Yeah, Scalia, Read the Damn Healthcare Bill

Antonin Scalia is a member of the Supreme Court, appointed by a Republican President.

Scalia recently asserted that the court couldn’t pick and choose which provisions of the Affordable Care Act are constitutional. It was either all or nothing.  “Mr. Kneedler, what happened to the Eighth Amendment?” Scalia asked. “You really want us to go through these 2,700 pages? Is this not totally unrealistic? That we are going through this enormous bill item by item, and decide each one?”

Described as a conservative voice and a son of New Jersey, in the oral argument over providing affordable healthcare to all Americans we also learned that Scalia does not know how to use his staff of brilliant clerks, and is too unconcerned to read the Healthcare bill before ruling on its constitutionality.

The  Healthcare Bill is long because it addresses complex issues, having about 470 sections, and was the subject of negotiation and compromise before it was approved by Congress and signed into law. In any mid-size law firm a staff of highly paid associates could digest a bill of its complexity in 48 hours. Each Justice on the Supreme Court has two brilliant clerks, a total of 18 skilled attorneys, and there are nine Justices. So, there are 27 lawyers, each of whom would have to read 100 pages of the 2,700 page bill. Yes, Scalia, I do expect you to read 100 pages. Let’s assume that the other Justices are as flippant as Scalia, and we only have 18 brilliant clerks, each of whom has to read 150 pages. Frankly, this could be done with ease over a long weekend. Scalia, it is unrealistic to not have the clerks read the bill. The clerks went to the best law schools in the country and excelled at every level. I would bet that many of them have already read the bill and have already summarized key provisions.

Scalia’s remarks are disingenuous to the point of deserving ridicule. Attorney Kneedler was circumspect enough not to point out to Scalia that the Justice Department has already parsed the bill and has already identified key aspects of the bill which can and should stand alone. And, the Justice Department didn’t do this work in secret, but filed pleadings with lower court federal judges. All of these pleadings were available to Scalia and his clerks.  And, no I don’t expect that Scalia will personally read the Bill, but if he wants to come to theJerseyShorein June, I will meet him in Manasquan and read the Healthcare Bill to him while he lounges on the beach.

Yes, Scalia, I do expect you to read the Healthcare Bill.

It is astonishing that Scalia would so baldly proclaim that he is not going to do a competent job, and his dereliction of his judicial duties undercuts public respect for the Supreme Court.

But, let us assume that Scalia’s remark about the length of the bill was no more than a rhetorical gesture, and not actually a reflection of his work ethic. Declaring the whole Bill unconstitutional would have the following effects.

Women will milk their breasts at their desks.

The Affordable Care Act “has approximately 450 separate pieces,” many of which are currently in effect. One lower court that ruled the ACA unconstitutional also recognized that “many provisions in the Act can stand independently without the individual mandate.”  For example, there is little doubt that the provision in the Act requiring employers to provide a ‘reasonable break time’ and separate room for nursing mothers to go and express breast milk [Act § 4207] can stand separately.

Small businesses will lose tax benefits.

The Affordable Care Act provides tax credits to eligible small businesses that offer insurance to their employees, offsetting up to 35 percent of employer premium costs beginning in tax year 2010. See ACA § 1421(a). If Scalia and the other radical republican judges have their way the federal government will immediately stop these tax credits  to  small businesses.

Scalia’s approach will injure the elderly and disabled and delay Medicare claims processing.

More than 20 sections of the ACA effected changes to Medicare payment ratesfor 2011, including extensions of a number of payment adjustments (such as add-on payments and exceptions to payment caps) that pre-date the ACA. These changes have already been incorporated through notice and comment rule making into Medicare payment regulations and implemented through edits to nearly every major Medicare claims processing system.

Scalia and his interventionist brethren will increase the Deficit.

To attempt at this juncture to devise an alternative, pre-ACA rate structure for  state-owned or operated Medicare providers  would impose staggering administrative burdens, and could cause major delays and errors in the payment of the roughly 100 million Medicare claims processed each month.

Scalia’s approach will cause more Medicaid Fraud

To prevent fraud and waste in the Medicaid program, the ACA required all states,to enter into contracts with auditors, to identify incorrectly paid claims and to recoup overpayments. See ACA § 6411. Moreover, the ACA requires states to suspend Medicaid payments to providers or suppliers when fraud is suspected. Declaring the entire bill to be unconstitutional is an invitation for more fraud.

Make the States challenging the law give back the taxpayer money they received and no longer want.

Twenty-five states (all but Alaska) were two-faced and while attacking affordable healthcare also applied for and were awarded federal grants to begin to take measures to ensure that their exchanges will be operational to carry out their grant agreements. These plaintiff states should return the more than $24 million already made available to them.

Kick Sick Americans Into the Gutter

Twelve plaintiff states contracted with HHS to run federally fundedhigh-risk insurance pools (Pre-existing Condition Insurance Plan, or PCIP, programs) established pursuant to the Affordable Care Act. See ACA § 1101. These pools provide coverage to eligible Americans who have been uninsured for more than 6 months because of a pre-existing condition.

Goodbye high risk pools. Goodbye insurance.

Your college student is about to become uninsured, and will be uninsurable if she has a pre-existing condition.

In their role as employers, most states sponsor their own group health plans. Thus, they are subject to ACA provisions already in effect that, for example, generally require insurers to offer parents the option to keep children on their plans until age 26, bar insurers from placing lifetime limits on the dollar value of coverage, and prohibit insurers from rescinding coverage unexpectedly after an illness or accident because of a mistake on a application.  Declaring the entire ACA unconstitutional will deprive millions of families and children in these plans of coverage and benefits

No insurance coverage for old and sick citizens who lose their jobs!

All plaintiff states that challenged the ACA currently participate in the ACA’s Early Retiree Reinsurance Program (“ERRP”). Early retirees are often ineligible for coverage from their former employers, but are too young to qualify for Medicare and too old, or too ill, to obtain coverage in the individual market. To encourage employers to continue coverage to early retirees and their families, the Act provides for $5 billion in ERRP subsidies through 2013. These subsidies reimburse 80 percent of the costs of certain medical claims of early retirees and their family members.

If Scalia bothered to read the ACA he might discover that this provision can stand alone.

Scalia encourages abuse to women by denying coverage.

All 50 states have applied for and received funding under the ACA’s Maternal, Infant, and Early Childhood Home Visiting Program, which appropriates $1.5 billion in funding over five years for states to deliver health care and other social services — such as prenatal care and domestic violence prevention — to families in at-risk communities who lack other resources. This funding will be halted by activist Republican justices. States have continued access to grants under this program to help families at great risk of health and developmental problems, child maltreatment, and domestic violence.

Ending Support for Consumers.

Thirteen plaintiff states were awarded over $11.1 million in grants pursuant to the Act’s Consumer Assistance Program, which authorizes and appropriates funding for states to help consumers navigate the health care market by, for example, facilitating enrollment in health plans and assisting with complaints and appeals against insurers.


 Justice Scalia plans to review and determine the constitutionality of an important piece of legislation that he has not read because it is too long. Scalia’s public statement is disrespectful of the Supreme Court and the rule of law. He should apologize. Scalia’s buddies on the Third Circuit Court of Appeals should stop defending the indefensible.

For those of you not hiding under a wild mushroom, it is no surprise that the radicals on the U.S. Supreme Court have declared war on 40 million poor and uninsured Americans.

Having entered the world of no holds barred political activism, the Republican controlled Supreme Court has waived any claim to being impartial and above the fray. Having chosen polemics over reasoned argument, the right wing radical justices invite Howling Patriot to give its point of view.

The radical ring leader and chief plotter against Poor People is Mr. Scalia, now famed for his broccoli analogy, best summarized as “let them eat broccoli,” paraphrasing another unelected and infamous person who was deposed and guillotined. In embracing Scalia’s sound bite, the other radicals gave the proverbial finger(ling) potato to poor Americans, many of whom are minorities or poor white trash with no political pull.

Why pick on Scalia. Well, Scalia is a very smart man, so he undoubtedly knew that his broccoli analogy was at best misleading, certainly wrong and did no more than  waste the time set aside for oral argument. Personally, I doubt Scalia has any interest in broccoli. From his girth we can reasonably assume that he is interested in food but is probably not eating enough vegetables. Not being able to put Scalia on the scales, we cannot be sure if he is obese, but let’s assume that since he is wearing two judicial robes stitched together that he meets a poor person’s definition of obese.

How would Scalia and his radical friends feel about waiting 12 hours in the emergency room to receive their basic healthcare? How will Scalia feel if his health insurance rates rise because he is obese and not eating enough broccoli?

How will Scalia feel if he has to self-fund his gastric bypass surgery? Oh, wait. We taxpayers are paying Scalia’s health insurance premiums and we will be on the hook for his obesity drugs and surgery.

Scalia has put the full weight of his specious arguments on the scales of justice, trying to tip the public discussion in a way that favors a radical agenda that ignores 200 years of constitutional precedent. Scalia also favors dismembering the portions of federal law that require hospitals to admit patients in financial need, rather than leaving them on the emergency room steps to die. Like his insensitive, male, radical brethren, Scalia has forgotten core American values like the pursuit of life, liberty and happiness. Once poor people are cutoff from access to healthcare, I expect that Scalia will want to stop the federal government from regulating cigarettes. If poor people smoke more and die sooner, then those deaths will relieve the pressures on the social security system so that Scalia can continue his attacks on a just and fair society by killing Social Security.

Scalia in his shiny robe is disassociated from
Americans who work hard, like the farmers who work in  fields cutting broccoli, or the uninsured looking for jobs which don’t exist because the government chose to bail out banks and fat financial cats . Scalia gets the full benefit of a government salary, government healthcare and government retirement benefits. He is getting fat on the hog. He should live a week on food stamps before he wanders down the path of stripping health insurance from Poor People.

Post Script: An ad hominem attack on Scalia avoids the merits of Obamacare, but is a fair riposte because Scalia’s approach also avoids the merits.