Thursday, December 10, 2020



Amazing: Trump Admin Fails to End DACA

Federal Judge Nicholas Garaufis on Friday ordered that the Deferred Action for Childhood Arrivals (DACA) immigration program be fully reinstated. This decision is the latest blow to President Donald Trump’s years-long effort to end Barack Obama’s unconstitutional executive order.

Recall this past summer the U.S. Supreme Court issued a 5-4 ruling against the Trump administration’s attempt to halt DACA — not over the question of the legality of the program itself but over procedural issues. The Court declared that the Trump administration violated the Administration Procedure Act when ending DACA.

Following this latest setback from Judge Garaufis, however, the Trump administration has essentially thrown in the towel, as the Department of Homeland Security announced that it would abide by the ruling and begin the reimplementation of DACA this week. This means that at least 300,000 more illegal aliens will be eligible to be added to the current 640,000 DACA recipients.

With the increasing likelihood of Joe Biden taking up residence at 1600 Pennsylvania Avenue in the new year, the possibility of truly ending DACA is all but dead. Biden has vowed not only to retain the program but to also press Congress to make it a pathway for U.S. citizenship for its recipients.

However, there remains the possibility that DACA’s reinstitution may be short-lived, as a federal judge in Texas will rule on the program’s constitutionality before the year is up. CBS News reports, “Judge Andrew Hanen, who has previously said DACA is likely illegal, has scheduled a hearing on this case for December 22.” Should Judge Hanen rule against DACA, then SCOTUS will likely and finally have to rule on the constitutionality of the program itself. And, hopefully, given the current conservative makeup of the Court, even Chief Justice John Roberts won’t be able to save yet another unconstitutional power grab.

DACA’s merits (or lack thereof) is actually not the primary issue here. Rather, it’s the manner in which Obama blatantly acted to circumvent Congress and the Constitution to issue an executive order that effectively legislated a new immigration law. Initially, it was a move that he himself repeatedly and correctly declared was beyond his constitutional authority. That wrong needs to be righted, irrespective of the larger illegal immigration issue.

Trump and the Delusional Left

Most of the US Left seems to have bought into the narrative that Trump is either a literal fascist or a conventional reactionary or right-wing strongman like Putin, Erdogan, Orban, Duterte, Bolsonaro, etc. I think all of this is a misunderstanding of what historic fascism actually was, how the US political and economic system actually works, and the Trump phenomenon itself.

Historic fascism and its similarities tended to appear in countries experiencing early or relatively early stages of industrialization, that were under the direct or indirect domination of external forces, and had experienced some kind of national humiliation (like Versaille), economic disaster (like the Great Depression), war devastation (like Cambodia in the 70s or Afghanistan in the 90s) or merely an archaic ruling class that was impervious to any kind of reform leading toward modernization (like Spain and Portugal in the 30s or Libya in the 60s or Iran in the 70s). That was true of Italian fascism and German Nazism, as well as revolutionary nationalist or religious fundamentalists in the Middle East like Nasser, Qaddafi, Assad, Khomeini, the Taliban,etc. The Pol Pot regime came to power in a similar context.

The USA is a much different kind of society, a highly sophisticated techo-state, with unprecedented wealth, military power, and technology, not a weak Second World/Third World system easily vulnerable to strong men and demagogues. The USA is closer to the Empire in “Star Wars” than postwar Italy. US Presidents are not traditional monarchs or dictators but managers in the employment of a plutocratic-technocratic oligarchy, the same way a CEO is answerable to major shareholders, boards of directors, creditors, and the fickleness of the market.

Michael Bloomberg gave the game away back in 2016 when he said that among the plutocratic class Trump is known as a cheat and a conman, and that’s why the power elite and the media worked overtime to unseat him. They view him as an oafish rogue from their own ranks whom the perceived backward peasants like because of rather than in spite of his crudities.

Plus, the theme of the Democrats’ last two campaigns has amounted to “Vote for us because at least we’re not that guy.” Trump himself is more a used car salesman than a fascist “man of action” type. To the degree that he has any serious political views at all, he seems to be a standard New York liberal in the Rockefeller Republican tradition who, like Nixon, appeals to the hardhat types even if he has nothing in common with them except a propensity for bad language.

Obamacare Makes Discrimination against Those with Preexisting Conditions Even Worse

If Republicans want to have a prayer of competing with Democrats on healthcare, they need to bury the conventional wisdom that Obamacare “banned” (Elizabeth O’Brien, Time), “outlawed” (Sharon Begley, Reuters), and “ended” (House Speaker Nancy Pelosi) discrimination against patients with preexisting conditions.

Obamacare has not eliminated discrimination against patients with preexisting conditions, and not by a long shot. Jeanne Balvin’s experience shows Obamacare perpetuates some forms of discrimination against the sick. Colette Briggs’s experience shows Obamacare has repealed other forms and replaced them with “backdoor discrimination” that is arguably worse. President‐​elect Joe Biden and his choice for Secretary of Health and Human Services, California attorney general Xavier Becerra, strongly support the rules that give rise to these forms of discrimination.

Colette Briggs, now 7 years old, received a leukemia diagnosis at the age of 2. On the surface, Obamacare would seem to guarantee she will get the treatment she needs. It requires insurers to enroll her family and to charge it a premium no higher than healthier families.

If Republicans want to have a prayer of competing with Democrats on healthcare, they need to bury the conventional wisdom that Obamacare “ended” discrimination against patients with preexisting conditions.

Under the surface, however, those same rules have pushed Obamacare plans to drop coverage for the only local providers who offer the treatment she needs, which they have done repeatedly for five years.

How does a ban on discrimination against the sick instead encourage such discrimination? To illustrate, let’s say the Briggs family costs $100,000 per year to insure. Obamacare requires insurers to charge the family far less — let’s say $20,000.

From an insurance company’s perspective, the Briggs family represents an $80,000 liability. Each year, the Briggs family will reliably choose whichever plan offers the best coverage for Colette’s illness.

The combined effects of these factors are to threaten insurers with an $80,000 loss if they make the mistake of offering the best coverage for Colette and to force insurers who want to stay in business to compete to make their plans worse for expensive patients, in the hope of encouraging those patients to select a different insurer.

Health plans can do so by dropping from their networks hospitals or doctors that expensive patients prefer (as in Colette’s case), requiring high or variable cost‐​sharing for drugs that expensive patients use, or requiring strict utilization controls (e.g., prior authorization, step therapy) for drugs that expensive patients use. Obamacare’s preexisting conditions provisions reward insurers who implement any design feature that differentially discourages unprofitable patients from selecting one of its plans.

Economic research provides evidence that these “protections” are forcing insurers to engage in such discrimination against patients with multiple sclerosis, infertility, substance abuse disorders, hemophilia, severe acne, nerve pain, and other conditions. Patient advocacy groups have alleged such discrimination against patients with cancer, cystic fibrosis, hepatitis, HIV, and other illnesses. Across all Obamacare plans, choice of doctors and hospitals has grown narrower, and drug coverage has gotten skimpier.

These findings aren’t particularly surprising or even controversial. Obamacare’s architects knew this sort of race to the bottom was a likely, if unintended, consequence of the law’s preexisting conditions provisions. They even included in the law a special insurer bailout program in the hope of preventing a race to the bottom. It isn’t working.

One cannot claim this race to the bottom is simply how health insurance works. “Short term” plans offer broader provider networks precisely because Congress exempts them from Obamacare’s preexisting conditions provisions. More importantly, prior to Obamacare, competition created incentives for insurers to offer better coverage for the sick by building up reserves according to how much consumers were willing to pay. Insurers have always faced incentives to renege on their commitments to the sick, but Obamacare’s “protections” made those incentives worse.

Indeed, this form of discrimination against preexisting conditions is arguably worse than the kind it (mostly) displaced. Unlike discrimination in pricing and enrollment, discrimination in plan design harms all consumers. It not only “undoes intended protections for preexisting conditions” but creates a marketplace where even “currently healthy consumers cannot be adequately insured.” Patient‐​advocacy groups insist discrimination in plan design “completely undermines the goal of the ACA.”

In 2017, Obamacare also discriminated against 61‐​year‐​old Arizona resident Jeanne Balvin, first because she is a woman and again because she had a preexisting condition.

Contrary to the conventional wisdom that Obamacare ended discrimination against women in health insurance, the law dramatically increased Balvin’s premiums because she’s a woman. Economic research shows Obamacare increased premiums for near‐​elderly women more than any other group because its preexisting conditions provisions lump those women together with sicker men of the same age.

Fortunately, Balvin found protection from Obamacare’s protections. In April 2017, she purchased a short‐​term plan from UnitedHealthcare, the largest insurer in the country. Since Congress exempts short‐​term plans from that hidden tax, her plan cost one‐​third as much as the cheapest Obamacare plan. When she required emergency surgery for diverticulitis, her short‐​term plan paid her hospital claims on time and in full.

The Obama administration didn’t like that short‐​term plans gave people like Balvin an alternative to Obamacare, though. So it invented a requirement that insurers must cancel all short‐​term plans after just three months. That rule stripped Balvin of her coverage right before she returned to the hospital two more times in July 2017, leaving her sick and uninsured.

Obamacare’s preexisting conditions provisions then discriminated against her again by barring her from enrolling in an Obamacare plan. With narrow exceptions, those provisions prohibit consumers from enrolling in coverage or switching plans outside a narrow window from Nov. 1 to Dec. 15. (A dozen states allow enrollment as late as Jan. 31).

The one‐​two punch of stripping Balvin of her coverage and then denying her Obamacare coverage left her with $97,000 in unpaid medical bills. The ban on mid‐​year enrollments may not appear to discriminate against patients with preexisting conditions. After all, it applies to everyone. But it exists to block people with preexisting conditions who would tank Obamacare’s risk pools, not by healthy people who would improve them.

When the Briggs’s insurer dropped coverage for Colette’s treatment (again) in March 2020, Obamacare blocked her family from switching to a plan that would have covered it. If a consumer misses this year’s open enrollment window and then contracts COVID-19 on Jan. 1, Obamacare will offer her coverage with an annual limit of zero.

Obamacare supporters criticize this type of discrimination when free markets do it, even though Obamacare does it for the same reason: Insurance pools are not sustainable otherwise. What is the difference between private insurance companies and Obamacare supporters? Insurers don’t pretend they aren’t discriminating against preexisting conditions.

Had Obamacare simply left the Briggs family alone, it would have had better access to care. When Colette was born in 2013, her family had a health plan that prohibited its insurer from dropping it or charging higher premiums. That is, discriminating against the family if, say, its newborn daughter developed leukemia.

Obamacare threw the family out of that plan, dramatically increased its premiums, and encouraged insurers to discriminate against Colette. In its struggle to get Obamacare to cover her treatment, the Briggs family has written op‐​eds, lobbied members of Congress, and even used its public relations skills to get NPR and the Washington Post to tell Colette’s story. It still had to create a GoFundMe page.

Had Obamacare left Balvin alone, she could have purchased a plan that covered her treatment for diverticulitis and beyond. Come Dec. 15, Obamacare will again deploy the sort of discrimination against patients with preexisting conditions that blocked her from enrolling in coverage.

It is time for policymakers to admit that Obamacare both discriminates against preexisting conditions and denies coverage and care to sick patients who otherwise would have had it. Remember that the next time someone stokes fear about what would happen if Congress or the Supreme Court were to overturn it.

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My other blogs. Main ones below:

http://dissectleft.blogspot.com (DISSECTING LEFTISM)

http://snorphty.blogspot.com TONGUE-TIED)

http://edwatch.blogspot.com (EDUCATION WATCH)

http://antigreen.blogspot.com (GREENIE WATCH)

http://john-ray.blogspot.com (FOOD & HEALTH SKEPTIC)

http://australian-politics.blogspot.com (AUSTRALIAN POLITICS)

https://heofen.blogspot.com/ (MY OTHER BLOGS)

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