Three Health Care Quick Takes
- Double (Counting) Talk: Also this morning at the House Energy and Commerce Committee, Rep. Shimkus asked Secretary Sebelius about the Medicare savings in the law: “Is [the law] using it [the savings] to save Medicare, or are you using it to fund health care reform? Which one?” Secretary Sebelius’ response: “Both.” (See the full exchange here.) This statement contradicts the non-partisan Medicare actuary, who has previously noted that the Medicare spending reductions in the law “cannot be simultaneously used to finance other federal outlays and to extend the [Medicare] trust fund, despite the appearance of this result from the respective accounting conventions.”
- Vinson Issues a Rebuke – And a Stay: Also this afternoon, Judge Vinson in Florida ruled on the motion to “clarify” sought by the government in the multi-state lawsuit. The first 10 pages or so of the ruling summarize his prior ruling declaring the entire health care law unconstitutional (and are a good précis of same, if you hadn’t yet had a chance to read the longer ruling). On page 14, Vinson removed any ambiguity in his earlier ruling:
So to “clarify” my order and judgment: The individual mandate was declared unconstitutional. Because that “essential” provision was unseverable from the rest of the Act, the entire legislation was void. This declaratory judgment was expected to be treated as the “practical” and “functional equivalent of an injunction” with respect to the parties to the litigation. This expectation was based on the “longstanding presumption” that the defendants themselves identified and agreed to be bound by, which provides that a declaratory judgment against federal officials is a de facto injunction. To the extent that the defendants were unable (or believed that they were unable) to comply, it was expected that they would immediately seek a stay of the ruling, and at that point in time present their arguments for why such a stay is necessary, which is the usual and standard procedure. It was not expected that they would effectively ignore the order and declaratory judgment for two and one-half weeks, continue to implement the Act, and only then file a belated motion to “clarify.”
Vinson also rebuked the government for telling the press that “implementation will proceed apace” within hours of his order, even as it took weeks to request “clarity” from the court as to the ruling’s import. However, Vinson did grant a stay of his ruling, “conditioned upon the defendants filing their notice of appeal within seven calendar days of this order and seeking an expedited appellate review.”
- 1099 in the House: This afternoon the other body passed by a 314-112 vote legislation that would repeal the health care law’s onerous 1099 paperwork reporting requirement. More than half of all Democrats opposed the legislation, attacking the pay-for – a re-capture of unwarranted health insurance subsidies received by individuals – as a tax increase, despite the fact that only one Democrat opposed last December a Medicare “doc fix” that was also paid for by increasing repayment requirements for subsidies individuals erroneously obtained.