On Tuesday, House Budget Committee Chairman Paul Ryan, R-Wis., [released] a budget blueprint that tackles the three big health care challenges facing the federal budget — ObamaCare, Medicare and Medicaid – with a strategy of repeal, vouchers and block grants. Done properly, those steps would simultaneously improve health care and help balance the budget within a decade. …

… the budget should complete the successful 1996 welfare reforms by eliminating the entitlement to Medicaid benefits, converting federal Medicaid and Children’s Health Insurance Program funding into fixed block grants, and freeing states to find innovative ways to provide care to the truly needy. Repealing ObamaCare‘s Medicaid expansion and capping federal Medicaid and CHIP outlays at nominal 2012 levels would together reduce federal deficits by $1.6 trillion over 10 years.

Block grants need not remove a single patient from the Medicaid or CHIP rolls. States could even expand enrollment. But block grants would require states to pay the full marginal cost of their programs today, rather than have Congress finance most of it through deficit spending. As in 1996, skeptics will predict horrific consequences. But they were wrong then — poverty fell dramatically after welfare reform — and they are wrong now.

If Republicans aim to capture this unique and crucial opportunity, they need to convey that a smaller government isn’t just compatible with better health care. It’s a prerequisite.

via Ryan Budget: A Huge Opportunity to Improve Health Care.

Colorado Attorney General John Suthers comments on Mike Rosen’s show, Tuesday Feb 1:

At the Volokh Conspiracy, Dave Kopel writes:

The mandate is not severable from the health control act. Defendants themselves have argued forcefully that the mandate is absolutely essential to the entire regulatory scheme. There is no severability clause. The mandate is tightly integrated into the entire act. …

The entire act is declared void. According to Cato’s Ilya Shapiro, this means that the federal government (presuming that it will obey the law) must immediately stop enforcing the entire health control law. Of course the 11th Circuit might grant a stay, and Judge Vinson might also do so, but as of right now, there is no stay.

Kopel’s whole post: Judge Vinson rules federal health control unconstitutional.

See also:

• The Nuts and Bolts of the ObamaCare Ruling, by Randy E. Barnett and Elizabeth Price Foley in the Wall Street Journal.
• Florida Ruling Goes Further than Any Obamacare Court Decision to Date, by Grace-Marie Turner.
• Judge Vinson’s ruling.

• “The Democrats remain in control of the Senate, and Harry Reid, returning in triumph, is unlikely to even schedule a vote. Repealing ObamaCare is just not going to happen while Obama is in office.”
• “Republicans should use their new investigatory powers to hold hearings and force officials like HHS Secretary Kathleen Sebelius to testify about the law. For example, since the law passed we have learned that health care spending will go up, not down as promised, and that millions of Americans will not be able to keep the insurance they have today.”
• “Republicans should seek repeal of those parts of the new law that are unpopular with Democrats as well as Republicans. … the law’s new long-term care entitlement is “a fiscal time bomb” … the law’s requirement that even small businesses file a 1099 tax form for every vendor that they do $600 worth of business with.”
• “With seniors having voted heavily against Democrats on Tuesday, there may be bipartisan support for revisiting cuts to [Medicare Advantage].”
• “repeal restrictions on popular options like Flexible Spending Accounts and Health Savings Accounts.”
• “Republicans in the House now control the power of the purse. They should refuse to fund implementation of the bill.”
• “Republicans will have to show that they have their own proposals for dealing with health care costs and the uninsured. They had a number of good ideas during the debate over reform, ranging from allowing the purchase of insurance across state lines to changing the tax treatment of individually owned insurance …”

Read the whole article:  “What Republicans Can — And Can’t — Do about ObamaCare.”

See also David Catron’s How the GOP Can Stop the Spread of Obamacare published in The American Spectator.

From the Wall Street Journal:

Republicans are promising to “repeal and replace” ObamaCare, and more than a few Democrats seem to be running on—or at least from—the same issue. And it’s a good campaign platform given the rising unpopularity and toxic side effects of one of the worst pieces of legislation Congress has ever passed. …

The “repeal pledge” is a project modeled after the famous taxpayer-protection pledge of Americans for Tax Reform, under which incumbents and candidates make a public promise to vote against tax increases. The tax pledge debuted in 1986 with the endorsement of Ronald Reagan and has helped to steel opposition to antigrowth policies. The repeal pledge aims to do the same for ObamaCare.

Efforts like these can be gimmicks, though when well done they educate the public and encourage politicians to commit to specific policy goals while drawing bright-line contrasts with their opponents. Pledges also help define electoral mandates. The 2010 campaign is already a referendum on the Obama Presidency, but if the repeal pledge gains currency it would allow voters to remonstrate this bill in particular and add momentum to the “repeal and replace” movement.

Launched a week ago by the nonprofit outfits Independent Women’s Voice and American Majority Action, the repeal pledge has been signed so far by 43 Republicans. Its sponsors are about to name a board of outside policy experts to evaluate all votes and let the public track how Members shake out on health care. The pledge applies beyond repeal per se to interim steps like discharge petitions to allow certain up-or-down votes in Congress on partial repeal, stripping funding from some ObamaCare subsidy or enforcement programs, and repealing certain regulations.

Read the whole article: The Repeal Pledge: Holding politicians to their promise to replace ObamaCare.

(Via Linda Gorman)

On Thursday, a federal judge in Florida ruled that a lawsuit challenging the constitutionality of the health care law can move forward. U.S. District Judge Roger Vinson allowed two of the suit’s challenges to proceed: 1) that Congress exceeds its authority with the “individual mandate” that requires almost all Americans to buy insurance, and 2) that the expansion of Medicaid compromises state sovereignty. The suit was brought by the governors and attorneys general of 20 states, and a summary judgment hearing to discuss its merits will be held in December.

Read the whole article: Most Serious Health-Care Challenge Marches Forward.

Read comments by Dave Kopel and Randy Barnett:

• Kopel: Comment on states’ victory on health control lawsuit.
• Barnett: District Court Judge Refuses to Dismiss AG’s Challenge to the Individual Mandate

And via FIRM, more views at HealthCareLawSuite.net: There is Reason to be Cautiously Optimistic.

With each passing week, it looks more and more like Republicans will retake control of Congress this fall. The latest Gallup poll gives the GOP a six-point edge. Rasmussen puts the Republican lead at seven points.

Even if Republicans take back Congress, they won’t be able to undo the Democrats’ legislative accomplishments right away. President Obama will be able to protect his signature achievements – like health reform – with his veto pen for as long as he calls the White House home.

But the GOP need not wait for a presidential victory in 2012 to begin repealing Obamacare. If Republicans assume congressional control this fall, they can – and should – start the repeal process as soon as the new Congress is seated in 2011 by refusing to fund the programs and initiatives created by the new law.

Read the whole article in Human Events: Repeal Obamacare by Choking Off Its Funding.

As I noted yesterday, this echoes my earlier post: ObamaCare: “debunk & defund” if you can’t repeal & replace.

Incremental revisions just won’t do. This 2,400-page law is the biggest entitlement since the Great Society. A wide-ranging program that puts one-sixth of our economy in the hands of politicians and bureaucrats can’t be fixed through a little tinkering. Lawmakers need to scrap the measure in its entirety.

Time is of the essence. Obamacare works like a one-way ratchet. Dismantling the huge new bureaucracies established by the measure will be effectively impossible once they’ve taken root.

Once all these taxes and government agencies are in full force, thousands of government employees will be dependent on the continued expansion of Obamacare for their livelihood. They’ll fight tooth-and-nail against any legislation that compromises their paycheck. If lawmakers don’t eradicate these taxes before they’re fully in place, all those bureaucrats will be here to stay.

Obamacare is also designed to make Americans dependent on government for insurance. …

Many Americans will get used to having other taxpayers foot the bill for ever-greater amounts of ever-more generous coverage.

This fall, Republicans will attempt to persuade the American people that they deserve to be put back in power. Exhibit A in their case should be a pledge to immediately repeal Obamacare. Scrapping the health-reform package in its entirety is the only way to prevent Obamacare from doing irreparable damage to the country.

Read the whole article: Repealing Obamacare: Politically Feasible, Morally Urgent.

Yet, if repealing is not possible, Merrill Matthews of the Council for Affordable Health Insurance suggests ways of curbing the harmful effects of the health control legislation, HR 3590.  I wrote a blog post about this in June.

Photo credit: Denver Post.

Is the Colorado Right to Health Care Choice Initiative a “public relations stunt,” as a political science professor says? No, it’s not.  Should a lawsuit against the mandatory insurance provision of HR 3590 succeed, the Feds will pressure states into enforcing it.  And regardless of the lawsuit, state-level legislation have influenced the enforcement and reform of federal legislation.

Of the Colorado Right to Health Care Choice Initiative,  Colorado College political science professor Bob Loevy says:

This is a nice public relations stunt but it’s not likely to have any more effect than that. … The U.S. Constitution contains a supremacy clause. The chance that you can use an initiated state law or constitutional amendment to reverse a law of Congress is highly unlikely.

Professor Loevy is right that a state level amendment is not likely to overturn a federal law, as I have noted in an earlier post about Missouri’s Proposition C.  But the Colorado Right to Health Care Choice Initiative is not about reversing federal legislation.  The text of the initiative is quite clear (emphasis added):

no statute, regulation, resolution, or policy adopted or enforced by the state of Colorado, its departments and agencies, independently or at the instance of the United States shall: (a) require any person directly or indirectly to participate in any public or private health insurance plan, health coverage plan, health benefit plan, or similar plan; or (b) deny, restrict, or penalize the right or ability of any person to make or receive direct payments for lawful health care services.

This June 30 podcast with Independence Institute Director of Operations Mike Krause and II President Jon Caldara elaborates on this point.  The Amendment is important should lawsuits against HR 3590′s mandatory insurance provision are successful.

Mike Krause says (again, emphasis added):

Let’s go back to the first part [of the Colorado Right to Health Care Choice Initiative] – the fact that the state of Colorado won’t be able to force citizens to purchase a public or private health care product. This doesn’t mean that your citizens amendment would block ObamaCare [or] override ObamaCare, the mandate, the federal mandate. What we’re talking about is what we can do in the state.

Jon Caldara replies:

Exactly … it certain sets up a good legal 10th Amendment challenge to the mandate, and only the mandate part, of ObamCare. And therefore we have more ammunition when it comes to protecting our 10th Amendment rights. This will certainly go up to the courts. Even now Attorney General John Suthers and nearly twenty of his compatriots are suing … the federal government.

If they are successful, and I expect they will be, this Amendment becomes absolutely crucial in Colorado. And the reason is if they find out that the feds cannot mandate to buy health insurance at the levels that they want and buy the companies they want and by the size they want, the federal government will do what the federal government always does: put pressure on the states, withhold money, and make the states do their bidding as their servants. Should this amendment become constitutional law, then the state of Colorado can’t do the federal government’s bidding.

Even if no lawsuit succeeds in overturning federally-mandated insurance (as unconstitutional), state-level initiatives against parts or all of HR 3590 (”ObamaCare”) have political value, as discussed in this St. Louis Today article:

political repercussions of [Missouri's] Proposition C are more significant than any legal ones. But, [said Patrick Tuohey, campaign manager for Missourians for Health Care Freedom], politics can be a powerful force that can lead to an effective repeal of the federal law.

[Tuohey] points to the the Real ID bill passed in 2005 by Congress that created some national standards for drivers licenses and other forms of state identification. There has been so much political opposition to the law that it has yet to be implemented, and Congress is considering changes.

Randy Barnett, professor of constitutional law at Georgetown University Law School, said the national debate over medical marijuana shows how state politics can affect federal policy.

Over the last decade, he said, several states have enacted laws allowing for the sales of medical marijuana, even though such sales contradict federal law. The Obama administration has reacted to the strength of the movement by deciding to allow the state laws to continue in force.

“It’s a real-world example of how these state initiatives can change the politics and ultimately the enforcement,” said Barnett, who took one of the landmark medical marijuana cases to the Supreme Court.

Voters overwhelmingly approved Proposition C at Tuesday’s election, but it will likely be overturned in court, law and health-care experts say.

Proposition C creates a law banning the government from forcing Missourians to buy health insurance under the federal health-care overhaul [HR 3590] starting in 2014.

“The Constitution clearly states that a federal law trumps a state law when they come into direct conflict,” said Richard Reuben, a professor at the University of Missouri School of Law in Columbia. “The core of Proposition C, which is the opt-out provision, appears to be in direct conflict with the new federal statute.”

Constitutional scholar Randy Barnett agrees. Here’s Barnett on the Fox Business Channel’s Freedom Watch commenting on Thomas Woods’ new book, Nullification:

(Original video on YouTube, full segment, chopped version)

Barnett concludes a blog post on the States’ ability to nullify federal law:

Political activists should not waste their precious energies on sketchy constitutional theories such as the assertion of a state power to nullify unconstitutional laws that, for better or worse, have long been rejected by the Supreme Court–as Wisconsin’s was in Ableman v. Booth–that five justices certainly would not today support, and that rest on dubious claims about original meaning.

As I hope you know, we have been working to bring to this Fall’s Colorado ballot a citizens’ amendment, the Right to Health Care Choice. Well, we just cleared a massive hurdle.  A federal court judge has placed an emergency injunction on a new state law that made it near impossible to get an initiative on the ballot.

In 2009 the state legislature, with heavy bipartisan support, passed a law outlawing paying petition gatherers by the signature they collect.  This may sound like a small change to the process, but as I have found out, it doubles or triples the cost of getting a citizens’ initiative on the ballot. …

Last Friday the ruling came down, and the worst part of the law has been enjoined.  We can now pay petition circulators by the signature, meaning we can now afford to petition the government.  Now we are off and running!

We still are counting on a large volunteer effort.  If you are interested in helping gather signatures contact Mike Krause at (click dots for Recaptcha)…@i2i.org, or give us a ring at 303.279.6536 and ask for Mike.

Become a fan of this cause on the Defend Colorado from ObamaCare Facebook page.

Here’s the full text of the Right to Health Care Choice Initiative.