AHLAlerts: American Health Line’s Blog

It been eight days since President Obama and his Democratic colleagues on Capitol Hill celebrated the enactment of health reform legislation, and it’s probably safe to say that there’s a little bounce in their step as they go about their daily routines. But reality is bound to set in and they’ll see that there’s plenty of work still to be done, not only with the new law but on other equally pressing issues, as well.

• “President Obama’s New Push Meets Capitol Hill Resistance“: President Obama, “emboldened” by the passage of the new health reform law, is hoping to capitalize on that victory to further some of his other potentially contentious legislative pursuits, White House aides confirm. However, Politico reports that “Democratic leaders’ desire to take advantage of [their] healthy majorities” in the House and Senate before the fall’s midterm elections “is running face-first into lawmakers’ survival instincts.” Congressional aides and members said that support for Wall Street regulation reform remained strong regardless of the outcome on the health reform law, but chances for progress on controversial items like climate change and immigration have waned (Allen, Politico, 3/31).
• “Now the Real Health Care Fight Begins“: For many health reform advocates, the enactment of health reform legislation last week marked the end of a long struggle to change the U.S. health care system. However, two public policy and history academics insist that the passage of the new law was “not the end of [that] political struggle,” but only “the start of a new chapter.” Eric Patashnik of the University of Virginia and Julian Zelizer of Princeton University write that reform supporters “need to put the cork back in the champagne bottle and get back to work” to “find ways to make the law more acceptable to a skeptical public, more workable and, most of all, more fiscally sustainable.” Because, “If they don’t, their hard-won political victory could remain at risk,” they write (Patashnik/Zelizer, Politico, 3/30).
• “Without Merit: Even as Politics, the States’ Lawsuit Against Health Care Reform Makes No Sense“: Slate contributor and former New York Gov. Eliot Spitzer (D) writes that “virtually all constitutional scholars agree” that the chance that the lawsuit by 14 state attorneys general challenging the constitutionality of the new law is successful is “at best marginal.” Spitzer, himself a former New York attorney general, writes that “this is a policy issue for political resolution, not a legal matter for judicial involvement.” He notes that the “public opposition to the health care bill, while initially virulent in some quarters, was to a great extent driven by the process of enactment, not the underlying substance.” So, “[a]s a purely political matter, many of those who filed the [lawsuit] will ultimately regret their opposition to what is sure to be a very popular law” (Spitzer, Slate, 3/30).

by Santosh Rao, staff writer

Is the widespread Republican opposition to the health reform law a bad sign for Mitt Romney’s 2012 presidential chances? After all, he was the governor of Massachusetts when it passed its massive health overhaul back in 2006. Bloggers are divided over the question.

“Romney isn’t the world’s most skilled politician, but he’s one of the more credible challengers Republicans can muster,” Ezra Klein writes. “If the passage of health care reform wounds his candidacy without killing it off entirely, that’s a big win for the Obama administration: It means Romney takes up some, but not enough, of the sensible Republican vote, making it even likelier that someone totally unelectable wins the nomination.”

However, The Atlantic‘s politics editor Marc Ambinder explains that the “entire political establishment suffers from anchor-bias illness: we place way too much importance on the last major event in a series when trying to figure out whether it will bear on the future.” Ambinder suggests that by 2012, RomneyCare — with its state-based approach — may look like a success compared to ObamaCare. He goes on to say that if health reform is not one of the top two issues for Republicans in 2012, then it’s no problem for Romney. Lastly he notes that the Republican’s “hierarchal” nominating process is favorable to Romney and that he’s actually an intelligent, good candidate.

Igor Volsky of “The Wonk Room” highlights the “awkwardness” of Romney’s stance that the state-level approach works but that national health reform is bad. According to Volsky, “On one hand, Romney needs to bolster his can-do image by arguing that the individual health insurance mandate, affordability credits, standard benefit package requirements, government-run exchanges and Medicaid expansion (elements of his health care reform) have improved the system.” However, “to retain the conservative base, he is also claiming that these successful policies should not be exported to other states” and that instead “lawmakers should implement a completely untested set of policies that would deregulate insurance markets and help states adopt reforms that are completely different from Massachusetts’ large risk pool approach,” Volsky writes, noting that that “simply doesn’t make any sense and I suspect that primary challengers will ultimately force Romney to walk away from his own health care law.”

Jonathan Chait of The New Republic doesn’t think that Romney can win the GOP nomination in 2012 because he doubts that Romney can win his party’s base with his position that “socialist tyranny is okay as long as it’s imposed on a state-by-state basis.” He notes how “in the context of the 2012 race, with the Affordable Care Act settled into law and a contested GOP primary going on, there will be lots of Republicans playing up the comparisons between RomneyCare and ObamaCare.” According to him, “Romney appears politically viable right now because most Republican voters have not been exposed to the RomneyCare-ObamaCare comparison — or if they have, it’s been made by advocates of the latter, rather than by Republicans who they trust. When the attacks come, Romney just has no convincing reply.”

by Julia Moss, staff writer

Attorneys general in a number of states are at odds with their governor or state legislature over whether to join in a lawsuit being prepared by 14 states challenging the constitutionality of the new health reform law, the AP/Boston Globe reports (Cooper/Chereb, AP/Boston Globe, 3/30).

The AGs on March 23 launched the lawsuit just hours after President Obama signed the Senate health reform bill (HR 3590) into law. Florida Attorney General Bill McCollum (R) filed one suit — joined by AGs from 12 other states — against the imposition of an individual mandate requiring U.S. residents to purchase insurance coverage or pay a fine or tax. The suit charges that the “Constitution nowhere authorizes the United States to mandate, either directly or under threat of penalty, that all citizens and legal residents have qualifying health care coverage.” The suit also claims that the law violates the Constitution’s 10th Amendment and, in a non-constitutional argument, that implementing reform will cost billions of dollars to states because they will be forced to expand Medicaid eligibility under the plan (American Health Line, 3/24). Indiana Attorney General Greg Zoeller (R) on Monday announced that the state is joining the lawsuit (American Health Line, 3/30).

The debate over whether to join the lawsuit has arisen in the following states:

• Arizona: Attorney General Terry Goddard (D) also resisted requests from Gov. Jan Brewer (R) to sue. Brewer has appealed to the state’s GOP-controlled Legislature for the authority to circumvent Goddard and file suit. Committees in both the House and Senate on Tuesday approved the governor’s request. Republican lawmakers have said the new health reform law violates the Constitution and would place an undue burden on the state’s Medicaid program, which already has experienced significant cuts this year (AP/Boston Globe, 3/30).
• Arkansas: Gov. Mike Beebe (D) and Attorney General Dustin McDaniel (D) declined a request by 33 Republican state legislators to join the suit. McDaniel said, “State budgets are tight enough right now without bringing actions that are entirely driven by political motivation rather than sound legal justification” (Slevin, Washington Post, 3/30).
• Georgia: Attorney General Thurbert Baker (D) has refused to join the lawsuit, stating that the claim that the mandate is unconstitutional is “frivolous” and “a waste of taxpayer money,” the New York Times reports. However, 31 Republicans in the Georgia Legislature on Tuesday signed a resolution calling for Baker’s impeachment. According to the Times, the impeachment is unlikely because Republicans do not have enough votes in the state Senate to approve the action (Brown, New York Times, 3/30). Gov. Sonny Perdue (R) has said he would bypass Baker by appointing a “special attorney general,” likely a pro bono lawyer or legal team, to file the lawsuit on the state’s behalf, the AP/Atlanta Journal-Constitution reports (McCaffrey, AP/Atlanta Journal-Constitution, 3/30).
• Nevada: Attorney General Catherine Cortez Masto (D) on Tuesday refused Gov. Jim Gibbons’ (R) demand to join the pending lawsuit. Masto said the case likely would be unsuccessful. Gibbons said he would “explor[e] his options” to move forward with the lawsuit on his own (AP/Boston Globe, 3/30).

Meanwhile, Republican AGs in Colorado, Washington and Wisconsin have attempted to join the lawsuit, despite objections from Democratic governors. In addition, Republican lawmakers in Kansas and Kentucky have called for their states to sue, and Missouri’s lieutenant governor made a similar request (AP/Boston Globe, 3/30).

– Cassandra Blohowiak