Liberals’ Ridiculous Health Care Charges Against Brett Kavanaugh

So much for subtle. On Tuesday, Senate Minority Leader Chuck Schumer (D-NY) placed health care at the top of the list of reasons to oppose Brett Kavanaugh’s nomination to the Supreme Court, throwing in some over-the-top rhetoric in the process:

We Democrats believe the No. 1 issue in America is health care and the ability for people to get good health care at prices they can afford. The nomination of Mr. Kavanaugh would put a dagger through the heart of that cherished belief that most Americans have.

Put aside for a moment that Obamacare itself has “put a dagger through the heart” of people’s ability “to get good health care at prices they can afford” by more than doubling individual insurance premiums during President Obama’s second term. The idea that a pending lawsuit would allow the Supreme Court to strike down Obamacare, and that a Justice Kavanaugh would cast the deciding vote to do so, ranges from implausible to ridiculous, for at least three reasons.

Second, as I previously noted, Kavanaugh wrote an opinion in 2011 that, while deferring a definitive judgment on the merits, suggested an inclination to uphold Obamacare’s mandate as constitutional. In one footnote of his opinion, Kavanaugh noted that “the fact that an exaction is not labeled a tax does not vitiate Congress’s [sic] power under the Taxing Clause.” To Kavanaugh, it mattered not that Congress said the mandate was not a tax to justify it as such under the Constitution—the same logic that troubled conservatives about Roberts’ ruling in the mandate case.

Kavanaugh did seem troubled by the fact that Obamacare contains both a statutory requirement to buy coverage and a penalty (“tax”) for those who fail to do so. But another footnote suggested a way out:

At oral argument, counsel for the Government argued that a citizen who refused to obtain health insurance would still be acting lawfully. If that were true, the mandate would presumably pass muster under the Taxing Clause. But it is not evident that the statutory language is fairly susceptible to such an interpretation. That said, perhaps the canon of constitutional avoidance would allow such an interpretation of this provision and thereby squeeze it within the Taxing Clause.

Roberts did exactly what Kavanaugh suggested, eliminating the “perhaps” from Kavanaugh’s last sentence, and defending the mandate as permissible under Congress’ Taxing Clause power.

Wall Street firms often note that past performance does not equate to future results, a motto worth noting here. But it seems highly unlikely that a judge willing to justify what Congress itself termed a “penalty” as a tax, and who cited the “canon of constitutional avoidance” as a way to uphold Obamacare, would suddenly vote to strike down the entire law—after Congress just last year declined to do so. (In fact, the Supreme Court may not even vote to hear the case at all.) All this makes Schumer’s talk of “dagger[s] through the heart” so much noise.

Schumer’s Strategy Could Be Improved

One could make a compelling argument that, if Schumer really wanted to defeat the Kavanaugh nomination, he would take the opposite tack, and “hug him close” on Obamacare. An exercise in trolling conservatives could cause them some serious discomfort: “We know Judge Kavanaugh would uphold Obamacare at the Supreme Court, because he laid the roadmap for saving Obamacare there six years ago.”

But Schumer has instead tried to play the health care card against Kavanaugh, for any number of potential reasons.

  • He worries about over-emphasizing abortion rights during the confirmation process, which could cause political heartburn for several Senate Democrats running for re-election this year in states Donald Trump won in 2016;
  • He wants to preview themes Democrats will push in the election campaign this fall;
  • He doesn’t want to anger Democrats’ base by conceding the health care issue, as they want him to fight Kavanaugh’s nomination and support Obamacare, even if doing so could improve the chances of defeating the nomination; and/or
  • He thinks it unlikely he can defeat Kavanaugh, and wants to keep his caucus united rather than make a long-shot tactical gamble that could divide Democrats.

This post was originally published at The Federalist.

Lowlights of Senate “Budget” Deal

In the budget agreement announced Wednesday between Republican Sen. Mitch McConnell and Democrat Chuck Schumer, McConnell’s negotiating position can be summed up thusly: “Give us the money we want for defense spending, and you can run the rest of the country.”

The result was a spending bonanza, with giveaways to just about every conceivable lobbying group, trade association, and special interest possible. The unseemly spectacle resembles “Oprah’s Favorite Things:” “You get a car! You get a car! You get a car! EVERYONE GETS A CAR!!!”

Even reporters expressed frank astonishment at the bipartisan profligacy. Axios admitted that “there’s a ton of health care money in the Senate budget deal,” while Kaiser Health News noted that the agreement “appear[s] to include just about every other health priority Democrats have been pushing the past several months.”

Of course, McConnell and Schumer want to ram it through Congress and into law by Thursday evening—because we have to pass the bill to find out what’s in it.

Lowlights of the Health Legislation

Repeal of Medicare Spending Restraints: The bill would repeal Obamacare’s Independent Payment Advisory Board (IPAB), a board of unelected bureaucrats empowered to make rulings on Medicare spending. I noted last year that conservatives could support repealing the power given to unelected bureaucrats while keeping the restraints on Medicare spending—restraints which, once repealed, will be difficult to reinstitute.

Congressional leaders did nothing of the sort. Instead the “deal” would repeal the IPAB without a replacement, raising the deficit by $17.5 billion. Moreover, because seniors pay for a portion of Medicare physician payment spending through their Part B premium, repealing this provision without an offset would raise seniors’ out-of-pocket costs. While a Congressional Budget Office (CBO) score of the bill as a whole was not available as of press time Wednesday evening, this provision, on its own, would raise Medicare premiums by billions of dollars.

Big Pharma Giveaway: In a further giveaway to the pharmaceutical industry, the bill would close the Medicare Part D prescription drug “donut hole” a year earlier—that is, beginning in 2019 rather than 2020. Having failed to repeal Obamacare, Republicans apparently want to expand this portion of the law, in the hopes of attracting seniors’ votes in November’s mid-term elections.

Extension of an Unreformed SCHIP Program: The bill would extend for another four years the State Children’s Health Insurance Program—a mandatory spending program that Republicans extended for six years just last month. I previously explained in detail that last month’s reauthorization failed to include at least ten different conservative reforms that Republicans previously supported. By extending the program for another four years, the “deal” would prevent conservatives from enacting any reforms for a decade.

Back in 2015, Republican aides pledged that “Republicans would like to reform and improve this program, and the next opportunity will be in two years when we have a new President.” Not only have Republicans done nothing of the sort, the additional extension will prevent this president—and potentially the next one as well—from reforming the program.

Mandatory Funding for Community Health Centers: The bill provides for $7.8 billion in mandatory spending for community health centers over the next two years, once again extending a mandatory program created by Obamacare.

While many conservatives may support funding for community health centers, they may also support funding them through the discretionary appropriations process, rather than by replenishing a pot of mandatory spending created by Obamacare to subvert the normal spending cycle. The normal appropriations process consists of setting priorities among various programs; this special carve-out for community health centers subverts that process.

Mandatory Opioid Funding: The bill also provides $6 billion in mandatory spending over the next two years to address the opioid crisis. As with the community health center funding, some conservatives may support increasing grants related to the opioid crisis—through the normal spending process.

The Schumer-McConnell “deal” would bust through the Budget Control Act spending caps, increasing the amount of funds available for the normal appropriations bills. (Most of this spending increase would not be paid for.) Additional mandatory health care spending on top of the increase in discretionary funding represents a spendthrift Congress attempting to have its cake and eat it too, while sticking future generations with the bill in the form of more debt and deficits.

But Wait—There’s More!

Surprisingly, the bill does not include an Obamacare “stabilization” (i.e., bailout) package. But other reports on Wednesday suggest that will arrive in short order too. One report noted that Democrats want to increase Obamacare premium subsidies. They not only want to restore unconstitutional payments that President Trump cancelled last fall, “but to expand it—and to bolster the separate subsidy that helps people pay their premiums.”

Republican leaders want to pass a massive Obamacare bailout in the next appropriations measure, an omnibus spending bill likely to come to the House and Senate floors before the Easter break. In a sign of Republicans’ desperation to pass a bailout, Wednesday’s report quoted a Democratic aide as saying that corporate welfare to insurers in the form of a reinsurance package “has become so popular among Republicans that Democrats don’t feel like they have to push very hard.”

There are two ways to solve the problem of rising premiums in Obamacare. One way would fix the underlying problems, by repealing regulations that have led to skyrocketing premiums. The other would merely throw money at the problem by giving more corporate welfare to insurers, providing a short-term “fix” at taxpayers’ ultimate cost. Naturally, most Republicans wish to choose the latter course.

Moreover, in bailing out Obamacare, Republicans will be forced to provide additional taxpayer funding of abortion coverage. There is no way—zero—that Democrats will provide any votes for a bill that provides meaningful pro-life protections for the Obamacare exchanges. Republicans’ desperation to bail out Obamacare will compel them to abandon any pretense of pro-life funding as well.

Most Expensive Parade Ever?

Press reports this week highlighted Pentagon plans to, at President Trump’s request, put on a military spectacle in the form of a massive parade. Trump tweeted his support for the Schumer-McConnell deal on Wednesday, calling it “so important for our great Military.”

It’s an ironic statement, on several levels. First, the hundreds of billions in new deficit spending coming from the military buildup included in the agreement would make the parade the most expensive ever, by far. Second, Michael Mullen, the former chairman of the Joint Chiefs of Staff, called our rising debt levels our biggest national security threat, because it makes us dependent on other countries to buy our bonds. Given that statement, one can credibly argue that this deficit-driven spending binge will harm our national security much more than the defense funds will help it.

Time will tell whether or not the legislation passes. But if it does, at some point future generations will look back and wonder why the self-proclaimed “king of debt” imposed a financial burden on them that they will not be able to bear easily—if at all.

This post was originally published at The Federalist.

Who Really Caved on the “Shutdown Showdown?”

While conventional wisdom over the past 18 or so hours, both at The Federalist and elsewhere, holds that Democrats “lost” the shutdown showdown, this contrarian takes the position of noted college football analyst Lee Corso: “Not so fast, my friend!”

While not conceding on the substance of immigration legislation, Senate Majority Leader Mitch McConnell (R-KY) made an important concession on process—one he has not made to conservatives. According to press reports, McConnell pledged that, if lawmakers cannot agree on an immigration package addressing the Deferred Action for Childhood Arrivals (DACA) program by February 8, the expiration date of the continuing resolution that passed Monday, he would begin a freewheeling and open debate on a stand-alone immigration measure—provided the federal government remains open.

No Budget—No Problem!

Compare McConnell’s comments on an immigration bill with this Politico report not two weeks ago: “Republican leaders are considering skipping passage of a GOP budget this year—a blow to the party’s weakened fiscal hawks that would squash all 2018 efforts to revamp entitlements or repeal Obamacare….McConnell has argued that he cannot pass deficit-reduction legislation using powerful budget procedures with his new 51-vote majority—and wasn’t even sure he could find the votes for a fiscal blueprint in the first place.”

While liberals’ priority—immigration policy—will get prime floor time thanks to the commitment McConnell made in exchange for Democrats’ votes to reopen the government, conservative priorities like reforming entitlements and repealing Obamacare won’t see the light of day, because McConnell doesn’t even want to try to pass a budget.

All of this gives conservatives an obvious lesson: For the next appropriations bill, they should withhold their votes unless and until McConnell publicly commits to passing a budget through the Senate, with reconciliation instructions allowing for entitlement reform and Obamacare repeal efforts.

Could Have Been (and Might Get) Worse

Contrast that response to this article from just last month, about bailing out Obamacare through a “stabilization” bill:

U.S. Sen. Susan Collins said she is confident President Donald Trump and Senate Majority Leader Mitch McConnell will ensure passage of two bills aimed at shoring up the insurance markets.…

Collins remains confident that Trump and McConnell, fellow Republicans, will keep their word and make sure the health care bills get approved, said Annie Clark, a spokeswoman for the senator.…McConnell committed in writing to support passage of the bills either before adoption of a final tax bill or before the end of the year, Clark said.

If McConnell didn’t want to bind the House to an Obamacare bailout measure, he sure did a much less convincing job making that clear to Collins than he did to Democrats regarding immigration in the past week. Granted, the Obamacare bailout hasn’t happened—yet. But rest assured that McConnell and Collins, among others, are already looking to the next appropriations bill as a vehicle to pass the “stabilization” measure.

The disparate treatment between immigration and an Obamacare bailout gives conservatives the “consolation” that McConnell could have made far worse concessions to Democrats. But conversely, if McConnell wants to respect the House’s prerogatives, why does Collins believe he made a commitment to her to do the exact opposite?

Given that daunting landscape ahead, conservatives shouldn’t focus their energies celebrating how they “won” this weekend’s battle, as doing so would guarantee they end up losing the larger war.

This post was originally published at The Federalist.

What’s Congress Doing with SCHIP?

Amidst the wrangling over Obamacare, reauthorization of the State Children’s Health Insurance Program (SCHIP) expired on September 30, the end of the federal government’s fiscal year. The two committees of jurisdiction—energy and commerce in the House, and finance in the Senate—each marked up their reauthorization bills last week. But House Energy and Commerce Committee Chairman Greg Walden (R-OR) said Monday the bill would not come to the House floor this week.

What’s the holdup? Why the delays in bringing to the floor for votes a bill whose authorization has already expired?

A Mixed House Package

The SCHIP reauthorization text varies little between the House and the Senate versions. On that front, conservatives may have qualms with supporting little more than a straight extension of the status quo. The bill extends—albeit for only one year, as part of a more gradual phase-out—enhanced funding to state SCHIP programs. The full 23 percent match increase would end in 2019, as under current law, while states would receive an additional 11.5 percent increase in 2020. Some states have received a 100 percent federal match for their child enrollees due to this Obamacare provision, which is a clear disincentive for states to fight fraud and improper spending.

Moreover, the bill extends Obamacare’s maintenance of effort requirement—limiting states from making changes to their programs—by an additional three years in most cases, from 2019 to 2022. The bill also does not include reforms the House proposed two years ago, which would require states to focus on covering poor children first—the program’s prime emphasis before the 2009 reauthorization signed by President Obama envisioned states expanding their programs to more affluent families.

On the positive side, however, the House did include good reforms to help pay for the new SCHIP spending. It includes several provisions designed to promote program integrity in Medicaid, including one that would effectively ensure that lottery winners, or others who receive large lump-sum payments, do not maintain coverage for this low-income program. The House bill would also increase Medicare means-testing for affluent families, reducing taxpayer subsidies for Part B (outpatient care) and Part D (prescription drug) coverage for individuals making over $160,000, and eliminating the subsidies entirely for individuals making more than $500,000.

In the Senate, a Stalemate

Meanwhile, over in the Senate—which has yet to decide how to pay for the new SCHIP spending—Minority Leader Chuck Schumer (D-NY) demanded last week that the Republican majority “immediately bring this bill to the Senate floor for a vote and include much-needed bipartisan provisions to stabilize the markets, lower premiums for 2018,” and extend other programs.

Schumer made those demands despite two inconvenient truths: Senate Health, Education, Labor, and Pensions Committee Chairman Lamar Alexander (R-TN) and Ranking Member Patty Murray (D-WA) haven’t yet reached agreement on a bipartisan “stabilization” bill—and most states finalized their 2018 insurance premiums on September 27, weeks ago. In other words, Schumer wants to enact an agreement that doesn’t exist to achieve premium reductions that can’t happen.

A cynic might surmise that, with his talk of “stabilization” measures, Schumer wants to use SCHIP to sneak through tens of billions of dollars in cost-sharing reduction payments to insurers—a provision that might prove unpopular, and controversial, as a stand-alone measure, but could pass through relatively unnoticed as part of a larger, “Christmas tree”-sized bill.

While the policy outcomes seem uncertain, and could range from fair to poor, the political ramifications seem clear. In 2007 and 2008, when President George W. Bush vetoed SCHIP bills due to provisions that would have diverted the program from the low-income children for which it was designed, Democrats organized protests, and ran ads against him. This year, when Democrats are holding up an arguably too-generous SCHIP bill literally because they want to defend the wealthy and insurance companies, Republicans have responded by…negotiating with them.

If one wants reasons behind conservative discontent with Washington, look no further than this bill.

This post was originally published at The Federalist.

Obamacare, The Constitution, and “Sabotage”

Donald Trump:           Nancy, Chuck, so good to see you. I wanted to bring you some good news: We’re starting construction on the border wall tomorrow.

Nancy Pelosi and Chuck Schumer:             What? Congress hasn’t appropriated money for the wall. And Congress has the “power of the purse,” not you. How can you say you’ll build the wall when we haven’t signed off on the funding?

Trump:            Because Barack Obama did it for years. What about his actions on Obamacare?

Pelosi:              What do you mean, what about Obamacare? It’s the law of the land—and you should stop sabotaging it!

Trump:            By “sabotaging Obamacare,” you mean failing to spend money on the cost-sharing subsidies to lower deductibles and co-payments…

Pelosi and Schumer: Right!

Trump:            …even though the text of Obamacare itself nowhere includes an appropriation for those subsidies…?

Pelosi and Schumer: Ummm…

Trump:            Let me get this straight: You’re accusing ME of sabotage, because YOU “forgot” to include an appropriation in Obamacare for more than $10 billion per year in spending?

Pelosi:              But “everyone understood” the law provided an appropriation…

Trump:            Even though you couldn’t be bothered to write it down?

Pelosi and Schumer: Ummm…

Trump:            Did either one of you—or for that matter, any Democrat—actually read the bill before voting for it?

Schumer:         I meant to, I swear! But Max Baucus said he hired the best experts, so we didn’t think we needed to.

Trump:            Didn’t those experts read the bill?

Schumer:         They spent all their time cutting deals to get the bill passed. Those Cornhusker Kickbacks don’t write themselves, y’know!

Trump:            Well, your loss is my gain. I’ve read some of the documents in the lawsuit over the cost-sharing subsidies. Do you know that the Obama Administration argued that the structure of the bill implied an appropriation, even though one doesn’t exist…?

Pelosi and Schumer: Yes…

Trump:            And Nancy, you remember the amicus brief you filed in the case right before my election, which said that the courts are “certainly not” the venue for litigating cases when the executive invents an appropriation, as it did with the cost-sharing subsidies…?

Pelosi:              But…but…but…

Trump:            That means I can argue that there’s an appropriation behind any law Congress has passed—like the bill you voted for, Chuck, authorizing construction of the border fence…

Schumer:         What?

Trump:            …And you can’t go to court to stop me!

Pelosi and Schumer: But you requested funding from Congress—and we refused to grant it!

Trump:            You mean, like Congress refused to appropriate funds for the Obamacare cost-sharing reductions, after President Obama requested them…?

Pelosi and Schumer: Ummm…

Trump:            The Obama Administration testified before Congress that it had the authority to spend money on the cost-sharing reductions because Congress didn’t explicitly stop them from spending it, correct?

Schumer:         Yes…

Trump:            And Nancy, your brief said the same thing: That unless Congress explicitly prohibits a President from spending money, the President has free rein to do so…

Pelosi:              But I was trying to protect Obamacare from sabotage!

Trump:            Did you take an oath to support and defend the Constitution, or to support and defend Obamacare?

Pelosi and Schumer: There’s a difference?

Trump:            Yes—and here it is. Thanks to President Obama’s precedent, I can make up whatever appropriations I want—and by your own admission, you can’t go to court to stop me. You could in theory enact a bill prohibiting me from spending money on these phantom appropriations. But because I have a veto pen, you’ll need a 2/3rds majority in each chamber to override me. You don’t have a 2/3rds majority, do you?

Pelosi and Schumer: No, Mr. President.

Trump:            Didn’t think so. So I’ll get my funding for the border wall—and increased defense funding to boot. And maybe I’ll find some other appropriations too. I think the structure of Michelle Obama’s school lunch program implies an appropriation for a new chef at Mar-A-Lago…

Pelosi:              You know, Mr. President, maybe we need to re-think our position on these phantom appropriations. I signed that legal brief the week before the election, not knowing who the next President would be. I thought that power would be safe in her hands…

Trump:            WRONG!

Pelosi:              But executive power has its limits—and Congress should jealously guard its “power of the purse,” regardless of which party holds power at the other end of Pennsylvania Avenue. Otherwise, we could see all sorts of unintended consequences from legislation…

Trump:            You mean, we had to pass the bill so that you could find out what is in it…?

Pelosi:              Well played, Mr. President.

The Implications of Trump and Schumer’s Argument over Cost-Sharing Reduction Payments

Leaders in both parties engaged in rhetorical bluster over the weekend regarding Obamacare’s cost-sharing reductions. Those payments to insurers for lowering deductibles and co-payments—ruled unconstitutional by a federal district court judge last May—remain in political limbo, and a subject of no small controversy.

But the rhetorical exchanges yielded inconvenient truths, both for Democratic leaders demanding the Trump administration continue the payments, and for the president himself, who has threatened to stop them.

Schumer: If the Payments Are Constitutional, Trump Can’t Withhold Them

Schumer therefore implicitly admitted—as elsewhere—that the payments are not only illegal, but unconstitutional. Obamacare lacks an explicit appropriation for the cost-sharing reduction payments. That’s the reason Judge Rosemary Collyer ruled the Obama administration’s actions in making said payments unconstitutional last year. (The ruling is currently stayed pending appeals.)

As one summary of the case noted, Train v. City of New York established the principle that “the President cannot frustrate the will of Congress by killing a program through impoundment.” Yet Schumer, in asking the Trump administration to continue making payments to a program that Congress never funded in the first place, wants the executive unilaterally—and unconstitutionally—to frustrate the expressed will of the legislative branch, thereby diminishing Schumer’s own authority as a lawmaker.

It’s highly likely Schumer, a lawyer who spent several years serving on both the House and Senate judiciary committees, knows full well the nature of unconstitutional actions, begun by the last administration, that he wants the current one to continue. But if he wants to have any credibility on the rule of law—whether criticizing the Trump administration’s other “abuses,” or standing up for the independence of the Russia investigation—he would be wise to 1) admit that the Obama administration violated the Constitution in making the payments to begin with and 2) hold the last administration just as accountable as he wants to hold the current president.

Trump: Upholding the Constitution Is a Choice

But for the president, as for Schumer, the question of the cost-sharing reduction payments should come down to a binary choice: Does a lawful appropriation for CSRs exist, or not? If a lawful appropriation exists, then the president must make the payments, consistent with Train v. City of New York outlined above. If a lawful appropriation does not exist, then the president must not make the payments, consistent with both Article 1, Section 9, Clause 7 of the Constitution—“No Money shall be drawn from the Treasury, but in Consequence of Appropriations made by Law”—his duty to “take Care that the laws be faithfully executed,” and his oath of office.

This conservative believes President Trump should have cancelled the CSR payments within days of taking office, not because it would have been popular—it likely would not have been—but because the rule of law demands it. Likewise, President Trump should have long since undone billions of dollars in reinsurance payments to insurers that the Government Accountability Office found illegal, and cancelled the “grandmothered” plans President Obama allowed some individuals to keep in 2014—violating his constitutional duty to “take Care that the laws be fully executed” in the process.

Making a clean break with the numerous legal and constitutional violations the Obama administration perpetrated to keep Obamacare afloat early in his administration would have demonstrated President Trump’s desire to escape the executive unilateralism of his predecessor.

Government of Laws, Or of Men?

That Barack Obama, a constitutional law professor, bequeathed such legal gamesmanship and a culture of inherently arbitrary actions to both parties stands as one element of his legacy. As the debate this weekend demonstrated, that legacy has affected—and infected—our constitutional discourse, and not for the better.

This post was originally published in The Federalist.

Schumer Admits Obama Violated the Constitution

Last week, one of Washington’s leading Democrats made what should be considered a stunning admission, yet few in the media bothered to notice, or care. In response to comments from Senate Majority Leader Mitch McConnell (R-KY) about a potential bailout of Obamacare insurers, Minority Leader Chuck Schumer (D-NY) said: “Democrats are eager to work with Republicans to stabilize the markets and improve [Obamacare]. At the top of the list should be ensuring cost-sharing payments are permanent, which will protect health care for millions.”

Schumer’s statement contradicts the Obama administration, which argued in federal court that the cost-sharing reductions are already permanent. It’s also an implicit admission that the Obama administration violated both the U.S. Constitution and federal criminal statutes by spending funds without an appropriation.

Not wanting to be bound by such niceties as the rule of law, the Obama administration started making the payments to insurers anyway, claiming the “text and structure” of Obamacare allowed them to do so. The House of Representatives sued, claiming a violation of its constitutional “power of the purse,” and last May, Judge Rosemary Collyer agreed, ruling that the administration violated the Constitution.

Schumer Admits Constitutional Violation

Schumer’s statement last Thursday stands out because the Obama administration and House Minority Leader Nancy Pelosi (D-CA) have claimed, both in court and elsewhere, that Obamacare made a permanent appropriation for the cost-sharing payments. The law did no such thing, and a federal district court judge so ruled, but they attempted to argue that it did.

By conceding that Obamacare lacks a permanent appropriation for cost-sharing reductions, Schumer’s admission raises some interesting questions. The Obama administration requested an explicit appropriation for the cost-sharing reduction payments, a request Congress promptly denied. If there isn’t a permanent appropriation for cost-sharing payments in Obamacare—as Schumer admitted—then the Obama administration spent money without an appropriation.

The Anti-Deficiency Act includes not just civil, but criminal, penalties: “An officer or employee of the United States Government or of the District of Columbia government knowingly and willfully violating [the Act] shall be fined not more than $5,000, imprisoned for not more than 2 years, or both.”

By calling on Congress to “ensure” permanent cost-sharing reductions, Schumer has essentially admitted that President Obama violated the Constitution, and members of his administration may have violated federal criminal statutes by spending money without an appropriation. This prompts one other obvious question: When will Schumer endorse a special counsel to investigate these matters?

Don’t Endorse Law-Breaking

In deciding to pay the cost-sharing subsidies without an appropriation, the Obama administration and its allies have endorsed a strategy of ends justifying means: They wanted to provide health insurance to more Americans, therefore it was acceptable to violate the Constitution. And if the administration violated the Constitution long enough, and on a big enough scale, they could change the law to meet their will. Now that a federal court has ruled that President Obama did in fact violate the Constitution, that’s exactly what Pelosi and Schumer want to do: Change the law to accommodate the Obama administration’s law-breaking.

Only after those weighty issues have been examined and adjudicated fully should Congress debate whether to appropriate funds for the cost-sharing reductions. To do otherwise would undermine the Constitution that members of Congress vowed to uphold, and further encourage the kind of flagrant law-breaking seen in the Obama administration.

This post was originally published at The Federalist.

Conservatives’ Choice: Power or Principle

In the days immediately preceding and following the November 8 election, I observed a distinct evolution in thinking among some rightist thinkers. Some went into the election pledging an outright rebellion in the Senate should a Majority Leader Chuck Schumer use the “nuclear option” to muscle through a Hillary Clinton Supreme Court nominee, but mere days later thought that a Majority Leader Mitch McConnell should consider abolishing the filibuster to allow President Trump’s nominee a smoother path to confirmation.

One couldn’t help but hold on to one’s neck for the bad case of whiplash. Some who proudly defended the filibuster as a bastion of deliberative legislating when they feared Democrats would win the White House and take back the Senate suddenly, instead, when presented with a Republican Senate and president-elect, considered this principle a trifling inconvenience. Those situational ethics present a more fundamental question: Are conservatives willing to forego policy “victories” that might result from a raw use of power, when exercising that power violates critical philosophical principles rooted in a belief in limited government?

Not Within the Law

The new president’s executive order on Obamacare, released Friday evening, instructed executive agencies to take actions “to the maximum extent permitted by law” to blunt the effects of Obamacare. There are indeed many ways the Trump administration can act within the scope of existing law to provide relief to consumers, many of which I outlined in a report last week. But blanket non-enforcement of the individual mandate doesn’t qualify as being within the law, any more than President Obama’s policy of blanket non-enforcement for certain classes of immigrants fit within statutory parameters.

Observers have noted the last administration’s many examples of executive overreach on Obamacare have given the new administration grounds to provide regulatory relief on multiple fronts. But two wrongs do not make a right. Take, for instance, the following analysis:

The Administration thus used the public pronouncements of its non-enforcement policies to encourage the regulated community to disregard provisions of [the law]. Prospectively licensing large groups of people to violate a congressional statute for policy reasons is inimical to the Take Care clause.

The quote comes from a paper by University of Michigan professor Nicholas Bagley, talking about President Obama’s 2013 “transitional policy” that allowed people facing cancellation notices to temporarily keep their pre-Obamacare plans. But the same description could apply to not enforcing the individual mandate as well. Conservatives believe that forcing individuals to purchase a product is unconstitutional—but so is an executive refusing to enforce the law. Is the answer to a constitutional violation really another constitutional violation?

Major Practical Concerns

In many cases, non-enforcement could result in lawsuits. The Obama administration’s unilateral actions generally led to more people getting benefits—insurance subsidies, immigration status, etc.—which made it difficult to find someone with standing to sue.

By contrast, if the Trump administration decides (as some have suggested) to give insurers permission to sell policies that do not meet all of Obamacare’s mandated benefits, purchasers of said policies would have grounds to sue insurers. Obamacare’s mandated benefits are prescribed in law, and if the law is clear, its text trumps (pardon the pun) any regulatory edict from the new administration. Most insurers probably wouldn’t even bother offering such policies because of the legal jeopardy and uncertainty they would face in doing so.

Making Repeal Less Likely?

There’s another practical implication of not enforcing the mandate that should worry conservatives: ironically, it could make Obamacare’s repeal more difficult.

Over the past few weeks Washington has debated whether Congress should repeal Obamacare without enacting a simultaneous replacement. Some pundits have been forthright in admitting that they wish to do so because they fear some members of Congress have a different vision of what an alternative regime should look like. To put it bluntly, they wish to hold repeal hostage to their vision for an Obamacare “replacement.”

The executive unilaterally ending some of Obamacare’s worst effects—albeit temporarily—will take the pressure off members of Congress to do so themselves. The justifiable fear is that action on repeal will get bogged down by internecine squabbling over a vision for “replace,” making the sole movement on Obamacare an executive action—which any future president (or even the current one) could overturn.

Reinforce Congress’ Role

If President Trump unilaterally eliminating the individual mandate isn’t the answer, then what is? For conservatives, the solution should lie with the branch the Constitution’s Framers considered the most important: Congress, the legislative branch Article I of the Constitution establishes. Through its oversight powers, Congress has the ability to investigate and act upon regulatory overreach.

The last Congress was less feckless in blunting unilateral executive actions than some might think. Its preliminary victory in the case of House v. Burwell, regarding Obamacare’s cost-sharing subsidies to insurers, set a critical precedent that Congress has the right to litigate on matters of constitutional import—namely, the executive (in this case, the Obama administration) spending funds without an express appropriation from Congress. Hopefully the Trump administration will vacate the Obama administration’s appeal of the District Court ruling, allowing this precedent to stand.

Obamacare Is Ultimately About Power

Obamacare was really never about health care so much as power—the power of government to regulate health care, tax health care, and force people to purchase health care (or at least health insurance). It seems somehow fitting that Obamacare gave the nation so many examples of executive unilateralism.

But to conservatives, the rule of law—in many ways the antithesis of raw power—stands pre-eminent. A Republican administration should not be tempted to “use unilateral actions to achieve conservative ends.” Such behavior represents a contradiction in terms. That’s why it’s important to watch the new administration’s actions closely in the coming days and weeks. Obamacare may not be worth keeping, but the rule of law is.

This post was originally published at The Federalist.

Obamacare Meets Monty Python

Weekly Newsletter: April 28, 2008

  • Genetic Non-Discrimination Act Returns for House Vote

    This week, the House is expected to vote on Senate amendments made to the Genetic Information Nondiscrimination Act (H.R. 493), in order to send the bill to the President’s desk. The compromise language negotiated between Senate sponsors and Sen. Tom Coburn (R-OK) allowed the bill to pass the Senate on a 95-0 vote last Thursday.

    The compromise language corrects several issues of concern to conservatives. Insurers and employers will be prohibited from discriminating against individuals on the basis of fetal genetic information, ensuring that individuals will not feel pressured into aborting their unborn children. In addition, existing policies on insurance underwriting for diseases already manifest in individuals will be maintained, and entities subject to existing privacy regulations under the Health Insurance Portability and Accountability Act (HIPAA) will not be subject to a new regulatory regime. Lastly, the compromise language improved a conservative concern that employers will not be subject to Equal Employment Opportunity Commission (EEOC) tribunals or lawsuits for decisions they make in their capacity as an insurer for their employees.

    Full House Votes to Override Medicaid Fiscal Integrity Regulations

    This past week, the full House by a 349-62 vote approved legislation (H.R. 5613) that would impose moratoria on several proposed regulations issued by the Centers for Medicare and Medicaid Services (CMS) to restore fiscal integrity to the Medicaid program. Although the bill was approved by the Energy and Commerce Committee 46-0, seven Energy and Commerce Committee Republicans opposed House passage— because of either substantive concerns about the legislation or as a protest against the expedited procedures under which the multi-billion dollar bill was considered.

    Despite the wide margin of passage, some conservatives may remain concerned by congressional actions to block regulations that respond to more than a dozen Government Accountability Office (GAO) reports released since 1994 highlighting the various ways states have attempted to “game” the Medicaid program and increase the amount of federal matching funds received. The history of these abuses has prompted the Administration to threaten a veto of any measure attempting to block CMS’ attempts to restore the fiscal integrity of the Medicaid program.

    Action now moves to the Senate, where Minority Leader Mitch McConnell (R-KY), Minority Whip Jon Kyl (R-AZ), and Finance Committee Ranking Member Chuck Grassley (R-IA) all support allowing CMS’ regulatory actions to continue without further intrusion from Congress. In addition, the American Medical Association (AMA)—which supports legislative action to block the regulations—on Friday expressed concern that HR 5613 would utilize funds from a physician quality improvement fund to help pay for the moratoria. Some conservatives may view the AMA letter as confirming the belief that, by using a physician quality fund “in a manner inconsistent with its intended purpose,” HR 5613 relies on budgetary gimmicks not consistent with the spirit of House pay-as-you-go budgetary scoring rules.

    RSC Briefs on the federal-state Medicaid relationship can be found here, here, here, and here.

    Article of Note: Broken Promises Ahead

    This week, The Hill reported that Congressional Democrats do not believe the fundamental health care overhauls advanced by Sens. Hillary Clinton (D-NY) and Barack Obama (D-IL) have a realistic chance of enactment in the near future. The story quoted several Democratic leaders:

  • Democratic Senate Campaign Committee Chairman Chuck Schumer (D-NY): “I am not sure that we’re ready for a major national health care plan;”
  • Senate Finance Committee Member Jay Rockefeller (D-WV): “We all know there is not enough money to do all this stuff;”
  • House Ways and Means Committee Member Kendrick Meek (D-FL): “The money is not necessarily there right now” to enact comprehensive reform;
  • Senate Finance Committee Chairman Max Baucus (D-MT): “If they try to solve all the problems, it’s going to be difficult;”
  • Former Senator John Breaux (D-LA): “You don’t want to rush and do something and do it incorrectly.”

    Some conservatives may not be surprised by the skepticism from within the Democratic Party, particularly as Sen. Clinton has recently admitted her willingness to raise tobacco taxes to pay for her reform plan, while also garnishing individuals’ wages who do not comply with an individual mandate to purchase health insurance. Rep. Meek’s comments that “there is…a Congress here with feelings and experience on this issue…this is not a kingdom, this is a democracy” speak to the reluctance of Congressional Democrats to accept their Presidential candidates’ desire to raise taxes and grow government-run health care. Some conservatives would argue that, by reforming health care to create new markets, the sector could slow its soaring growth, obviating the need for additional taxes and spending to finance new public health care programs.

    Read the article here: “Dems Hedge on Health Care