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AP sources: Administration mulls pared health law Roswell Daily Record
WASHINGTON (AP) — Covering all the bases ahead of a momentous Supreme Court ruling, the Obama administration plans to move ahead with major parts of the president’s health care law if its most controversial provision does not survive, according to veteran Democrats closely involved with the legislation. Even if the requirement that nearly every U.S. resident have health insurance is declared unconstitutional, the remaining parts of the law would have far reaching impact, putting coverage within reach of millions of uninsured people, laying new obligations on insurers and employers, and improving Medicare benefits even as payments to many service providers get scaled back. The White House says President Barack Obama is confident the whole law will be upheld when the court issues its ruling in the next week or two, but officials will be ready for any outcome. “We do believe it’s constitutional, and we ... hope and expect that’s the decision the court will render,” senior adviser David Plouffe said Sunday on ABC. “We obviously will be prepared for whatever decision the court renders.” Administration officials have not wanted to discuss contingency
In this March 25 file photo, people visit the Supreme Court in Washington.
plans to avoid creating the impression that the president is preparing for a high court rebuke. Nevertheless, the Obama administration will move ahead to implement major elements of the law if the individual coverage requirement is struck down, two senior Democrats told The Associated Press. One is a leading Democrat familiar with the administration’s thinking, the other a highlevel Capitol Hill staffer. The two Democrats spoke on condition of anonymity to avoid appearing to be out of step with the administration’s public stance. Because the law’s main coverage expansion does
not begin until 2014, there would be time to try to fix serious problems that losing the individual coverage requirement may cause for the health insurance industry. Surviving parts of the law would “absolutely” move ahead, said the congressional official. A Congress mired in partisan trench warfare would be unable to repeal or amend what’s left of the law, allowing the administration to advance. Much of the money for covering the uninsured was already provided in the law itself. “Legislatively we can’t do a thing, and we are going to move full speed ahead (with
Tuesday, June 19, 2012
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implementation),” the official said. How the Supreme Court will decide is unclear. It may uphold the law, strike it down entirely or do something in between. Skeptical questioning by the court’s conservative justices during oral arguments this spring has fueled speculation that the court may invalidate the so-called individual mandate. Opponents say the requirement that individuals have coverage is unconstitutional, that the federal government can’t tell people to obtain particular goods or services. Supporters say the man-
date is a necessary component of a broader scheme to regulate health insurance, which is well within the powers of Congress. By requiring people to carry health insurance or pay a fine, the law seeks to broaden the pool of people with coverage, helping to keep premiums affordable. If the mandate is struck down, that would still leave in place a major expansion of Medicaid, the federalstate safety net program for low-income people. The Medicaid expansion was originally estimated to account for about half the more than 30 million people slated to get coverage under the law. Without a mandate, the number would be smaller but still significant. Federal tax credits to help middle-class people buy private health coverage would also survive, as would new state-based insurance markets. Such subsidies have never previously been available, and millions are expected to take advantage of them, whether or not insurance is required by law. Still, it could be tricky to salvage the law’s full blueprint for helping middle-class uninsured people. Overturning the mandate would have harmful consequences for the private insurance market. Under the law, insurers would still
have to accept all applicants regardless of health problems, and they would be limited in what they can charge older, sicker customers. As a result, premiums for people who directly buy their own coverage would jump by 15 percent to 20 percent, the Congressional Budget Office estimates. Older, sicker people would flock to get health insurance but younger, healthier ones would hold back. To forestall such a problem, the administration asked the court — if it declares the mandate unconstitutional — to also strike down certain consumer protections, including the requirement on insurers to cover people with pre-existing health problems. That would mitigate a damaging spike in premiums. Whether or not the court goes along with that request, more work would be needed to find alternatives to a federal mandate. That could provide an opening for state officials, as well as major insurance companies, to join in finding workable substitutes for the mandate. Congressional approval would likely be needed. Without the individual requirement, some 14 million people would still get coverage, budget office estimates suggest.
Veterinarians consider giving NC zoo elephant contacts
RALEIGH, N.C. (AP) — After C’sar the bull elephant lost weight, grew depressed and underwent surgery because of eye trouble, his keepers at a North Carolina zoo began to consider a pioneering move in pachyderm medicine: giving him a set of king-size contact lenses. Officials at the North Carolina Zoo in Asheboro and the North Carolina State University’s College of Veterinary Medicine are weighing whether the risks are worth it. C’sar’s caregivers said an elephant has never been fitted with corrective lenses, and they are unsure if they want C’sar to be the world’s first test subject. The 12,000-pound, 38-year-old African bull elephant has been at the zoo since 1978. “He just stood around and leaned against the walls,” said senior veterinarian Ryan DeVoe. “He was just not interested in anything going on around him.” After C’sar had cataract surger-
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In this May 18 photo, C'sar the elephant stands at the North Carolina Zoo in Asheboro, N.C.
ies in October and May, he perked up and started regaining weight. However, when the natural lenses from both of his eyes were removed, the animal was left
farsighted. C’sar’s eyes are a bit larger than the eyes of a horse, said Richard McMullen, assistant professor of veterinary ophthalmolo-
gy at N.C. State. The lenses would need to be soft and almost three times larger than contacts fitted for a human: 38 millimeters in diameter and about half a millimeter thick. It will be August at the earliest before C’sar’s eyes are sufficiently healed to wear contacts. German-based Acrivet would create the contacts if called upon by C’sar’s caregivers. A spokeswoman said the technology for animal contacts has only been around for a little under a decade and the company has never made elephant contact lenses before. The custom creations for C’sar would be the largest the manufacturer has ever made. McMullen, who per for med C’sar’s two surgeries, believes corrective lenses would further improve the elephant’s wellbeing. “In dogs, we have seen their quality of life increase,” McMullen said. The elephant wouldn’t have to
Nuns start tour protesting Republican budget plan DES MOINES, Iowa (AP) — A group of Roman Catholic nuns began a nine-state bus tour protesting proposed federal budget cuts Monday, saying they weren’t trying to flout recent Vatican criticisms of socially active nuns but felt called to show how Republican policies are affecting lowincome families. The tour was organized by Network, a Washington-based Catholic social justice group criticized in a recent Vatican report that said some organizations led by nuns have focused too much on economic injustice while failing to promote the church’s teachings on abortion and same-sex marriage. The Vatican asked U.S. bishops to look at Network’s ties to another group of nuns it is reorganizing because of what the church calls “serious doctrinal problems.” Sister Simone Campbell, Network’s executive director, said while the tour may appear to have been organized to counter recent criticism of social activist nuns by the Vatican and American bishops, it was not. The timing was in response to consideration of the federal budget in Congress, she said. But if the 14 nuns who will rotate on and off the bus during the next
She said the Vatican and bishops speaking so harshly of nuns has split the church.
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Sister Simone Campbell, executive director of Network, speaks during a stop of the Nuns on the Bus tour, Monday, in Ames, Iowa.
two weeks weren’t trying to counter the Vatican, they likely did little to ease its concerns about social activism. The tour kicked off with a rally that had the feel of a political event. About 20 supporters brought flowers and balloons and sang, “Alleluia,” as the nuns boarded a modern tour bus decorated with bright-colored graphics. While the nuns say they aren’t opposing any specific Republican candidate, they plan stops at the offices of several closely tied to the budget process, including House Speaker John Boehner of
Ohio, and Wisconsin Rep. Paul Ryan, the architect of the House-passed budget. Their first stop Monday was Rep. Steve King’s office in Ames. The tour will end in Washington on July 2. The mandate to crack down on socially active nuns upset some church parishioners who turned out to support the nuns. “They want to bully these nuns and shut them down and tell them: ‘Get back in your place, ladies.’ No, it’s not going to be that way anymore,” said Mary Ann McCoy, of Des Moines, who attends St. Ambrose Cathedral.
“They’re women of courage,” McCoy said. “Back in the Old Testament they talked about prophets. A prophet is somebody who speaks for God and these are the things that God talked about — injustice, the poor, the marginalized, woman. Jesus was the greatest prophet when he went out and he shook things up a lot. Well, I think the sisters are walking the walk and talking the talk and that’s what’s important to us.”
While the Vatican has criticized Network, church officials have not ordered a full-scale overhaul of it as is being done with another group, the Leadership Conference of Women Religious. After a two-year investigation, the Vatican concluded the conference had undermined Roman Catholic teaching with radical feminist themes and taken positions that undermined Catholic teaching on the all-male priesthood, marriage and homosexuality. Three U.S. bishops, including Seattle Archbishop J. Peter Sartain, have been given five years to reorganize that group.
go under anesthesia to get the contacts inserted, but he might have to be sedated.
C’sar already responds well to his post-surgery eye drops. The bull elephant’s handlers have trained him to lean his eye in between the six-inch thick steel bars to receive the medicine. With contacts, he would need four-tofive doses daily.
Zookeepers aren’t certain how often the contacts would need to be changed. Their best guess is every three months. Zoo officials also don’t know what health complications might arise over time.
While this would be the first corrective lens for an elephant, it wouldn’t be the first contact. McMullen said a contact has been used once before on an elephant in Amsterdam in February, but just as a bandage to keep foreign objects out of the eye after surgery.