Archive for June 29th, 2015

Gay Hollywood Mafia Money and Propaganda Succeeds — Supreme Court Ignores States Rights, Will of American People, United States Constitution And Bill of Rights and Rules in Favor of Same Sex Gay Marriage — Betrayal of Oath of Office — End The Two Party Tyranny — Videos

Posted on June 29, 2015. Filed under: American History, Articles, Babies, Blogroll, Business, Catholic Church, Comedy, Communications, Congress, Constitution, Corruption, Faith, Family, Federal Government, government, government spending, history, Law, liberty, Life, Literacy, media, Narcissism, People, Philosophy, Political Correctness, Politics, Press, Psychology, Rants, Raves, Regulations, Religion, Strategy, Supreme Court, Talk Radio, Taxation, Wealth, Welfare, Wisdom, Writing | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

Project_1

The Pronk Pops Show Podcasts

Pronk Pops Show 494 June 26, 2015

Pronk Pops Show 493 June 25, 2015

Pronk Pops Show 492 June 24, 2015 

Pronk Pops Show 491 June 23, 2015

Pronk Pops Show 490 June 22, 2015

Pronk Pops Show 489 June 19, 2015

Pronk Pops Show 488 June 18, 2015

Pronk Pops Show 487 June 17, 2015

Pronk Pops Show 486 June 16, 2015

Pronk Pops Show 485 June 15, 2015

Pronk Pops Show 484 June 12, 2015

Pronk Pops Show 483 June 11, 2015

Pronk Pops Show 482 June 10, 2015

Pronk Pops Show 481 June 9, 2015

Pronk Pops Show 480 June 8, 2015

Pronk Pops Show 479 June 5, 2015

Pronk Pops Show 478 June 4, 2015

Pronk Pops Show 477 June 3, 2015 

Pronk Pops Show 476 June 2, 2015

Pronk Pops Show 475 June 1, 2015

Pronk Pops Show 474 May 29, 2015

Pronk Pops Show 473 May 28, 2015

Pronk Pops Show 472 May 27, 2015

Pronk Pops Show 471 May 26, 2015

Pronk Pops Show 470 May 22, 2015

Pronk Pops Show 469 May 21, 2015

Pronk Pops Show 468 May 20, 2015 

Pronk Pops Show 467 May 19, 2015

Pronk Pops Show 466 May 18, 2015

Pronk Pops Show 465 May 15, 2015

Pronk Pops Show 464 May 14, 2015

Pronk Pops Show 463 May 13, 2015

Pronk Pops Show 462 May 8, 2015

Pronk Pops Show 461 May 7, 2015

Pronk Pops Show 460 May 6, 2015

Pronk Pops Show 459 May 4, 2015 

Pronk Pops Show 458 May 1, 2015 

Pronk Pops Show 457 April 30, 2015 

Pronk Pops Show 456: April 29, 2015 

Pronk Pops Show 455: April 28, 2015

Pronk Pops Show 454: April 27, 2015

Pronk Pops Show 453: April 24, 2015

Pronk Pops Show 452: April 23, 2015 

Pronk Pops Show 451: April 22, 2015

Pronk Pops Show 450: April 21, 2015

Pronk Pops Show 449: April 20, 2015

Pronk Pops Show 448: April 17, 2015

Pronk Pops Show 447: April 16, 2015

Pronk Pops Show 446: April 15, 2015

Pronk Pops Show 445: April 14, 2015

Pronk Pops Show 444: April 13, 2015

Pronk Pops Show 443: April 9, 2015

Pronk Pops Show 442: April 8, 2015

Pronk Pops Show 441: April 6, 2015

Pronk Pops Show 440: April 2, 2015

Pronk Pops Show 439: April 1, 2015

Pronk Pops Show 438: March 31, 2015

Pronk Pops Show 437: March 30, 2015 

Pronk Pops Show 436: March 27, 2015 

Pronk Pops Show 435: March 26, 2015

Pronk Pops Show 434: March 25, 2015

Pronk Pops Show 433: March 24, 2015

Pronk Pops Show 432: March 23, 2015

Pronk Pops Show 431: March 20, 2015

Pronk Pops Show 430: March 19, 2015

Pronk Pops Show 429: March 18, 2015

Pronk Pops Show 428: March 17, 2015 

Pronk Pops Show 427: March 16, 2015

Pronk Pops Show 426: March 6, 2015

Pronk Pops Show 425: March 4, 2015

Pronk Pops Show 424: March 2, 2015

Story 1: Gay Hollywood Mafia Money and Propaganda Succeeds — Supreme Court Ignores States Rights, Will of American People, United States Constitution And Bill of Rights and Rules in Favor of Same Sex Gay Marriage —  Betrayal of Oath of Office — End The Two Party Tyranny — Videos

supreme_courtgaymarriageobama_gay_evolvedObamaObama-Gay-Evolutionobama-gay-marriage-present-cartoonobama_gayshollywood gay mafia and obamabiden  obamaobama_biden_shootgunobama biden honeymoonman holeobama-rainbowgiftjpgImageCartoon-for-no-sex-marriagegary-mccoygay marriage actunemployment

First Amendment

The First Amendment guarantees freedoms concerning religion, expression, assembly, and the right to petition.  It forbids Congress from both promoting one religion over others and also restricting an individual’s religious practices.  It guarantees freedom of expression by prohibiting Congress from restricting the press or the rights of individuals to speak freely.  It also guarantees the right of citizens to assemble peaceably and to petition their government.

Amendment I

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the government for a redress of grievances.

https://www.law.cornell.edu/constitution/first_amendment

14th Amendment

The Fourteenth Amendment addresses many aspects of citizenship and the rights of citizens.  The most commonly used — and frequently litigated — phrase in the amendment is  “equal protection of the laws“, which figures prominently in a wide variety of landmark cases, including Brown v. Board of Education (racial discrimination),Roe v. Wade (reproductive rights),  Bush v. Gore (election recounts), Reed v. Reed (gender discrimination),  and University of California v. Bakke (racial quotas in education).  See more

Amendment XIV

Section 1.

All persons born or naturalized in the United States, and subject to the jurisdiction thereof, are citizens of the United States and of the state wherein they reside. No state shall make or enforce any law which shall abridge the privileges or immunities of citizens of the United States; nor shall any state deprive any person of life, liberty, or property, without due process of law; nor deny to any person within its jurisdiction the equal protection of the laws.

Section 2.

Representatives shall be apportioned among the several states according to their respective numbers, counting the whole number of persons in each state, excluding Indians not taxed. But when the right to vote at any election for the choice of electors for President and Vice President of the United States, Representatives in Congress, the executive and judicial officers of a state, or the members of the legislature thereof, is denied to any of the male inhabitants of such state, being twenty-one years of age, and citizens of the United States, or in any way abridged, except for participation in rebellion, or other crime, the basis of representation therein shall be reduced in the proportion which the number of such male citizens shall bear to the whole number of male citizens twenty-one years of age in such state.

Section 3.

No person shall be a Senator or Representative in Congress, or elector of President and Vice President, or hold any office, civil or military, under the United States, or under any state, who, having previously taken an oath, as a member of Congress, or as an officer of the United States, or as a member of any state legislature, or as an executive or judicial officer of any state, to support the Constitution of the United States, shall have engaged in insurrection or rebellion against the same, or given aid or comfort to the enemies thereof. But Congress may by a vote of two-thirds of each House, remove such disability.

Section 4.

The validity of the public debt of the United States, authorized by law, including debts incurred for payment of pensions and bounties for services in suppressing insurrection or rebellion, shall not be questioned. But neither the United States nor any state shall assume or pay any debt or obligation incurred in aid of insurrection or rebellion against the United States, or any claim for the loss or emancipation of any slave; but all such debts, obligations and claims shall be held illegal and void.

Section 5.

The Congress shall have power to enforce, by appropriate legislation, the provisions of this article.

https://www.law.cornell.edu/constitution/amendmentxiv

U.S. Supreme Court Rules In Favor Of Same Sex Marriage SCOTUS Gay MArriage Ruling

Inside the courtroom for SCOTUS gay marriage ruling

Shields and Gerson on Supreme Court’s gay marriage, Obamacare decisions

Special Report: Supreme Court legalizes same-sex marriage

Supreme Court: States CANNOT Ban Same Sex Marriage

Same-sex marriage ruling divides some GOP candidates

GOP Congress Shows Little Appetite to Fight Gay Marriage Ruling…

US Supreme Court backs gay marriage – BBC News

Supreme Court rules in favor of same-sex marriage. What’s next?

Lead Plaintiff on Supreme Court’s same-sex marriage ruling

Obama hails Supreme Court’s gay marriage ruling

The Equal Protection Clause Does Not Require States To License Same-Sex Marriages

Civil Unions Vs Marriage: Laura Ingraham Weighs In | Larry King Now

Civil Unions or Gay Marriage

Civil Unions: A Love Story

Why aren’t civil unions good enough for YOU?

Rome: Same sex couples celebrate first civil unions

Debate: Does the Constitution require states to recognize same-sex marriage?

GAY MARRIAGE (Virtual Press Conference)

Jim Obergefell responds to Supreme Court decision on same-sex marriage

The Marxist/Gay “Takedown” of America

“SIR, I WILL NOT OBEY THAT ORDER.”

Obama Admits Communist “Schooled” him on White Racism

From the Vault • Barack Obama • SEP 1995

22-CityView presents Barack Obama speaking at the Cambridge Public Library. Recorded on September 20,1995, this originally aired on Channel 37 Cambridge Municipal Television as an episode of the show “The Author Series.” In this episode Obama discusses his book “Dreams from My Father: A Story of Race and Inheritance,” which at the time had just been released a few months previously.

PJTV: Are You a Homophobe For Not Supporting Gay Marriage?

Megyn Kelly Panel Battles on Whether Clinton & Obama Are Phonies Having Evolved on Gay Marriage

The Real Reason Obama Evolved On Gay Marriage

Biden’s Same-Sex Interview: Is the Obama Administration For-Against Gay Marriage?

VP Joe Biden ENDORSES same-sex marriage

Obama’s Gay Marriage Support: Forced by Biden

Obama Opposed Gay Marriage For The Worst Reason Of All

Axelrod: Obama hid position on gay marriage in 2008

David Axelrod on Obama’s Gay Marriage Stance

Obama LIED…About Opposing Gay Marriage

Barack Obama on Gay Marriage

Obama 2004: “I Am Not A Supporter Of Gay Marriage”

Obama In 2004: “I Don’t Think Marriage Is A Civil Right”

The Daily Show – Rights Courts

Bill Maher: The Gay Mafia Is REAL

Bill Maher: “There is a Gay Mafia, If You Cross Them You Get Wacked”

Hollywood “Gay Mafia” Explored! (2014)

Hollywood Gay Mafia – David Geffen, Barry Diller, Sandy Gallin III

The Gay Mafia Is Upset With ET Williams

CULTURAL MARXISM: The Corruption of America

The Historic Ruling On Same-Sex Marriage

Gay Marriage Backers Win Supreme Court Victory

http://www.nytimes.com/2015/06/27/us/supreme-court-same-sex-marriage.html?_r=0

Supreme Court opinion on same sex marriage

The Supreme Court ruled 5-4 that the Constitution requires that same-sex couples be allowed to marry no matter where they live and that states may no longer reserve the right only for heterosexual couples. Supreme Court rules gay couples nationwide have a right to marry

The Supreme Court’s Same-Sex Marriage Decision Is Already Being Used to Sell You Washing Machines

From Miller Lite to Maytag, here’s how popular brands reacted to the SCOTUS ruling this morning.

Not very long ago, even the token gay television character could cause an uproar, and while popular brands may have voiced unequivocal support for some sort of nebulous gay “pride,” many avoided staking a position on the controversial political question of same-sex marriage. Today, with the U.S. Supreme Court declaring “the right of same-sex couples to marry” throughout the country, brands from Miller Lite to Maytag were quick to react in support the decision on social media. It all may be a bit hokey and opportunistic, but the extent to which iconicly American brands aren’t worried about alienating customers with pro-gay-marriage messages perhaps shows us more than anything that America is ready for marriage equality to be the law of the land. Here’s a sampling of brand tweets this morning about the SCOTUS marriage decision:

@MillerLite: As long as you are you, #ItsMillerTime. #LoveWins

@MillerLite/Twitter@MillerLite/Twitter

@TheMaytagMan: Here’s to finding the one who completes you. #SCOTUSMarriage

@TheMaytagMan/Twitter@TheMaytagMan/Twitter

@Cheerios: And now, no one can tell you otherwise. #LoveWins

@Cheerios/Twitter@Cheerios/Twitter

‏@ChipotleTweets: Homo Estas? Very well, thank you. #LoveWins 

@ChipotleTweets/Twitter@ChipotleTweets/Twitter

@VogueMagazine: LoveWins today: http://vogue.cm/1Ja0KIU

@voguemagazine/Twitter@voguemagazine/Twitter

@Staples: MAKE equality HAPPEN #LoveWins

@Staples/Twitter@Staples/Twitter

@CocaCola: It’s now official. Love is love is love. #LoveWins

@CocaCola/Twitter@CocaCola/Twitter

@SubPop: It’s a great day in the USA. #lovewins 

@subpop/Twitter@subpop/Twitter

@Macys: From this day forward… #loveislove

@Macys/Twitter@Macys/Twitter

@Uber_Ohio: Destination: Love #SCOTUSmarriage #LoveWins

@Uber_Ohio@Uber_Ohio

@Motorola: Today #LoveWins and we couldn’t be happier – Now everyone can #ChooseLove

@Motorola/Twitter@Motorola/Twitter

Elizabeth Nolan Brown is a staff editor at Reason.com.

http://reason.com/blog/2015/06/26/brand-tweets-about-gay-marriage-decision

Supreme Court rules gay couples nationwide have a right to marry

By Robert Barnes

The Supreme Court on Friday delivered a historic victory for gay rights, ruling 5 to 4 that the Constitution requires that same-sex couples be allowed to marry no matter where they live and that states may no longer reserve the right only for heterosexual couples.

The court’s action marks the culmination of an unprecedented upheaval in public opinion and the nation’s jurisprudence. Advocates called it the most pressing civil rights issue of modern times, while critics said the courts had sent the country into uncharted territory by changing the traditional definition of marriage.

“Under the Constitution, same-sex couples seek in marriage the same legal treatment as opposite-sex couples, and it would disparage their choices and diminish their personhood to deny them this right,” Justice Anthony Kennedy wrote in the majority opinion. He was joined in the ruling by the court’s liberal justices Ruth Bader Ginsburg, Stephen G. Breyer, Sonia Sotomayor and Elena Kagan.

All four of the court’s most conservative members — Chief Justice John G. Roberts Jr. and Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr. — dissented and each wrote a separate opinion, saying the court had usurped a power that belongs to the people.

How same-sex marriage became legal across the country VIEW GRAPHIC
Reading a dissent from the bench for the first time in his tenure, Roberts said, “Just who do we think we are? I have no choice but to dissent.”

In his opinion, Roberts wrote: “Many people will rejoice at this decision, and I begrudge none their celebration. But for those who believe in a government of laws, not of men, the majority’s approach is deeply disheartening.”

[It’s the first time Roberts has had such a bold statement from the bench]

Scalia called the decision a “threat to American democracy,” saying it was “constitutional revision by an unelected committee of nine.”

In a statement in the White House Rose Garden, President Obama hailed the decision: “This ruling is a victory for America. This decision affirms what millions of Americans already believe in their hearts. When all Americans are truly treated as equal, we are more free.”

Obama said change on social issues can seem slow sometimes, but “sometimes there are days like this when that slow and steady effort is rewarded with justice that arrives like a thunderbolt. This morning the Supreme Court recognized that the Constitution guarantees marriage equality. In doing so they’ve reaffirmed that all Americans are entitled to equal protection under the law. . . . Today we can say in no uncertain terms that we have made our union a little more perfect.”

How people outside the court reacted to the gay marriage ruling
View Photos A sea of cheering, rainbow flag-waving people filled the sidewalk in front of the Supreme Court to celebrate the decision.
There were wild scenes of celebrations on the sidewalk outside the Supreme Court, as same-sex marriage supporters had arrived early, armed with signs and rainbow flags. They celebrated the announcement of a constitutional right to something that did not legally exist anywhere in the world until the turn of the new century.

Jim Obergefell, who became the face of the case, Obergefell v. Hodges, when he sought to put his name on his husband’s death certificate as the surviving spouse, said: “Today’s ruling from the Supreme Court affirms what millions across the country already know to be true in our hearts: that our love is equal.”

“It is my hope that the term gay marriage will soon be a thing of the past, that from this day forward it will be simply, marriage,” he said. “All Americans deserve equal dignity, respect and treatment when it comes to the recognition of our relationships and families.’’

But Austin R. Nimocks, senior counsel for the Alliance Defending Freedom, a pro-traditional marriage group, said: “Today, five lawyers took away the voices of more than 300 million Americans to continue to debate the most important social institution in the history of the world. That decision is truly unfortunate. . . . Nobody has the right to say that a mom or a woman or a dad or a man is irrelevant. There are differences that should be celebrated. Millions of Americans still believe that.’’

[Opponents of gay marriage are divided on whether to resist the ruling]

This country’s first legally recognized same-sex marriages took place just 11 years ago, the result of a Massachusetts state supreme court decision. Now, more than 70 percent of Americans live in states where same-sex couples are allowed to marry, according to estimates.

The Supreme Court used cases from Michigan, Ohio, Kentucky and Tennessee, where restrictions about same-sex marriage were upheld by an appeals court last year, to find that the Constitution does not allow such prohibitions.
Kennedy has written the Supreme Court’s most important gay rights cases: overturning criminal laws on homosexual conduct, protecting gays from discrimination and declaring that the federal government could not refuse to recognize same-sex marriages performed where they were legal.

He often employs a lofty, writing-for-history tone, and Friday’s decision was no different.

Referring to the couples who brought the cases before the court, Kennedy wrote: “It would misunderstand these men and women to say they disrespect the idea of marriage. Their plea is that they do respect it, respect it so deeply that they seek to find its fulfillment for themselves. Their hope is not to be condemned to live in loneliness, excluded from one of civilization’s oldest institutions.”

Kennedy did not respond directly to the court’s dissenters, but he addressed the argument that the court was creating a new constitutional right. The right to marriage is fundamental, he said. The difference is society’s way of thinking who may marry, he said.

“The limitation of marriage to opposite-sex couples may long have seemed natural and just, but its inconsistency with the central meaning of the fundamental right to marry is now manifest,” he wrote. “With that knowledge must come the recognition that laws excluding same-sex couples from the marriage right impose stigma and injury of the kind prohibited by our basic charter.”

Scalia declared that Kennedy’s writing style was “as pretentious as its content is egotistic.”

And Roberts, in a biting dissent far more harsh than his usual style, said the decision was “an act of will, not legal judgment” with “no basis in the Constitution or this court’s precedent.”

“The court invalidates the marriage laws of more than half the states and orders the transformation of a social institution that has formed the basis of human society for millennia, for the Kalahari Bushmen and the Han Chinese, the Carthaginians and the Aztecs,” Roberts wrote. “Just who do we think we are?”
The questions raised in the cases decided Friday were left unanswered in 2013, when the justices last confronted the issue of same-sex marriage. A slim majority of the court said at the time that a key portion of the Defense of Marriage Act — withholding the federal government’s recognition of same-sex marriages — was unconstitutional. In a separate case, the court said procedural issues kept it from answering the constitutional question in a case from California, but that move allowed same-sex marriages to resume in that state.

Since then, courts across the nation — with the notable exception of the Cincinnati-based federal appeals court that left intact the restrictions in the four states at issue — have struck down a string of state prohibitions on same-sex marriage, many of them passed by voters in referendums.

When the Supreme Court declined to review a clutch of those court decisions in October, same-sex marriage proliferated across the country.

Public attitudes toward such unions have undergone a remarkable change as well. A recent Washington Post-ABC poll showed a record 61 percent of Americans say they support same-sex marriage. The acceptance is driven by higher margins among the young.

[Interactive: See how gay rights have spread around the world over 224 years]

When the justices declined in October to review the string of victories same-sex marriage proponents had won in other parts of the country, it meant the number of states required to allow gay marriages grew dramatically, offering the kind of cultural shift the court often likes to see before approving a fundamental change.

The Obama administration had urged the court to find that the Constitution requires such restrictions be struck down, and Solicitor General Donald B. Verrilli Jr. made the case on behalf of the administration at the court’s oral arguments in April.

“In a world in which gay and lesbian couples live openly as our neighbors, they raise their children side by side with the rest of us, they contribute fully as members of the community . . . it is simply untenable — untenable — to suggest that they can be denied the right of equal participation in an institution of marriage, or that they can be required to wait until the majority decides that it is ready to treat gay and lesbian people as equals,” he said.

http://www.washingtonpost.com/politics/gay-marriage-and-other-major-rulings-at-the-supreme-court/2015/06/25/ef75a120-1b6d-11e5-bd7f-4611a60dd8e5_story.html

How each justice came down on same-sex marriage

  • Mark Berman

The Supreme Court’s ruling followed a swell of courts striking down state bans on same-sex marriage and a surge in public support for such marriages. Still, the high court’s 5 to 4 ruling was a historic and narrow victory for gay rights.

The court’s four most conservative members dissented, and each of them wrote a separate opinion decrying the decision. Justice Antonin Scalia, unsurprisingly, wrote the fieriest dissent, needing just two sentences to say that the majority’s decision is a “threat to American democracy.”

He the decision a “judicial Putsch,” says it is delivered in a style “as pretentious as its content is egotistic” and — at one point — follows a quote from the majority opinion with “Really?” and another with “Huh?” In a footnote, Scalia says that if he ever joined an opinion that opens the way the majority opinion does, “I would hide my head in a bag.” He then adds: “The Supreme Court of the United States has descended from the disciplined legal reasoning of John Marshall and Joseph Story to the mystical aphorisms of the fortune cookie.” Scalia was not a fan.

For more on how Scalia explained his decision and how the other justices explained theirs, head to Post Nation.

The paragraph gay marriage supporters will never forget

  • Max Ehrenfreund

The final paragraph of Justice Anthony Kennedy’s opinion holding that couples of the same sex havea constitutional right to wed is a cogent statement of what marriage means.

kennedygraf

Kennedy is responding to opponents of gay marriage who argue that it undermines the traditional sanctity of an ancient institution by redefining it. The point of same-sex unions is not to weaken marriage, he argues, but to expand it in the nation as a whole and honor it more fully in their own lives.

These lines echo the final paragraph of Loving v. Virginia, the case in which the Supreme Court threw out laws banning interracial marriage in 1967.

“Marriage is one of the ‘basic civil rights of man,’ fundamental to our very existence and survival,”Chief Justice Earl Warren wrote then.

And the passage is also reminiscent of the conclusion of Griswold v. Connecticut, an important case from 1965 on contraception among married couples.

“Marriage is a coming together for better or for worse, hopefully enduring, and intimate to the degree of being sacred,” Justice William O. Douglas argued. “It is an association that promotes a way of life, not causes; a harmony in living, not political faiths; a bilateral loyalty, not commercial or social projects. Yet it is an association for as noble a purpose as any involved in our prior decisions.”

http://www.washingtonpost.com/blogs/post-nation-live/liveblog/live-updates-supreme-court-rules-gay-couples-nationwide-have-a-right-to-marry/

SAME SEX MARRIAGE

Kayoun Kim

One issue receiving considerable attention in the popular press is same-sex marriage and the current loosening of social constraints against gay marriage. Same-Sex Marriage , defined as marriage between two people of the same biological sex and/or gender identity, is a new social phenomenon, “leading to a new type of family formation. In modern times same-sex marriage did not exist until the twenty-first century when an increasing number of countries began permitting same-sex couples to marry legally. In addition, beginning in the late twentieth century there has been a growing global movement to regard marriage as a fundamental human right to be extended to same-sex couples. These events are extraordinary given that even during most of the twentieth century, homosexuals were closeted and the concept of same-sex marriage was inconceivable, perceived by nearly all as an oxymoron.” (Chamie, Joshph, and Barry, M. 2011. “Same-Sex Marriage: A New Social Phenomenon.” Pppulation Council37(3): 529-551)

Marriage equality has made significant gains with public opinion and within state legislature, since Massachusetts legalized same-sex marriage within its borders in 2004. A result of the change in legal status in same-sex marriage is the growth in the marriage industry for gay men and lesbians. “Currently, as of 15 October 2014, 29 states and the District of Columbia, and ten Native American tribal jurisdictions allow and fully recognize same-sex marriages: California, Colorado, Connecticut, Delaware, Hawaii, Idaho, Illinois, Indiana, Iowa, Maine, Maryland, Massachusetts, Minnesota, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, Oklahoma, Oregon, Pennsylvania, Rhode Island, Utah, Vermont, Virginia, Washington, West Virginia and Wisconsin. There are 21 states, and 2 territories (Puerto Rico and U.S. Virgin islands), that explicitly prohibit same-sex marriages in their constitutions and/or by statute, including: Alabama, Alaska, Arizona, Arkansas, Florida, Georgia, Kansas, Kentucky, Louisiana, Michigan, Mississippi, Missouri, Montana, Nebraska, North Dakota, Ohio, South Carolina, South Dakota, Tennessee, Texas and Wyoming. Of these states banning same-sex marriage, the following states have been declared that same-sex marriage bans unconstitutional, but the rulings have been stayed: Alaska, Arkansas, Florida, Kentucky, Michigan and Texas.” (“Same-Sex Marriage Fast Facts.” 2014. CNN U.S. October 14. (http://www.cnn.com/2013/05/28/us/same-sex-marrage-fast-facts/))

“As a result of successful legal challenges and related social and policy developments, same-sex marriage is generating a combination of elation, controversy, and opposition in many countries around the world, notably in the United States. Indeed, the legal recognition of same-sex marriage has emerged as one of the most socially, politically, and legally divisive issues of the day. While most reactions to this new form of marriage and family formation have been intense and vocal, many commentators as well as the general public have little factual knowledge about same-sex marriage. All too often, public opinion and attitudes concerning same-sex marriage are based on apprehension, misconception, and hearsay.” (Chamie, Joshph, and Barry, M. 2011. “Same-Sex Marriage: A New Social Phenomenon.” Pppulation Council37(3): 529-551)

Attitudes Towards Same-Sex Marriage

During the 21st century, public support for same-sex marriage has grown considerably, and national polls conducted since 2011 show that a majority of Americans support legalizing it.
“On May 9, 2012, Barack Obama became the first sitting U.S. president legalize same-sex marriage through popular vote.” ( Stein, Sam. 2012. ” Obama Backs Gay Marriage.” Huff Post Politics, May 5. (http://www.huffingtonpost.com/2012/05/09/obama-gay-marriage_n_1503245.html))
“Support for same-sex marriage jumped 21 percent points from 2003, when Massachusetts became the first state to legalize same-sex marriage, to 2014. Currently, a majority (55%) of Americans favor allowing gay and lesbian couples to legally marry, compared to 41% who oppose. In 2003, less than one-third (32%) of Americans supported allowing same-sex couples to legally marry, compared to nearly 6 in 10 (59%) who opposed.” (“Survey A shifting Landscape: A decade of Change in American Attitudes about Same-Sex Marriage and LGBT Issues.” 2014. Public Religion Research Institute, January 26. (http://publicreligion.org/research/2014/02/2014-lgbt-survey/))

Prevalence of Same-Sex Households

“According to the Census Bureau, the same-sex couples households in the US in 2010 were 646,464.” (Amy Roberts and Caitlin Stark. 2014. “By the numbers: Same-sex marriage.” CNN Politics, October 6. (http://www.cnn.com/2012/05/11/politics/btn-same-sex-marriage/) One study demonstrated how using linked micromaps can improve mapping of same-sex couples household data. This study found that “an estimated 1 percent of US couple households, from 2006 through 2010, were same-sex couples households, and the percentage of same-sex couples household is much higher in metropolitan areas than in non-metropolitan areas. It found that the reason that Washington D.C. has the highest percentage of same-sex households because Washington D.C. itself is a central city.” (Mast, Brent, D. 2013. “Visualizing Same-Sex Couple Household Data With Linked Micromaps.” US Department of Housing and Urban Development15(2):267-271.)

Same-Sex Marriage Experience

Aine Marie Humble examined married older same-sex couples’ experiences of transitioning into marriage in order to explore how and why these couples in mid-to later life decided to marry and the characteristics of their weddings and wedding planning. She found that getting married for many older same-sex couples is even harder than for younger same-sex couples, because older cohorts of same-sex couples could not easily dispel the internalized beliefs “such as same-sex couples could never marry and marriage was not for them due to the fact that they have lived most of their lives through years of homophobia and heterosexism, which has affected their worldviews. Moreover, some older same-sex couples, particularly those in long-term relationships, may already view themselves as married and thus do not initially see the need for the legal marriage.” (Humble, Aine, M., 2013. “Moving from Ambivalence to Certainty: Older Same-Sex Couples Marry in Canada.” Canadian Journal on Aging 32(2): 131-144)
Pamela J. Lannutti examined the ways in which legally recognized same-sex marriage has affected the lives of same-sex couples in order to see how same-sex marriage is benefiting and challenging these couples on the individual and interpersonal levels. She found that “all of the couples that she had interviewed with expressed some way in which same-sex marriage improved or strengthened their romantic relationship, and others expressed that it contributed to a closer emotional bond between them. However, some participants expressed that they were stressed out during their marriage decision process or planning their weddings, because they lacked support from their families-of-origin.” (Lannutti, Pamela, J. 2007. “”This is Not a Lesbian Wedding”: Examining Same-Sex Marriage and Bisexual-Lesbian Couples.” Co-published simultaneosly in Journal of Bisexuality 7(3/4): 237-260; and: Bisexuality and Same-Sex Marriage 7(3/4): 237-260.)
Pamela J. Lannutti’s another study examined same-sex couples’ attractions to marriage and obstacles that challenged them when considering marriage. She found that the primary reason why same-sex couples decide to marry is because it would offer greater legal protections and civil benefits for their committed relationship. Another reason is that it would make it easier to bring children into their lives or protect their relationships with the children they already had. In terms of obstacles of same-sex marriage, the majority of these couples (41%) expressed that family disapproval, usually parental disapproval, was an obstacle to their marriage.

Reference Page

Chamie, Joshph, and Barry, M. 2011. “Same-Sex Marriage: A New Social Phenomenon.” Population Council 37(3): 529-551.

“Same-Sex Marriage Fast Facts.” 2014. CNN U.S. October 14. (http://www.cnn.com/2013/05/28/us/same-sex-marriage-fast-facts/)

Stein, Sam. 2012. “Obama Backs Gay Marriage.” Huff Post Politics, May 5. (http:222.huffingtonpost.com/2012/05/09/obama-gay-marriage_n_1503245.html)

“Survey A shifting Landscape: A decade of Change in American Attitudes about Same-Sex Marriage and LGBT Issues.” 2014. Public Religion Research Institute, January 26. (http://publicreligion.org/research/2014/02/2014-lgbt-survey/)

Amy Roberts and Caitlin Stark. 2014. “By the numbers: Same-sex marriage.” CNN Politics, October 6. (http://www.cnn.com/2012/05/11/politics/btn-same-sex-marriage/)

Mast, Brent, D. 2013. “Visualizing Same-Sex Couple Household Data with Linked Micromaps.” US Department of housing and Urban Development 15(2): 267-271.

Humble, Aine, M., 2013. “Moving from Ambivalence to Certainty: Older Same-Sex Couples Marry in Canada.” Canadian Journal on Aging 32(2): 131-144

Lannutti, Pamela, J. 2007. “”This is Not a Lesbian Wedding”: Examining Same-Sex Marriage and Bisexual-Lesbian Couples.” Co-published simultaneously in Journal of Bisexuality 7(3/4): 237-260; and:Bisexuality and Same-Sex Marriage 7(3/4): 237-260.)

http://www.personal.psu.edu/users/k/v/kvk5348/essay%20and%20image.html

Obama marriage shift ‘boost’ for donors

President Barack Obama’s public support for gay marriage could be a boon to his campaign war chest.

Supporters of gay marriage predicted the president’s announcement Wednesday that he thinks same-sex couples should be able to marry would energize the gay community.

Democratic donor Steve Elmendorf said he believes Obama’s announcement will “energize people for Obama at all levels. It’s not just about the LGBT community…everybody all the way up to the maximum [donors] will be excited.”

“It’s going to create some real energy for the campaign, not just for the donor community, but among people who care about this issue,” he added.

Obama already had significant financial support from LGBT donors. About one in six of Obama’s top campaign “bundlers” are gay, according to a Washington Post analysis. But the president’s reluctance to publicly come out in favor of gay marriage was a sticking point for some potential donors.

“It’ll be a big boost for donors,” one gay lobbyist said of the Wednesday announcement. “It’s been very frustrating to the gay community that he’s done so much that there is just this one issue. It’s the civil rights issue of our generation.” The lobbyist added that independents are the most likely donors to be swayed by Obama’s new stance, since many gay donors have already been supportive of Obama.

One gay bundler told Capital City New York that it will be “immeasurably easier” for him to raise money for Obama in the LGBT community and among progressives more broadly.

“Whether it’s for shoe leather or whether it’s for financial contributions, I think it will engage people,” said Chuck Wolfe, president of the Gay and Lesbian Victory Fund, noting that much of the community’s support and financial donations already go to Obama. Obama has helped usher in a new era of gay rights at the federal level, helping pass the controversial repeal of the military “Don’t Ask, Don’t Tell” repeal.

A heightened enthusiasm for the president in the LGBT community following this announcement could spur donors to shell out big bucks for his campaign, especially given conservative Republicans push on this issue in other states like Minnesota and GOP presumptive nominee Mitt Romney’s opposition to gay marriage.

Obama’s public announcement came just a day after North Carolina, a swing state for the presidential election in November, voted on a state ballot measure that prohibits marriage or rights to same-sex couples.

Elmendorf dismissed critics of Obama’s timing.

“We’re in a presidential campaign so everyone is going to say it’s politically motivated,” Elmendorf said. “I take him at his word. It’s not unusual for people of his age and demographic.”

The vast majority of money from gay and lesbian rights groups goes to Democratic candidates, according to the Center for Responsive Politics. In the 2010 election cycle, 96 percent of the $1.3 million given to federal candidates by LGBT organizations’ PACs and employees went to Democrats.

Still, some LGBT advocates say there’s been a lull in enthusiasm since last year’s repeal of the “Don’t Ask, Don’t Tell” policy for gays in the military.

“There’s been a drop off in participation and enthusiasm and even knowledge that we’re not done,” said Denny Meyer, a spokesman for American Veterans for Equal Rights.

But the shift on gay marriage could energize voters as well as donors who have burned out, he said. “The president making a policy change like that could result in people realizing … you have to make this happen by voting for people who will pass this.”

Obama’s decision to publicly support gay marriage didn’t appease all gay activists, and Republicans accused the White House of trying to have it both ways on the contentious issue.

Clarke Cooper, head of Log Cabin Republicans, wrote in an email that “LGBT Americans are right to be angry that this calculated announcement comes too late to be of any use to the people of North Carolina, or any of the other states that have addressed this issue on his watch.”

Futher, Cooper said that the administration has, “manipulated LGBT families for political gain as much as anybody, and after his campaign’s ridiculous contortions to deny support for marriage equality this week Obama does not deserve praise for an announcement that comes a day late and a dollar short.

http://www.politico.com/news/stories/0512/76128.html#ixzz3eE1voM5P

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Supreme Court Obamacare Attack On American Consumer Sovereignty and Individual Freedom — Big Government Tyranny and Coercion — Videos

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Story 1: Supreme Court Obamacare Attack On American Consumer Sovereignty and Individual Freedom — Big Government Tyranny and Coercion — Videos

“The state is that great fiction by which everyone tries to live at the expense of everyone else.”

“Each of us has a natural right, from God, to defend his person, his liberty, and his property.”

~ Frederic Bastiat

“Liberty is always freedom from the government.”

“The fact is that, under a capitalistic system, the ultimate bosses are the consumers.

The sovereign is not the state, it is the people.”

“The common man is the sovereign consumer whose buying or abstention from buying ultimately determines what should be produced and in what quantity and quality.”

“It is important to remember that government interference always means either violent action or the threat of such action.

The funds that a government spends for whatever purposes are levied by taxation.

And taxes are paid because the taxpayers are afraid of offering resistance to the tax gatherers.

They know that any disobedience or resistance is hopeless.

As long as this is the state of affairs, the government is able to collect the money that it wants to spend.

Government is in the last resort the employment of armed men, of policemen, gendarmes, soldiers, prison guards, and hangmen.

The essential feature of government is the enforcement of its decrees by beating, killing, and imprisoning.

Those who are asking for more government interference are asking ultimately for more compulsion and less freedom.”

~Ludwig von Mises

“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined —’to say what the law is.’ … That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

~Chief Justice John Roberts

“Today’s interpretation is not merely unnatural; it is unheard of. Who would ever have dreamt that ‘Exchange established by the State’ means ‘Exchange established by the State or the Federal Government’? Little short of an express statutory definition could justify adopting this singular reading.”

“We should start calling this law SCOTUScare.”

~Justice Antonin Scalia

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The Truth About Obamacare

In Upholding Obamacare’s Subsidies, Justice Roberts Rewrites the Law—Again

Time to start calling the Affordable Care Act SCOTUScare.

Supreme Court Chief Justice John Roberts has rewritten the law to save Obamacare—again.

Roberts’ majority opinion today in King v. Burwell, which ruled that the Obama administration’s decision to allow health insurance subsidies flow through the law’s federal exchanges, leaves no doubt that Roberts considers it his duty to keep the law afloat.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he writes. “If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

And so Roberts decided that a law which explicitly and repeatedly states that subsidies are limited to exchanges “established by a State,” and which defines “State” as one of the 50 states or the District of Columbia, actually allows subsidies in exchanges established by a State or the federal government. Roberts’ decision does not interpret Obamacare; it adds to it and reworks it, and in the process transforms it into something that it is not.

Roberts has not merely tweaked the law; he has rewritten it to mean the opposite of what it clearly means. Why include the phrase “established by a State under Section 1311″—the section dealing with state-based exchanges—except to limit the subsidies to those particular exchanges? Roberts’ opinion reconceptualizes this limiting language as inclusive.

The Chief Justice frames his decision as a form of respectful deference to congressional intent. As my colleague Damon Root noted earlier, his opinion cautions that in “every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan.”

But Roberts’ opinion is far more than a fair reading of the legislative plan; it is a Court-imposed decision as to what that plan must be.

As Justice Antonin Scalia writes in a scathing dissent, Roberts presumes, with no definitive evidence, that his interpretation is the one that Congress intended. “What makes the Court so sure that Congress ‘meant’ tax credits to be available everywhere?” Scalia asks. “Our only evidence of what Congress meant comes from the terms of the law, and those terms show beyond all question that tax credits are available only on state Exchanges.”

Roberts’ opinion declares its intent to uphold the law’s basic policy scheme, arguing that there would be adverse insurance market effects to a decision in favor of the challengers. In other words, there would have been policy implications to a ruling for the plaintiffs. That is almost certainly true, but it is not an excuse to rewrite the clear language of the law.

As Scalia says in the dissent, “The Court protests that without the tax credits, the number of people covered by the individual mandate shrinks, and without a broadly applicable individual mandate the guaranteed-issue and community-rating requirements ‘would destabilize the individual insurance market.’ If true, these projections would show only that the statutory scheme contains a flaw; they would not show that the statute means the opposite of what it says.” The majority has decided how Obamacare’s policy scheme should work, and redrafted the statute accordingly.

If Roberts had truly wanted to defer to Congress, he could have ruled that the law means what says rather than what it does not, and effectively handed the issue back to the legislature, letting Congress decide whether and how to update the law in accordance with its own wishes. Instead, Roberts made the choice for Congress—taking its power to craft law for itself. As Scalia writes, “the Court’s insistence on making a choice that should be made by Congress both aggrandizes judicial power and encourages congressional lassitude.”

This is not the first time that Roberts has rewritten the law in order to uphold it. In 2012, he declared that the law’s individual mandate to purchase insurance was unconstitutional under the Constitution’s Commerce Clause—and yet upheld it by declaring that the law’s penalty was instead permissible as a tax. In the same decision, he also found that the law’s threat to revoke all federal Medicaid funding from states that decline to participate in Obamacare’s expansion of the program was unconstitutionally coercive. But rather than strike the whole thing down, Roberts rewrote it, allowing the Medicaid expansion, and the rest of the law, to continue but without the same threat to state budgets.

In his dissent, Scalia argues that there’s a pattern to these rulings. “Under all the usual rules of interpretation, in short, the Government should lose this case. But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved.”

If anything, it’s even worse. What Roberts has saved is not the law so much as the Obama administration’s dubious, textually unsupported interpretation and implementation of Obamacare. This is not judicial restraint. It is judicial hubris.

And while it would be overstatement to say that this damages the legitimacy of the Court, it certainly reflects on the legacy and status of the law. As even Roberts admits in his opinion, the law “contains more than a few examples of inartful drafting” and generally “does not reflect the type of care and deliberation that one might expect of such significant legislation.” It is a shoddy, messy piece of legislation, held together, barely, by Supreme Court duct tape.

At this point, then, the law is as much a joint project between the administration and the Roberts court as it is a creation of Congress. As Scalia snarks at the end of his dissent, “we should start calling this law SCOTUScare.” Regardless of what we call it, that’s effectively what it has become.

http://reason.com/blog/2015/06/25/in-upholding-obamacares-subsidies-justic

Supreme Court Rules Obamacare Subsidies Are Legal

By Krishnadev Calamur

The U.S. Supreme Court on Thursday handed the Obama administration a major victory on health care, ruling 6-3 that nationwide subsidies called for in the Affordable Care Act are legal.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” the court’s majority said in the opinion, which was written by Chief Justice John Roberts. But they acknowledged that “petitioners’ arguments about the plain meaning … are strong.”

The majority opinion cited the law’s “more than a few examples of inartful drafting,” but added, “the context and structure of the Act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

Roberts was joined by the court’s liberal justices, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan, as well as by Anthony Kennedy.

In his dissent, Justice Antonin Scalia said: “We should start calling this law SCOTUScare,” an apparent reference to the fact the Supreme Court has now saved the Affordable Care Act twice. Scalia called the majority’s reading of the text “quite absurd, and the court’s 21 pages of explanation make it no less so.”

As NPR’s Nina Totenberg reported in March, opponents of the law contended “that the text of the law does not authorize subsidies to make mandated insurance affordable in 34 states.”

At issue were six words in one section of the law. As Nina pointed out: “Those words stipulate that for people who cannot afford health coverage, subsidies are available through ‘an exchange established by the state.’ ” She added:

“The government [contended] that those words refer to any exchange, whether it is set up by the state itself or an exchange run for the state by the federal government in accordance with individual state insurance laws and regulations. The challengers [said] the statute means what it says and no more.”

The court agreed Thursday with the government’s position.

The decision comes three years after a bitterly divided high court upheld the Affordable Care Act as constitutional by a 5-4 vote.

President Obama made a statement on the ruling late Thursday morning, saying the Affordable Care Act “is here to stay.”

http://www.npr.org/sections/thetwo-way/2015/06/25/417425091/supreme-court-rules-obamacare-subsidies-are-legal

Supreme Court Upholds Obamacare Subsidies in King v. Burwell

SCOTUS rules 6-3 in favor of administration in major defeat for critics of the health law.

Obamacare’s health insurance subsidies will live, thanks to the Supreme Court.

The High Court has ruled 6-3 in favor of the administration to uphold the subsidies in Obamacare’s federal exchanges. The case challenged the administration’s decision, through the Internal Revenue Service, to allow subsidies in the 36 exchanges run by the federal government under the law.

The challengers argued that the plain text of the law, which states that subsidies are only available in an exchange “established by a State,” defining “State” to mean the 50 states or the District of Columbia, prohibited subsidies in the federal exchanges. The administration argued that the IRS rule allowing those subsidies was consistent with the overall structure of the law, and with congressional intent.

Writing for the majority, Chief Justice John Roberts sided with the administration’s position, saying that although the health law contains “more than a few examples of inartful drafting,” the Court nevertheless believes that the relevant section of the law “can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt.” The complete ruling can be read here.

Basically, the Supreme Court, decided they’d rather squint at the law and look at its general shape rather than bother too much with the plain meaning of the relevant text.

This is a major victory fo the administration and backers of the health law, whose decision to ignore the plain text of the law has been blessed by the Court. It’s also a big loss for critics of Obamacare, who hoped to see the law’s implementation restrained by its legislative text, and for straightforward interpretation of congressional statute.

What it means is that the crazy array of post-King scenarios that many had speculated about over the last few months will never come to pass. Obamacare stays the same, in terms of both policy and politics. It’s a ruling for the status quo.

Reason will have much more on this throughout the day.

http://reason.com/blog/2015/06/25/supreme-court-upholds-obamacare-subsidie

Supreme Court Allows Nationwide Health Care Subsidies

The Supreme Court ruled on Thursday that President Obama’s health care law allows the federal government to provide nationwide tax subsidies to help poor and middle-class people buy health insurance, a sweeping vindication that endorsed the larger purpose of Mr. Obama’s signature legislative achievement.

The 6-to-3 ruling means that it is all but certain that the Affordable Care Act will survive after Mr. Obama leaves office in 2017. For the second time in three years, the law survived an encounter with the Supreme Court. But the court’s tone was different this time. The first decision, in 2012, was fractured and grudging, while Thursday’s ruling was more assertive.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice John G. Roberts Jr. wrote for a united six-justice majority. In 2012’s closely divided decision, Chief Justice Roberts also wrote the controlling opinion, but that time no other justice joined it in full.

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Demonstrators expressed their support for the Affordable Care Act outside of the Supreme Court on Thursday. CreditDoug Mills/The New York Times

In dissent on Thursday, Justice Antonin Scalia called the majority’s reasoning “quite absurd” and “interpretive jiggery-pokery.”

He announced his dissent from the bench, a sign of bitter disagreement. His summary was laced with notes of incredulity and sarcasm, sometimes drawing amused murmurs in the courtroom as he described the “interpretive somersaults” he said the majority had performed to reach the decision.

“We really should start calling this law Scotus-care,” Justice Scalia said, to laughter from the audience.

In a hastily arranged appearance in the Rose Garden on Thursday morning, a triumphant Mr. Obama praised the ruling. “After multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay,” he said, adding: “What we’re not going to do is unravel what has now been woven into the fabric of America.”

The ruling was a blow to Republicans, who have been trying to gut the law since it was enacted. But House Speaker John A. Boehner vowed that the political fight against it would continue.

“The problem with Obamacare is still fundamentally the same: The law is broken,” Mr. Boehner said. “It’s raising costs for American families, it’s raising costs for small businesses and it’s just fundamentally broken. And we’re going to continue our efforts to do everything we can to put the American people back in charge of their health care and not the federal government.”

The case concerned a central part of the Affordable Care Act that created marketplaces, known as exchanges, to allow people who lack insurance to shop for individual health plans. Some states set up their own exchanges, but about three dozen allowed the federal government to step in to run them. Across the nation, about 85 percent of customers using the exchanges qualify for subsidies to help pay for coverage, based on their income.

The question in the case, King v. Burwell, No. 14-114, was what to make of a phrase in the law that seems to say the subsidies are available only to people buying insurance on “an exchange established by the state.”

A legal victory for the plaintiffs, lawyers for the administration said, would have affected more than six million people and created havoc in the insurance markets and undermined the law.

Chief Justice Roberts acknowledged that the plaintiffs had strong arguments about the plain meaning of the contested words. But he wrote that the words must be understood as part of a larger statutory plan. “In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

The court decided in King v. Burwell that tax subsidies are being provided lawfully in three dozen states that have decided not to run the marketplaces for insurance coverage. Full analysis »
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This was challenging, he said, in light of the law’s “more than a few examples of inartful drafting,” a consequence of rushed work behind closed doors that “does not reflect the type of care and deliberation that one might expect of such significant legislation.”

But he said the law’s interlocking parts supported a ruling in favor of the subsidies, particularly given that a contrary decision could have given rise to chaos in the insurance markets. A ruling rejecting subsidies in most of the nation would have left in place other parts of the law, including its guarantee of coverage regardless of pre-existing conditions, its requirement that most Americans obtain insurance or pay a penalty, and its expansion of Medicaid.

Without the subsidies, many people would be unable to afford insurance, and healthier consumers would go without coverage, leaving insurers with a sicker, more expensive pool of customers. That would raise prices for everyone, leading to what supporters of the law called death spirals.

“The statutory scheme compels us to reject petitioners’ interpretation,” Chief Justice Roberts wrote, referring to the challengers, “because it would destabilize the individual insurance market in any state with a federal exchange, and likely create the very ‘death spirals’ that Congress designed the act to avoid.”

In dissent, Justice Scalia wrote that the majority had stretched the statutory text too far.

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Copies of the court’s ruling in favor of nationwide health insurance subsidies were rushed to television news reporters. CreditDoug Mills/The New York Times

“I wholeheartedly agree with the court that sound interpretation requires paying attention to the whole law, not homing in on isolated words or even isolated sections,” Justice Scalia wrote. “Context always matters. Let us not forget, however, why context matters: It is a tool for understanding the terms of the law, not an excuse for rewriting them.”

“Reading the act as a whole leaves no doubt about the matter,” he wrote. “ ‘Exchange established by the state’ means what it looks like it means.”

Justice Scalia said the decision had damaged the court’s reputation for “honest jurisprudence.”

The court, he said, had taken into its own hands a matter involving tens of billions of dollars that should have been left to Congress.

“It is up to Congress to design its laws with care,” he added, “and it is up to the people to hold them to account if they fail to carry out that responsibility.”

Justices Clarence Thomas and Samuel A. Alito Jr. joined Justice Scalia’s dissenting opinion.

Chief Justice Roberts rejected the argument that Congress had limited the availability of subsidies in order to encourage states to create their own exchanges, a notion that had occurred to almost no one at the time the law was enacted.

Sixteen states and the District of Columbia have established their own exchanges. Under the law, the federal government has stepped in to run exchanges in the rest of the states.

“The whole point of that provision,” Chief Justice Roberts wrote, “is to create a federal fallback in case a state chooses not to establish its own exchange. Contrary to petitioners’ argument, Congress did not believe it was offering states a deal they would not refuse — it expressly addressed what would happen if a state did refuse the deal.

The case started when four plaintiffs, all from Virginia, sued the Obama administration, saying the phrase meant that the law forbids the federal government to provide subsidies in states that do not have their own exchanges.

The plaintiffs challenged an Internal Revenue Service regulation that said subsidies were allowed whether the exchange was run by a state or by the federal government. They said the regulation was at odds with the Affordable Care Act.

In July, the United States Court of Appeals for the Fourth Circuit, in Richmond, Va., ruled against the challengers.

Judge Roger L. Gregory, writing for a three-judge panel of the court, said the contested phrase was “ambiguous and subject to multiple interpretations.” That meant, he said, that the I.R.S. interpretation was entitled to deference.

The Supreme Court’s ruling was more forceful. “This is not a case for the I.R.S.,” Chief Justice Roberts wrote. “It is instead our task to determine the correct reading.”

http://www.nytimes.com/2015/06/26/us/obamacare-supreme-court.html

SUPREME COURT OF THE UNITED STATES

Syllabus

KING ET AL. v. BURWELL, SECRETARY OF HEALTH AND HUMAN SERVICES, ET AL.

CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT

Supreme Court Ruling – Obamacare Subsidies Stay

Posted by William A. Jacobson

Decision just in in King v. Burwell. Here.

In a 6-3 ruling authored by Chief Justice Roberts, the Court held that subsidies are available on the federal exchanges. Those voting in the majority were Roberts, Kennedy, Ginsburg, Breyer, Sotomayor, and Kagan.

Had the court ruled otherwise, it would have put all of Obamacare in jeopardy, since 38 states do not have exchanges and Obamacare is too expensive for most people without a subsidy.

The issue was whether only state-established exchanges could issue tax credits, or whether the federal exchanges could also. Challengers to IRS regulations pointed to the words “established by the State” in the legislation as clear and unambiguous that subsidies were limited to state exchanges.

The Court rejected this assertion:

These provisions suggest that the Act may not always use the phrase “established by the State” in its most natural
sense. Thus, the meaning of that phrase may not be as clear as it appears when read out of context. [at 11.]

As he did in upholding an Obamacare constitutional challenge in 2012, Roberts found a way to read the law so as to save the law:

The upshot of all this is that the phrase “an Exchange established by the State under [42 U. S. C. §18031]” is properly viewed as ambiguous. The phrase may be limited in its reach to State Exchanges. But it is also possible that the phrase refers to all Exchanges—both State and Federal—at least for purposes of the tax credits. If a State chooses not to follow the directive in Section 18031 that it establish an Exchange, the Act tells the Secretary to establish “such Exchange.” §18041. And by using the words “such Exchange,” the Act indicates that State and Federal Exchanges should be the same. But State and Federal Exchanges would differ in a fundamental way if tax credits were available only on State Exchanges—one type of Exchange would help make insurance more affordable by providing billions of dollars to the States’ citizens; the other type of Exchange would not.2 [at 12-13]

The Court found Obamacare so “inartfully drafted” that the Court essentially wrote the law for Congress through “statutory interpretation.”

The Affordable Care Act contains more than a few examples of inartful drafting. (To cite just one, the Act creates three separate Section 1563s. See 124 Stat. 270, 911, 912.) Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through “the traditional legislative process.” Cannan, A Legislative
History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History, 105 L. Lib. J. 131, 163 (2013). And Congress passed much of the Act using a complicated budgetary procedure known as “reconciliation,” which limited opportunities for debate and amendment, and bypassed the Senate’s normal 60-vote filibuster requirement. Id., at 159–167. As a result, the Act does not reflect the type of care and deliberation that one mightexpect of such significant legislation….

Anyway, we “must do our best, bearing in mind the fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme.” Utility Air Regulatory Group, 573 U. S., at ___ (slip op., at 15) (internal quotation marks omitted). After reading Section 36B along with other related provisions in the Act, we cannot conclude that the phrase “an Exchange established by the State under [Section 18031]” is unambiguous. [at 14-15]

Nowhere in any of the opinions is the term “Gruber” mentioned. Jonathan Gruber, one of the architects of the law, stated on numerous occasions that there was a specific purpose of the language to exclude the federal exchange, so as to pressure states to get subsidies for their citizens by establishing exchanges.

Architect of Obamacare: Only get tax credits if buy on state exchanges

The Court rejected the Gruber view of Congressional intent:

The whole point of that provision is to create a federal fallback in case a State chooses not to establish its own Exchange. Contrary to petitioners’ argument, Congress did not believe it was offering States a deal they would not refuse—it expressly addressed what
would happen if a State did refuse the deal.

Having found the term “established by the State” ambiguous, the Court read it in a way such as to save Obamacare and prevent a “death spiral” of the law:

Given that the text is ambiguous, we must turn to the broader structure of the Act to determine the meaning of Section 36B. “A provision that may seem ambiguous in isolation is often clarified by the remainder of the statutory scheme . . . because only one of the permissible meanings produces a substantive effect that is compatible with the rest of the law.” United Sav. Assn. of Tex. v. Timbers of Inwood Forest Associates, Ltd., 484 U. S. 365, 371 (1988). Here, the statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very “death spirals” that Congress designed the Act to avoid. [at 15]

Reliance on context and structure in statutory interpretation is a “subtle business, calling for great wariness lest
what professes to be mere rendering becomes creation and attempted interpretation of legislation becomes legislation itself.” Palmer v. Massachusetts, 308 U. S. 79, 83 (1939). For the reasons we have given, however, such reliance is appropriate in this case, and leads us to conclude that Section 36B allows tax credits for insurance purchased on any Exchange created under the Act. Those credits are necessary for the Federal Exchanges to function like their State Exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid. [at 21]

Roberts and the majority did not want to be the ones to take down Obamacare, and that drove everything:

Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter. Section 36B can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt. [at 21]

Scalia’s dissent, joined by Thomas and Alito, was stinging, and in my opinion correct as to the absurdity of the Court contorting itself to save the law (as Roberts did in the original Obamacare challenge):

The Court holds that when the Patient Protection and Affordable Care Act says “Exchange established by the State” it means “Exchange established by the State or the Federal Government.” That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so. [at 1]

Scalia points out that the words have a plain meaning:

This case requires us to decide whether someone who buys insurance on an Exchange established by the Secretary gets tax credits. You would think the answer would be obvious—so obvious there would hardly be a need for the Supreme Court to hear a case about it. In order to receive any money under §36B, an individual must enroll in an insurance plan through an “Exchange established by the State.” The Secretary of Health and Human Services is not a State. So an Exchange established by the Secretary is not an Exchange established by the State—which means people who buy health insurance through such an Exchange get no money under §36B.

Words no longer have meaning if an Exchange that is not established by a State is “established by the State.” …. [at 2, italics in original]

Scalia argued — persuasively — that the overriding goal seems to be saving Obamacare, not exercising normal judicial interpretation of plain language:

“[T]he plain, obvious, and rational meaning of a statute is always to be preferred to any curious, narrow, hidden sense that nothing but the exigency of a hard case and the ingenuity and study of an acute and powerful intellect would discover.” Lynch v. Alworth-Stephens Co., 267 U. S. 364, 370 (1925) (internal quotation marks omitted). Under all the usual rules of interpretation, in short, the Government should lose this case. But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved. [at 2-3]

Scalia wrote that the majority opinion rewrote the law “with no semblance of shame”:

The Court interprets §36B to award tax credits on both federal and state Exchanges. It accepts that the “most natural sense” of the phrase “Exchange established by the State” is an Exchange established by a State. Ante, at 11. (Understatement, thy name is an opinion on the Affordable Care Act!) Yet the opinion continues, with no semblance of shame, that “it is also possible that the phrase refers to all Exchanges—both State and Federal.” Ante, at 13. (Impossible possibility, thy name is an opinion on the Affordable Care Act!) [at 3]

Scalia then delivered the best line of the day. Looking back over multiple decisions from the Court to rewrite Obamacare in order to save it, Scalia insisted that the law now should be called SCOTUScare:

Today’s opinion changes the usual rules of statutory interpretation for the sake of the Affordable Care Act. That, alas, is not a novelty. In National Federation of Independent Business v. Sebelius, 567 U. S. ___, this Court revised major components of the statute in order to save them from unconstitutionality. The Act that Congress passed provides that every individual “shall” maintain insurance or else pay a “penalty.” 26 U. S. C. §5000A. This Court, however, saw that the Commerce Clause does not authorize a federal mandate to buy health insurance. So it rewrote the mandate-cum-penalty as a tax. 567 U. S., at ___–___ (principal opinion) (slip op., at 15–45).

The Act that Congress passed also requires every State to accept an expansion of its Medicaid program, or else risk losing all Medicaid funding. 42 U. S. C. §1396c. This Court, however, saw that the Spending Clause does not authorize this coercive condition. So it rewrote the law to withhold only the incremental funds associated with the Medicaid expansion. 567 U. S., at ___–___ (principal opinion) (slip op., at 45–58). Having transformed two major parts of the law, the Court today has turned its attention to a third. The Act that Congress passed makes tax credits available only on an “Exchange established by the State.” This Court, however, concludes that this limitation would prevent the rest of the Act from working as well as hoped. So it rewrites the law to make tax credits available everywhere.

We should start calling this law SCOTUScare. [at 20-21, emphasis and hard paragraph breaks added.]

The legacy of this Court, Scalia wrote, will live on just as Obamacare, but in infamy:

Perhaps the Patient Protection and Affordable Care Act will attain the enduring status of the Social Security Act or the Taft-Hartley Act; perhaps not. But this Court’s two decisions on the Act will surely be remembered through the years. The somersaults of statutory interpretation they have performed (“penalty” means tax, “further [Medicaid] payments to the State” means only incremental Medicaid payments to the State, “established by the State” means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.

I dissent.

http://legalinsurrection.com/2015/06/supreme-court-ruling-obamacare-subsidies/

From ‘Jiggery-Pokery’ to ‘SCOTUScare,’ Read the Best Quotes From Today’s Obamacare Ruling

Justice Antonin Scalia’s flair for the dramatic shines through, while Chief Justice John Roberts plays it straight.

Jessica Ellis, right, with

Supporters of the Affordable Care Act react with cheers as the opinion for health care is reported outside of the Supreme Court in Washington on Thursday .

By U.S. News Staff
Thursday’s 6-3 ruling by the Supreme Court upholding the validity of tax credits that help millions of people afford health insurance under the Affordable Care Act came down to a literal matter of interpretation.

At issue were words in the law that subsidies could be distributed for health coverage purchased through “an Exchange established by the State.” The plaintiffs argued the law should be read literally, nullifying subsidies provided through exchanges that relied on the federal government. The Obama administration countered that the law never intended to limit subsidies in such a way.

Chief Justice John Roberts authored the court’s majority opinion, and was countered by Justice Antonin Scalia’s dissent. Here are some select quotes from both.

Roberts:

John Paul Stevens, Supreme Court Justice 13
Chief Justice John Roberts authored the court’s majority opinion.

“The upshot of all this is that the phrase ‘an Exchange established by the State under [42 U. S. C. §18031]’ is properly viewed as ambiguous. The phrase may be limited in its reach to State Exchanges. But it is also possible that the phrase refers to all Exchanges—both State and Federal—at least for purposes of the tax credits.”

“It would be odd indeed for Congress to write such detailed instructions about customers on a State Exchange, while having nothing to say about those on a Federal Exchange.”

“The Affordable Care Act contains more than a few examples of inartful drafting. Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through ‘the traditional legislative process’ … As a result, the Act does not reflect the type of care and deliberation that one might expect of such significant legislation.”

“The statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very ‘death spirals’ that Congress designed the Act to avoid.”

“In petitioners’ view, Congress made the viability of the entire Affordable Care Act turn on the ultimate ancillary provision: a sub-sub-sub section of the Tax Code. We doubt that is what Congress meant to do.”

“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined —’to say what the law is.’ … That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

Scalia:

widemodern_scalia_091613.jpg

Justice Antonin Scalia authored the court’s dissenting opinion.

“Today’s interpretation is not merely unnatural; it is unheard of. Who would ever have dreamt that ‘Exchange established by the State’ means ‘Exchange established by the State or the Federal Government’? Little short of an express statutory definition could justify adopting this singular reading.”

“We should start calling this law SCOTUScare.”

“The Court holds that when the Patient Protection and Affordable Care Act says ‘Exchange established by the State’ it means ‘Exchange established by the State or the Federal Government.’ That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so.”

“Yet the opinion continues, with no semblance of shame, that ‘it is also possible that the phrase refers to all Exchanges—both State and Federal.’ (Impossible possibility, thy name is an opinion on the Affordable Care Act!)”

“The Court’s next bit of interpretive jiggery-pokery involves other parts of the Act that purportedly presuppose the availability of tax credits on both federal and state Exchanges.”

“Much less is it our place to make everything come out right when Congress does not do its job properly. It is up to Congress to design its laws with care, and it is up to the people to hold them to account if they fail to carry out that responsibility.”

“Pure applesauce.”

“The somersaults of statutory interpretation they have performed (‘penalty’ means tax, ‘further [Medicaid] payments to the State’ means only incremental Medicaid payments to the State, ‘established by the State’ means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.”

Read the full opinion and dissent below: 

http://www.usnews.com/news/articles/2015/06/25/read-the-best-quotes-from-roberts-and-scalia-in-the-king-v-burwell-obamacare-opinion

Key Facts about the Uninsured Population

Decreasing the number of uninsured is a key goal of the Affordable Care Act (ACA), which provides Medicaid coverage to many low-income individuals in states that expand and Marketplace subsidies for individuals below 400% of the poverty line. Baseline estimates show that over 41 million individuals were uninsured in 2013, prior to the start of the major ACA coverage provisions, and early evidence suggests that the ACA has reduced this number. This brief describes trends in coverage leading up to the ACA, reviews early estimates of the impact of the ACA on the uninsured, examines the characteristics of the uninsured population, and summarizes the access and financial implications of not having coverage.

Summary: Key Facts about the Uninsured Population

What was happening to the uninsured leading up to the ACA?

Trends in the uninsured have historically tracked economic conditions, with the number of uninsured people increasing during recessionary periods when people lost their jobs. Public programs provided a safety net during the Great Recession and prevented many from going uninsured. On the eve of the ACA, as the economy stabilized, coverage losses slowed. However, over 41 million people were still without coverage in 2013.

What has been happening to the uninsured under the ACA?

As of 2014, the ACA helps expand coverage to millions of currently uninsured people through the expansion of Medicaid eligibility and establishment of Health Insurance Marketplaces. The ACA also includes reforms to help people maintain coverage and make private insurance affordable and accessible. Early evidence on coverage in the first few months of 2014 indicates that the number of uninsured has declined since the availability of these new provisions.

Why are so many Americans uninsured?

The high cost of insurance has been the main reason why people go without coverage. In 2013, 61% of uninsured adults said the main reason they were uninsured was because the cost was too high or because they had lost their job. Many people do not have access to coverage through a job, and gaps in eligibility for public coverage in the past have left many without an affordable option.  Even after ACA coverage expansions, Medicaid eligibility for adults remains limited in states that did not expand their programs.

Who are the uninsured?

Most of the uninsured are in low-income working families. In 2013, nearly 8 in 10 were in a family with a worker, and nearly 6 in 10 have family income below 200% of poverty. Reflecting the more limited availability of public coverage, adults have been more likely to be uninsured than children. People of color are at higher risk of being uninsured than non-Hispanic Whites.

How does the lack of insurance affect access to health care?

People without insurance coverage have worse access to care than people who are insured. Almost a third of uninsured adults in 2013 (30%) went without needed medical care due to cost. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.

What are the financial implications of lack of coverage?

The uninsured often face unaffordable medical bills when they do seek care. In 2013, nearly 40% of uninsured adults said they had outstanding medical bills, and a fifth said they had medical bills that caused serious financial strain.  These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.

What was happening to the uninsured leading up to the ACA?

The number of uninsured people steadily increased throughout most of the past decade due to decreasing employer sponsored insurance coverage and rising health care costs. The recent recession led to a steep increase in uninsured rates from 2008 to 2010 as a high jobless rate led millions to lose their employer sponsored coverage.1Medicaid and CHIP prevented steeper drops in insurance coverage, as many Americans became newly eligible for these programs when their income declined during the recession. From 2011 to 2013, uninsured rates dropped as the economy improved and early provisions expanding coverage under the ACA went into effect.

Key Details:

Figure 1: Uninsured Rates Among the Nonelderly, 2000-2013

  • The share of the nonelderly population with employer-sponsored coverage declined steadily between 2000 and 2010, dropping nearly ten percentage points over the decade.2 In 2011, this trend ended as the share with employer-sponsored coverage held nearly constant at around 58% between 2011 and 2013. This break in trend was likely due to uptake of the ACA provision that allowed young adults to continue as dependents on parents’ private plans until age 26. It also reflects improving economic conditions. The unemployment rate peaked at 10.0 percent in October 2009. From 2010 on, the unemployment rate improved steadily, corresponding with a drop in the uninsured rate from 2010 to 2013 (Figure 1).
  • The share of people covered by Medicaid increased significantly during the recent recession due to the weak economy and loss of jobs, which led to declining family incomes and decreasing employer-sponsored coverage among families. Between 2007 and 2013, over 10 million people—primarily children—gained Medicaid coverage. These gains offset some of the loss of employer coverage over the period.
  • In 2013, the uninsured rate among nonelderly individuals was at 16.7%, a level comparable to pre-recession uninsured rates (Figure 1). Still, many uninsured individuals had been uninsured for long periods, often five years or more,3 indicating that their lack of coverage was related to forces outside the recession. With the major ACA coverage provisions going into effect in 2014, many are newly-insured.

What has been happening to the uninsured under the ACA?

Under the ACA, as of 2014, Medicaid coverage is expanded to nearly all adults with incomes at or below 138% of poverty in states that expand, and tax credits are available for people who purchase coverage through a health insurance Marketplace. Early data suggest that the ACA has helped expand coverage to millions of previously uninsured people, but some—particularly poor adults in states that do not expand Medicaid—are still left without affordable coverage.

Key Details:

Figure 2: Percentage Point Decrease in Uninsured by State Medicaid Expansion Status, 2013- Q1 2014

  • As of mid-April 2014 (after the first open enrollment period), over 8 million people selected plans through the federal or state Marketplaces.4 The vast majority of Marketplace enrollees (85%) were eligible for premium tax credits. Many Marketplace enrollees are newly-insured. A survey of people with private non-group plans after open enrollment found that nearly six in ten (57 percent) of those with Marketplace coverage were uninsured prior to purchasing their current plan.5 Other data from insurers suggest a large increase in the individual market in the first quarter attributable to the ACA.6
  • Enrollment data also show that as of July 2014, Medicaid enrollment has grown by 8 million since the period before open enrollment (which started in October 2013).7 This growth is an increase of 14% in monthly Medicaid enrollment.8 Enrollment increases were higher (20%) among states that chose to expand Medicaid eligibility. These data suggest that Medicaid enrollment growth is related to ACA expansions.9
  • Early survey data suggest that the uninsured rate is falling. The early release of estimates from the first quarter (January through March) of the 2014 National Health Interview Survey indicates that the uninsured rate dropped for nonelderly individuals in the first quarter of 2014 by a full percentage point relative to the first quarter of the previous year.10 However, the NHIS early results were not likely to have captured most or all of the ACA’s effects, as many people enrolled in coverage after survey data were collected. NHIS early results also show that states that chose to expand Medicaid saw significant declines in uninsured rates among adults from 2013 to the first quarter of 2014 (Figure 2). States that did not choose to expand Medicaid did not see corresponding declines. Several private polls and surveys also indicate that the uninsured rate has been decreasing since the period prior to ACA open enrollment. While these surveys have different methodologies and often have high error margins that make point estimates unreliable, they are all in agreement that the uninsured rate has dropped in 2014.
  • Even with the availability of new coverage options, millions remain uninsured. Previous analyses show that many poor adults in states that do not expand Medicaid will continue to be at risk to be uninsured.11 People of color, people living in the South,12 and individuals living in rural areas are especially at risk to be left out of ACA coverage expansions.13

Why are so many Americans uninsured?

Insurance is expensive, and few people can afford to buy it on their own. Most Americans obtain health insurance coverage through an employer, but not all workers are offered employer-sponsored coverage. Also, not all who are offered coverage by an employer can afford their share of the premiums. Medicaid and the Children’s Health Insurance Program (CHIP) cover many low-income individuals, particularly children. However, Medicaid eligibility for adults remains limited in some states, and few people can afford to purchase coverage on their own without financial assistance.

Key Details:

Figure 3: Reasons for Being Uninsured among Uninsured Nonelderly Adults, 2013

  • Uninsured individuals report that cost poses a major barrier to purchasing coverage. In 2013, 61% of adults said that the main reason they are uninsured is either because the cost is too high or because they lost their job, compared to 1.7% who said they are uninsured because they do not need coverage (Figure 3). Under the ACA, financial assistance is available to help many uninsured people afford coverage.
  • Not all workers have access to coverage through their job. Most uninsured workers are self-employed or work for small firms where health benefits are less likely to be offered.14 Low-wage workers who are offered coverage often cannot afford their share of the premiums, especially for family coverage.15,16
  • Workers usually enroll in employer-sponsored health insurance if they are eligible.17 However, it has become increasingly difficult for many workers to afford coverage. In 2014, the average annual total cost of employer-sponsored family coverage was $16,834, and the worker’s share averaging $4,823 per year.18 Between 2004 and 2014, total premiums have increased by 69%, and the worker’s share has increased over 81%.19 Starting in 2015, under the ACA, employers with 50 or more workers will be penalized if they do not offer affordable coverage. As of 2014, the ACA provides Marketplace tax credits or Medicaid coverage for many employees without access to affordable employer-sponsored insurance.20
  • In 2013, over 51 million nonelderly individuals were covered by Medicaid and CHIP.21 Historically, Medicaid was only available to low-income children, parents, pregnant women, people with disabilities, and the elderly. While states have increasingly expanded eligibility for children over time, eligibility for parents remained much more limited before ACA coverage expansions.22
  • As of September 2014, 28 states are moving forward or will be moving forward with expanded Medicaid eligibility for most nonelderly individuals under 138% FPL.23 This expansion will fill in historical gaps in eligibility for public coverage. However, in states that do not expand their Medicaid programs, eligibility for adults remains limited: the median eligibility level for parents is just 47% of poverty, and adults without dependent children are ineligible in nearly all states not expanding.

Who are the Uninsured?

The majority of the uninsured are in low-income working families. Reflecting the more limited availability of public coverage, adults are more likely to be uninsured than children. People of color are at higher risk of being uninsured than non-Hispanic Whites.

Key Details:

Figure 4:  Characteristics of the Nonelderly Uninsured, 2013

  • Based on the most recent data that is available (which reflects coverage prior to the major ACA provisions), over six in ten of the uninsured have at least one full-time worker in their family, and 16% have a part-time worker in the family (Figure 4).
  • Individuals below poverty are at the highest risk of being uninsured, and this group accounted for 27% of all the uninsured in 2013 (the poverty level for a family of three was $19,530 in 2013). In total, almost nine in ten of the uninsured are in low- or moderate-income families, meaning they are below 400% of poverty (Figure 3).
  • While a plurality (46%) of the uninsured are White, non-Hispanic, people of color are at higher risk of being uninsured than White non-Hispanics. People of color make up 40% of the population but account for over half of the total uninsured population. The disparity in insurance coverage is especially high for Hispanics, who account for 19% of the total population but more than 30% of the uninsured population. Hispanics and non-Hispanic Blacks have significantly higher uninsured rates (25.6% and 17.3%, respectively) than Whites (11.7%).24
  • About eight in ten of the uninsured are U.S. citizens and 19.7% are non-citizens. Uninsured non-citizens include both lawfully present and undocumented immigrants. Undocumented immigrants and legal immigrants residing in the U.S. for less than five years are ineligible for federally funded health coverage.
  • Uninsured rates vary widely by state and by region, with individuals living in the South and West the most likely to be uninsured (Figure 5). This variation reflects different economic conditions, availability of employer-based coverage, demographics, and eligibility for public coverage.

How does the lack of insurance affect access to health care?

Figure 5: Uninsured Rates Among the Nonelderly by State, 2013

Almost a third of uninsured adults (30%) in 2013 went without needed care each year due to cost (Figure 5). Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.25, 26, 27, 28 Research also has suggested that insurance can decrease likelihood of depression and stress.29

Key Details:
  • Health providers can choose to not provide care to the uninsured. Only emergency departments are required by federal law to screen and stabilize all individuals. However, the uninsured are not necessarily more likely to use the emergency room than those with insurance.30 If the uninsured are unable to pay for care in full, they are often turned away when they seek follow-up care for urgent medical conditions.31
  • The uninsured receive less preventive care and recommended screenings than the insured. In 2013, only 1 in 3 uninsured adults (33%) reported a preventive visit with a physician in the last year, compared to 74% of adults with employer coverage and 67% of adults with Medicaid.32 Uninsured older adults (ages 50-64) were far less likely than their insured counterparts to report having been screened for cancer in the past five years.33

Figure 6:  Barriers to Health Care Among Nonelderly Adults by Insurance Status, 2013

  • Receiving needed care is especially important for the uninsured since they are generally not as healthy as those with private coverage. The uninsured are at higher risk for preventable hospitalizations and for missed diagnoses of serious health conditions.34 After a chronic condition is diagnosed, they are less likely to receive follow-up care and as a result are more likely to have their health decline.35 Lack of follow-up attributed to being uninsured can delay the detection of certain cancers, which can result in adverse outcomes.36 It follows that the uninsured also have significantly higher mortality rates than those with insurance.37,38
  • The uninsured report higher rates of postponing care and forgoing needed care or prescriptions due to cost compared to those enrolled in Medicaid and other public programs (Figure 6). A seminal study of health insurance in Oregon found that the uninsured were less likely to receive care from a hospital or doctor than newly insured Medicaid enrollees.39A follow-up study found that newly insured Medicaid enrollees were much less likely to delay care because of costs than the uninsured.40

What are the financial implications of lack of coverage?

The uninsured often face unaffordable medical bills when they do seek care. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.

Key Details:

Figure 7: Financial Consequences of Medical Bills by Insurance Coverage, 2013

  • Those without insurance for an entire year pay for one-fifth of their care out-of-pocket.41 They are typically billed for any care they receive, often paying higher charges than the insured.42
  • Medical bills can put great strain on the uninsured and threaten their physical and financial well-being. The uninsured are significantly more likely than individuals covered by employer coverage, non-group insurance or Medicaid to have trouble paying medical bills (Figure 7). Almost 40% of uninsured adults have outstanding medical bills.
  • A study based on the Oregon Health Insurance Experiment found that the uninsured were more likely to experience financial strain from medical bills and out-of-pocket expenses than those with Medicaid coverage. The uninsured were also more likely than the insured to have to postpone care because of costs.43
  • The uninsured live with the knowledge that they may not be able to afford to pay for their family’s medical care, which can cause anxiety and potentially lead them to delay or forgo care. Almost three-quarters (70%) of the uninsured are not confident that they can pay for the health care services they think they need, compared to 13% of those with employer coverage and 37% with Medicaid.44
  • The average uninsured household has no net assets.45 Without sufficient income or assets to pay their medical bills, uninsured individuals often see their debts accumulate while their credit ratings are compromised. Medical debts contribute to almost half of all bankruptcies in the United States.46

Conclusion

Over 41 million nonelderly individuals were uninsured in 2013.  This figure represents the baseline against which most changes in the ACA will be measured. While we do not yet know the full effect of the major coverage provisions of the ACA, early evidence indicates that it is working to expand insurance to those who need it.

Going without coverage can have serious health consequences for the uninsured because they receive less preventive care, and delayed care often results in more serious illness requiring advanced treatment. Being uninsured also can have serious financial consequences. The ACA holds promise for many people who will gain access to health insurance coverage, but monitoring how coverage changes and who is left out of coverage expansions is also important.

http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/

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