Gregg Takes More Rational Approach To Health Care Exchanges Than Pence

One of the most pressing issues facing Indiana's next governor when he takes office next year is how the state will deal with health care exchanges, which provide a marketplace for consumers and business owners to shop for health insurance policies, mandated under the federal Affordable Care Act. U.S. Rep. Mike Pence says he doesn't want the state to set up a state-run health care exchange using federal grant money because he doesn't like Obamacare and believes its legal certainty is in doubt. In the absence of a state health care exchange, federal bureaucrats will tailor a plan for Indiana's citizens to its liking. His Democratic opponent, John Gregg, takes a more rational approach to the issue in suggesting the state should adopt some hybrid approach in conjunction with the federal government. Quoting Howey Politics, Gregg said Pence's approach would put Indiana "at the mercy of the federal government." "I want to make this clear, it does not matter whether you support the Affordable Care Act or not," Gregg said. "Whether you love it or hate it, it is the law of the land. My job as governor will be protect the best interests of the people of this state and enforce the law in a way that will benefit all Hoosiers and makes healthcare more affordable and more accessible for all Hoosiers."  Gregg accuses Pence of "abdicat[ing] his responsibility and throw[ing] Hoosiers under the federal bureaucracy bus." Here's how Gregg suggested Indiana should confront this issue:

Pence Opposed To Implementing State Health Care Exchange

Republican gubernatorial candidate Mike Pence has decided after receiving a briefing from Gov. Mitch Daniels' administration that Indiana should not implement a state health care exchange, a key component of the federal Affordable Care Act. The purpose of the state-run health care exchanges is to provide a mechanism for individuals and small businesses to purchase health insurance coverage that is mandated under Obamacare. Essentially, it would allow individuals and small businesses to compare insurance products and shop for a health insurance plan which they can afford and which best meets their needs. A basic plan would have to provide comprehensive health insurance and prescription drug benefits. Subsidies or tax credits are made available to those with low or moderate incomes to purchase health insurance.

According to Pence's statement, his view is that Obamacare "erodes the freedom of every Hoosier" and "will increase the cost of health care and cripple job creation in our state." As a consequence, he thinks "Indiana should take no part in this deeply flawed healthcare bureaucracy." Pence claims that it would cost the state $50 million per year to set up a health care exchange and that it will raise health care premiums. He also doesn't like the fact that Obamacare raises taxes on businesses, which he says will cost the state jobs. He also cites uncertainty regarding the ACA, even though the Supreme Court upheld its constitutionality earlier this summer. He seems to be banking on the election of a Republican president and Congress to repeal the Act. Pence also "hailed the Healthy Indiana Plan as an innovative, consumer-driven model that will increase access to health care and drive down the cost."

Even if you are opposed to Obamacare, it seems to me we might be biting off our nose to spite our face not to move forward with setting up a state-run health care exchange. In the absence of state action, the federal government will assume responsibility for setting up exchanges for people in states without state-run health care exchanges, which seems to be the opposite thing people who oppose the federal law dislike so much. Indiana already administers enrollment for Medicaid, CHIP and HIP so it would seem to be in a better position to tailor a plan suited for our state's needs than a bunch of bureaucrats in Washington. The federal government is providing grants to the states to set up and administer their state-run exchanges.

Cook Medical Cancels Expansion Plans Due To Obamacare Tax Increases

Bloomington-based Cook Medical had planned to open five new manufacturing plants in the Midwest, including Indiana, as part of a planned expansion, but it has shelved those plans because of a new tax that it will have to pay beginning in January under Obama's Affordable Care Act. The company says the new tax could result in the loss of 1,000 American jobs as it shifts its expansion overseas due to the unfriendly business climate Obama's administration has dealt it. From the IBJ:

Cook Medical Inc. had been planning to open five new manufacturing plants over the next five years in small communities around the Midwest, including Indiana, but has shelved those plans because of the hit it will take from a new U.S. tax on medical devices.

The Bloomington-based medical device maker estimates it will pay between $20 million and $30 million once the tax takes effect in January, Pete Yonkman, executive vice president of strategic business units at Cook Medical, said this week.

The 2.3-percent tax on sales of all medical devices was created as part of President Obama’s 2010 health reform law to help pay for its expansion of health insurance coverage to as many as 30 million more Americans. The tax is projected to raised about $2.9 billion per year . . .

Cook officials have long been critical of the medical device tax. Even before it became law, Bill Cook said it could cost the company as many as 1,000 jobs.

Since then, Cook officials have said their future growth will be focused overseas. Cook already has production facilities in Ireland, Denmark and Australia . . .

CBS News Report Confirms Roberts Switched Health Care Vote

CBS News' Jan Crawford confirms the truth behind speculation following Thursday's Supreme Court opinion authored by Chief Justice John Roberts upholding the Affordable Car Act that the Chief Justice had switched his vote after initially siding with the Court's four conservative justices to strike down the individual mandate, the cornerstone of the Act that mandates that all individuals not currently coverered by health insurance purchase a policy or pay large tax penalties to the government. Citing two sources with knowledge of the Court's deliberations, Crawford says Roberts initially sided with Justices Alito, Kennedy, Scalia and Thomas to strike down the individual mandate when the Court conferenced to discuss the case after the oral argument in March. What Roberts did not make known to the other justices during conference was whether he believed the entire Act should be struck down as unconstitutional or whether portions of the Act could be severed so portions deemed constitutional would survive as law.


Crawford claims that Roberts, unlike other justices, pays close attention to media reporting of the high court's deliberations. As Roberts felt public pressure building, he looked for a way to uphold a significant part of the law on a different ground rather than simply striking the individual mandate as an overreach of Congress' power to regulate commerce. By May, the four conservative justices became aware that the Chief Justice had grown wobbly on his stance. Crawford says her sources tell her that Roberts began lobbying Justice Kennedy to join him in upholding the law under Congress' taxing authority, an issue that had received little discussion when the case was heard in the courts below. Kennedy balked at switching his view, and he and the three other justices tried in vain to pull Roberts back to his original position for nearly a month before concluding his mind could not be changed. According to Crawford's sources, the dissenting opinion, which the other four thought would be the majority opinion was truly a joint effort with Justices Kennedy and Scalia doing most of the writing of it. She says reports that Roberts had originally written the dissenting opinion are inaccurate. To show their disapproval of Roberts' switch, the four chose to ignore his opinion according to Crawford's sources: "The fact that the joint dissent doesn't mention Roberts' majority was not a sign of sloppiness, the sources said, but instead was a signal the conservatives no longer wished to engage in debate with him."


Regardless of how you feel about the legal outcome of Obamacare, I find it very disturbing that the Chief Justice of the Supreme Court would allow public pressure to alter his decison-making process in deciding cases before the Court. Supreme Court justices are given life-time appointments to the Court to help insulate them from public pressure like the political branches of government. Theoretically, Supreme Court justices are suppose to decide cases based upon the law, not political considerations. Yet Roberts seems to have decided this case more out of concern for how he is viewed publicly than what he believes the Constitution required him to do. During his confirmation hearings, he insisted that he was not going to be a judicial activist. His critics believe that is the only way you can describe his decision to rewrite a key provision of the Affordable Care Act that expressly provided that the invididual mandate was a penalty to be read as a tax.

Crawford, incidentally, landed the first TV interview with Chief Justice Roberts after he was appointed by President Bush to the bench. She is a graduate of the University of Chicago law school and attended school when President Obama began teaching a constitutional law class at the law school as a guest lecturer. She also formerly worked as a reporter for the Chicago Tribune at the same time David Axelrod worked as a political reporter for the newspaper.

Did Chief Justice John Roberts Switch Vote At The Last Minute?

Some bloggers who follow Supreme Court opinions with more than a passing glance are finding some tell-tale signs in today's opinion affirming the Affordable Care Act that Chief Justice John Roberts had originally joined the four conservative justices (Alito, Kennedy, Scalia and Thomas) in what was going to be a majority opinion striking down the Act in its entirety. Ed Whelan at the National Review online speculates on the possibility that Roberts had actually assigned the opinion to himself and then later switched on the idea that the individual mandate was actually a tax and not a penalty as the Act expressly provides, which became the basis for affirming the Act under the Congress' general power to tax. Under this scenario, his original draft opinion striking down the law was belatedly picked up and became the dissenters' joint opinion. The dissenting opinion typically distinguishes between the justice who authored it and the justices who joined the dissenting author. The dissenting opinion today named no specific author. The Volokh Conspiracy provides even more details that suggest the dissenters' opinion was originally written as a majority opinion here. Breitbart notes an AP report claiming that Justice Anthony Kennedy was visibly angry during the reading of today's opinion, which seems rather out of character for the justice viewed as being the swing vote on the Court. Breitbart's Joel Pollack echoes this sentiment in a blog post after today's decision wondering if the Chief Justice was bullied into switching his vote by Obama. Interestingly, the day after the Court conferenced following oral arguments of the case, Obama immediately went on the offensive and began attacking the Court as if he had been provided an inside account of the Court's vote in conference on the case and the vote was not favorable to the administration's position. It was as if Obama was threatening the Court if it dared to strike down Obamacare. Most people fail to grasp the fact that Barack Obama comes from the most corrupt element of the Chicago Democratic political machine. These guys will stop at nothing to get what they want. Who knows how they would have threatened Roberts. You can bet that Axelrod and Company has a dossier on every member of the Supreme Court, as well as virtually every member of Congress.

Pence Compares Obamacare Decision To 9/11 Terrorist Attacks

Republican gubernatorial candidate Mike Pence is quickly backtracking on a comment he made to colleagues earlier today comparing today's Supreme Court decision upholding the Affordable Care Act to the 9/11 terrorist attacks. The Star's Mary Beth Schneider has Pence's apology issued after Politico first reported on the comments he made while speaking at the House Republican Conference following today's decision:

“I made an unfortunate statement,” Pence said. “Let me just say my remarks at the Republican Conference, following the Supreme Court decision, were thoughtless.”

Pence, in a call with Indiana reporters, did not address whether he was comparing the justices to terrorists.

Instead, he said he “certainly did not intend to minimize any tragedy our nation has faced, and I apologize.”

Asked for the context of his remarks, Pence said he made the comments at the GOP meeting within an hour of the Supreme Court decision being announced.

“I had the opportunity as a former chairman of the conference to address the group. As I said, my remarks following the Supreme Court decision were thoughtless and I never intended to minimize any tragedy our nation has faced and I apologize,” he said. “I certainly did not intend to make any such comparison (of the ruling to the 9/11 terrorist attacks) but let me just say to the extent that it’s been reported, to the extent that people interpreted my remarks that way, I apologize.”

I suppose some would agree with the similarities, particularly the 9/11 Truthers who remain convinced that our own government was at least complicit, if not a participant in a false flag operation intended to seize more government control over the American people's lives. If you agree with the four justices who dissented in today's Supreme Court decision, you see today's decision as placing "liberty at peril." Be that as it may, Pence's comments will be seized upon by his critics as a further indication that he is too much of an extremist to serve as our state's governor. Indiana Democrats, meanwhile, put out a press release applauding Chief Justice John Roberts for setting aside partisanship and voting to uphold the Affordable Care Act. The executive director of the Democratic National Committee was less diplomatic in reacting to today's decision. "It's constitutional, Bitches," Patrick Gaspard tweeted. He followed up by saying that he let his excitement "get the better of me."

Obamacare Survives

The political pundits and prognosticators really missed this one. The U.S. Supreme Court today upheld the Affordable Care Act, also known as Obamacare, in its entirety. Chief Justice John Roberts joined liberal members of the Court in finding that the individual health insurance mandate, the cornerstone of the Act, was a constitutionally permitted tax on Americans even if it does violate the Commerce Clause of the U.S. Constitution. The Act requires Americans who fail to obtain health insurance to pay a penalty to the IRS. Although the Act describes the payment as a penalty and not a tax, a majority of the Court determined that it was still a tax, although not within the meaning of the Anti-Injunction Act, which prohibits lawsuits restraining the assessment or collection of a tax. While the opinion delivered by Chief Justice John Roberts found that the individual mandate violated the U.S. Commerce Clause, the majority found that the authority for the individual mandate could be found in Congress' taxing power. The Court's opinion does impose some restrictions on the portion of the Act expanding Medicaid coverage but still upholds that portion of the Act as well as long as federal funding is not withheld from states that don't go along with the expanded Medicaid coverage provided by the Act. Justices Alito, Kennedy, Scalia and Thomas wrote in a dissenting opinion that they would have struck down the Act in its entirety based on their view that Congress had exceeded federal power both in mandating the purchase of health insurance and in denying all nonconsenting states their federal funding for their respective state Medicaid programs.

UPDATE:  The dissenter's opinion argues that a tax and a penalty are mutually exclusive. The Act clearly defines a "penalty", not a "tax" that affected Americans must pay if they choose not to purchase health insurance. And yes, it only applies to Americans. Undocumented aliens and prisoners will not be subject to the "penalty," but as we know, health care providers cannot deny services to undocumented aliens, which results in the government (i.e., the American taxpayers) picking up their health care tab. As the dissenting opinion points out, a penalty is "a punishment for an unlawful act or omission." "[T]o say that the Individual Mandate merely imposes a tax is not to interpret the statute but to rewrite it," the dissent opines. Indeed, the Obama administration repeatedly argued during oral argument that it was not imposing a new tax on Americans. Nonetheless, the majority opinion written by the Chief Justice upholds it on that basis despite the contrary language used by Congress and the interpretation offered of it by the administration. The dissenting opinion is also very critical of the Medicaid expansion that essentially extorts the states into helping finance the massive expansion of the program by threatening to withhold funding for their existing Medicaid programs. "The fragmentation of power produced by the structure of our Government is central to liberty, and when we destroy it, we place liberty at peril," concludes the dissenters.