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Life Health > Health Insurance > Your Practice

SCOTUS PPACA Day 2: Now It's a Fight

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I went to bed Monday night amazed that for all I had seen and heard that day on the SCOTUS steps, while covering the rallies and protests over PPACA’s Constitutionality challenge, this was supposed to be the quiet day. Tuesday, they would be hearing arguments over the individual mandate – the requirement that everybody finally knuckle down and buy at least rudimentary health insurance if they have not done so already. And this is what people are fighting mad over. Tuesday would be an interesting day, I figured. And I was not wrong.

I arrived at the SCOTUS steps at 7:30 am, half an hour before a planned rally by a coalition of women’s rights groups led by Planned Parenthood was scheduled. Already, there were groups trying to shout over each other. You could hear it from a block away. But that was not the most amazing part. The most amazing part was seeing the line of people queued up with their tickets to attend the arguments themselves.

They were all under 30. And they did not look like they were part of a singular group, either. They looked like Millennials who figured out that the PPACA case would be their generation’s big SCOTUS landmark, and they all wanted to see it happen personally. It was really exciting, actually. These guys knew that however the Supreme Court ruled, it would affect them more than any other adult group. Capitol-watchers, take note. The Millennials look like they are finally coming into their own.

Meanwhile, on the SCOTUS steps, the same handful of Tea Partiers I saw yesterday were there again today, getting drowned out by a rather large group (Somewhere between 50 and 75, I’d say) of pro-PPACA demonstrators. The mood of the pro-PPACA folks was unusually cheery, considering how early and cold it was. It all made me wonder about the opposition. I had expected to see more…a lot more. Where the hell were they? I thought most Americans were supposed to disapprove of PPACA. If so, none of them bothered to make that known so far.

PPACA SCOTUS tea party

That is, until StudentsForLife, a pro-life college student group appeared. They were smallish (maybe 20-30 people) but they were polished and prepared, and they also hashed out a truce with the other side that they could get the podium mike uninterrupted for a little while without being shouted over, and then they would do likewise when it was the pro-PPACA crowd’s turn. Very civil, I thought.

StudentsForLife were mainly upset over the contraception issue attached to PPACA, as well as the notion of federally funded abortions. That was it. And to the other side’s credit, they stayed quiet throughout, and I started to think that maybe we were seeing a breakthrough. If only everybody involved in this debate could be so reasonable with each other, maybe some common ground could be found. Hope springs eternal.

The group ended their time with a prayer that SCOTUS would overturn PPACA. It made me think about how a faith group in favor of PPACA the day earlier prayed that PPACA would be upheld. One of these groups was not going to get what it wanted. They also had a ceremonial destruction of a copy of the PPACA text. “Don’t worry, we’re not Occupy,” their spokesman said. “We’ll clean it up.”


When the Planned Parenthood group took over, it was a much larger and louder event, with multiple speakers and, frankly, the kind of event I’d been expecting to see here all along. But more importantly, the stories being told to support PPACA all spelled out either shortcomings in the health insurance system pre-reform, or improvements to it post-reform.

A Stage 3 cancer victim who said she would be dead if not for PPACA.

A mother of four whose kids needed a bone marrow transplant, the cost of which drove them into bankruptcy, even though they were employed, financially responsible and insured. It just wasn’t enough.

A family of three (with one on the way) who spoke of how PPACA provided for an expensive treatment for a rare disease that a) would have been considered a pre-existing condition before PPACA) and b) would have made it impossible for the mom to have kids.

A young woman from Oregon whose parents’ auto body business was saved because of a PPACA-related drop in health insurance premiums.

A rape victim whose screening from HIV became a pre-existing condition that made her uninsurance. Her job? Health insurance agent.


There is probably an argument from the other side that counters each of these examples, but I was just grateful that the debate had shifted from shouting slogans to actually discussing health and what it could do…and not do. This is the true heart of this issue, after all. And it has been depressing to see how little it was being talked about. Probably because so few people really understand it, or care to learn. How nice it would have been for industry spokespeople to have been around to explain themselves to the public, but given the mood on the Hill, keeping a safe distance was probably a good idea.

The next group to speak is the Tea Party, and here is where things get uncomfortable. A pro-PPACA demonstrator from the previous group crashes the Tea Party rally with her sign and a bullhorn, and the Tea Party, already highly strung, reacts with fervor. There is pushing and jostling, and suddenly, a guy like me, nestled at the foot of all of the television cameras, realizes that if I wanted to die by trampling, this might be a decent way to go about it.

Eventually, things calm down, though, and the Tea Party makes its complaints  about how PPACA is un-Constitutional and that if left in place, it will give the federal government unprecedented power that can turn into telling people what to eat, what to wear, etc. Nowhere is there mention of what PPACA actually does, about the healthcare it guarantees, how it might impact the insurance industry…nothing. There is some talk about how expensive it will all be, and that Obama and Pelosi and Reid all lied when originally pitching the package, but honestly, the numbers they use vary so much it reduces down to an amorphous gripe about federal spending.

The bright spot is a snap appearance of Michele Bachmann, who shows up to give a little stump speech about the day she swore to repeal PPACA, and for the Tea PArty to keep fighting the good fight. Seeing her in public, and amid friendly faces, you can see how she became the darling of the Tea Party. You can also see how she washed out of the Presidential race so soon. Having so little room for compromise in ones profile makes it difficult to make the gauntlet of grey area concessions it takes to build the support required to win a general election. That’s just how it is.


I go for a cup of coffee to warm up and to contemplate the fact that in the space of a few hours, I have both narrowly avoided frostbite and gotten badly sunburned. This is the kind of problem you’d expect mountain climbers to have, not some hapless editor navigating the activist/media scrum at the foot of the SCOTUS steps. But from down there, the SCOTUS entrance is so far away it might as well be atop Mount Olympus, so perhaps my mountain climbing experience isn’t that far off.

In the afternoon Americans for Financial Prosperity set up in the upper Senate park, and even though it is some 40 minutes before their rally is set to begin, it is clear that something big is in the works. So this is where the opposition has been hiding? The park is a sea of people in red “Hands off my Healthcare!” t-shirts, but there is also the occasional person dressed as a Minuteman,or somebody in an Ayn Rand t-shirt. There are more yellow “Don’t Tread on Me” flags than there are American flags, interestingly, and within the next half-hour, what surely was at least 2,000 people come to the park. It could have been more, but it was impossible to tell from the ground. There was nowhere to get elevated enough to get a sense of attendance, but there were a lot of people there. Many times more than the groups on the SCOTUS steps, in fact. I later learn that various Tea Party chapters bused in their members from all over the eastern half of the country (at least, those were the only states I heard called out) to attend.

Soon the show gets rolling, and a procession of Tea Party favorites take the stage to talk about how awful Obamacare is, how it’s a federal overreach, and how, regardless of what happens in the Supreme Court, the people in attendance will not comply with it. There is a strange disconnect of logic here; the crowd reacts favorably to speakers who note how the Greatest Generation fought in WWII for this country, and should not be tyrannized by Obamacare, foisted by a federal government the Founding Fathers forefathers never envisioned. Those same Founding Fathers never envisioned a federal government capable fighting World War II, as well, though. It was a point I doubted the AFP crowd would have wanted to hear made.


it is easy to take cheap shots at a group like this. It is not demographically diverse; almost entirely white, almost entirely over 50, and largely male. It is not particularly sophisticated in its arguments, at least not when you are in a huge crowd that really only seemed interested in finding new ways to shout that Obamacare sucks. And it is a crowd that seems largely unaffected by Obamacare, since few of them seemed destitute and many seemed like they either had a job with benefits, or had retired from one. LIke the crowd in the SCOTUS steps, their problems with PPACA really weren’t mechanical; they were ideological. It really ground these folks that the Democrats gained a supermajority and passed a groundbreaking new set of rules. In our modern age of incessant political warfare, this kind of achievement, regardless of party, simply cannot be forgiven by the other side.

Here’s the thing, though: the AFP crowd was very passionate about hating PPACA. They sword up and down that even if it was not overturned by the highest court of the land, they still wouldn’t obey it. There was simply no room for compromise here. So when I mentioned to a few people casually about how this all might affect insurance companies, I got some interesting responses.

Once I’d identify myself and the publication I work for, I got the question of what my readers thought of PPACA. I said that from what I could see, most were deeply unapproving of it. “But not all?” I would be asked with suspicion. No, Id’ reply. Not all. For I have received letters from health agents, brokers and executives saying that it’s a shame their industry has been upended, but in truth, it’s long overdue. Upon hearing this, the Tea Party answer was along the lines of, “So they’re playing both sides of the fence, are they? Figured as much. They’ll get theirs.”


Here’s the thing: the industry has invested a lot in getting PPACA overturned, and groups like the AFP are the closest thing they are going to find at the grassroots level to an ally. But what a dangerous ally it would be. For once they finish overturning PPACA, they would set their sights on another bogeyman to battle, and the monolithic insurance industry is as good a bad guy as anyone.

That’s the theory, anyway. It might all be academic. For the record, I don’t think SCOTUS will overturn PPACA. I think Roberts will be the swing vote, and that he will be reticent to overturn that which Congress put into motion. The other justices will find along their ideological lines, and the rest of the country will continue living with the laws they have been living with for the last two years. The utter bewilderment I saw among AFP folks at how the legal groundwork for the individual mandate could have been deemed Constitutional at all really isn’t so crazy when you take a close look at it. It’s convoluted, sure, and it is never a good sign when any government effort must make such circuitous paths of logic in order to present itself before a skeptical public. But is the IM un-Constitutional? I don’t think so. No more than every state’s separate requirements that people buy automobile liability insurance violates state Constitutions.

PPACA SCOTUS politicos

I know that is an imperfect comparison, but it’s close enough to make me think that perhaps the folks most outraged over PPACA ought to be a bit more realistic about how their government functions, how it has functioned since before they were born, and how it will likely function well into the future. More than a few times, I heard folks at the AFP rally shout “Revolution!” If this kind of lawmaking is really what they want to put a stop to, then that might be the only way to stop it. All I know is that I’ve covered both Americans for Financial Prosperity and Occupy Wall Street, and only one of them has so far suggested that if voting the bums out, perhaps stronger action is called for. And it wasn’t the ratty kids dressed like casual hobos and sitting in drum circles.


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