Court ruling on ACA muddies the future of the health care law

The U.S. Court of Appeals for the Fifth Circuit in a 2-1 decision ruled the individual mandate of the Affordable Care Act (ACA) unconstitutional and instructed the lower court, which had previously held the ACA unconstitutional, to determine whether the remaining portions of the ACA can stand.

“APIAHF is extremely disappointed in the court’s decision that puts the health of millions of Americans at risk, said Juliet K. Choi, senior vice president for government & external relations of APIAHF. 

The Fifth Circuit Court of Appeals in New Orleans ruled that the ACA's individual mandate is unconstitutional, but stopped short of saying that the entire Obama-era law is invalid.

“The Fifth Circuit’s decision against the ACA could potentially disrupt our entire American health care system by leaving the decision to a sole judge who had already ruled against the ACA.," Choi said.

The Democratic attorneys general, led by California, who have intervened in the case shave already indicated that they will appeal the decision to the Supreme Court.

If the Supreme Court chooses to hear the case, Texas v. United States, right away, the ACA's fate could become the centerpiece of the 2020 presidential election. 

If the SCOTUS justices wait until the lower court rules, the future of Obamacare would remain in limbo for years.

The opinion from the U.S. Court of Appeals for the Fifth Circuit is an embarrassment, both to the Republican-appointed judges who put their names to it and to the federal judiciary as a whole, reports The Atlantic. (The third judge on the panel, appointed by Jimmy Carter, dissented vehemently.)

Since the implementation of the ACA, sometimes referred to as Obamacare, the coverage disparity between whites and Asian Americans and Pacific Islanders had virtually disappeared.

Anticipating the matter will head to the U.S. Supreme Court, Choi said, "It is unlikely the Court would hear the appeal before the 2020 Elections, which underscores the need to elect leaders that will ensure our health care is protected.”

APIA Health Forum: Trump tax bil will have a negative impact on health care.

SCREEN CAPTURE / NBC

Around 2:30 a.m., Dec. 2, the U.S. Senate approved the controversial tax reform bill.

The U.S. Senate passed a horrendous tax reform bill that will change America for decades if signed by Donald Trump. It was written up in secret, amended at the last minute and voted upon in the early morning hours of Saturday, Dec. 2.

Although called a tax bill, its impact on health care will impact Americans for decades by eliminated the individual mandate of the Affordable Care Act, sometmes referred to as Obamacare. 

RELATED: Asian American senators decry the tax vote

On Saturday afternoon, the Asian & Pacific Islander American Health Forum issued the following press release:

"Today, the Asian & Pacific Islander American Health Forum (APIAHF) released a statement following the Senate's passage of tax legislation, including an amendment to repeal the individual mandate of the Affordable Care Act (ACA). Due to the repeal, an estimated 13 million people will lose their health insurance.

"'It is shameful that in the midst of open enrollment as millions of Americans head to the Affordable Care Act's marketplace to get coverage they can rely on, the Senate has voted to partially dismantle that same coverage in order to pass tax cuts that benefit the wealthiest in our nation, while adding an estimated 1 trillion dollars to our deficit,' said Kathy Ko Chin, APIAHF president and CEO. 

"This is dangerous for communities, such as Asian Americans, Native Hawaiians, and Pacific Islanders, who disproportionately face disparities and barriers in accessing health insurance and utilizing health care. 
"The increase to the deficit will also lead to automatic future spending cuts to certain programs like Medicare and the Prevention and Public Health Fund. Health care must be affordable and available for all. We will work alongside other health advocates in calling on Congress to listen to their constituents and heed the call to protect our care.

"Since the ACA became law, the individual mandate has helped to reduce the uninsured rates for Asian Americans, Native Hawaiians and Pacific Islanders (AA and NHPI) by half. The Congressional Budget Office estimated repealing the mandate will lead to 13 million people losing their health insurance and premiums will increase by 10 percent. 

"Many AAs and NHPIs disproportionately experience a range of chronic conditions that, prior to the ACA, were considered pre-existing conditions that required routine access to preventive care and treatment. Before the ACA, many groups, such as Korean, Indonesian and Micronesian Americans had uninsured rates above 20 percent.

"The House plans to vote on the tax bill (this week) and must work with the Senate to reconcile differences. If passed, the bill will then move to President Trump for signature, setting the stage for further attacks on health care programs in 2018.

"APIAHF urges the House to reject the Senate Bill and to stand up for the constituencies they represent."

The House in a 222-192 vote on Monday (Dec. 3) voted to approve a motion to go to conference with the Senate on tax legislation.

The people responsible for Americans' health issued a joint statement this month, the American Psychiatric Association, American College of Physicians, American Congress of Obstetricians and Gynecologists, and American Academy of Pediatrics, among others, voiced strong opposition to the GOP's tax proposal.

The American Hospital Association approved of some portions of the bill that included the tax-exemption for nonprofit hospitals, but was also dismayed at the elimination of the individual mandate.

"We are also disappointed that the tax legislation passed with a provision that would eliminate the individual mandate, which would result in the loss of health insurance coverage for millions of Americans," said an AHA statement. "The goal of the ACA was to extend coverage and, as a result, millions have benefitted from access to needed care. We must protect that access to care for those who need it and ensure the most vulnerable patients are not left behind."

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Profiles in Disapppointment - Sen. John McCain

The John McCain memorial in Hanoi

IN A RECENT TOUR of Hanoi, our tour bus cruised past a memorial commemorating McCain's imprisonment. The bus didn't stop, didn't even pause for photographs. By the time the guide announced it, we were way pass the monument to see the details. 

Sitting in the back seat of the bus, I was able to get a better look than others on the bus and managed to click a few shots of the memorial. 

I couldn't believe what I saw. The memorial was of a man being hung by his arms, head bowed. That was John McCain and the reason the senator can't raise his arms above his shoulders to this day. The torture he endured in his six years as a POW during the Vietnam War is unimaginable.

McCain's heroism and patriotism cannot be questioned. But Donald Trump ridiculed the hero during the 2016 presidential campaign. "I like people who were not captured," he said.

Sen. John McCain giving his speech Tuesday.

I have had so much respect for the man since he first ran for office. That's why I'm disappointed in the John McCain of 2017.

Senator McCain gave one of his best speeches today (July25) when he spoke in front of the Senate after the vote to open debate on the House's Trumpcare bill that would have 22 millioin people lose their health insurance.

Just days after an operation, Arizona's senator gave an emotional speech seemingly rebuking the GOP's procedure that created a health plan behind closed doors. “I. Will. Not. Vote. For. This. Bill. As it is today," he pronounced emphatically. "It's a shell of a bill right now. We all know that.”

A few hours later, he inexplicitly voted for the Republican-sponsored Better Care Reconciliation Act—the Trumpcare bill McCain said he would could not support. Fortunately, the Republicans lost that vote, 43-57, far short of the to votes needed to pass. (It would be 50-50 and then Veep Pence would break the tie as he did in the vote to open debate.)

McCain has not hesitated to criticize Trump, especially in regards to the Russia connection. He has questioned Trump's knowledge on national security issues and foreign relations. McCain has even been the target of Trump's slings when Trump rediculed the former prisoner of war's service record.

But when it comes to a vote, as in the Obamacare repeal vote, McCain has consistently followed the party line, choosing party over country.

McCain's own state is one of 31 states that expanded Medicaid under the ACA, and Republican Gov. Doug Ducey is worried about tens of thousands losing their health insurance. His constituents would applaud him if McCain voted against any version of Trumpcare and instead helped the Democrats fix the flaws in the ACA.His vote Monday to repeal the current health care law even though there is no plan to replace it, was in stark contrast to the inspirational words that he uttered earlier in the day.

McCain blasted the way Republican leaders conjured up the healthcare proposal, “coming up with a proposal behind closed doors in consultation with the administration, then springing it on skeptical members, trying to convince them that it was better than nothing.

“I don’t think that’s going to work in the end, and it probably shouldn’t,” he said.

“I. Will. Not. Vote. For. This. Bill." proclaimed McCain. 

The senator will have a chance to redeem himself in the coming days when Trump and the GOP try to repeal Obamacare or make it so watered down it will be doomed to fail. Words - no matter how noble or eloquent -- ring hollow and mean absolutely nothing if they are not turned into action.

UPDATED: This date was updated to clarify the Senate vote that took place Tuesday night.

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Anti-ACA Tom Price approved by Senate in late night vote

Rep. Tom Price

REP. TOM PRICE, the man who will lead the charge in doing away with the Affordable Care Act, was approved by the GOP-dominated Senate late last night when most Americans were fast asleep.

Price won confirmation on a party-line vote of 52-47, which came around 2 a.m. Friday. Senate Democrats, united in their opposition to him as the government’s top health official, argued that the intersection of his personal investments and legislative behavior warranted deeper scrutiny of his ethics.

"The Asian American and Pacific Islander community has seen the greatest decrease in our uninsured rate--by 59 percent--under the ACA, the largest of any racial group nationally," said Doreena Wong, director of Advancing Justice-LA's health access program."

"And consistently, AAPIs have expressed significant support for the ACA, even across party lines -- for example, a poll in Spring 2016 found that 76 percent of Asian/American voters supported the ACA, including 60 percent of those identified as Republican. A repeal of the ACA means that hundreds of thousands of our community members stand to lose critically needed health coverage," said Wong.

The nomination of the Georgia congress member was opposed by the Congressional Tri-Caucus – which is composed of the Congressional Asian Pacific American Caucus (CAPAC), the Congressional Black Caucus, and the Congressional Hispanic Caucus. The three groups sent a letter to the Senate Committee on Finance and the Senate Committee on Health, Education, Labor and Pensions (HELP), urging them to oppose the nomination of Rep. Tom Price to be Secretary of Health and Human Services.

“Throughout his career in Congress, Rep. Price’s words and actions have not aligned with the health priorities of minority communities. He has consistently supported changes to the Affordable Care Act, Medicare, and Medicaid that will have devastating impacts on the communities that we represent,” the Members wrote.

The letter discussed Rep. Price’s strong opposition to the Affordable Care Act, a critical piece of legislation that has allowed millions of African Americans, Latinos, and AAPIs to gain access to quality, affordable health care. The congressional members also highlighted Price’s proposals to make drastic changes to Medicare and Medicaid that would disproportionately hurt communities of color.

Price, an orthopedic surgeon, claims that “nothing has had a greater negative effect on the delivery of health care than the federal government’s intrusion into medicine through Medicare.” Of course, the exact opposite is true. Medicare saves lives. It allows seniors and people with disabilities, those with the greatest health needs, to obtain life-saving health care.

If he tries to do away with Medicare, one of the most successful of the government programs, the Baby Boomers who are aging into their retirement years, will be greatly affected.

The GOP has no plan to replace the ACA, also known as Obamacare. Trump said that it would take at least year, or two, before the Obama initiative could be completely dismantled.

Ironically, despite GOP attacks, the ACA has seen its enrollment increase this past enrollment period. Over 20 million people have enrolled.

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AAPI oppose Obamacare critic as head of Health & Human Services

 Rep. Tom Price might become Secretary of Health & Human Services, 

DONALD TRUMP may have found his hatchet man to do away with Obamacare and render Medicare and Medicaid ineffective. Trump's choice of  Rep. Tom Price, R-Georgia, for Secretary of Health & Human Services has drawn sharp criticism from Asian/Americans. 

Price's nomination signals the President Donald Trump's determination to give private health insurance a way to fatten their bottom line while doing away with the all the major health care benefits government has developed in the last 50 years.

In other words, the incoming administration appears to be ready and willing to destroy the American health care system as we know it.

Whose health coverage will be the most affected? Millions of seniors, low-income families and children, including many of the people who voted for Trump.

Asian Americans Advancing Justice opposes the nomination of Price. As a member of Congress, Rep. Price has been one of the lead critics of the Patient Protection and Affordable Care Act (ACA) and has repeatedly attempted to repeal or gut the ACA.

Among Price’s most dangerous proposals are limiting tax credits for the poor, privatizing Medicare, barring federal funding to Planned Parenthood, and converting Medicaid to block grants which would pretty much negate its role as a safety net program.

Price and the Republicans want Medicare to whither away. Before Medicare was enacted in 1962, a whopping 48% of seniors lacked health insurance as opposed to only 2 percent today.

Despite overwhelming approval of Medicare by the American public, Price has been consistent in his ideological opposition. "Nothing has had a greater negative effect on the delivery of health care than the federal government’s intrusion into medicine through Medicare," he said. 

Since implementation in 2010, the ACA has given 20 million previously uninsured Americans access to critical health care services. Among the ACA’s success stories is the significant increase in health insurance coverage amongst Asian Americans and Pacific Islanders (AAPI). Repealing the ACA would likely double the uninsured rate to 19.4 percent and cost an estimated 24 million people their health coverage.

"The Asian American and Pacific Islander community has seen the greatest decrease in our uninsured rate--by 59 percent--under the ACA, the largest of any racial group nationally," said Doreena Wong, director of Advancing Justice-LA's health access program."

"And consistently, AAPIs have expressed significant support for the ACA, even across party lines -- for example, a poll in Spring 2016 found that 76 percent of Asian/American voters supported the ACA, including 60 percent of those identified as Republican. A repeal of the ACA means that hundreds of thousands of our community members stand to lose critically needed health coverage," said Wong.

Although Republicans plan to cut Medicaid — the primary program providing health care to low-income individuals , Price’s plans for Medicaid are even worse. His latest budget proposalwould have repealed Medicaid expansion entirely, without replacing it.

Eventually, Republicans would phase out Medicaid, leaving the poorest to fend for themselves.

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