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Obamacare on Trial
Obamacare on Trial
Obamacare on Trial
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Obamacare on Trial

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This short book analyzes the Obamacare case — focusing on many points the Supreme Court was never told about — including the fact that the constitutional framers themselves had approved mandates to buy health insurance! (126 pages).

"An illuminating analysis of the Supreme Court decision on Obamacare that offers rigor and insight, written by a brilliant legal mind." – Amy Chua, Yale Law Professor and author of World on Fire, Days of Empire, and Battle Hymn of the Tiger Mother.

"Einer Elhauge is the single best and most incisive commentator on the constitutionality of the individual mandate and the Affordable Care Act more generally. His gathering of precedent and penetrating analysis will convince you that much of the Court's arguments were mistaken." – Ezekiel J. Emanuel, M.D., Ph.D., University of Pennsylvania Professor and Chair of the Department of Medical Ethics and Health Policy, former Special Advisor for Health Policy to the Obama White House OMB, New York Times columnist, and author of many books on health care.

"Elhauge asked a brilliant and devastatingly simple question of the Supreme Court's so-called 'originalists.' They simply ignored it. This beautiful book tells a story history won't forget." – Lawrence Lessig, Harvard Law Professor, and leading scholar and author of many books on Constitutional Law and Internet Law.

"Anyone who cares about the Supreme Court's approach to constitutional issues -- and especially about the claims of some Justices that they try to follow the Constitution's original meaning – must read Einer Elhauge's devastating analysis of what all nine Justices, and the hundreds of advocates whose briefs and arguments they studied, simply failed to take into account when the Supreme Court decided the Health Care Case of 2012. No history of that decision will be complete unless it includes this brilliant and eminently readable little book -- a book that deserves to become an instant classic." – Laurence H. Tribe, Harvard Law Professor, leading constitutional law scholar, acclaimed Supreme Court advocate, and author of many books, including the highly influential treatise, American Constitutional Law.

"Einer Elhauge brings to the debate over the individual mandate an extraordinary combination of skills: he is deeply knowledgeable about health policy, and he is also a terrific lawyer. This book is the result of his exceptional insight, and it demonstrates why the attacks on the health care reform law were so utterly misguided. Anyone who wants to understand this chapter in our history should read this book." – David Strauss, University of Chicago Law Professor, author of The Living Constitution, and leading constitutional law scholar who has argued 18 cases before the Supreme Court.

"Elhauge's lucid account of the battle over health care mandates seeks answers to important questions wherever they may lie, without letting policy preferences or political ideology drive outcomes. That's a rare and refreshing approach. He re-inspires confidence in the notion that the Constitution's principles can unite people with disparate views, rather than being bent by a bare majority to whatever preordained task is at hand." Jonathan Zittrain, Harvard Law Professor, co-director of the Berkman Center, and author of The Future of the Internet -- And How to Stop It.

LanguageEnglish
PublisherEiner Elhauge
Release dateAug 1, 2012
ISBN9781476122588
Obamacare on Trial
Author

Einer Elhauge

Einer Elhauge is the Petrie Professor of Law at Harvard Law School and founding director of the Petrie-Flom Center for Health Law Policy, Biotechnology and Bioethics. He served as Chairman of the Antitrust Advisory Committee to the Obama Campaign. He teaches a gamut of courses ranging from Antitrust, Contracts, Corporations, Legislation, and Health Care Law. Before coming to Harvard, he was a Professor of Law at the University of California at Berkeley, and clerked for Judge Norris on the 9th Circuit and Justice Brennan on the Supreme Court. He received both his A.B. and his J.D. from Harvard, graduating first in his law school class. He is an author of numerous pieces on range of topics even broader than he teaches, including antitrust (monopolization, predatory pricing, tying, bundled discounts, loyalty discounts, disgorgement, petitioning and state action immunity, the Google Books Settlement, and the Harvard v. Chicago schools of antitrust), public law (statutory interpretation, legislative term limits, the 2000 Presidential election, the ObamaCare mandate, and the implications of interest group theory for judicial review), corporate law (social responsibility and sale of control doctrine), patent law (patent holdup and royalty stacking), the legal profession (the value of litigation and counseling advice), and health law policy (healthcare fragmentation, medical technology assessment, how to make health law a coherent legal field, and how to devise a morally just and cost effective medical system). His most recent books include: "Research Handbook on the Economics of Antitrust Law (Edward Elgar Publishing Ltd. 2012)"; "The Fragmentation of U.S. Health Care: Causes and Solutions" (Oxford University Press 2010); "Statutory Default Rules" (Harvard University Press 2008); "U.S. Antitrust Law and Economics (Foundation Press 2011)"; and "Global Competition Law and Economics" (Hart Publishing 2011). Currently he is writing books about Contract Theory, Health Law Policy, and Re-engineering Human Biology, as well as working on articles on sundry other topics. For his website and publications, see http://www.law.harvard.edu/faculty/elhauge/ .

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    Book preview

    Obamacare on Trial - Einer Elhauge

    OBAMACARE ON TRIAL

    Einer Elhauge

    Copyright 2012 Einer Elhauge

    Smashwords Edition

    Preface – If Health Insurance Mandates Are Unconstitutional, Why Did the Founding Fathers Back Them? – A Response to Critics on the Founding Fathers and Health Insurance Mandates – A Further Response to Critics on the Founding Fathers and Insurance Mandates – The Broccoli Test – The Irrelevance of the Broccoli Argument Against the Insurance Mandate – It's Not About Broccoli!: The False Case Against Health Care – Economists Argue Over the Cost of Caring for the Uninsured – Don’t Blame Verrilli for Supreme Court Health-Care Stumble – The Roberts-Kagan Compromise on Obamacare? – What a Nobel Prize-Winning Economist Can Teach Us About Obamacare – Even the Most Conservative Supreme Court Justices Have Already Declared Mandates Constitutional – The Killer Precedent for Today’s Decision – The Fatal Flaw in John Roberts' Analysis of the Commerce Clause – Roberts' Real Long Game? – Chief Justice Robert’s Opinion – About the Author

    Einer Elhauge is Petrie Professor of Law at Harvard University and Founding Director of the Petrie-Flom Center in Health Law Policy

    PREFACE

    Like most law professors, I did not take the constitutional challenge to Obamacare seriously at first. This is not because I favored its mandate to purchase health insurance. Indeed, I had publicly written in opposition to that mandate on policy grounds during the 2008 Obama campaign, when I was defending what was then Barack Obama’s own opposition to the mandate favored by Hillary Clinton. But Supreme Court precedent made it implausible to think the mandate was unconstitutional.

    As it became clearer that the threat was serious, I took a closer look and began to write about what I was finding in newspapers and magazines like The New York Times, The New Republic, and The Atlantic. It turned out that the constitutional challenge not only lacked any persuasive support in text, history, or precedent, but simply ignored the fact that the constitutional framers themselves had approved many purchase mandates, including mandates to buy health insurance itself! Instead, the challenge relied on a series of legal moves that had long been discredited in rigorous legal analysis, including: a formalistic reliance on linguistic labels rather than real functional effects; a distinction between action and inaction that was well-known to fail; and the argument that the existence of a political power could not be justifiable if one could imagine it might be abused in absurd ways.

    This book collects the various essays I wrote about these weaknesses, many of which unfortunately were never raised in the briefs or oral arguments and thus were never addressed in the opinions of the Supreme Court justices. I have not modified any of these essays because I want to preserve the sense of real-time dynamic engagement with the arguments that were being made both in and outside the Court by supporters of the constitutional challenge. However, I have added Postscripts to some of the essays to reflect new or additional information that I was unable to include in the original essays.

    Finally, I include at the end of this book excerpts from the opinion of Chief Justice Robert on the constitutionality of Obamacare’s health insurance mandate, so you can judge for yourself whether you find it persuasive in light of my analysis.

    IF HEALTH INSURANCE MANDATES ARE UNCONSTITUTIONAL, WHY DID THE FOUNDING FATHERS BACK THEM?

    Einer Elhauge, The New Republic (April 13, 2012)

    In making the legal case against Obamacare’s individual mandate, challengers have argued that the framers of our Constitution would certainly have found such a measure to be unconstitutional. Nevermind that nothing in the text or history of the Constitution’s Commerce Clause indicates that Congress cannot mandate commercial purchases. The framers, challengers have claimed, thought a constitutional ban on purchase mandates was too obvious to mention. Their core basis for this claim is that purchase mandates are unprecedented, which they say would not be the case if it was understood this power existed.

    But there’s a major problem with this line of argument: It just isn’t true. The founding fathers, it turns out, passed several mandates of their own. In 1790, the very first Congress—which incidentally included 20 framers—passed a law that included a mandate: namely, a requirement that ship owners buy medical insurance for their seamen. This law was then signed by another framer: President George Washington. That’s right, the father of our country had no difficulty imposing a health insurance mandate.

    That’s not all. In 1792, a Congress with 17 framers passed another statute that required all able-bodied men to buy firearms. Yes, we used to have not only a right to bear arms, but a federal duty to buy them. Four framers voted against this bill, but the others did not, and it was also signed by Washington. Some tried to repeal this gun purchase mandate on the grounds it was too onerous, but only one framer voted to repeal it.

    Six years later, in 1798, Congress addressed the problem that the employer mandate to buy medical insurance for seamen covered drugs and physician services but not hospital stays. And you know what this Congress, with five framers serving in it, did? It enacted a federal law requiring the seamen to buy hospital insurance for themselves. That’s right, Congress enacted an individual mandate requiring the purchase of health insurance. And this act was signed by another founder, President John Adams.

    Not only did most framers support these federal mandates to buy firearms and health insurance, but there is no evidence that any of the few framers who voted against these mandates ever objected on constitutional grounds. Presumably one would have done so if there was some unstated original understanding that such federal mandates were unconstitutional. Moreover, no one thought these past purchase mandates were problematic enough to challenge legally.

    True, one could try to distinguish these other federal mandates from the Affordable Care Act mandate. One could argue that the laws for seamen and ship owners mandated purchases from people who were already engaged in some commerce. But that is no less true of everyone subject to the health-insurance mandate: Indeed, virtually all of us get some health care every five years, and the few exceptions could hardly justify invalidating all applications of the statute. One could also argue (as the challengers did) that activity in the health care market isn’t enough to justify a purchase mandate in the separate health insurance market. But the early mandates required shippers and seamen to buy health insurance without showing they were active in any market for health insurance or even health care, which was far more rare back then.

    Nor do any of these attempted distinctions explain away the mandate to buy guns, which was not limited to persons engaged in commerce. One might try the different distinction that the gun purchase mandate was adopted under the militia clause rather than the commerce clause. But that misses the point: This

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