At DOMA Hearing, Chief Justice Suggests Gays Are Too Powerful For Equal Protection

During oral arguments this morning, U.S. Supreme Court Chief Justice John Roberts appeared to at least entertain the argument by House Republicans that gays and lesbians are too politically powerful for constitutional protection.

Roberts suggested that gays and lesbians must be “politically powerful” because politicians are “falling all over themselves” to endorse gay marriage, according to a tweet by Mother Jones’ Adam Serwer. The brief by Paul Clement, who represented the House of Representatives in defending DOMA, had reasoned that gays and lesbians are winning political battles and “have the attention of lawmakers,” an absurd claim since the “power” assertion is factually inaccurate, and because such an argument would also cancel out protections for racial minorities and women.

Roberts and his fellow conservatives also expressed concern over the White House’s decision not to defend the Defense of Marriage Act, with Kennedy calling it “very troubling” and Justice Antonin Scalia criticizing the Justice Department’s “new regime.”

By contrast, several of the court’s liberal justices expressed alarm over the impact of DOMA’s actual deprivation of federal marriage benefits on gays and lesbians, with Justice Ruth Bader Ginsburg calling the rights left for married couples after DOMA “skim milk” and questioning, “What kind of marriage is this?” Justice Elena Kagan, meanwhile, pointed to evidence from a House of Representatives report that lawmakers passed DOMA with improper motives. Justice Anthony Kennedy, the likely swing vote, repeatedly expressed a different concern with DOMA — that it impinged on state definitions of marriage.

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Justice Kennedy Suggests Children Of Same-Sex Couples Suffer ‘Immediate Legal Injury’ From Ban

Early in this morning’s Supreme Court oral argument over the constitutionality of the California ban on same-sex marriage, Justice Anthony Kennedy suggested the children of same-sex couples suffer “immediate legal injury” from Proposition 8, according to Bloomberg. “They want their parents to have full recognition and status,” Kennedy said, adding that the “voice of those children” is important.

Kennedy, who is likely the swing vote, also suggested he was very uncomfortable striking down Proposition 8, according to a tweet from SCOTUSblog. Kennedy raised dismissing the case, which would leave in place the lower court ruling invalidating the same-sex marriage ban, but would not set any precedent about equal rights or marriage equality.

In response to Kennedy’s assertion, Justice Antonin Scalia questioned whether children would actually be harmed by Proposition 8, saying there is “considerable disagreement” about the “consequences” of same-sex marriage. “I take no position on whether it’s harmful or not, but it’s certainly true there is no answer to that scientific question,” he said, according to tweets from the Huffington Post’s Ryan Reilly.

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South Carolina Republican Suggests GOP Opposes Medicaid Expansion Because Obama Is Black

Confederate flag flying on grounds of South Carolina's state capitol

On Tuesday, the South Carolina House rejected extra Obamacare funding for the state’s Medicaid program. One Republican legislator offered a novel reason for the Republican majority’s decision: the President’s race.

State Rep. Kris Crawford’s comments came during the early stages of the state Medicaid debate in late January. Crawford suggested that it was politically beneficial for Republicans (who run a Statehouse that flew the Confederate flag in front of it as recently as December 2011) to oppose any political initiatives spearheaded by a black man:

Rep. Kris Crawford, a Republican from Florence and also an emergency room doctor, supports the expansion but expects the Republican caucus to vote as a block against the Medicaid expansion.

“The politics are going to overwhelm the policy. It is good politics to oppose the black guy in the White House right now, especially for the Republican Party,” Crawford said.

South Carolina’s voter ID law was blocked last year by the Department of Justice on grounds that it violated the Voting Rights Act. The author of the law admitted to receiving, and responding positively to, racist emails in support of the law.

Governor Nikki Haley’s (R) steadfast opposition to the Medicaid expansion is becoming increasingly lonely; a wave of Republican governors have recently accepted federal assistance in providing health care for their poor citizens. South Carolina hospitals, who strongly support the expansion, have gone so far as to ask that their taxes be raised to pay for it.

(HT: David Graham.)

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Fed Study Suggests A Central Idea Underlying Obamacare Is Wrong

A core idea at the heart of President Obama’s healthcare reform law is the notion that while expanding coverage is expensive, there are huge offsetting savings to be had from reforming how medicine is practiced by doctors and hospitals. Who knows, maybe a third of the $2.7 trillion spent on healthcare is wasted.

Now this notion is based mostly on the research of the Dartmouth Institute for Health Policy & Clinical Practice. It shows Medicare spending in some regions of the country is significantly higher than others. Kaiser Health News: “This geographic variation in spending, which the government has also examined, was a motivating force behind a number of government initiatives including changes in Medicare payment to reward hospitals and doctors who provide good care efficiently.”

And if that research is wrong? Well, then we have a problem. And a paper from a Federal Reserve economist suggests just that (via KHN):

[T]he variation in Medicare spending across states is attributable to factors that affect health and health behaviors, rather than practice styles. … It is not surprising that states in the South spend more on Medicare and have worse outcomes. These states perform significantly worse in numerous areas, including high school graduation rates, test scores, insurance, unemployment, violent crime, and teenage pregnancy. There are many ways that such differences can affect health utilization and outcomes, including differences in underlying health, social supports and social stressors, patient self-care and advocacy, ease of access to services, capabilities and quality of hospital and physician nurses and technicians, and cultural differences in attitudes toward care. A comparison of health spending in Mississippi with health spending in Minnesota is not likely to provide a usual metric of the ‘inefficiencies’ of the health system, nor is likely to provide a useful guide to improve the quality of care in places where it is lacking.

Certainly this is still an open issue, as the KHN article makes clear. But the fact that it is — and that we still rejiggered a fifth of the economy partly based on this research — should give policymakers pause — and perhaps a new found sense of humility.

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