (1 Timothy 5:8)


The biggest health-policy debate in America right now is whether or not states should opt in to Obamacare’s dramatic expansion of Medicaid, our government-run health care program for the poor. Governors from both parties are concerned that the costs of the expansion will be higher than projected, and that the federal government will back out of its funding commitments.

But if you want to see the future of Medicaid, all you have to do is look at the blue states where progressives hold sway, where governments have expanded Medicaid by paying doctors less.

Medicaid suffers from the developed world’s worst health outcomes. The main reason is that the program pays doctors and hospitals so little that many doctors lose money treating Medicaid patients. As a result, many doctors don’t take Medicaid, and people on Medicaid die sooner from cancers that could have been adequately treated at an earlier stage. (Forbes)

Roughly 20 states have taken at least an initial step toward defining “essential health benefits,” according to a new analysis from the National Academy of State Health Policy (NASHP).

The Affordable Care Act lists broad categories of essential benefits, such as “emergency services” and “prescription drugs,” which every individual and small-group plan will have to cover beginning in 2014. The Health and Human Services Department is leaving it to the states to fill in their own specific requirements by selecting a “benchmark” plan that others will have to meet.

Twenty-three states have assessed their options for benchmark plans, according to NASHP, and 13 have gotten as far as establishing a comment period to gather public input. Only three states—California, Virginia and Washington—have settled on a benchmark. (Healthwatch)

The Congressional Research Service, a division of the Library of Congress that provides legal and policy analysis to members of Congress, published a report last week that concludes that the Supreme Court’s ruling has no effect on the health care law’s so-called “maintenance of effort” provision, which prohibits states from cutting existing Medicaid services before 2014.

While the report acknowledges the complexity of the Supreme Court ruling, its reading supports the view—held by Maine Democrats—that the state is prohibited from making $10 million in Medicaid cuts that Republican lawmakers approved in May as part of a supplemental budget and that LePage signed into law. (Bangor Daily News)

Thirteen states are moving to cut Medicaid by reducing benefits, paying health providers less or tightening eligibility, even as the federal government prepares to expand the insurance program for the poor to as many as 17 million more people.
  • Illinois cut enrollees to four prescriptions a month; imposed a copay for prescriptions for non-pregnant adults; raised eligibility to eliminate more than 25,000 adults and eliminated non-emergency dental care for adults.

  • Alabama cut pay for doctors and dentists 10 percent and eliminated coverage for eyeglasses.

  • Florida cut funding to hospitals that treat Medicaid patients by 5.6 percent – following a 12.5 percent cut a year ago. The state is also seeking permission to limit non-pregnant adults to two primary care visits a month unless they are pregnant, and to cap emergency room coverage at six visits a year.

  • California added a $15 fee for those who go to the emergency room for routine care and cut reimbursements to private hospitals by $150 million.

  • Wisconsin added or increased monthly premiums for most non-pregnant adults with incomes above $14,856 for an individual.
South Dakota, Maryland, Colorado, Louisiana, New Hampshire, Hawaii and Maine also are making reductions to their programs. Connecticut is weighing cuts likely to go into effect this fall.

As American Action Forum asks, "If states opt out of Medicaid, what does this say about the cost of the ACA?"

- Father, of all the moving parts in the health care debate, when the rolls are frozen from increasing or decreasing, the needs go up, and the money goes down, we know natural law still says something has to give, and services go down. We ask that You would open the eyes of your people to see that rationing of health care services is already happening, and this is just the beginning. May the eyes of many be opened over these next 99 days.

- "With her enticing speech she caused him to yield, With her flattering lips she seduced him. Immediately he went after her, as an ox goes to the slaughter, Or as a fool to the correction of the stocks, Till an arrow struck his liver. As a bird hastens to the snare, He did not know it would cost his life." (Proverbs 7:21-23)


'Taxmageddon' isn't only about the half-trillion-dollar blow to the economy that arrives in 2013 on the end of the Bush-Obama tax rates. Several of the Affordable Care Act's worst tax increases kick in too, such as the new excise tax on medical devices.

The 2.3% levy applies to the sale of everything from cardiac defibrillators to artificial joints to MRI scanners. The device tax is supposed to raise $28.5 billion from 2013 to 2022, and it is especially harmful because it applies to gross sales, not profits. Companies at make-or-break margins could be taxed out of existence, especially in an intensely competitive industry where four of five businesses are start-ups or midsized.

As even the liberal papoose Elizabeth Warren recently put it, the device tax "disproportionately impacts the small companies with the narrowest financial margins and the broadest innovative potential." (WSJ)

- Father, we thank you for the thriving system of medical innovation you have given us through which we have been able to bless the world. We ask that you would preserve this, help this continue, and thwart any hindrances to startup innovation.

- "Abandoning that one, Isaac moved on and dug another well. This time there was no dispute over it, so Isaac named the place Rehoboth (which means “open space”), for he said, “At last the LORD has created enough space for us to prosper in this land.”" (Genesis 26:22, NLTSE)


A federal judge has set a bench trial date to hear arguments that the attorneys who crafted them say are a unique challenge to the constitutionality of the health care reform law.

U.S. District Court Judge Keith Starrett, who presides in the Hattiesburg Division of the Southern District of Mississippi, has put a case with numerous plaintiffs including Gov. Phil Bryant on the calendar for the term beginning in October.

McDaniel said in earlier interviews that the part of the lawsuit remaining in litigation evokes the right to medical privacy established by the 1973 Supreme Court decision in Roe v. Wade, which decided medical privacy extended to a woman's right to have an abortion.

He said the federal government forcing Americans to disclose medical information to an insurer—or a private third party—would violate the rights to medical privacy supported by decades of case law.

- Father, if there were ever what looked like a lose-lose situation before us, it is this. We know that the enemy of our enemy is not necessarily our friend. We ask You to work in this situation as only You can to bring about justice for the unborn, for patients, doctors and all Americans for your glory.

- "And it came to pass on a certain night that the angel of the LORD went out, and killed in the camp of the Assyrians one hundred and eighty-five thousand; and when people arose early in the morning, there were the corpses—all dead." (2 Kings 19:35)


The Affordable Care Act could cost McDonald’s and its franchisees more than $400 million a year in additional health-care expenses, Chief Financial Officer Peter Bensen said on Monday.

McDonald’s estimates that each restaurant will incur between $10,000 and $30,000 in added annual costs, Bensen said in response to an analyst’s question on a conference call to discuss the fast-food giant’s second-quarter results, according to an unedited transcript of the call provided by FactSet. There are about 14,000 McDonald’s restaurants in the U.S., meaning McDonald’s expects the total cost to the company and its franchisees to be in the range of $140 million to $420 million. McDonald’s owns about 11% of its U.S. restaurants, while the rest are franchised. (WSJ)

- Father, while there is more than a little irony in this situation, we know this reflects the situation of many businesses and franchisees all across the country. We ask that people who have no interest in politics and would rather mind their own business would realize they will soon have no option but to speak up, and speaking up now would be better. 99 days, Lord!

- "When I have brought them to the land flowing with milk and honey, of which I swore to their fathers, and they have eaten and filled themselves and grown fat, then they will turn to other gods and serve them; and they will provoke Me and break My covenant. Then it shall be, when many evils and troubles have come upon them, that this song will testify against them as a witness; for it will not be forgotten in the mouths of their descendants, for I know the inclination of their behavior today, even before I have brought them to the land of which I swore to give them." (Deuteronomy 31:20-21)

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