Fourth Circuit Court of Appeals rejects constitutional challenge to Healthcare Act

Via Think Progress:

The Fourth Circuit just handed down two opinions ordering that Virginia Attorney General Ken Cuccinelli’s challenge to the Affordable Care Act, along with another challenge to brought by Jerry Falwell’s Liberty University, both must be dismissed entirely on jurisdictional grounds. Judge Davis dissented from the Liberty University opinion to say that he would reach the merits and uphold the law. Today’s decisions are the first court of appeals decisions to dismiss a case for want of jurisdiction after a lower court reached the merits – potentially raising the possibility that one or more of the justices could agree with them and prevent this constitutional question from being decided on the merits until after 2014.

Fourth Circuit opinions homepage

The Gathering Storm comes to NC

Here’s what we have to look forward to in the next year if the move to put the Gay People Can’t Marry amendment on the ballot passes. This is a National Organization for Marriage ad. You may notice that the background resembles what they run on the Weather Channel during a tropical storm update. Suddenly you are very afraid of whatever these people are talking about. It makes me nervous, too. Don’t these folks have somewhere to go in this storm. Shouldn’t they be in the basement or something? Or maybe a closet?

Needless to say, the ad invited a few responses.

What’s to come in the special session

The North Carolina General Assembly has been more unpredictable than usual this year. The upcoming special session, which GOP leaders say will last only three days, has been especially hard to nail down with the exception of the constitutional amendment to limit who can marry. The range of other options left in the adjournment resolution in the last session left a lot of possibilities.

Via NC Policy Watch:

Hard as it might be to believe – especially in light of the much ballyhooed promises of the state GOP to bring all sorts of new openness and transparency to state government this year – no one in the House or Senate leadership has officially announced what’s on the agenda for next week.

In an article for the Indy, I tried to break down what can be brought up, but what will be brought up is a different matter. The only real clues have been in interviews with legislative leaders in both the House and Senate.
Since I filed that story there have further indications that eminent domain would not likely come up and the deal to allow gambling expansion at the Cherokee casino is not ripe.

Still, a lot can happen in three days. From the Indy article:

Under the adjournment resolution passed at the end of the previous special session, the ground rules for the upcoming session allow the General Assembly to consider bills that have been vetoed, legislation from conference committees, redistricting revisions, local bills and “any bills relating to election laws.”

Here’s the adjournment bill:



A JOINT RESOLUTION further adjourning the 2011 regular session of the general assembly to a date certain and limiting the matters that may be considered upon reconvening.

Be it resolved by the House of Representatives, the Senate concurring:

SECTION 1. When the Senate and the House of Representatives adjourn on Thursday, July 28, 2011, they stand adjourned to reconvene on Monday, September 12, 2011, at 12:00 noon.

SECTION 2. During the regular session that reconvenes on Monday, September 12, 2011, only the following matters may be considered:

(1) Bills:

a. Revising the Senate districts and the apportionment of Senators among those districts.

b. Revising the Representative districts and the apportionment of Representatives among those districts.

c. Revising the districts for the election of members of the House of Representatives of the Congress of the United States and the apportionment of Representatives among those districts.

d. Bills responding to actions related to the Voting Rights Act of 1965.

e. Bills responding to actions related to litigation concerning Congressional, State House, or State Senate districts.

(2) Bills returned by the Governor with her objections under Section 22 of Article II of the Constitution of North Carolina, but solely for the purpose of considering overriding of the veto upon reconsideration of the bill.

(3) Bills in which the General Assembly makes an appointment or appointments to public office and which contain no other matter.

(4) Bills:

a. Proposing an amendment or amendments to the Constitution of North Carolina and containing no other matter.

b. Proposing an amendment or amendments to the Constitution of North Carolina and containing no other matter other than statutory conforming changes to implement such bills.

c. Bills that solely make statutory and transitional changes to implement bills under sub‑subdivision a. of this subdivision.

(5) Any bills relating to election laws.

(6) Adoption of conference reports for bills which were in conference as of Thursday, July 28, 2011.

(7) Joint resolutions proposing a joint session to consider confirmation of the Governor’s appointments to the State Board of Education pursuant to G.S. 115C‑10.

(8) Joint resolutions confirming the Governor’s appointments to the State Board of Education pursuant to G.S. 115C‑10.

(9) Local bills pending in the House Rules Committee on July 28, 2011.

(10) Bills to ratify and make statutory conforming changes pursuant to a Tribal Compact negotiated by the Governor.

(11) A joint resolution further adjourning the 2011 Regular Session to a date certain.

SECTION 3. This resolution is effective upon ratification.

In the General Assembly read three times and ratified this the 28th day of July, 2011.

ACLU files suit over Choose Life plates

The ACLU announced this morning that it has filed suit against the state over the Choose Life license plates adopted in the regular session this spring.
The organization wants the state to issue a pro-choice specialty plate. According to the release:

RALEIGH — The American Civil Liberties Union of North Carolina Legal Foundation (ACLU-NCLF) filed a lawsuit today in the federal district court for the Eastern District of North Carolina on behalf of North Carolinians seeking a specialty license plate that supports a woman’s right to reproductive freedom. During this year’s legislative session, the North Carolina General Assembly passed House Bill 289, which authorized the issuance of a “Choose Life” license plate. However, the legislature repeatedly refused to authorize a plate that supported the countervailing position in favor of reproductive freedom. Six amendments were proposed in the legislature to authorize an additional new plate that stated either, “Trust Women. Respect Choice,” or simply “Respect Choice.” The legislature rejected all six amendments. As such, the lawsuit alleges that the State is engaging in unconstitutional viewpoint discrimination in violation of the First Amendment.

“If anti-choice drivers are permitted to express their views on their license plates, people like me should be able to express our view that women deserve full reproductive freedom,” said Sue Holliday, plaintiff and certified nurse midwife.

Complaint (pdf)

Other links at the bottom of the release.

Cost containment

In order for healthcare cost containment to work, you have to actually contain the cost.
New report from the State Auditor’s office shows how the state healthcare plan fumbled the overpayments to Bpatist Hospital. Via the report (pdf):

Using the combination of variables most closely aligned with the cost containment intent of the contract’s inflation adjustment provision, the estimated overpayment to Baptist Hospital for outpatient services is approximately $1.34 million, or 75% higher than the Plan’s calculation method.

Also, they didn’t even recover the lower amount.

This spells out what happened:

However, the State Health Plan did not have a plan for monitoring Baptist Hospital outpatient fee increases and determining if an inflation adjustment discount was allowed, and no one was assigned this responsibility. As a result, inflation adjustment analyses were not performed, and the discount rate was not increased during the entire contract period.
The State Health Plan should have sought fee increase information directly from Baptist Hospital as part of its contract monitoring plan. The National State Auditors Association “Best Practices in Contracting for Services” states, “Contract Monitoring is an essential part of the contracting process. Monitoring should ensure that contractors comply with contract terms, performance expectations are achieved, and any problems are identified and resolved. Without a sound monitoring process, the contracting agency does not have adequate assurance it receives what it contracts for.”
Because the State Health Plan did not monitor Baptist Hospital outpatient fee increases and did not increase the discount rate as allowed in the contract, the State Health Plan paid more to Baptist Hospital for outpatient services than it had to per the contract.