JOHN BOEHNER

As the Obama administration presses ahead with the health care law, officials are bracing for the possibility that a federal judge in Virginia will soon reject its central provision as unconstitutional and, in the worst case for the White House, halt its enforcement until higher courts can rule….Virginia’s attorney general, Kenneth T. Cuccinelli II, a Republican who filed the Richmond lawsuit, argues that if Judge Hudson rejects the insurance requirement he should instantly invalidate the entire act on a nationwide basis.

Mr. Cuccinelli and the plaintiffs in the Florida case, who include attorneys general or governors from 20 states, have emphasized that Congressional bill writers did not include a ‘severability clause’ that would explicitly protect other parts of the sprawling law if certain provisions were struck down.  An earlier version of the legislation, which passed the House last November, included severability language.  But that clause did not make it into the Senate version, which ultimately became law.  A Democratic aide who helped write the bill characterized the omission as an oversight.

Without such language, the Supreme Court, through its prior rulings, essentially requires judges to try to determine whether Congress would have enacted the rest of a law without the unconstitutional provisions....Lawyers for Virginia have sought to turn one of the federal government’s arguments on its head.  They note that the health law explicitly refers to the insurance requirement as ‘an essential part’ of the act’s regulatory scheme, and that Justice Department lawyers — in pressing their point that the law permissibly regulates commerce — have called it the ‘linchpin.’  If it is so essential, Virginia’s lawyers have asked, why should a judge believe that Congress intended for the rest of the act to stand without it?  

Any illusion that the cases are not highly politicized was lost when Republican leaders raced this month to file friend-of-the-court briefs in Pensacola, and Democrats responded with briefs from state legislators and supportive economists.  Among the Republicans intervening in the case are Representative John A. Boehner of Ohio, the future speaker; 32 United States senators; and Gov. Tim Pawlenty of Minnesota, a possible presidential candidate.

We are going to do everything we can to repeal and replace the health care bill.  This is a job-killing law.  We know that from the Congressional Budget Office, we know that from Suffolk University, both of whom said 780,000 jobs can be lost.  Let’s get health care reform that doesn’t cost jobs and can bend down the cost curve.  This new law does neither of that.

One of the most fundamental ideas in the new health law is that employers should offer health insurance to their workers, or else they would have to pay a penalty, beginning in 2014.  The fear has been that many businesses would opt for ‘or else,’ leaving their workers searching for coverage....Twenty percent [of small businesses] - one-fifth - told Mercer they are ‘likely’ to stop offering health plans once people have the option of buying insurance from state-run exchanges, virtual marketplaces.

• “[The] increase in prices would make federal costs for Medicare’s drug benefit and the costs faced by some beneficiaries slightly higher than they would be in the absence of those provisions…”
• “The legislation also imposes an annual fee on manufacturers and importers of brand-name drugs. CBO expects that the fee will probably increase the prices of drugs purchased through Medicare and the prices of newly introduced drugs purchased through Medicaid and other federal programs by about 1 percent. Those increases will be in addition to the ones described above that stem from the new requirements for discounts and rebates.”
• “The premiums of drug plans will increase along with the increase in net drug prices, so the premiums paid by beneficiaries will increase slightly.”

At a news conference at the Capitol, the likely speaker, Representative John A. Boehner of Ohio, and the Senate Republican leader, Mitch McConnell of Kentucky, both said they wanted the health care law repealed and replaced.

‘I believe that the health care bill that was enacted by the current Congress will kill jobs in America, ruin the best health care system in the world and bankrupt our country,’ Mr. Boehner said. ‘That means that we have to do everything we can to try to repeal this bill, and replace it with common-sense reforms that will bring down the cost of health insurance.’ Earlier in the day, Mr. Boehner called the health care law a ‘monstrosity.’

Workers can expect to pay hundreds of dollars more for their health care coverage next year. In 2011, the combined average of premium and out-of-pocket costs for health care coverage for an employee is projected to climb to $4,386, according to an annual study by Hewitt Associates to be released this week. That's a 12.4 percent increase, or $486, over this year.

Premiums are being affected by the implementation of the new federal health care law...Next year, workers are expected to contribute about $184 a month, 12 percent more than they do now.  Their out-of-pocket costs will jump, too, rising 12.5 percent, to $181 a month in expenses, which include covering deductibles as well as co-payments and co-insurance for prescriptions and visits to the doctor.

Many Democrats are ready to publicly embrace an issue they largely ceded to Republicans and their accusations of a costly, big-government takeover.  This week, almost every big insurance company in America—including Aetna, Cigna, UnitedHealth Group, WellPoint, Humana, Coventry, some Blue Cross Blue Shield affiliates and others—stopped writing ‘child-only’ policies in the individual market....The collapse of the child-only market is a preview of what will happen when guaranteed issue and the rest of ObamaCare comes on line in 2014 for adults, except then insurers will have nowhere to flee.

The Obama administration is getting a crash course in the old axiom ‘you break it you bought it’ when it comes to their recently enacted health care plan.  The administration thought themselves clever scheduling the first wave of insurance market reforms to take effect just before the November election...Many consumers will get an initial taste of these changes this fall.  Co-pays and cost sharing will rise....the fastest way to cut costs is to reduce options, and employer plans are rolling out new products with narrow networks of doctors and hospitals. This is the irony of Obamacare.  The President promised more choice and lower prices.  We're getting the opposite.  Now that the administration has broken the private market, they will own these consequences.

Polling shows the law remains unpopular with much of the public….With crucial midterm elections six weeks away, the White House is undertaking an effort to tell people what's in the law that will help them....President Barack Obama once told Democratic lawmakers they'd be proud to campaign on historic health care legislation.  Six months later, the only Democrats running ads about it are the ones who voted ‘no.’

• ObamaCare means higher premiums, as today’s New York Times reports: “commercial insurance premiums for many people under 65 and many small businesses are increasing 10 percent to 25 percent or more.  Insurers say that a significant share of the increases is attributable to requirements of the new law, a contention that infuriates Obama administration officials and Democrats in Congress.”

• ObamaCare means if you like your health plan (too bad) you can’t keep it, according to today’s Los Angeles Times: “Major health insurance companies in California and other states have decided to stop selling policies for children rather than comply with a new federal healthcare law that bars them from rejecting youngsters with preexisting medical conditions....Insurers said they were acting because the new federal requirement could create huge and unexpected costs for covering children. They said the rule might prompt parents to buy policies only after their kids became sick, producing a glut of ill youngsters to insure.  As a result, they said, many companies would flee the marketplace, leaving behind a handful to shoulder a huge financial burden.”

• ObamaCare means higher drug costs for seniors, as yesterday’s Washington Post reported: “‘There is legitimate concern that some manufacturers will steeply increase the price of drugs in order to offset the cost of the discount to the manufacturers at the expense of both consumers and the Medicare program itself,’ the Center for Medicare Advocacy and the Medicare Rights Center said in a letter to the agency that oversees the federal health insurance program.  That agency, the Centers for Medicare and Medicaid Services, announced in August that the average monthly premium for Medicare prescription drug plans will rise next year by a dollar, to $30.”

• ObamaCare means new mandates on states that are collectively facing a $112 billion budget shortfall, as the Washington Post noted:  “[E]xperts are starting to wonder if states with depleted budgets - such as California, Oklahoma and Virginia - can keep up with the conveyer belt of grant opportunities and account for millions of dollars once the money is awarded.  Cindi Jones, director of the Virginia Health Reform Initiative, has major concerns about whether employees can keep up. ‘We have less staff doing more,’ she said. ‘It's just difficult to pull somebody off their job to write grants.  Second, when you do get grants, if you're successful, you have to have staff to manage it.’  Jones likened the process to ‘a tennis court and everyone throwing balls at you. That's what it seems like.’”

Health-insurance companies are raising rates in Colorado, ending sales of child-only policies and blaming their actions in part on the federal health reform law...

UnitedHealthcare has asked for an 8.3 percent increase in large-group plans, affecting 71,400 people; it also asked for 20.5 percent increases for 241 individuals.  Aetna, in one plan covering 22,500 people in Colorado, wants a 12.5 percent average boost. Other group plans from Aetna ask for 26.4 percent hikes covering 6,600 people...The Golden Rule Insurance Co. asked for a flurry of increases of up to 26.8 percent for nearly 2,000 people.  Colorado Choice Health Plans seeks 12.3 percent increases for large groups, which cover 2,300 people.

After claiming reform would save $143 billion over 10 years, proponents now admit - and figures confirm - that it will raise costs.  ‘Bending the cost curve on health care is hard to do,’ President Obama now explains.  This despite all the smoke and mirrors used to arrive at those rosy figures - such as projected savings from cutting waste, fraud and abuse in Medicare, which are speculative at best. Strip away the gimmicks, noted former Congressional Budget Office director Douglas Holtz-Eakin, and the $143 billion ‘savings’ turns into a $562 billion deficit over 10 years....

And the law may have unintended consequences that hurt, not help, Americans get access to health care.  Some insurers may stop offering new individual policies for children, according to the Associated Press.  The American Council on Education says it could make it impossible for universities to offer student health plans, removing an affordable option.  Polls show seniors deeply concerned about its effects on Medicare and their tax bills.

Pelosi's prediction that the law would create 400,000 jobs ‘immediately,’ like other predictions about an imminent economic rebound, is looking hollow.  The reality is that the health care law may well cost jobs, stall business expansion and dampen job growth.  Mandates could force smaller insurers out of business and make a mockery of President Obama's oft-repeated claim that ‘if you like your current coverage, you can keep it.’

[T]he Obama administration and its allies hope tough new insurance restrictions due to go into effect Sept. 23 and an accompanying public relations push will help turn the tide and give Democrats campaign-ready ammunition six weeks ahead of the midterm elections…..The Obama administration is planning multiple efforts, involving senior officials, to communicate the insurance reforms both in person and online, a White House aide told POLITICO….

The newly launched Health Information Center, a multimillion-dollar, Democrat-led effort to defend the new law, is building a ‘war room,’ a collection of fact sheets and other resources, which allies can use to defend and explain the new provisions. ‘We’re helping health care groups across the country fight back on misconceptions,’ said spokeswoman Erikka Knuti.  Groups that support the law, including Health Care for America Now, Families USA, U.S. PIRG, Young Invincibles and Main Street Alliance, plan to hold hundreds of rallies and educational events to inform voters about the new provisions.

A federal judge indicated on Tuesday that he would give a green light to a lawsuit filed by elected officials from 20 states who are challenging the constitutionality of the new health care law and its requirement that most individuals obtain medical insurance....His comments from the bench on Tuesday suggested initial skepticism of the federal government’s claim that an individual’s decision to not purchase insurance constitutes commercial ‘activity’ that can be regulated by Congress. ‘You’re trying to turn the word upside down and say activity is really equivalent to inactivity,’ Judge Vinson at one point challenged Ian H. Gershengorn, a deputy assistant United States attorney general.

At least five of the 34 House Democrats who voted against their party’s health care reform bill are highlighting their ‘no’ votes in ads back home.  By contrast, party officials in Washington can’t identify a single House member who’s running an ad boasting of a ‘yes’ vote — despite the fact that 219 House Democrats voted in favor of final passage in March.  One Democratic strategist said it would be ‘political malfeasance’ to run such an ad now....

It’s a far cry from where Democrats hoped they would be when they passed the landmark legislation in March.  Many senior Democrats said last winter that the law’s popularity would increase as Americans were able to better understand the complex law and take advantage of its benefits.

Whopping rate increases are coming soon for many people with individual health-insurance policies....Regence BlueShield's rate increase — an average 16.5 percent — was one of the highest. It was topped by Asuris Northwest Health, a Regence subsidiary, with an increase of 23.7 percent.  Group Health Cooperative, the fifth-largest insurer of individuals, was considerably lower, with an 8.2 percent increase. But its newer program, Group Health Options, asked for a 22 percent increase.

The progressive coalition Health Care for America Now fought hard to pass health care reform. Now it’s fighting hard to help reelect lawmakers who voted for the bill – even if it means not talking about it...HCAN’s field crews are finding that the best way to support reform-friendly lawmakers is to talk about something else: jobs, the economy or other issues likely to resonate with voters more....

But what HCAN describes as a tactical shift reform opponents see as proof that the law is unpopular, a loser for Democrats in a tough election cycle. ‘Voters don’t like health reform and they know that,’ says Douglas Holtz-Eakin, a former CBO director who now works with the American Action Forum on their Operation Healthcare Choice project. ‘Independents are key to control, health reform is unpopular but jobs and economy could move votes. When it comes to substance, on health reform, they’re in bad shape.’