Trump's Full Court Press on healthcare

[LawBeefaroni]

Health care doesn’t force policy choices on its insureds. It’s a legitimate medical care even if you don’t believe in treatment.

I think we're about to be told that's not the case. Our robed tyrants have already hinted that the policy of the federal government shouldn't be stepping on people's "Christians" religious beliefs.

They'll argue that it forces them to pay for treatments (for others) that go against their beliefs.

Lose the tax exempt status for religious organizations and then we can talk.

[Smoove_B]

Going to post this here as I think it applies:

US District Judge Reed O’Connor in Texas rules that requiring employers to provide coverage for PrEP drugs (preventing the transmission of HIV) violates the religious rights of employers under federal law (RFRA). O’Connor also rules that the U.S. Preventive Services Task Force (PSFT) violates the Appointments Clause because he finds the members are officers of the United States not appointed properly.

Deeper dive:

There are so many bombs sewn into this ruling.

1. O'Connor says members of the Preventive Services Task Force—which requires insurers to provide preventive coverage, including vaccines and cancer screenings—are appointed illegally. Which may render their mandates unlawful.

O'Connor wants "further briefing on the appropriate remedy." One fix would be for the Secretary of HHS to simply "ratify" the work of the Preventive Services Task Force.

But O'Connor says the secretary *cannot* ratify its work. So his remedy might just destroy the task force.

2. O'Connor also suggests that the *entire government infrastructure* currently regulating private insurers is illegal. Not just the Preventive Services Task Force, but also the Advisory Committee on Immunization Practices and the Health Resources and Services Administration.

Invalidating the PSTF, ACIP, and HRSA would undo a huge portion of the Affordable Care Act, freeing private insurers from the obligation to provide so much basic coverage—again, we're talking vaccines, pregnancy care, cancer screening and treatment ... The list is nearly endless.

Of course, Reed O'Connor is the same judge who tried to strike down the entire Affordable Care Act in 2018.

He was reversed 7–2 at the Supreme Court.

Now he's trying again. This approach is definitely iffy, but it has a better shot at success IMO.

3. Turning back to PrEP:

O'Connor accepts that it "encourages homosexual behavior, drug use, and sexual activity"—a contested claim backed by no empirical evidence.

But he says that if the plaintiffs believe it, the courts must accept it—they can't question its "correctness."

O'Connor says that courts must accept tendentious empirical claims backed by zero evidence if religious people believe them to be true. That goes a step beyond what the Supreme Court did in Hobby Lobby. It totally dismisses the value of provable facts in religious freedom claims.

Then O'Connor says that requiring insurers to cover PrEP—which radically reduces the risk of HIV infection—is not a "compelling government interest" under the Religious Freedom Restoration Act.

No compelling interest in protecting as many people as possible against HIV? Really?

Today's ruling seeks to strip patients of guaranteed coverage for HIV prevention. That, in itself, is alarming.

But it's also Reed O'Connor's next effort to overturn much of the Affordable Care Act. It's about so much more than PrEP. This is an assault on the ACA, period. /end

[LordMortis]

Conner, Cannon... Roberts... what's the difference? The best we can hope for is this is not forgotten and the voters understand how judicial was pretty much FUBAR after 2015.

[malchior]

Let me also guess that this judge is one of a few judges in some backwater district court. We all missed part of the plan over the last few years. We knew they were stacking the courts but I don't think anyone really had a view on what might be the fuller plan. Which is funneling meaningful cases to radical unethical judges (don't dare call them activist!) to take broad chops at the system.

[Smoove_B]

Let me also guess that this judge is one of a few judges in some backwater district court.

From his Wiki page:

O'Connor has become a "go-to" favorite for conservative lawyers, as he tends to reliably rule against Democratic policies. Attorneys General in Texas appear to strategically file cases in O'Connor's jurisdiction so that he will hear them.

Of note:

He was nominated by President George W. Bush in 2007.

All part of the long-con.

[stessier]

Seems as good a place as any.

[LawBeefaroni]

Seems as good a place as any.

You know why it's not a headline in every newspaper? Break it down by race. We are just fine with social inequity and healthcare disparities.

[Daehawk]

People cant afford doctors and healthcare. Simple. Bring in free healthcare and if the republicans dont like it then they dont have to get it.

[Kraken]

Wife and I are currently in a ridiculous hall of mirrors over medical bills incurred because we didn't get referrals...to a medical practice that we've been using for over 10 years. They got taken over by a conglomerate and changed their name, and now our insurance company doesn't like them anymore. We've straightened this out twice, according to our primary care office, but the provider that needs the referrals insists that they FAX paper. I tried for the third time to get them to do that just this morning.

So ridiculous. No other advanced country has such a convoluted system of referrals, in- and out-of-network providers, copays and deductibles, and all that tommyrot.

[LawBeefaroni]

People cant afford doctors and healthcare. Simple. Bring in free healthcare and if the republicans dont like it then they dont have to get it.

Doesn't work that way. You need buy-in across the board otherwise you will still have huge disparities.

All the sickest/highest risk will go for the free option because they'll be priced out of the private ones. The public system will get overwhelmed and providers will opt out since the reimbursement will he terrible and they'll get all the worst outcomes dumped on them.

We kind of already have this with Medicaid. So are we talking about just expanding Medicaid eligibility?

[LordMortis]

Wife and I are currently in a ridiculous hall of mirrors over medical bills incurred because we didn't get referrals...to a medical practice that we've been using for over 10 years. They got taken over by a conglomerate and changed their name, and now our insurance company doesn't like them anymore. We've straightened this out twice, according to our primary care office, but the provider that needs the referrals insists that they FAX paper. I tried for the third time to get them to do that just this morning.

So ridiculous. No other advanced country has such a convoluted system of referrals, in- and out-of-network providers, copays and deductibles, and all that tommyrot.

That's one nice thing about being on a PPO and probably will be largest contributing reason I elect to stay on COBRA for another year before going to the ACA.

[LawBeefaroni]

They got taken over by a conglomerate and changed their name, and now our insurance company doesn't like them anymore.

It's likely that the new owner's contracts with the insurance company pay them more than before so they insurance company is trying to control cost by controlling access.. Previously your providers may have been paid X, now they're getting, say, 1.30X. Or they simply don't have a contract with the insurance company, although in that case usually a referral wouldn't solve.


And yes, faxes are still a thing in healthcare for some reason. I just had a large national insurance company require we send records via fax. Over 500 pages, took one person an entire day to send (couldn't send all at once, needed separate covers). They flat out refused any other method including physical delivery of paper or thumb drive. And every provider office still has a fax.

[Kraken]

They got taken over by a conglomerate and changed their name, and now our insurance company doesn't like them anymore.

It's likely that the new owner's contracts with the insurance company pay them more than before so they insurance company is trying to control cost by controlling access.. Previously your providers may have been paid X, now they're getting, say, 1.30X. Or they simply don't have a contract with the insurance company, although in that case usually a referral wouldn't solve.


And yes, faxes are still a thing in healthcare for some reason. I just had a large national insurance company require we send records via fax. Over 500 pages, took one person an entire day to send (couldn't send all at once, needed separate covers). They flat out refused any other method including physical delivery of paper or thumb drive. And every provider office still has a fax.

The new master, Mass General Brigham, is the largest and most expensive healthcare organization in MA. BCBS tries to steer members clear of them as they are never a preferred provider, but they're too big to shun.

Our PCP explained that when they enter the referral into their system, it will update BCBS's records, and BCBS will reprocess the claim. BCBS confirmed by phone that this is so. While I stood watch yesterday, the PCP office manager entered the referral and got confirmation that it was approved, which she printed out for me. But the eye doctor who keeps billing me insists that somebody has to fax them a piece of paper. The PCP lady promised that she would, but IDK if she followed through. I'm probably going to end up having to pay the damned bill. This is our third attempt to fix it and I'm still not confident that I succeeded. (Wife has an identical situation with a different doc at the same eye practice).

This is stupid. I want socialism.

[Smoove_B]

To bring this to a close:

Judge Reed O'Connor STRIKES DOWN a major provision of the Affordable Care Act requiring insurers to cover a vast amount of preventive care cost-free (contraception, cancer screening, PrEP, a ton of pregnancy-related care). The ruling applies nationwide.

...

O'Connor rules that the U.S. Preventive Services Task Force—the federal agency that decides which medical care all insurers must cover—is unconstitutional because it violates the Appointments Clause, and invalidates its power to enforce anything against anyone nationwide.

I anticipated this decision in September when O'Connor first telegraphed it. It is nothing short of catastrophic to the U.S. health care system. Millions of Americans, including many pregnant women, will have to forgo basic care if it is upheld.

One correction, this decision on its face down not overturn the full contraception mandate (yes). Just everything else.

[Kraken]

We already have the most expensive health care system with the worst outcomes (life expectancy, infant mortality) among peer nations, so -- let's make it even worse!

[malchior]

Cool. Anyone want to pretend this country isn't in the midst of an existential crisis? No reasonable peer country would allow cases of this importance to be transparently funneled to corrupt ideologues who aren't afraid to abuse their power.

We already have the most expensive health care system with the worst outcomes (life expectancy, infant mortality) among peer nations, so -- let's make it even worse!

This could be cross-posted to the Live Free and Die thread. Same thing with the post about North Dakota and lunches for children. It's all connected. Life expectancy is dropping because our society is breaking down. Quickly.

As an aside, we should expect this to be eventually overturned....maybe next year...but in the meantime the rapacious insurance companies may do everything they can do to capture profits in the meantime at the expense of people's health.

[LawBeefaroni]

As an aside, we should expect this to be eventually overturned....maybe next year...but in the meantime the rapacious insurance companies may do everything they can do to capture profits in the meantime at the expense of people's health.

That would be extremely short sighted of them. Contraception, cancer screening, etc. lower costs mid to long term.

[malchior]

As an aside, we should expect this to be eventually overturned....maybe next year...but in the meantime the rapacious insurance companies may do everything they can do to capture profits in the meantime at the expense of people's health.

That would be extremely short sighted of them. Contraception, cancer screening, etc. lower costs mid to long term.

True but that might be a feature for them. Increased costs sometimes turn into increased premiums and profit. Not reliably but short-term thinking for immediate profits is pretty prevalent nowadays.

[El Guapo]

As an aside, we should expect this to be eventually overturned....maybe next year...but in the meantime the rapacious insurance companies may do everything they can do to capture profits in the meantime at the expense of people's health.

That would be extremely short sighted of them. Contraception, cancer screening, etc. lower costs mid to long term.

True but that might be a feature for them. Increased costs sometimes turn into increased premiums and profit. Not reliably but short-term thinking for immediate profits is pretty prevalent nowadays.

Decent chance that this gets stayed pending appeal, though.

Is this the usual Texas judge that the conservatives funnel ACA and other similar cases to?

[malchior]

As an aside, we should expect this to be eventually overturned....maybe next year...but in the meantime the rapacious insurance companies may do everything they can do to capture profits in the meantime at the expense of people's health.

That would be extremely short sighted of them. Contraception, cancer screening, etc. lower costs mid to long term.

True but that might be a feature for them. Increased costs sometimes turn into increased premiums and profit. Not reliably but short-term thinking for immediate profits is pretty prevalent nowadays.

Decent chance that this gets stayed pending appeal, though.

It's fifth circuit. It may come down to the panel so...maybe? The most MAGA circuit in the land.

Is this the usual Texas judge that the conservatives funnel ACA and other similar cases to?

Correct. He struck down all of ACA in the past.

[waitingtoconnect]

Cool. Anyone want to pretend this country isn't in the midst of an existential crisis? No reasonable peer country would allow cases of this importance to be transparently funneled to corrupt ideologues who aren't afraid to abuse their power.

Sadly most countries do this. In the US it’s actually more transparent because the media is still competitive whereas in the Uk and Australia it’s far far more insidious because the media is mostly far right wing.

[El Guapo]

Cool. Anyone want to pretend this country isn't in the midst of an existential crisis? No reasonable peer country would allow cases of this importance to be transparently funneled to corrupt ideologues who aren't afraid to abuse their power.

Sadly most countries do this. In the US it’s actually more transparent because the media is still competitive whereas in the Uk and Australia it’s far far more insidious because the media is mostly far right wing.

Do you know whether it's possible in the UK and Australia to virtually pick your judge by filing in a given location? That's the part of the system here that really needs to be fixed (you know, if our system was still capable of fixing problems).

[Pyperkub]

Yup, how Pro-Life policies impact health care

https://boingboing.net/2023/03/31/secon ... abies.html

Hospitals who don't deliver babies.

Call the Midwife!

Sent from my SM-S908U1 using Tapatalk

[malchior]

Do you know whether it's possible in the UK and Australia to virtually pick your judge by filing in a given location? That's the part of the system here that really needs to be fixed (you know, if our system was still capable of fixing problems).

Yeah. I feel like many people don't know how bad this situation is. It might be the worst in the 5th circuit but it is also present in the 10th and 9th to some degree. The judicial leadership in certain districts appears to be politicizing the process by intentionally assigning single-coverage areas with specific judges that make it easy to target them with pet lawsuits. Anti-abortion lawsuit? Funnel it to Judge Matthew Kacsmaryk by filing it in Amarillo. Anti-ACA? Funnel it to Judge Reed O’Connor by filing it in Fort Worth. Are you a former President looking for some delay in your national security case? Funnel it to Aileen Cannon by filing it in St. Petersburg.

[Smoove_B]

I'm putting this here because it's they type of political cancer that has metastasized from all things Trump:

Should you be turned away from medical care because a provider has a moral or ethical objection to something about you? You could be — under a bill that is likely headed for the House floor next week.

House Bill 819, which sponsors call the Medical Ethics Defense Act, would allow any healthcare provider, hospital or institution, or insurer or other payer to refuse to provide care or service to any person if the provider has a "religious, moral or ethical" objection to doing so. The GOP-backed measure passed the House Health committee Thursday.

The bill reiterates a decade-old state law that allows any healthcare provider to object to performing abortions on religious grounds. However, H819 goes far beyond abortion to allow the refusal of any type of care to any person. That could include refusal of care to patients based on sexual orientation, gender identity, or even political opinions or marital status, opponents say.

[Victoria Raverna]

Is there a limit on which religion? If not then anyone can create new religion and religious reasons as needed to refuse to provide service for any reason they want.

[malchior]

Sure why not. Let's add another fudge factor to our terrible health care system. Maybe they can add a screening option in my insurance portal for procedures Doctors won't do because of their personal interpretation of thousands-year old texts. I'd bet money that nearly all of them will only impact women and marginalized groups.

[Unagi]

Is there a limit on which religion? If not then anyone can create new religion and religious reasons as needed to refuse to provide service for any reason they want.

That's kinda the whole problem. And yet, there are a few big religions already in place, ones people don't need to create, that already are backed by texts that describe horrible ancient views and avenues for discrimination.


Our world extends a 'blank check' to "religious beliefs" that we do not allow in any other part of our life. We let actual facts be pushed around by people who 'feel differently' about it.

[Unagi]

(and I didn't even read Malchiors response yet)

[Unagi]

I'd bet money that nearly all of them will only impact women and marginalized groups.

nearly all? I would take that bet - and say that I bet 100% of them will only impact women and marginalized groups.

[RunningMn9]

Is there a limit on which religion? If not then anyone can create new religion and religious reasons as needed to refuse to provide service for any reason they want.

It doesn’t need to be religious. You can object to anything you want on moral or ethical grounds.

Let it pass, and immediately refuse to treat Christian conservatives on moral/ethical grounds.

[Smoove_B]

Yes, they're still coming for the Affordable Care Act in 2024:

A federal appeals court on Friday found unconstitutional a key component of the Affordable Care Act that grants a health task force the effective authority to require that insurers both cover an array of preventive health interventions and screenings and refrain from imposing out-of-pocket costs for them.

The lawsuit centered on the objections of a coalition of small businesses in Texas to the requirement that they cover a drug for HIV prevention, known as PrEP, in their employee health plans. The appeals court did not, however, overturn the related ACA pillar; the practical, immediate impacts of its ruling apply narrowly to the plaintiffs in this case.

Of note:

Legal experts expect that the case, Braidwood v. Becerra, will ultimately advance to the Supreme Court, given that it poses crucial questions about the constitutionality of the health task force’s effective authority and that of other federal health bodies. Additionally, the current court has demonstrated interest in cases concerning the delegation of congressional authority to agencies and experts.

In response to Friday’s ruling from the 5th U.S. Circuit Court of Appeals in New Orleans, public health advocates expressed concern that, should the Supreme Court ultimately void the task force’s authority, this could compromise the nation’s already sluggish HIV fight.

[Kraken]

The ACA has succeeded at expanding coverage and reining in costs, so of course Republicans hate it...even though it enshrines for-profit insurance in law.

[Blackhawk]

Between this and Medicare, I have a feeling that by the time I reach an age to take full advantage of it, they'll have implemented the affordable treatment option of suicide booths for the poor.

[Isgrimnur]

Between this and Medicare, I have a feeling that by the time I reach an age to take full advantage of it, they'll have implemented the affordable treatment option of suicide booths for the poor.

Only after they've worked you to the point of uselessness.

[Blackhawk]

Between this and Medicare, I have a feeling that by the time I reach an age to take full advantage of it, they'll have implemented the affordable treatment option of suicide booths for the poor.

Only after they've worked you to the point of uselessness.

I'm on disability. I qualify for the waiver to expedite.

[LordMortis]

Between this and Medicare, I have a feeling that by the time I reach an age to take full advantage of it, they'll have implemented the affordable treatment option of suicide booths for the poor.

Only after they've worked you to the point of uselessness.

Wait. They did that to me a few years ago. Wudderyatrina say?

[Brian]

Between this and Medicare, I have a feeling that by the time I reach an age to take full advantage of it, they'll have implemented the affordable treatment option of suicide booths for the poor.

Only after they've worked you to the point of uselessness.

Wait. They did that to me a few years ago. Wudderyatrina say?

Happy Carousel Day, citizen.

[LordMortis]

/waves... No... Wait...

[Pyperkub]

Assumes 5th Circuit batshittery.

Reads article... Yup.