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Culturally and Linguistically Appropriate

A passage that I couldn't resist sharing after stumbling upon it ...

The standards shall ensure that the summary is presented in a culturally and linguistically appropriate manner and utilizes terminology understandable by the average plan enrollee.


I would strongly suggest that something similar could be found in a variety of bills. The requirement is essentially a "common language" or "no legalese" clause. It just smacks of some obvious irony that a federal version of this mandate would include so many multi-syllable words - ultimately disqualifying itself for inclusion in the very document being developed.

It's moments like this that I wish I had a hotline to Washington Monthly's Charles Peters.


Once again …

Once again, the workday is a bit too much fun-filled with research projects to dive too deeply into subjects that I wish I had the time to blog about. One point to interrupt that for, however, is to extend an open invite to any/all folks who might wish to partake of some political activity tonight. And on that note, my State Rep is kicking off his 2014 campaign season at our favorite Italian Restaurant: Barry's Pizza. So consider this an invite to join us between 5 and 7pm for free food and drinks.

Aside from that, there's a little serendipity in reading Steven Teles' "Kludgeocracy in America" thesis while also reviewing the House Appropriations hearing on the state CPRIT agency's botched grant process. Specifically, the agency's expressed desire during the committee to go ahead and award grants approved during the moratorium period that they were under at the time:

Should outgoing Governor Perry opt for a more four-eyed Presidential run in 2016, I look forward to hearing how this is totally different from any failings of Obamacare.


Election-Eve Aggreposting …

One final sampling before the votes start trickling in tomorrow ...

» Washington Post: Let’s shatter the myth on Glass-Steagall
I'm glad to see a bit of provocative thinking on this topic. Of course, I'm old enough to remember that it was the late Sen. William Proxmire who led the charge to get Glass-Steagall undone. Proxmire wasn't exactly a Phil Gramm carbon copy, so it bears some attention that there was a liberal critique of the law, as well. Whether the final, passed version of the law was something Proxmire still found merit with or whether there were any issues that came up afterward that might make him change his mind, I don't know. But I'm not certain that just putting Glass-Steagall back in place is much of a solution.

» NY Times: Genetic Data and Fossil Evidence Tell Differing Tales of Human Origins
If science and whatnot isn't your bag, just think of this as pre-historic multiculturalism and diversity.

» NY Times: Political Fortunetelling
Fanciful fiction, to be sure. But I don't think every one of the names mentioned will be absent enough political ambition on the top job. Cuomo should be a certainty. But even after that, I'd expect a few of the rest. As far as the sponsorship element to the tale, I'm more doubtful. But the two strands of the story do weave in with the over-celebritization of politics.

» Dan Froomkin: You Know What the ‘Voter ID’ Push Is All About, So Say So
What? ... and tell the truth?

On the Wednesday-through-Friday reading pile:

» NY Times: What Can Mississippi Learn From Iran?
» New Yorker: We Are Alive - Bruce Springsteen at sixty-two.
» New Yorker: Fussbudget - How Paul Ryan captured the G.O.P. (Ryan Lizza)

Highly coincidental that today's batch includes two writers who I think are very much missed from their previous employers: Froomkin from the Washington Post and Lizza from The New Republic.

In other news, I've got a quick one-day getaway "vacation-let" planned for San Antonio at the end of the week. If the heat doesn't kill me while I'm there, I hope to see enough of the outdoors to do a bit of blogging about some beautiful sights, scenes, and sounds from another little dot on the map.


Runoff, Pre-Early-Vote Aggrepost

No rest for the weary. Rock & roll, yes. Rest, no ...

And for newsier-ish events and whatnot, here's a bit of a sampler so that I don't feel too far behind on all the goings-on around here:

» Wash. Post: In Virginia, frenzied weekend highlights fight ahead in state for Obama, Romney
» LA Times: Nevada isn't a sure bet for Obama
I'm told there's still a Presidential election going on. Too early to really take polls seriously. But that shouldn't stop anyone from gnawing away a few precious fingernails to deal with the anxiety.

» GC Daily News: Jason Murray to spend 7 months in jail
A good poster-child for voters paying more attention to who they vote for down-ballot.

» FW Star-Telegram: Keller City Council nixes proposed food truck park
Nice to see a conservative little corner of Tarrant County so concerned about too much competition in the food industry.

» Kevin Drum: Medicaid Expansion May Turn Out to Be an Offer States Can't Refuse
Kudos to KDrum for picking up on this. And also kudos to Arkansas for honestly reviewing the tradeoffs involved in expanding Medicaid.

They figure that in 2015 the new law would cost them $42 million and save them $131 million. So it's a clear winner. But that's because the federal government picks up 100% of the tab for expansion during the first three years. That declines to 90% by 2020, and Arkansas figures that by 2021 the expansion of Medicaid would cost them $3.4 million per year.

Now, that's $3.4 million out of a $4 billion Medicaid budget, of which Arkansas pays $750 million. So it's not a lot of money, especially considering the number of people it would help.

There are still critiques to be had with the expansion and Drum cautions that Arkansas' mileage may vary from others. But it sure would be nice to see Texas try a little honest accounting on this issue. It would certainly be a lot better than ...

» Chron: Passing on Medicaid expansion is the right call for Texas
Signed by State Sen. Bob Deuell (R); State Rep. Charles Schwertner (R); State Representative Mark Shelton (R); and State Rep. John Zerwas (R). Most interesting, because ...

» Kaiser Health News: Businesses Will Push Perry to Rethink Medicaid Expansion

"Fights seem to follow the money, and there is a lot of money at stake in Texas on this," said Phil King, a Republican state representative from outside Fort Worth who opposes the Medicaid expansion. "Maybe you need to rename this 'The Full-Employment Act for Lobbyists.'"

With world-renowned medical institutions such as the University of Texas and a large part of its Medicaid coverage handled by private insurers such as Amerigroup, the state's health industry is "just behind oil and gas" in size and influence, said Vivian Ho, a health economist at Rice University. "Given how much Amerigroup has to gain from a Medicaid expansion in Texas, they may be one of the most effective organizations to lobby Perry and the state legislature to fund the expansion."

Founded in the mid-1990s in Virginia Beach, Va., Amerigroup contracts with 13 states to manage Medicaid care, generally for a fixed fee per member. Now grown to Fortune 500 size, the company had twice as many Texas members last year -- 632,000 -- as in any other state.

Oughtta provide a good deal of entertainment in the lege come January.

Oh yeah, and this happened:

And just for a little bit of retro-linkage, here's an interesting local story from 1986 on how familiar names may or may not have wrecked havoc on political primary outcomes. Elsewhere, TBogg notes a hilarious example of Randian hypocrisy.


Whaddaya Know …

» Washington Post: Supreme Court upholds health-care law, individual mandate

The only provision that seems to have been struck down is the one that removes Medicaid funding from states if they opt out of expanding Medicaid coverage. That's a far cry from the Toobin-esque certainy I've expressed that the court will make a political decision against either the law as a whole or merely the individual mandate (which would have been a means to simply undermine the entire bill without overturning it). I'm certainly happy for the sake of the Commerce Clause that I'm wrong about that. For the sake of what I still consider to be an overly expensive re-write of health insurance law, not so much.

It will be interesting to see what happens to popular opinion of Obamacare and/or the individual mandate as a result of this decision. Also worth watching for is how the "repeal and replace" argument evolves. There's still an election to go through and for all those who think that the ACA was health care reform, it'll take that election to truly uphold the law before much of the bill goes into effect.


Obamacare Goes to Court: Day Two

» NY Times: Hard Questions From Justices Over Insurance Mandate

Doesn't sound like the individual mandate had a good day in court yesterday. Says Ezra ...

The quick read is that today went very badly for supporters of the individual mandate. As one of the experienced Supreme Court watchers who runs SCOTUSblog tweeted, “Paul Clement” — the attorney arguing against the health-care law — “gave the best argument I’ve ever heard. No real hard questions from the right. Mandate is in trouble.”

... and Toobin is more blunt in his assessment:

"This was a train wreck for the Obama administration .... This law looks like it's going to be struck down. I'm telling you, all of the predictions including mine that the justices would not have a problem with this law were wrong... if I had to bet today I would bet that this court is going to strike down the individual mandate."

So it looks like the only question left is whether the scope of the opinion will be narrowly tailored to nix the individual mandate, or if the majority in the court will strike for bigger gold in limiting the commerce clause.

The Washington Post interviews Randy Barnett of Georgetown Law and captures his take on the issue at hand ...

... the duty to pay taxes is part of your duty to support the government in return for the protections the government gives you. What the government is claiming here is this power — and this ought to disturb people on the left — to make people do business with private companies when Congress thinks it’s convenient.

That's a fair encapsulation of why I've consistently found the individual mandate troubling. The argument that we're all engaged in the health care market, hence we should pay for it by some means, is problematic on logical grounds. First, the only reason it's offered is because of a Hippocratic Oath that doesn't exactly bind any doctor to see any patient on any grounds whatsoever. At least not in any legally codified manner that I'm familiar with. Secondly, the assumption is that the entirety of the uninsured do not manage to cover the health care costs that they end up incurring. I'm sure that the net effect is a loss of dollars, but I've not seen anything that outlines the scope of the problem (ie - what percentage of uninsured contribute to the problem). I'm uninsured since I don't know when (minus some time during 2010). I have incurred zero health care expenses in the past decade. The last time I did, I paid my bill in full. So why do I need to be forced into the insurance market against my will to fix a problem that I don't contribute to?

In sum, the so-called "health care reform" bill signed into law is, in effect, nothing more than a health insurance reform in this regard. And that brings me to the final problem I have with the mandate: why are we sanctifying the insurance market? Is that really the highlight of liberal thought, these days? ... forcing people to deal with the insurance industry? That seems a far cry even from Al Gore's trope of "the people vs the powerful."


Obamacare Meets the Court

Today's the day. The Supreme Court begins four days of hearings on four aspects of the administration's health care reform. There's no such thing as instant gratification when it comes to these things, though. We won't have an opinion until the summer in all likelihood. And the courtroom is officially a twitter-free zone. A lot is already known about how both sides are going to make their arguments. But the spectacle this week is to see what can be determined about individual justices' questions, doubts, and leanings in the questions they raise. Audio of the hearings will be released by the end of each day of arguments. Fun times.

Here's a small sample of the overviews:

» Wonkbook: Absolutely everything you need to know about health-reform Supreme Court debut
» Kaiser Health News: The Health Law And The Supreme Court: A Primer For The Upcoming Oral Arguments
» Kaiser Health News: Scorecard: What The Health Law Has Delivered, Or Not

That ought to get you up to speed on the outline of the court's case and some objective merits of Obamacare's success or lack thereof to date. Not that the latter matters to the court ... but since most of us aren't forming our opinions of the law in constitutional terms, I happen to think its worth a review at this point. Make of it what you will.

If its a little bit of the pre-game tic-toc you want ...

» NY Times: In Health Care Case, Lawyers Train for 3-Day Marathon
» Wash. Post: Supreme Court to hear arguments on timing of health-care ruling

And there happens to be ample coverage of the lawyers who will be making the most noise this week ...

» NY Mag: The Paul Clement Court
» NY Times: A Lawyer Who Can Simplify the Complex Draws a Big One: Obama’s Health Overhaul

Jonathan Cohn has pretty much been building up to this point and here's a single instance of where he's opining these days ...

» New Republic: If Medicare Is OK, Obamacare Should Be Too

As for me, I've had my marker on the table for quite some time. I think the court strikes down the individual mandate ... even if it means a supposed "fractuous" 5-4 ruling. Roberts, et al can certainly make a logical argument that strikes a few chords of constitutional law. But for all intents and purposes, it will be another political ruling from this court.

Now, what that means for the rest of the law or the fate of health care reform as passed, still remains to be seen. Given that the grand bargain of health reform seemed contingent upon there being an individual mandate, I don't see how it survives without. Whether it could be salvaged with something like Paul Starr's recommendation for an individual mandate, we'll see how much room there is for that during the summer.

ADD-ON: Some more good reading from the twitter chatter that does exist ...

» The Atlantic: How Obamacare Will Be Settled: A Primer on the Commerce Clause
» ACA Litigation: Some things to look for tomorrow

CONCLUSION: Day one looks like the easiest of them all. Up for discussion today was whether the justices could or could not rule on a law that hasn't fully taken effect yet. And it seems that much of what took place was that the justices browbeat the very attorney they hired to argue that they shouldn't. Yeah. You read that right. Government for ya ...

In the first day of hearings at the Supreme Court over President Barack Obama's signature health care law, justices seemed skeptical Monday about arguments that they have no authority to decide the key issues now. Eight of the nine justices put challenging questions to Robert Long, the lawyer who argued for postponing a decision on the case.

That's from Politico's email after today's hearing. It's all downhill from here.


Sebelius’ Defense

» Wash. Post: The Affordable Care Act, helping Americans curb health-care costs (Sec. Kathleen Sebelius)

Consider this piece the overview/defense of Obama's health care reform endeavor.

If health-care costs continue to rise unchecked, they will threaten America’s ability to compete and will become unaffordable for most families. One of the major reasons we passed the Affordable Care Act was to bring down costs, something the health-care law does in three ways: by increasing insurance-market competition, assisting those who can’t afford coverage, and tackling the underlying cost of medical care.

One of many reasons that I'm a sceptic is the effort is that many of the items Sec. Sebelius mentions are fairly minor things that can be (and I would expect to see) undone with a single vote in Congress. Take enough chips away it through small-ball votes rather than big-ticket "repeal" measures, and the plan is the gift that keeps on giving - weekly or monthly "end Obamacare" votes. And many of them are reforms that I'm sure the insurance industry will find the means to defeat and no constituency to defend exists. The 1099 measure is a perfect case in point for this.

Not that a slow-bleed attack wouldn't happen to any health care reform approach. But for the price of this one, I see the "savings" still seem far more ephemeral and the costs far more real. If you spend north of $800B, I'd like to feel more confident that something good would come from it. It'll take a bit more than general defenses of the plan to convince me of that.


Aggre-blogging: The Post-Christmas Lull

Still slaving over pixels, demographics, and writing. I trust that your extended weekend was better. An abbreviated news roundup as the rest of the news world took a few days off.

» San Antonio Express-News: D.C. judges see Texas bias
Standard disclaimer: you’re just not following redistricting’s legal round properly unless you’re reading Michael Li’s blog. The DC Circuit court has spoken up on Texas Redistricting … and the early news is not good for the Texas GOP. There’s also some interesting tidbits in the court’s decision regarding coalition districts. It’ll be interesting to see what that means for the HD26/137/149 corridor in the Houston area. (Related: Michael has the Houston-area Organization of Chinese-Americans’ amicus brief posted for more reading on the treatment of those three districts.)

» Wash. Post: Code for America: An elegant solution for government IT problems (Vivek Wadhwa)
It sure would be great to have local government that saw value in something like this. Just sayin’.

» New Republic: The Mandate Miscalculation (Paul Starr)
» New Repubic: Was the Mandate a Mistake? (Jonathan Cohn)
Yeah, so I’m still with Paul Starr on this one. It’s arguable that the health care mandate cost Democrats their governing majority, although I’m also of the opinion that if Obama signed into law a mandate that we all like puppies, that would have served as a suitable substitute. Still … I think the puppy thing would have faded as an issue by now. Staking your political reputation as being a “BFD” on health care reform by forcing everyone to go buy health insurance, not so much.

» Economist: The faith (and doubts) of our fathers
I’ve always found it odd that the relatively modern “War on the Founders” was a necessary pre-condition to the Christian faith. That and creationism and forced prayer in school. Steven Waldman’s “Founding Faith” is a good enough rebuttal to the first while still noting the importance that Christian faith had in the founding.

» Demos: From Citizenship To Voting: Improving Registration For New Americans
Bookmarked for future reading.

» A bit of Greg Trivia for the few who might care: I’ve never seen Van Halen with David Lee Roth. I’ve seen Van Hagar and Van Cherone (which was a great live show, FWIW). I didn’t catch either the Sammy Reunion tour of 2004 or the first DLR Reunion tour of 2007. I did manage to take in the Sam & Dave show in 2002. Dave’s voice was shot and I left after his very horrible set. But the allure lives on. Still, I may have to entertain the idea of catching this version of the reunion for a while. At least until I see how expensive the tickets are.

Van Halen - Long Version Trailer from Van Halen on Vimeo.


A Mandated Roundup

I'm not even going to pretend to have enough time to dive into all of these, individually. But since they do make for some pretty good reading on the current state of either health care reform or the commerce clause (however you decide to see it), I'd be the worst blogger in the world if I didn't at least pass them on.

» NY Times: Doing the Judicial Math on Health Care (Adam Liptak)
» Tapped: The Mandate Alternative (Paul Waldman)
» NY Review of Books: Is Health Care Reform Unconstitutional? (David Cole)
» Post-Partisan: Give me liberty or give me health care (Charles Lane)
» The Plum Line: The flawed conservative case against the mandate (Greg Sargent)
» Ezra Klein: If not the insurance mandate, then what? (Derek Thompson)
» Ezra Klein: Courts are political, news at 11 (Dylan Matthews)
» Wonkbook: What the Vinson ruling means (Ezra Klein)

While there's nothing in there to make me move from my opposition to an individual mandate, I still think there's a high possibility of any constitutional ruling of it taking the commerce clause of the Constitution too far being very dangerous for a lot of other laws that rely on that clause.

Among all the reading on the topic, I do find it mildly amusing that there are still people willing to state that we just don't know whether the Supreme Court will issue a 5-4 ruling or something with more consensus. Obviously, my marker is still on a 5-4 ruling, with the likeliest scenario that it would be 5-4 against (at minimum) the mandate. Interesting to see a lot of other folks coming to that conclusion.

Among the links, the NYRB article has a good comparison to the New Deal court that's worth reading. One complaint I have with it is that I think the comparison made is a bit too broad. Cole alludes to the Court shifting from generally anti-New Deal rulings toward pro-New Deal rulings, but doesn't highlight that it was fundamentally two specific changes that had much to do with it: Justice Owen Roberts changed much of how he was voting on the court (for whatever reasons you and/or history choose to believe) and the 1937 retirement of Justice Willis Van Devanter. In other words, the court didn't simply "reverse course" ... two very specific things happened that enabled the outcome of votes on the Court to end up. I don't see much chance for similar specific changes happening to the court in a short amount of time.

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