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(Supreme Court sketch: Art Lien)

The U.S. Supreme Court gets a second shot at the Affordable Care Act this morning, with arguments set to start any minute in King v. Burwell.

If you were hoping to catch the arguments via live stream, well, you can’t. That’s because the nation’s highest court still does not allow cameras in the courtroom.

A number of open government organizations are taking advantage of the public interest in this case to make their case for the need of live coverage there, via the public announcement below.

In the meantime, some media outlets will be having reporters shuttling in and out of the courtroom with reports on the questioning and we’ll be posting some of those here as we see them.

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Justice Ruth Bader Ginsburg asking about standing of challengers to sue, per Wall Street Journal live blog:

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Here’s the mid-argument update from SCOTUSblog:

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Justices move from standing to questions about reading the statute literally — as challengers ask — and the problems with that.  More from SCOTUSblog:

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From Election Law Blog’s Rick Hasen:

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Here’s what Justice Anthony Kennedy was asking, per SCOTUSblog update:

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Questioning going overtime:

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Plenty of questioning on the merits means likely no ruling based upon lack of standing, says SCOTUSblog:

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Justice Kennedy pushed government lawyer Michael Carvin, asking if “pressuring” states into creating their own exchanges is problematic. His response, per WSJ:

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Justices Elena Kagan and Sonia Sotomayor jump in, per WSJ:

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Questioning of the Solicitor General, arguing in favor of the reading that subsidies were availalbe under either exchange, wasn’t much easier. Per SCOTUSblog:

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Arguments have ended.  Here’s a few post-game predictions from legal experts and court watchers:

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News

Supreme courtIn case you missed it yesterday, be sure to check out this article by NC Policy Watch’s Sharon McCloskey about North Carolina’s support for the provision of subsidies to low-income residents purchasing Obamacare.

Last week, Attorney General Roy Cooper signed on to a brief, on behalf of North Carolina, supporting these subsidies for low-income enrollees on the federal exchange.

In a number of lawsuits filed in federal courts, ACA opponents have argued that the law as written limits those subsidies to those who purchase on a state exchange and not, as interpreted by the Internal Revenue Service, to purchasers on either a state or federal exchange.

That interpretation would exclude North Carolinians, as well as the residents of the 33 other states in which governors opted to join the federal exchange rather than construct one of their own, from receiving the aid.

The lawsuit has been through several appeals and will now be heard by the U.S. Supreme Court on March 4th.

Twenty-two other states also signed the brief and collectively argue that a challenge to the subsidies should be rejected because they weren’t informed that residents of their state would be harmed if the state chose to use the federal exchange.

Most experts agree that a decision limiting subsidies to purchasers on state exchanges would cripple Obamacare.

The non-partisan Urban Institute projects that in 2016, the loss of subsidies in the 34 states using the federal exchange would deprive more than 9.3 million Americans of almost $29 billion in financial assistance — an average of $3,090 per eligible person — and increase the number of uninsured by about 8.2 million people nationally.

To read the full article, visit Policy Watch’s main page here.

Commentary

Notwithstanding the unceasing efforts to undermine and obstruct the Affordable Care Act, America’s health care law continues to pile up an impressive list of accomplishments. The latest was detailed this morning in this post by Tara Culp-Ressler at Think Progress:

“For the first time in a decade, the number of people struggling to pay their medical bills has started to decline, according to a new survey released on Thursday by the Commonwealth Fund. The researchers attributed the historic drop to the number of people gaining insurance under the health care reform law.

Between 2012 and 2014 — as Obamacare’s main coverage expansion took effect — the Commonwealth researchers found that the number of people who had issues paying for health treatment dropped from 41 percent to 35 percent. Over the same time period, the people who skipped out on health services because they couldn’t afford them declined from 43 percent to 36 percent:

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CREDIT: Commonwealth Fund

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CREDIT: Commonwealth Fund”

Commentary

mc-1Governor Pat McCrory emerged from his much-publicized meeting with a handful of other governors and President Obama at the White House  Tuesday breathlessly declaring that Obama is open to considering waivers to allow North Carolina to crafts its own version of Medicaid expansion under the Affordable Care Act.

But that shouldn’t be news to McCrory or anybody else.  Nine states, most of them with Republican governors, have already expanded Medicaid with waivers from the feds or have been in discussions with the Obama Administration about waivers for their own versions of the program.

Neighboring Tennessee is the latest state with Republican leadership to move forward, with Governor Bill Haslam unveiling a proposal for Medicaid expansion last month. 

Apparently McCrory had to fly to Washington to figure out that the Obama Administration was willing to work with state officials who are developing their own Medicaid plan.  Or maybe he just wanted us to know he was talking tough with Obama.

I presented a very strong argument for more flexibility if we even consider Medicaid expansion, so we can have a North Carolina plan instead of a Washington plan, and especially a plan that would encourage more people to get a job or get training before we expand another government program,” McCrory said after the meeting.

While it’s too bad it took McCrory much longer than many Republican governors to realize the Obama Administration was willing to work with the states to provide health care for people who need it, at least he seems to finally understand it.

There’s also the head-scratching logic that more people will have to get a job before Medicaid is expanded, as if only people who are working need to be able to see a doctor, not to mention the people with chronic illnesses whose lack of access to treatment prevents them from working in the first place.

But maybe now McCrory can get on with what he should have done already, following the lead of his Republican colleagues across the country by expanding Medicaid in North Carolina and providing health care coverage for several hundred thousand low-income people and creating thousands of jobs in the process. It is past time.

Commentary

Reporter Dylan Scott at Talking Point Memo has the details of another wonky but important way that the Affordable Care Act is succeeding in holding down health care costs:

The medical-loss-ratio requirement mandates that insurance companies spend at least 80 percent of premiums on actual health benefits. It is one of the various provisions intended to help shape the behavior of insurance companies, making the market more efficient and cost-effective for consumers. Administrative costs are kept down, meaning that more of people’s money is going to real care.

“The medical loss ratio requirement and rate review mandated by the ACA put downward pressure on premium growth,” officials from the federal Centers for Medicare and Medicaid Services wrote in their report. Overall private insurance spending, of which premiums are a part, grew at a 2.8-percent rate — the lowest since at least 2007.

As Larry Levitt, vice president at the non-partisan Kaiser Family Foundation, put it to TPM in an email: “That is how it’s intended to work.”

In other words: Still more evidence that the ACA is insuring more people (and thereby saving tens of thousands of lives) and holding down overall health care costs.

Click here to read the entire story.