After Republicans’ first attempt to swiftly repeal and replace the Affordable Care Act failed, President Donald Trump finds himself in a difficult position: he has to administer a law that he has frequently called a “disaster.” The question now becomes: will President Trump and Tom Price, his Secretary of Health and Human Services, try as hard as possible to support the law that’s already on the books or will they take steps to undermine it?

As Republicans continue to try to broker a compromise between their more moderate and conservative wings–and there’s at least some evidence they are making progress–questions about the existing law may need to be answered before any new legislation makes its way to the president’s desk. While many of these pending decisions are somewhat small or would require a long time before taking effect, there’s one relatively arcane component of the Affordable Care Act–cost-sharing subsidy payments–that could swiftly pull the rug out from under the health insurance exchanges that about 12 million people rely on for health insurance. Read on for an overview of the Affordable Care Act exchanges and to see how a pending lawsuit gives President Trump unique control over the fate of a major part of his predecessor’s landmark accomplishment.

An Overview of the Health Insurance Exchanges

The Affordable Care Act, more commonly known as Obamacare, is an extraordinarily long piece of legislation that touched almost every part of the U.S. health care system–an industry that accounts for nearly one-fifth of the entire economy. One of the law’s primary goals was to lower the number of people without health insurance coverage. To do this, the law dramatically increased the number of people on Medicaid–the government-run health insurance program for low-income Americans–by expanding outreach and eligibility to a larger number of Americans. It also created federal and state-run health insurance exchanges on which people who do not get health insurance through their employer and also don’t qualify for Medicare or Medicaid can buy health insurance. While most of the coverage gains came from expanding Medicaid, creating regulated exchanges and offering subsidies made health insurance available to groups who previously did not have access to it on the individual market, notably those with preexisting conditions.

Individuals could buy health insurance before the Affordable Care Act’s passage, but insurers could charge people with chronic health conditions a lot more for insurance and could even deny coverage outright. The ACA introduced significant marketplace reforms to ensure that all insurance plans offered on the exchanges cover a minimum set of services, known as the 10 essential benefits, and prevented companies from denying anyone coverage because of a preexisting condition. The law also included provisions that prohibited charging people higher premiums based on certain characteristics like gender or health status. For other characteristics, the law set specific ranges at which companies can use to price premiums. For example, companies can charge no more than three times as much for their elderly customers as they can for their youngest customers.

The law had a number of provisions to try to make the marketplaces stable for insurers and consumers. One of the most discussed (and controversial) market stabilization components of the law is the individual mandate–the requirement that everyone get health insurance or pay a tax penalty. To help make insurance affordable for consumers, the ACA provided premium subsidies to people making less than 400 percent of the federal poverty line. The premium credits are tied to a benchmark plan to ensure that an individual or a family’s healthcare spending is capped at a certain percentage of their income. This means that if insurance premiums change dramatically from one year to the next then the subsidy will also adjust for those who are eligible. Finally, the law also had several stabilization programs that sought to reduce the risk that insurers would face when beginning to sell plans on the new exchanges.

Cost-Sharing Reductions

One of the many ways the law sought to make care affordable for low-income Americans is the cost-sharing reduction requirements. The cost-sharing reduction provision is relatively small in the overall scope of the law, but remains an important component because it addressed costs that people face when going to get care. In addition to premiums, health insurance plans typically include several forms of cost-sharing, which involve out-of-pocket costs when someone visits the doctor or fills a prescription. The Affordable Care Act sought to reduce these costs for people with incomes up to 250 percent of the federal poverty level. People who are eligible for cost-sharing reductions must enroll in silver insurance plans, the middle tier plans, on the insurance exchanges. Based on an eligible consumer’s income, insurers adjust the value of the plan to ensure that they cover a certain percentage of all costs. The government then provides a subsidy to insurers so they recoup those costs. A typical silver plan has an actuarial value of 70 percent, meaning that the insurance company will, on average, pay 70 percent of the cost for covered services–the other 30 percent typically comes through different cost-sharing. In plans eligible for cost-sharing reductions, the actuarial value of a silver plan increases based how close a person or family is to the federal poverty level. For the lowest income Americans who buy insurance on the exchanges, the actuarial value goes as high as 94 percent.

This year there are 7.1 million Americans who have plans with cost-sharing reductions, accounting for 58 percent of all plans on the exchanges. The total cost of the subsidies provided by the government is about $7 billion each year. This process–in which insurers are required to reduce cost-sharing for certain low-income customers and then the government subsidizes the insurers–is key to understanding the current challenge, which we’ll get to in the next section.

It’s worth noting that the law was not implemented exactly as it was designed, as legal and legislative obstacles played a significant role in the way the law took effect. Additionally, while the law has many provisions to reduce the burden on insurers and consumers, there are a number of local marketplaces that are particularly fragile at the moment. Several insurers have pulled out of the exchanges and there are several counties where people buying insurance on the health exchanges have only one insurance plan to pick from. At the same time, there are several places where the exchanges have been particularly successful–where strong competition between insurers has created a stable market for consumers. Debating the overall success of the Affordable Care Act and what should be done going forward is clearly important, but that is beyond the scope of this piece. What is clear is that the law led to a significant legal and political backlash, which brings us to the next part of the story.

The Lawsuit

The passage of the Affordable Care Act sparked a number of legal challenges, several of which have made their way to the Supreme Court. But the lawsuit that is the most important right now is the one challenging the cost-sharing subsidies. Interestingly, this lawsuit didn’t come from private citizens, small businesses, or religious institutions, but from another branch of the government.

In November 2014, Republicans in the House of Representatives filed a lawsuit against the executive branch to challenge two aspects of the ACA’s implementation. The lawsuit first argued that President Obama overstepped his constitutional authority by delaying the implementation of the employer mandate–a requirement that companies of a certain size must provide health insurance for their employees or pay a fine. Second, it claimed that the Obama Administration’s payments to insurers for the cost-sharing subsidies were illegal because the money had not been properly appropriated. A federal judge dismissed the first claim but allowed the second to proceed.

The Arguments

Both sides of the lawsuit agree that money cannot be spent unless it is properly appropriated, but the dispute focuses on the question of whether or not the current law amounts to an appropriation. House Republicans argue that although the ACA created the subsidy, the payments are not linked to a specific appropriation. Although the law calls for the payments to be paid, it doesn’t specify a source for the payments. This is not the case for the law’s premium subsidies, which are paid out in the form of refundable tax credits and are appropriated by the statute that allows the IRS to make refund payments. When the issue first emerged, President Obama asked Congress for a specific appropriation but Congress declined. After the lawsuit began, the Obama Administration argued that the same appropriation that is used for the premium subsidies can be used to make the subsidy payments to insurers.

Nicholas Bagly, a law professor and health care expert at the University of Michigan, has studied the implementation of the Affordable Care Act and argues that the Republicans’ lawsuit has a point. The justification used by the Obama Administration doesn’t quite make sense because tax credits are not the same thing as direct payments to insurance companies. As Bagley puts it, “It’s an enormous stretch to read an appropriation that governs refunds for individual taxpayers as also covering payments to insurers.” However, he also argues that the Republican lawsuit should have been thrown out by the courts in the first place. The White House and Congress are two coequal branches of government and they have the authority to resolve the dispute between themselves. If Congress has a problem with something the president is doing, it can pass a law that stops him from doing it. Congress could also pass a law appropriating the funding for the cost-sharing payments and the problem would be resolved. Allowing one branch to take an issue with another branch to the courts could set a problematic precedent as political disputes should ideally be resolved by elected officials.

What’s Next and Why It’s Important

After the district judge’s initial ruling–which allowed the cost-sharing subsidy claim to continue but dismissed the employer mandate claim–a separate ruling in 2016 ordered President Obama to stop making the payments. Obama immediately appealed the decision and the judge stayed her ruling so the White House could appeal. This means that right now, if President Trump decided to stop reimbursing insurers for cost-sharing reductions, he could drop the appeal and the judge’s injunction blocking the payments would stand. Doing so would have massive consequences for the fate of the health insurance exchanges. This is also something that the president has publicly considered, but the fate of these payments remains unclear.

On April 10, the Department of Health and Human Services told the New York Times that it planned to continue making the cost-sharing payments to insurers while the lawsuit was being litigated. But a few days later, in an interview with the Wall Street Journal, Trump said that he would consider withholding the payments as a way to force Democrats to negotiate on health care legislation. This was, in effect, a threat to undermine the insurance markets as a way to force a deal. Democrats have also reportedly considered demanding a specific appropriation for the payments for their support in a funding bill that will be needed before the end of April to avoid a government shutdown. While the politics of the issue remain unclear, the ultimate effects that ending the payments would have are fairly clear.

Consequences for Health Insurance Markets

Ending the cost-sharing subsidy payments would have dramatic consequences for the individual health insurance market. Ending the payments would not change the fact that insurers who sell plans on the exchanges would still need to provide cost-sharing reductions for customers who qualify–whether they get reimbursed by the government or not. The Kaiser Family Foundation, a non-partisan organization that analyzes health care policy, estimated that average premiums would need to increase by 19 percent to offset the lack of government funding. These estimates varied by location, ranging from a projected 9 percent increase in North Dakota to a 27 percent in Mississippi. Alternatively, insurers may simply leave the exchanges altogether.

After several insurance companies had difficulty turning a profit in the early years of the ACA’s implementation, several companies decided to stop selling plans in many markets. The current uncertainty surrounding the cost-sharing payments and health care policy more generally, could lead many companies to pull out from the exchanges. Trade groups have already started to warn lawmakers that blocking the payments may cause insurers to drop out of the markets. By June 21, all health insurers will need to decide whether or not they plan to sell insurance on the ACA exchanges next year. This year there are more than 960 counties in the country with just one insurer offering to sell plans on the exchanges, and if companies decide to pull out, several markets could collapse altogether.

Conclusion

As Republicans continue their efforts to repeal and replace the Affordable Care Act, President Trump may need to make decisions about the current law before he has an opportunity to sign a new law overhauling it. Arguably the most pressing of these challenges is what to do about the lawsuit challenging the cost-sharing subsidy payments. Trump could decide to stop the pending lawsuit and block the payments almost immediately, throwing exchanges that provide insurance to 12 million Americans into chaos. He could continue the current policy–allowing the appeal to move forward and payments to be made to insurers–or he could ask Congress to appropriate the required funding and resolve the issue once and for all.

In the meantime, the subsidy payments will continue to play an important role in legislative negotiations, particularly the funding bill needed to keep the government open past April 28. Meanwhile, insurers must deal with uncertainty as they decide if they want to continue to sell plans on the state and federal exchanges. While much remains in question, the end result will largely be the product of Congressional politics. Both parties seem to think they have the upper hand–assuming the other will be blamed if subsidy payments are blocked and insurers hike premium prices or leave the markets altogether.

Kevin Rizzo

Kevin Rizzo is the Crime in America Editor at Law Street Media. An Ohio Native, the George Washington University graduate is a founding member of the company. Contact Kevin at krizzo@LawStreetMedia.com.

The post Behind the Lawsuit that Could Upend the Affordable Care Act Exchanges appeared first on Law Street.

It’s been a little over two years since the horrifying shooting at Sandy Hook Elementary School, in Newtown, Connecticut, but legal battles over the tragedy are still ongoing. Most recently, the families of eight of the Newtown victims have filed a lawsuit against the estate of shooter Adam Lanza’s mother, alleging that she was negligent because she left her guns accessible to her son.

Nancy Lanza owned a Bushmaster AR-15 rifle, often classified as an assault weapon. On December 14, 2012, Adam Lanza accessed that rifle from his mother’s house and used it to kill 26 people at Sandy Hook Elementary. He also killed his mother at their home before going to the school.

Since Nancy Lanza is deceased, the lawsuit is being filed against her estate, and more particularly, its insurance policy. Samuel Starks is named as the defendant, as he’s the administrator of that estate, and he has said that he estimates its worth at $64,000; however, it is estimated that homeowner insurance polices that Lanza had are worth up to $1 million. That’s a normal avenue in cases like this, as according to the Connecticut Post:

Bridgeport lawyer Josh Koskoff, representing eight of the families suing, said homeowner’s insurance applies when a person is injured as a result of an unsecured firearm in a home being accessed by a third party.

Technically, there are two separate lawsuits filed against Lanza. One involves three of the children killed and four of the educators killed. Two of the teachers who were injured have also signed onto that lawsuit. A separate suit, on behalf of one of the deceased children, has also been filed.

The lawsuits both point out that Adam Lanza has access to the gun “despite the fact that she knew, or should have known, that his mental and emotional condition made him a danger to others.”

This isn’t the first lawsuit brought by some of the families of the victims of the Sandy Hook tragedy. In December 2014 on the two-year anniversary of the shooting, nine of the families filed a lawsuit against Bushmaster, the manufacturer of the Bushmaster AR-15 rifle. Camfour, the distributor the gun, and Riverview Sales, the shop that sold it to Nancy Lanza, were also all named in the suit.

Yet another lawsuit has been filed by the parents of two of the deceased students against the town, stating that it didn’t properly protect the school. The crux of that lawsuit was that one of the substitute teachers who was killed in the school that day, Lauren Rousseau, wasn’t given a key to lock her classroom door. As a result, Lanza was able to enter and kill 14 out of the 15 people in that room.

In a lot of ways these lawsuits are mainly symbolic. There’s not going to be much money that comes out of them, most likely, but they send a message to a number of people that what happened that fateful day was wrong. Guns should not be accessible to someone who has exhibited mental or emotional issues. Distributors should not sell guns that have the potential to be used to kill many people. Schools need to take all steps to make sure that even substitute teachers have the ability to secure their classrooms. These are the kinds of messages that the plaintiffs are hoping to send with these lawsuits–whether or not they’ll be successful will be up to the courts.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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The workers’ compensation system around the nation has been complicated for decades. Particularly in California, a measure from the early 2000s is now coming to light as more and more women are trying to get workers’ compensation. There’s a battle raging over whether or not there’s an inherent gender bias in the handling of workers’ compensation claims in California; the concern is that women who try to get workers’ compensation are “penalized” for gender-related conditions like pregnancies and menopause. Read on to learn about the gender bias in worker compensations claims in California, what’s being done, and a look at the discussions happening in other states.

What is workers’ compensation?

Workers’ compensation is a form of insurance provided in the workplace that can consist of wage replacements and medical benefits for employees who were injured while working. Usually by accepting these funds, employees acknowledge that they will not sue their employers for negligence. Workers who are permanently disabled while on the job receive compensation from insurers based on a calculation of the level of disability and what portion of the injury is linked to their jobs. Insurers may also weigh the worker’s previous health conditions or prior injuries. In California specifically, the process is overseen by the Division of Workers’ Compensation which:

Monitors the administration of workers’ compensation claims, and provides administrative and judicial services to assist in resolving disputes that arise in connection with claims for workers’ compensation benefits.

DWC’s mission is to minimize the adverse impact of work-related injuries on California employees and employers.

State of Workers’ Compensation

If you were to look at the statistics, it looks like fewer and fewer people nationwide are getting hurt at work, though that isn’t exactly the case.

A report came out recently about how the system is reporting very low numbers. The real reason? Changing the circumstances for what qualifies as a workplace injury, and the simple dissolution of programs that pay for such accidents. According to the Washington Post, the number of people injured at work is probably twice what is reported because people fear losing their jobs. Or people, like those in the construction industry, are misclassified as independent contractors.

The Washington Post recently discussed the national state of workers’ compensation problems, saying:

Since 2003, the investigation found, 33 states have weakened their workers’ compensation regulations, scaling back the procedures that will be covered and the duration for which benefits are offered. In addition, while businesses often push for reforms on the grounds that workers’ compensation costs are out of control, data shows that premiums are lower than they’ve been at any point since the early 1990s.

California’s Belabored Workers’ Compensation Program

Workers’ compensation programs have received complaints that they are inherently flawed throughout the United States. Lately the debate has been particularly focused in California. Complaints come from the fact that outside medical reviewers look at the cases and after brief exams or only by reading the medical records can deny recommended treatments or rule that injuries aren’t work-related.

Reform Under Governor Schwarenegger 

Some problems with the California system can be traced back to a bill that reformed the program, which was signed in 2004 by then-Governor Arnold Schwarzenegger. It changed what types of injuries qualified under the program, how long certain employees would receive coverage after being injured, and required the injured employees to choose from a specific pool of independent doctors. At the time, Schwarzenegger said:

This bill completes a process that brought together Republicans and Democrats, business and labor, and all the affected parties to produce billions of dollars in savings, protect workers, and root out fraud and waste in the system. No longer will workers’ compensation be the poison of our economy. Our message to the rest of the country and the world is that California is open for business. We are making our state once again a powerful, job-creating machine.

At that time, California employers were paying the highest workers’ comp rates in the nation: $6.33 for every $100 in payroll, compared to a national average of $2.46.

Although the bill was supposed to save Californians money, there were some problems with it. The new bill made it more difficult for workers to get in to see doctors and left them waiting for months without any answers to their problems.

Reform Under Governor Brown 

In 2012, Governor Jerry Brown put some of the power back in the hands of the state, deciding that disputes should be handled by independent medical reviewers whose decisions cannot be overturned. The law was a bit quirky, as this didn’t just apply to the new cases, but also retroactively to past requests, and it impacted everything from already-scheduled doctor’s visits to prescription refills. In some cases, treatments were stopped in the middle with little more than an official notice.

This new system also has problems, however, as in recent years reviewers have denied treatment in up to 91 percent of the cases. People who were receiving treatment for years suddenly found themselves left out in the cold, and many had to return to work to continue to pay for the medication they needed.

Christine Baker, who oversees workers’ compensation in California, has stated that the reform is “speeding up the decision making process” and taking the aid away from people who are using it for prescription abuse.

Many of the judges, including John C. Gutierrez, a workers’ comp jurist since the 1980s, are some of the biggest adversaries of the law. According to Gutierrez, “the only interest that’s being protected here is industry and I feel that their financial influence has had an impact on how this legislation came out.” He went on to say that he felt like workers “are losing their voice.”

This is a problem in the state regardless of gender, but when it comes to comparing women and men, there is an even bigger problem looming.

Gender Bias in Workers’ Comp Rulings

California Assemblywoman Lorena Gonzalez introduced a bill (AB305) on March 4, 2015 that aims to eliminate the gender bias in workers’ compensation rulings.

This comes after a Bay Area woman who suffers from Carpal Tunnel Syndrome, which damages the nerves in the hands and often limits movement, was denied workers’ compensation for a strange reason: she was postmenopausal, which meant that she was predisposed to nerve damage. 

The woman enacted the help of attorney Sue Borg who says that she sees many cases where a woman who is injured on the job and files a claim for compensation is “penalized” for things like pregnancies and menopause. “It seems like it should be obvious that we shouldn’t see this, but it happens in insidious ways all the time,” Borg said.

Gonzalez aims to ensure that being female does not constitute a preexisting condition, and hopes to stop the reduction of compensation for female workers based on pregnancies, breast cancer, menopause, osteoporosis, and sexual harassment. All of this discrimination is happening, even though there are laws against gender discrimination in the workplace.

Breast Cancer

One of the biggest problems facing women seeking workers’ compensation is breast cancer. There have been numerous reports of how breast cancer is treated among firefighters and police officers. According to the Corporate Counsel:

Gutierrez reports that the bill’s supporters claim gender bias in workers’ compensation is a big issue, and one that is “especially evident in the way breast cancer is treated among firefighters and police officers.” For instance, female police officers who have to undergo double mastectomies for breast cancer linked to hazardous materials on the job are considered 0 to 5 percent disabled, Gutierrez reports, whereas a male officer with prostate cancer is considered 16 percent disabled and would be paid for the injury.

One such case involves a San Francisco firefighter who was denied permanent disability after having to undergo a double mastectomy, as well as an Orange County hotel housekeeper who was injured on the job but only received two percent payment on her claim–despite doctors putting her disability level at 100 percent–due to prior conditions “related to childbirth, obesity, age and naturally occurring events.”

Pregnancy

Pregnancy has always been a fairly controversial issue when it comes to the workplace, but many women are now being denied workers’ compensation due to it, or facing claims that it is the “cause” of the problem. Things like back pain, muscle strain, and injuries caused by fatigue have all been attributed to pregnancy and not the workplace. “I’ve had a child, and if now being a mother is a pre-existing condition in California, I find that unacceptable,” said Christine Pelosi, chair of the California Democratic Party’s women’s caucus.

State Fires Back

The claims were immediately disparaged by the Workers’ Compensation Action Network, which said that payment decisions were never a result of discrimination. According to the Sacramento Business Journal: “A spokesman from Industrial Relations could not immediately produce data on gender-related bias or discrimination, but the agency will look into the matter and respond with its findings.”

Conclusion

The nation, and particularly California, has a lot of work to do in the coming months to try to look at reports and see if there is a problem. If there is, it could mean an inundation of old cases that may be able to be retried, meaning companies could owe a lot of money to women all over the state.

Surely California is only the beginning and more and more states, as well as the federal government, will have to look at their workers’ compensation laws and see if there are problems lurking in them. In the end, the people who don’t get covered by workers’ compensation won’t always work through their pain; many will end up on government subsidies, which means that the tax payers will have to cover the costs.

Resources

Primary

Department of Industrial Relations: Division of Worker’s Compensation California

Department of Industrial Relations: A Guidebook for Injured Workers

Additional

Corporate Counsel: Charges of Gender Bias in Workers’ Compensation

NPR: Injured Workers Suffer as ‘Reforms’ Limit Workers’ Compensation Benefits

Heartland Institute: Schwarzenegger Signs Workers Comp Reform

The New York Times: A Racy Silicon Valley Lawsuit and More Subtle Questions About Sex Discrimination

SF Gate: Gender Bias Rampant in Workers’ Comp Cases, Women’s Groups Charge

ProPublica: The Demolition of Workers’ Comp

NPR: As Workers’ Comp Varies From State to State, Workers Pay the Price

Property Casualty 360: California Workers’ Comp Bill Passes Legislature; Insurer Groups Cautious

BradBlog: Schwarzenegger’s Workers’ Comp ‘Reform’ Killed My Client

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Noel Diem

Law Street contributor Noel Diem is an editor and aspiring author based in Reading, Pennsylvania. She is an alum of Albright College where she studied English and Secondary Education. In her spare time she enjoys traveling, theater, fashion, and literature. Contact Noel at staff@LawStreetMedia.com.

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Once again, the fate of the Affordable Care Act–Obamacare–rests in the hands of the nine justices of the Supreme Court. This time, the case is called King v. Burwell, and today, on this rainy Wednesday, oral arguments began. The case itself serves as an argument for proofreading and very deliberate writing, given that most of the accomplishments made by the implementation of Obamacare pretty much hang on one word written into the law: “state.”

Here’s a quick summary: Obamacare requires everyone to have insurance, and for those who buy insurance from the Exchanges implemented by the law, subsidies are supposed to be provided. Now, some states didn’t set up their own exchanges but instead relied on the federal exchange. Which should be fine, except there’s this one little part of the law that says:

The premium assistance amount determined under this subsection with respect to any coverage month is the amount equal to the lesser of—

(A) the monthly premiums for such month for 1 or more qualified health plans offered in the individual market within a State which cover the taxpayer, the taxpayer’s spouse, or any dependent (as defined in section 152) of the taxpayer and which were enrolled in through an Exchange established by the State under 1311 of the Patient Protection and Affordable Care Actor

A very literal interpretation of this clause would make it seem like those subsidies only apply to those who get their insurance on the state exchanges. But the IRS went ahead and gave subsidies to those on the federal exchange anyway, mostly because the government is arguing that the law was intended to be chopped up like that.

To put it simply: we’re watching a Supreme Court case over the use of the word “state” when it maybe should have said “government” or another less descriptive word.

Anyway, it’s not that this is a traditional legal issue. It’s a political play masked as a lawsuit–Republicans don’t want Obamacare to survive, and this is yet another attempt to get the law rendered significantly less effective than it is now.

No one knows exactly what’s going to happen–while the argument itself seems relatively specious, justices’ political beliefs could play a part. Justice Anthony Kennedy, the perennial swing vote, and Chief Justice John G. Roberts, who wrote the decision in the last big Obamacare case, are both being viewed as potential defectors from the conservative side of the bench.

Protesters from both sides have shown up at the Supreme Court, despite a rainy morning. In fact, I saw people camped out there as early as midnight last night–awaiting the chance to make their opinions about America’s healthcare future known.

TOP’s Claudette w/daughters demanding #SCOTUS keep health care for 9.6 mill. Americans #KingvBurwell #DontTakeMyCare pic.twitter.com/Z6XZDiJ1WO

— TXOrganizingProject (@TXOrgProject) March 4, 2015

Good size turnout of happy patriots defending the Constitution. “KEEP THE IRS OUT OF MY HEALTH CARE!” #KingvBurwellpic.twitter.com/BlWccHjGvL

— Tea Party Patriots (@TPPatriots) March 4, 2015

In some ways the biggest question isn’t what the court will do–after all that’s out of everyone’s hands with the exception of the nine justices–but what will happen after King v. Burwell is decided. If it’s decided that people can’t, in fact, get subsidies from the IRS if they’re on the federal exchange, the federal government can’t really do anything.

So that leaves two possible groups who can act–the United States Congress, and the states that relied on the federal exchanges. Unfortunately, it’s relatively unlikely that either will act. The states that chose not to set up the exchanges in the first place often did so because they did not agree with Obamacare. Congress…well a Republican-controlled Congress, will certainly not amend the law to fix it.

The most recently floated possibility came in the form of an op-ed from Representatives John Kline (R-MN), Paul Ryan (R-WI), and Fred Upton (R-MI). Entitled “An Off-Ramp From Obamacare,” and published in the Wall Street Journal, Kline, Ryan, and Upton used heavy-handed car-wreck metaphors to describe an alternative to the subsidies should King v. Burwell find that the federal subsidies are not allowed. This new plan would allow states to opt-out of Obamacare’s mandates, both for the individuals and employers, and would give people tax breaks rather than subsidies to buy insurance.

That doesn’t seem that different, but there is a worrisome element to the plan put forth by Kline, Ryan, and Upton. And that is the idea that people can afford to purchase the insurance and then wait until tax time to recoup that money. For the millions of Americans who live paycheck to paycheck, that isn’t necessarily a possibility.

Let’s be honest here, this entire thing is a mess. The Supreme Court could go either way, and if it chooses to declare the subsidies null and void, there will be a lot of people struggling to figure out what that means for their health care. If that’s the case, there’s no guarantee that House Republicans will actually get their crap together to make this “off-ramp” a reality, and even if they do, there will still be a lot of problems. The future of Obamacare looks just as messy as its past.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

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In a tragic, but very confusing story, a woman from Utah is suing herself–and a Utah court just said that she can move forward. Barbara Bagley, is representing her late-husband Bradley Vom Baur’s estate, suing the woman whose negligence may have caused the auto accident in which he passed away. The person who may have caused the accident? That’s right–it’s the same Barbara Bagley. So Barbara Bagley is suing Barbara Bagley. Confused yet? I sure am. How exactly can someone sue themselves?

Well, essentially it’s the same as when two separate people are involved in an accident like this–if someone passes away in a car accident, their “estate” can sue the person who caused the accident. In her lawsuit, she is essentially just arguing that Bagley who controls Vom Baur’s estate, and Bagley who drove the car are two different parties with two different interests. She’s asking for unspecified damages for his medical and financial expenses, loss of financial support and companionship, and the physical pain he suffered.

Bagley was driving a Range Rover in 2011 with her husband when she lost control. The car flipped after she hit a bush, and her husband, Vom Baur, was thrown from the car. He suffered extensive injuries and passed away a little over a week later. The side of Bagley that controls Vom Baur’s estate is claiming that she was negligent for failing to look ahead properly and keep control of her vehicle.

This may be a tactic to get the insurance money that Bagley desires. University of Utah Law Professor Shima Baradaran explains:

She is claiming her own negligence in her husband’s death. In order to recover for the costs of his death she has to kind of claim her own negligence. So basically she’s suing herself so that the insurance recovery can follow.

This does mean that Bagley has two separate sets of lawyers. The lawyers defending Bagley on behalf of her late-husbands estate are privately hired. The attorneys defending her as a driver come from her insurance carrier.

Now, of course, there’s been a legal battle before the case actually commenced over what Bagley is doing. The lawyers for Bagley as the driver have tried to get the case thrown out. As they wrote in a motion to dismiss:

Further, if this suit is allowed to continue, a jury would be asked to determine whether Barbara Bagley’s fault caused Barbara Bagley’s own harm. The jury would be asked to determine how much money will fairly compensate Barbara Bagley for the harm she caused herself. The jury will be highly confused — it cannot order a person to compensate herself In January 2014, a judge actually dismissed the case. But this week, an appeals court said that Bagley is able to sue herself.

Originally, a judge agreed with them, and threw out the case in 2014. But this week, an appeals court reversed that decision, and said that the case can move forward. The defense–the insurance company representatives for Bagley–hasn’t said whether or not it will try to bring it to the Supreme Court.

It’s a weird case, certainly, although not entirely unexpected in today’s litigation-happy world. In some ways it’s also a heartbreaking case–a woman is admitting that her negligence caused her husband’s death because that’s the way that she’s going to be able to pay off his bills. Finally, it’s a fascinating case. The ability to separate different parts of legal identity is certainly a mostly-unexplored field. Whether or not this case goes forward, or whether it ends up at the Utah Supreme Court, it will be interesting to see which of Bagley’s interests succeeds.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Utah Appeals Court Rules Woman May Sue Herself appeared first on Law Street.

If you are going to a pharmacy for a particular drug, you’re often offered a choice — do you want the name brand or the cheaper generic? Generics have long been lauded for their ability to provide the same benefits to patients while also offering a less hefty price tag; however, recently generics have been getting more expensive, and people are wondering why. Congress announced this week that it’s going to launch an investigation into why the price of generic drugs is rising.

When a drug company develops a particular drug, it gets to hold the patent for approximately twenty years (some nations or jurisdictions give protections for a bit longer). During that period, that company is the only one that can produce that particular drug. After the patent expires, however, other companies can make a “generic” version of the drug.

There are certain regulations created by the Food and Drug Administration (FDA) to make sure that the generic drugs are able to be distributed. The FDA requires that a generic drug has the same active ingredients as the one that it is imitating, but not necessarily the same inactive ingredients (such as coloring). A generic has to perform the same function as the name brand, and it must of course meet the same health and safety standards.

Generic drugs tend to be less expensive than the name brands — and given the high cost of American health care, offer great and affordable options for consumers. However, it seems like the cost of these drugs is increasing. For example, the patent for Ambien, a popular sleep aid, recently expired. Now it’s a lot easier to get a generic version of Ambien for a cheaper price, and more people are able to get the product they need.

A study completed in August discovered that some generic prices have been dropping, while others have been rising almost exponentially. According to the Wall Street Journal:

The prices paid by pharmacies more than doubled for one out of 11 generics. And in a few cases – notably, the tetracycline antibiotic and the captopril blood pressure pill – the cost increases not only exceeded 1,000%, but topped 17,000%…. Yes, 17,000%.

Doctors have reported how troubling this kind of price increase can be in certain generic drugs for the patients who rely on them. Some patients who are on fixed incomes, such as those on Medicaid, may not be able to pay for the non-covered costs of the drugs if prices skyrocket that much. They may try to skip their prescriptions in an attempt to make ends meet. Not only is this obviously problematic for the patients themselves, but it also leads to more emergency room visits and a less healthy society in general.

That brings us to the investigation that Congress is evidently undertaking to try to figure out why exactly these generic prices are climbing so sharply and how to reverse the trend. The analysis is being pushed by Senator Bernie Sanders of Vermont and Representative Elijah Cummings of Maryland. We can all say a lot about the inadequacies of Congress, but this is a good move on its part. It’s really important that we get the prices of generics under control, because price increases like this are almost always passed directly to the consumer. With as many healthcare problems as we have, this is an issue that needs to be nipped in the bud as soon as possible.

—

Anneliese Mahoney (@AMahoney8672) is Lead Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

Featured image courtesy of [Chris Potter/Stockmonkeys.com via Flickr]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Congress to Investigate Rising Generic Drug Costs appeared first on Law Street.

Health care costs have long been a hot topic of conversation in American culture. We’ve had problems with our health care system because the costs are high, of course, but also because sometimes they’re simply unknown. Often people who go in for a procedure, even with insurance, have no idea how much they’re going to owe until they receive a bill in the mail. One state has finally decided that that’s a bad way of doing things–starting this month, the state of Massachusetts is providing “price tags” for healthcare.

As of last week, if you are insured through a private company, you can go on that company’s website, type in what medical procedure you’re looking to get, and it will tell you how much it costs. This is part of an act that Massachusetts passed in 2012 that aimed to create greater transparency in healthcare costs, and make the system more efficient.

Now this system isn’t perfect, nor is it centralized. Not every single cost associated with a particular medical procedure will be listed–for example some places won’t list the cost of reading a scan or processing a test or an accompanying hospital stay.

The WBUR reporter who checked out the system, Martha Bebinger, also noticed some other interesting components. Health care costs vary by hospital or doctor, as well as by insurance provider. In some cases the difference was negligible, but in others, it was striking. For example, the cost of an Upper Back MRI ranges from around $600 to $1800, depending on where you go. Bebinger also noticed that the costs can change from day to day.

This is a valuable tool, because in addition to allowing patients to figure out where would be the best place to get a particular procedure, it also allows them to plan ahead. Some of the sites also create calculations of co-pays and the like, making the sites even more budget-planner friendly. Some of the sites allow the ability to leave patient reviews, so people can get some idea of the quality of the healthcare they will get before they actually commit. And while the system is by no means centralized, all of the big insurance providers in Massachusetts seem to have created some sort of online site with the ability to price-check.

The new requirements have also been applauded because of the hope that they may drive healthcare prices down. If people are able to readily access prices, they will shop around, and private doctors may offer slightly lower prices to incentivize customers.

The only possible concern I see is that people may be discouraged from going to the doctor’s office if they know in advance how much it will cost. However, I would imagine that those cases would be few and far between, and that overall, more transparency will benefit people who are on a budget.

Massachusetts has, in the past, introduced innovations in its health care system that ended up becoming national trends–the Affordable Care Act was loosely based on Massachusetts’s system of healthcare. Massachusetts may once again be in the position of testing an idea that could eventually end up a national norm.

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post Healthcare Procedures in Massachusetts Now Have Price Stickers appeared first on Law Street.

I’m going to take a break from feminist issues today and discuss something that is, literally, life or death: America’s horrible healthcare costs.

Recently, just as I had my first run-in with military dress codes, I also got to experience a military doctor’s office. I went in for a physical exam, waited maybe ten minutes all around, and ended up leaving without having to pay a cent for the appointment or prescriptions. The only thought on my mind was: why can’t everyone’s health care be this great?

Outside of the United States, healthcare is that great in several countries. Just last summer while studying abroad in London, my friend rushed herself to the hospital thinking her appendix was bursting. Turned out to be just a pulled muscle, but an ER visit didn’t cost her a pence — and she wasn’t even a citizen!

So what’s wrong with American health care? For a country whose citizens claim it to be number one, we are way behind on things that really matter. According to the World Health Organization, America ranks thirty-fifth in life expectancy and thirty-seventh in healthcare systems.

Yikes.

Why are we so low in the rankings? The answer is not simple.

American healthcare costs are alarmingly higher than in other developed countries. An MRI in the U.S. averages $1,121, while in the Netherlands it’s only $319. Need an angiogram? That’ll be $914, but you could have gotten it for $35 in Canada! Are you on the drug Lipitor? Then you know it’s around $124 a month — it costs $6 a month in New Zealand. Some may argue that we are wealthier than these countries, so it makes sense that we would spend a bit more. Sure, but the amount the United States spends on health care is way above what it should be.

Then there is the argument that countries with free health care pay more in taxes. False. The average U.S. citizen pays more in taxes toward public health care than the United Kingdom, Canada, and a whole list of other countries with free health care.

Some blame insurance. American citizens not having health insurance was a factor in rising healthcare costs, yes. Those who didn’t have it still needed care, then went bankrupt from trying to pay for it, so our tax money ended up paying for it. The Affordable Care Act has alleviated some of the problem, but it is still being fought over in congress.

Still others point to over-utilization and malpractice spending, saying that Americans simply go to the doctor more and therefore spend more, but there is no data to support that either. Plus, who would want to go to the doctor more than they need to, especially when a doctor’s visit will soon cost more than a car?

None of these issues is the one thing that has skyrocketed our health care spending. In fact, all of them are to blame. Therefore, there will be no simple solution. Reaching a fix is made harder by the fact that the topic of health care is gridlocked in our government. Republicans block Democrats because they’re not Republican, and vice versa.

A lot of people like to gripe about Obamacare.

Half of Congress even decided to throw a hissy fit over not getting their way on the subject, and shut down the government. Sure, the Affordable Care Act might not be perfect, but at least it’s something. Those people most vehemently opposing it aren’t offering up any better solutions. Until both parties can get over their pride, sit down and say “what is going to be best, and cost less, for the American people?” healthcare costs will continue to be higher than they need to be.

My opinion? Healthcare should be free and easily accessible for everyone. Period.

Data and statistics for this post came from the WHO website and this article from The New York Times.

Morgan McMurray

Morgan McMurray is an editor and gender equality blogger based in Seattle, Washington. A 2013 graduate of Iowa State University, she has a Bachelor of Arts in English, Journalism, and International Studies. She spends her free time writing, reading, teaching dance classes, and binge-watching Netflix. Contact Morgan at staff@LawStreetMedia.com.

The post Debunking Common Myths About American Healthcare Costs appeared first on Law Street.

Remember when F-Word blogger Hannah R. Winsten reported back in December that Michigan lawmakers were debating a bill that would prevent health insurance plans from covering abortion, essentially requiring women to purchase what came to be known as rape insurance? Well, that revolting bill is now a revolting law thanks to the Michigan GOP and (I am disappointed to say) three Democrats. Yep, rape insurance is real, people.

However, the real doozy is that abortion riders don’t exist. (Straight swindle!)

As the Detroit News explains, “the state “opt-out” rider law clashes with provisions of the Affordable Care Act, which outlaws both separate riders and any government subsidy of abortion. Under federal law insurers cannot offer a rider to a standard, inclusive policy. And new state law bars insurers from including elective abortion coverage in any policy, on or off the exchange.”

What this means: Michigan women who purchase their health insurance as an individual and not part of a group plan don’t have the ‘promised’ option to purchase the abortion rider. Because the bill passed violates the Affordable Care Act’s provisions of outlawing separate riders and government subsidies on a standard policy. This makes it impossible for any insurer to give the option of selling a separate rider to individual women.

That, my friends, is what we call a grade-A cluster fuck.

It is hard to say whether the politicians knew and just didn’t care that the bill clashes with the federal healthcare law; however, it is easy to confirm who pays the price. Michigan women have only one option: pay that abortion fee.

—

Ashley Powell (@danceAPdance)

Click here to read the original post published December 5, 2013.

Happy almost Friday, folks! This week is almost over. THANK GOODNESS. Coming back after a holiday is rough, am I right?

If you have a uterus and you live in Michigan, your week has been especially rough. Shit is getting REAL over there in the Mid-West. Lawmakers in the Great Lakes State are currently debating a bill that would require women to buy rape insurance.

That’s right. Rape insurance.

I tell you, this shit just gets more ridiculous every week I write about it. It’s actually insane.

Here’s how it’s going down. Lawmakers in Michigan don’t want health insurance to cover abortion. Why? They’re not fans of a woman’s right to choose, and so, while they can’t completely outlaw abortion, they can use insurance technicalities to restrict women’s options.

What happens when insurance doesn’t cover abortions? Women either have babies that they don’t want or are unable to carry, or they pay a hefty price to terminate. Obviously, not ideal. So! While Wolverine legislators were batting around this nifty little bill, the same question came up that always comes up when we start talking about restricting women’s access to abortions.

“But what about cases of rape and incest?!” Because, empathy. For like, five seconds.

The legislators of Michigan had an answer ready and waiting. Make women buy additional insurance to cover the possibility of needing an abortion in the future.

This little tidbit prompted Republican Gov. Rick Snyder to veto the bill last year when it was first introduced. He wasn’t too keen on legislation that required women to pay for abortions out of pocket, unless of course, they had paid extra for that separate insurance rider. “I don’t believe it is appropriate to tell a woman who becomes pregnant due to a rape that she needed to select elective insurance coverage,” Snyder said when he rejected the bill last winter.

Well, duh. Obviously.

That would be like telling a man who had a heart attack that he couldn’t have life-saving surgery, because he didn’t plan ahead and book an operating room beforehand. Or like telling a cancer patient that she can’t receive treatment because she hadn’t reserved a chemo supply ahead of time. Plan ahead, people, be prepared! For all of the possible things that could happen to you ever! (Because that’s possible.)

Folks, let’s get one thing straight. No one plans to get an abortion. Needing one is definitely not a desirable situation to be in. Really, abortions are a last resort. An emergency measure, taken after something has unintentionally gone wrong. Maybe she got raped. Maybe the condom broke. Maybe she forgot to take her birth control pill that day. Maybe she just discovered that the baby won’t survive the pregnancy or infanthood.

Whatever the situation, abortions are last ditch efforts to rectify a bad situation that wasn’t planned for. So asking women to plan for unplanned emergencies — and be monetarily penalized either way — makes absolutely no sense.

It’s about as logical as this guy.

But, alas, the anti-choicers think it does make sense, and they’ve got a rage-inducing argument as to why that is. One prominent advocate of the bill claimed that rape is like a car accident, and it was totally fine to make women pay for extra insurance in order to prepare for it.

This is so incredibly gross on so many levels.

First of all, we’re comparing women’s bodies to cars right now. To cars. Inanimate objects that can be damaged, fixed, or replaced. One car is much like another—it gets you from A to B. Women’s bodies are not like cars. They are not replaceable. Their value doesn’t depreciate after a traumatic event. They are not interchangeable. They are not for you to use.

Actually, women’s bodies are attached to living, breathing, human beings. They happen to have vaginas. But they also have lives, passions, emotions, and agency. And when you liken their bodies being raped to a car being crashed, you ignore the human involved in the trauma. You assume she’s an object, instead of a subject.

Stop that right now.

Second of all, expecting women to prepare themselves for rape is absurd and cruel.

Preparation assumes the inevitable. You prepare for a car accident—if we’re going to follow through with this terrible example—because being involved in one, someday, is more or less inevitable. People are stupid. Let a bunch of idiots operate heavy machinery near each other, and things are bound to go wrong eventually. Better prepare yourself for the asshole who forgot to use his blinker and caused a pileup on the freeway.

But rape? That shouldn’t be inevitable. Rape doesn’t happen because of human error. Rape isn’t something that idiots do. Rape happens when one person makes a conscious decision to violate another person. Consent isn’t given. Accidents aren’t made. This isn’t an “oops I didn’t mean to get sexually violent with you, my bad,” kind of situation.

Not at all.

When we treat rape like it is inevitable, we give rapists a free pass. We’re sending them the message that, hey, you’re only human! People make mistakes. No big deal. But it is a big deal. And it wasn’t a mistake. This isn’t like forgetting to use your blinker, or running a red light. This is violence and coercion. And there’s always another option.

So, to all the anti-choicers of Michigan, I have a question for you: If a man was shot, and he had to pay out of pocket to have the bullet removed because he hadn’t planned ahead with elective murder insurance, how would you feel about that?

Probably like this kid.

Not so good, I’m guessing. Because it’s ridiculous to ask a man to prepare himself for the possibility that one day, he might be a homicide victim. No one expects to be on the receiving end of that kind of violence.

So stop asking women to do the same. We don’t need to prepare for our impending rape. We shouldn’t be waiting expectantly, insurance policy in hand, to be the victims of sexual violence. And we sure as hell aren’t cool with legislators putting a price tag on our uteruses.

So, stop it, OK? Just stop it.

Stop restricting our access to safe abortions. Stop legislating our bodies. Stop objectifying us. And stop being so cavalier when it comes to rape.

Do you think the GOP can handle that, folks? Discuss!

—

Hannah R. Winsten (@HannahRWinsten) is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow.

Featured image courtesy of [ProgressOhio via Flickr]

Ashley Powell

Ashley Powell is a founding member of Law Street Media, and its original Lead Editor. She is a graduate of The George Washington University. Contact Ashley at staff@LawStreetMedia.com.

The post Fail of the Week: Michigan’s Rape Insurance Law appeared first on Law Street.

So as I predicted in my previous article, issues of liability were around the corner. It looks like they came sooner than expected and from an unexpected volunteer. On Tuesday, Malaysia Airlines announced the first batch of payments it would make to families of passengers on Flight 370. The amount? $5,000 per passenger. This pre-emptive payment is not by any means the final payment by Malaysia Airlines, as the Montreal Convention set the $150,000 threshold, and experts expect next of kin compensation could eventually exceed millions of dollars per passenger.

So far, Malaysia Airlines has also provided money for food, lodging, and any travel expense the families may have since the incident unfolded on March 8. The airline has pledged to continue this aid for as long as possible. But with more and more people assuming all lives have been lost, people are turning their eyes toward compensation for the families of passengers.

One attorney, Monica Kelly, spoke to CNN and said that within her experience, Malaysia airlines may be forced to pay between $400,000 and $3 million per family.

Another attorney, Mike Danko, said the amount of money families are awarded has a lot of to do with where they filed a lawsuit. For instance, U.S. courts will probably give families more money than those in China. Passengers on Flight 370 came from 14 different countries, so lawsuits could be filed in any of those.

At least in the US, one of the more difficult (and arbitrary) set of decisions will come when the courts decide how much each family gets… by figuring out how much each person’s life was worth in the first place. Each passenger will be assessed separately, and the amount of money awarded to each family is decided on a number of factors. For instance, someone with 3 small children may receive more money than a single person in his 40s.

But Malaysia Airlines may have some help, as well. Airlines tend to be covered by insurance policies ranging between $2 to $2.5 billion, with as much as $10 million set aside by each passenger, according to Brian Havel, director of the International Aviation Law Institute at DePaul University.

And as previously discussed, the logistics surrounding this still-missing aircraft could slow the process down. But assuming a long period of time goes by and no sign of the aircraft is found, courts might go ahead and rule the passengers as deceased, allowing families to sue for damages and collect life insurance.

[CBS] [CNN] [Yahoo]

—

Molly Hogan (@molly_hogan13)

Featured Image Courtesy of [Allen Watkin via Flickr]

Molly Hogan

Molly Hogan is a student at The George Washington University and formerly an intern at Law Street Media. Contact Molly at staff@LawStreetMedia.com.

The post First Payments from Malaysian Plane Crash: Only $5,000? appeared first on Law Street.

Happy almost Friday, folks! This week is almost over. THANK GOODNESS. Coming back after a holiday is rough, am I right?

If you have a uterus and you live in Michigan, your week has been especially rough. Shit is getting REAL over there in the Mid-West. Lawmakers in the Great Lakes State are currently debating a bill that would require women to buy rape insurance.

That’s right. Rape insurance.

I tell you, this shit just gets more ridiculous every week I write about it. It’s actually insane.

Here’s how it’s going down. Lawmakers in Michigan don’t want health insurance to cover abortion. Why? They’re not fans of a woman’s right to choose, and so, while they can’t completely outlaw abortion, they can use insurance technicalities to restrict women’s options.

What happens when insurance doesn’t cover abortions? Women either have babies that they don’t want or are unable to carry, or they pay a hefty price to terminate. Obviously, not ideal. So! While Wolverine legislators were batting around this nifty little bill, the same question came up that always comes up when we start talking about restricting women’s access to abortions.

“But what about cases of rape and incest?!” Because, empathy. For like, five seconds.

The legislators of Michigan had an answer ready and waiting. Make women buy additional insurance to cover the possibility of needing an abortion in the future.

This little tidbit prompted Republican Gov. Rick Snyder to veto the bill last year when it was first introduced. He wasn’t too keen on legislation that required women to pay for abortions out of pocket, unless of course, they had paid extra for that separate insurance rider. “I don’t believe it is appropriate to tell a woman who becomes pregnant due to a rape that she needed to select elective insurance coverage,” Snyder said when he rejected the bill last winter.

Well, duh. Obviously.

That would be like telling a man who had a heart attack that he couldn’t have life-saving surgery, because he didn’t plan ahead and book an operating room beforehand. Or like telling a cancer patient that she can’t receive treatment because she hadn’t reserved a chemo supply ahead of time. Plan ahead, people, be prepared! For all of the possible things that could happen to you ever! (Because that’s possible.)

Folks, let’s get one thing straight. No one plans to get an abortion. Needing one is definitely not a desirable situation to be in. Really, abortions are a last resort. An emergency measure, taken after something has unintentionally gone wrong. Maybe she got raped. Maybe the condom broke. Maybe she forgot to take her birth control pill that day. Maybe she just discovered that the baby won’t survive the pregnancy or infanthood.

Whatever the situation, abortions are last ditch efforts to rectify a bad situation that wasn’t planned for. So asking women to plan for unplanned emergencies — and be monetarily penalized either way — makes absolutely no sense.

It’s about as logical as this guy.

But, alas, the anti-choicers think it does make sense, and they’ve got a rage-inducing argument as to why that is. One prominent advocate of the bill claimed that rape is like a car accident, and it was totally fine to make women pay for extra insurance in order to prepare for it.

This is so incredibly gross on so many levels.

First of all, we’re comparing women’s bodies to cars right now. To cars. Inanimate objects that can be damaged, fixed, or replaced. One car is much like another—it gets you from A to B. Women’s bodies are not like cars. They are not replaceable. Their value doesn’t depreciate after a traumatic event. They are not interchangeable. They are not for you to use.

Actually, women’s bodies are attached to living, breathing, human beings. They happen to have vaginas. But they also have lives, passions, emotions, and agency. And when you liken their bodies being raped to a car being crashed, you ignore the human involved in the trauma. You assume she’s an object, instead of a subject.

Stop that right now.

Second of all, expecting women to prepare themselves for rape is absurd and cruel.

Preparation assumes the inevitable. You prepare for a car accident—if we’re going to follow through with this terrible example—because being involved in one, someday, is more or less inevitable. People are stupid. Let a bunch of idiots operate heavy machinery near each other, and things are bound to go wrong eventually. Better prepare yourself for the asshole who forgot to use his blinker and caused a pileup on the freeway.

But rape? That shouldn’t be inevitable. Rape doesn’t happen because of human error. Rape isn’t something that idiots do. Rape happens when one person makes a conscious decision to violate another person. Consent isn’t given. Accidents aren’t made. This isn’t an “oops I didn’t mean to get sexually violent with you, my bad,” kind of situation.

Not at all.

When we treat rape like it is inevitable, we give rapists a free pass. We’re sending them the message that, hey, you’re only human! People make mistakes. No big deal. But it is a big deal. And it wasn’t a mistake. This isn’t like forgetting to use your blinker, or running a red light. This is violence and coercion. And there’s always another option.

So, to all the anti-choicers of Michigan, I have a question for you: If a man was shot, and he had to pay out of pocket to have the bullet removed because he hadn’t planned ahead with elective murder insurance, how would you feel about that?

Probably like this kid.

Not so good, I’m guessing. Because it’s ridiculous to ask a man to prepare himself for the possibility that one day, he might be a homicide victim. No one expects to be on the receiving end of that kind of violence.

So stop asking women to do the same. We don’t need to prepare for our impending rape. We shouldn’t be waiting expectantly, insurance policy in hand, to be the victims of sexual violence. And we sure as hell aren’t cool with legislators putting a price tag on our uteruses.

So, stop it, OK? Just stop it.

Stop restricting our access to safe abortions. Stop legislating our bodies. Stop objectifying us. And stop being so cavalier when it comes to rape.

Do you think the GOP can handle that, folks? Discuss!

—

Hannah R. Winsten (@HannahRWinsten) is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow.

Featured image courtesy of [American Life League via Flickr]

Hannah R. Winsten

Hannah R. Winsten is a freelance copywriter, marketing consultant, and blogger living in New York’s sixth borough. She hates tweeting but does it anyway. She aspires to be the next Rachel Maddow. Contact Hannah at staff@LawStreetMedia.com.

The post LADIES: Michigan Says You Need Rape Insurance appeared first on Law Street.

Ask anyone what the biggest political controversy is of President Obama’s presidency: you’ll hear a few people talk about Benghazi and the NSA will inevitably come up. But it’s pretty safe to say that the majority of respondents will reference the Affordable Care Act. Otherwise known as ObamaCare, the ACA has been a huge talking point for partisan politics. And like with any hugely-partisan issue, lies abound. Here are the top 10 lies being told about the ACA:

10. 8.2 million Americans can’t find full-time work because of ObamaCare
Who Told it: The RNC and multiple Republican politicians, including John Boehner and Eric Cantor.

Courtesy of Talk Radio News Service via Flickr.

Why it’s a lie: The RNC looked at the Bureau of Labor Statistic’s figures this summer. They report the amount of people who are working a part-time job and would like to be working full time. What they do not report is why these workers are working a part time job….in fact there’s literally nothing about the Affordable Care Act in these statistics. Awesome unfair extrapolation RNC, you go.

9. “Obamacare contains an ‘abortion surcharge and a secrecy clause’ that forces ‘pro-life Americans…to pay for other people’s abortions.” 
Who told it: Rep Chris Smith (R-NJ)

Why it’s a lie: If you don’t want abortion coverage, you don’t choose one of the plans that includes abortion coverage. States are required to offer plans with and without the provision. If a woman chooses to have abortion coverage, she pays a separate fee into a separate account so that no federal dollars support abortion services. Every American has the option to choose a plan that does not give to abortion coverage.

8. Obamacare will add $6 trillion to the deficit.
Who told it: Rep George Holding (R-NC)

This was the time the same Rep fell asleep in Congress.

Why it’s a lie: Because the Affordable Care Act won’t raise the deficit at all, as projected by the CBO. In fact, it will reduce the deficit. Go back to sleep, Rep Holding.

These next couple examples will come from a category I like to call “things that happened on Fox News that aren’t true.”

7. A woman named Allison Denijs went on the Sean Hannity show and claimed that Obamacare would cost her more, and wouldn’t contain insurance for her daughter with a preexisting condition. 

Who said it: It was part of a segment on Sean Hannity’s show meant to show that “Average Americans are feeling the pain of Obamacare and the healthcare overhaul train wreck.”

Why it’s a lie: Stories like this are popping up on conservative outlets all across the country. But the case is that these stories aren’t actually true. Let’s look specifically at Ms. Denijs’s story. Her family currently pays $13,000 to purchase their own insurance, and then another $600 a month to cover their daughter with a preexisting condition. But under Obamacare, preexisting conditions are no longer an issue. A reporter who interviewed her found that she had never even looked at the exchange, and that she could find almost the exact same plan for just $7600 a year through the exchange.

6. On the same program, a man named Paul Cox claimed that he had to cut back on employee’s hours at his small construction business. 
Who said it: It was part of a segment on Sean Hannity’s show meant to show that “Average Americans are feeling the pain of Obamacare and the healthcare overhaul train wreck.”

 Why it’s a lie: The same Slate journalist who followed up on the Denijs’ story found that Mr. Cox only has 4 employees. Remember, Obamacare only applies to small businesses with 49 employees or more. This was the result of Slate’s interview with Cox: ” Paul revealed that he has only four employees. Why the cutback on his workforce? “Well,” he said, “I haven’t been forced to do so, it’s just that I’ve chosen to do so. I have to deal with increased costs.” What costs? And how, I asked him, is any of it due to Obamacare? There was a long pause, after which he said he’d call me back. He never did.”

5. Congress and the President are exempt from Obamacare. 
Who told it: Lots and lots of people. I’ll choose to harp on Rep Steve Scalise (R-LA) though.

Why it’s a lie: The ACA provides insurance for people who don’t already have it through employers. Congress provides insurance to its staffers and members. So in a sense, they are exempt, it’s just the same way that most Americans are. They do not need to use the exchanges to find insurance because they already have it.

On the note of people being exempt….

4. Muslims, Amish, and some other religious groups are exempt from the law. 

Who said it: A few different sources, but it mainly came from a chain email/Facebook/meme that claims that the word “Dhimmitude” is contained in the ACA text. It claims that Dhimmitude is the “Muslim system of controlling non-Muslin populations conquered through jihad (Holy War). Specifically, it is the TAXING of non-Muslims in exchange for tolerating their presenceAND as a coercive means of converting conquered remnants to Islam!”. It also claims that “Muslims are specifically exempted from the government mandate to purchase insurance and also from the penalty tax for being uninsured! Islam considers insurance to be “gambling,” “risk-taking,” and “usury” and is thus banned. Muslims are specifically granted exemption based on this.”

Why it’s a lie: There is a “religious conscience” exemption in the ACA. But it’s not based on a religion as a whole, rather a specific sect. For example, Amish might be exempt because they have established a history of making their own provisions. Self-employed Amish, don’t, in fact, pay Social Security taxes because they don’t collect Social Security benefits. They are self-sufficient. Muslims in the US are required to have the insurances as everyone else, for example, car insurance. They do not have the same kind of history as Amish groups, so they most likely wouldn’t meet this exemption.

3. It’s possible to go to jail if you don’t pay for insurance under Obamacare. 
Who said it: On Fox and Friends on October 28th, Brian Kilmeade stated that young people will either get insurance or pay the penalty “in order to avoid prison time or whatever ramifications.”

Liar, Liar, Pants on Fire

Why it’s a lie: There is a penalty in place if you don’t have insurance through an employer and don’t get it through the exchanges or some other means–$90 or 1% of income. However, there is specifically no criminal penalty–meaning it’s impossible to go to prison. (Unless of course, you don’t pay any of your taxes, but that’s a whole different story.) Here’s what the ACA says:

In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.

2. President Obama lied when he said “If you like your coverage you can keep it.”
Who said it: Everyone. I’m not kidding. Everyone.

Why it’s a lie: So this one is tricky. Obama did, multiple times, say if you like your coverage, you can keep it. Multiple times. And the thing is, that’s not completely true. If you like your coverage, but your coverage covers absolutely nothing, then you cannot keep it. The purpose of the ACA is to make sure that every single person in the United States has affordable, adequate healthcare that won’t lead to bankruptcy if a medical emergency occurs. If you’re a healthy youngish adult, it’s completely possible to get an insurance plan that stays great if you’re healthy, but bankrupts you if something happens. So, some people won’t be able to keep their plans, because their plans are bare-bones pieces of crap from the insurance companies that barely cover a paper cut. Was it correct of Obama to say that everyone can keep their plans? No. And he deserves all the political backlash he’s receiving for that. But, does forcing people to get adequate coverage hurt anyone? Absolutely, not. It’s good for those people, it’s good for the economy, and chances are it might even be cheaper. Remember to look for the silver lining, people.

1. Obamacare is the worst thing to happen to the US since slavery.
Who said it: Dr. Ben Carson during the Value Voters Summit.

Why it’s a lie: To channel the always amazing Amy Poehler: REALLY? Really, Dr. Ben Carson, since slavery? To begin, how could you ever consider comparing a bill intended to provide healthcare to everyone to enslaving other humans. That’s not apples vs. oranges, that’s kittens vs. demons. Also, I know that a lot of us slept through US History, but this country has done a lot of horrible, horrible things since slavery. We’ve had half a dozen wars, Japanese-American internment, dropping nuclear bombs on other nations, and now I’m too angry to think of any more. But seriously, Dr. Ben Carson, how did that ever seem like a good comparison?

And I know I’m supposed to be done now, but for anyone else who wants to get really angry today, let’s remember that a very large percentage of Americans don’t even know what the ACA is. Need I remind you of this Jimmy Kimmel video?

That’s it, I’m done.

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Anneliese Mahoney (@AMahoney8672) is Lead Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

Featured image courtesy of [LaDawna Howard via Flickr]

Anneliese Mahoney

Anneliese Mahoney is Managing Editor at Law Street and a Connecticut transplant to Washington D.C. She has a Bachelor’s degree in International Affairs from the George Washington University, and a passion for law, politics, and social issues. Contact Anneliese at amahoney@LawStreetMedia.com.

The post ObamaStillCares: Top Ten Lies About the Affordable Care Act appeared first on Law Street.