November 18, 2011
2011
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| November 18, 2011 |
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HEADLINE
Court Agrees to Hear Affordable Care Act Case
This week, the U.S. Supreme Court agreed to hear arguments on the constitutionality of the healthcare reform law, the Affordable Care Act. Arguments will be heard this spring, with a decision possible as early as June 2012.
While the Supreme Court’s decision to hear the case was expected, the variety of issues which the Supreme Court chose to consider was somewhat surprising. As expected, the court will consider whether the individual mandate is constitutional. A central issue in that discussion is whether the federal power to regulate interstate commerce allows the federal government to regulate economic “inactivity,” or put another way, does the federal government have the authority to compel citizens to purchase a private good such as health insurance. A closely related issue of “severability” (can the rest of the Affordable Care Act move forward if the individual mandate is considered unconstitutional?) will also be considered by the court.
Somewhat surprisingly, the court agreed to hear arguments on whether the federal courts yet have jurisdiction over the individual mandate, which is enforced by a tax penalty, until the tax is collected. Current tax law prevents courts from hearing tax cases until the tax is actually collected, which will not be until 2015.
The most surprising part of the Supreme Court’s announcement is that it will hear arguments on whether the Medicaid expansion required in the Affordable Care Act unconstitutionally coerces state governments.Twenty-six states have filed court actions claiming unconstitutional coercion. Medicaid is a voluntary health insurance program jointly funded by states and the federal government. While not a popular choice, all states have the option of terminating their Medicaid programs. Because of the states’ ability to leave the Medicaid program, many legal observers were surprised that the court agreed to hear arguments on this issue.
BUDGET
Congress Passes First FY2012 Spending Minibus
Late this week, both chambers of Congress approved the first series of FY2012 appropriations bills as part of “minibus” spending legislation that includes another temporary spending bill to fund government programs until December 16. The minibus package, which includes the FY2012 Agriculture, Commerce-Justice-Science and Transportation-Housing and Urban Development appropriations bills, passed the House by a vote of 298 – 121, followed by a Senate vote a few hours later of 70 – 30. Passage of the temporary measure to fund government programs was necessary because the current resolution expires at midnight on November 18, 2011. The President is expected to sign the legislation into law today.
Though today’s vote marks a small victory for normal appropriations procedures, Congress must quickly find a way to finalize and pass nine more FY2012 appropriations bills, including the health spending bill, known as one of the contentious bills. The State Department and Foreign Operations spending bill, which includes funding for global health programs including USAID’s tuberculosis program, was included in the next minibus of three bills up for consideration, but this package stalled earlier this week after policy disagreements on Cuba and other matters. The ATS is sending a letter to members of the House and Senate Foreign Operations Appropriations subcommittees in support of funding for USAID’s TB program and the Global Fund to Fight AIDS, TB and Malaria.
It is unclear whether Congress will be able to pass all nine remaining appropriations bills with the minibus approach by the new appropriations deadline of December 16. Yet another temporary spending measure funding government programs may be necessary to provide them with more time.
Meanwhile, the Super Committee is struggling to meet the November 23 deadline to produce a plan for cutting the deficit by at least $1.2 trillion over ten years. The possibility of a two-step process has been floated recently as a way to produce a compromise between committee Republicans, who are opposed to any tax increases and Democrats, who support revenue increases. Under this scenario, the Super Committee would pass a proposal next week that includes goals and principles to guide House and Senate committees in drafting deficit-cutting legislation. This approach may extend decisions on details and plans for specific program cuts into next spring, at least. Other than some expected cuts to Medicare, no other specific health program cut proposals have been released. The committee is expected to continue working on a proposal over the weekend and into next week, although Congress will be in recess for the Thanksgiving holiday.
The Washington Letter is written by the American Thoracic Society government relations office and emailed to all ATS members living in the United States. The letter keeps clinicians, scientists, and patients abreast of legislative, judicial, and regulatory issues in pulmonary, critical care, and sleep medicine. Each week's edition is archived on the ATS Web site, www.thoracic.org. If you have any questions or one more information about becoming involved in advocacy, please contact the ATS Washington office at 202-296-9770.
