EMTALA from 1986 became an illegal immigration magnet, 5-4 Supreme Court decision now may make it an abortion magnet

 Supreme Court allows emergency abortions in Idaho for now :

The federal government sued, leading a federal judge in August 2022 to block the state from enforcing provisions concerning medical care that is required under the federal Emergency Medical Treatment and Labor Act, or EMTALA.

That 1986 law mandates that patients receive appropriate emergency room care. The Biden administration argued that care should include abortions in certain situations when a woman’s health is imperiled even if death is not imminent.
 

Republican enthusiasm for the Line Item Veto began under Reagan and was their version of the imperial presidency

No different than Reagan's enthusiasm for federal mandates like EMTALA, which is the proximate cause of ObamaCare. But J. T. Young doesn't remember it that way, or that far back, here:

'Unmentioned in Obama's legacy is that he killed the line-item veto. While not having done so directly, Obama's presidency has ended this long-time Republican goal just as assuredly as if he had. The political and fiscal role reversals between the Congress and presidency - and between Republicans and Democrats - transpiring for twenty years, have culminated with this administration.

'Twenty years ago, Republicans, armed the Contract with America, dramatically rode to Congressional majorities for the first time in decades. Prominent within that important document was a call for a line-item veto for the president.

'The intent was to give a president power to eliminate wasteful federal spending with pinpoint accuracy. Instead of having to veto an entire bill, and risk shutting down all, or part of the government, a president would be able to stop particular provisions but leave a larger spending bill intact. This authority would reverse the "Hobson's Choice" that prevailed between Congress and a president.'

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'Ronald Reagan said to Congress in his 1986 State of the Union address, "Tonight I ask you to give me what forty-three governors have: Give me a line-item veto this year. Give me the authority to veto waste, and I'll take the responsibility, I'll make the cuts, I'll take the heat."'

WHATEVER CONSERVATISM IS, IT MOST CERTAINLY IS NOT ABOUT SEEKING TO ACQUIRE MORE POWER BUT RATHER ABOUT SEEKING TO DIFFUSE AND DISTRIBUTE IT, SOMETHING THE CONGRESS DELIBERATELY BETRAYED IN THE 1920s WHEN IT DECIDED TO STOP THE NATURAL EXPANSION OF REPRESENTATION. NO BRANCH OF THE GOVERNMENT MAY BE SAID SINCE THAT TIME TO BE IN ANY WAY CONSERVATIVE IN SPIRIT, EXCEPT IN THE OCCASIONAL IRRITABLE MENTAL GESTURE IN THAT DIRECTION WHICH IS USED AS A CLOAK FOR MORE SELF-AGGRANDIZEMENT. NO ONE ANYWHERE RETAINS "SELF-RESTRAINT" IN THEIR LEXICON.

Most Of The Free-Rider Problem Is An EMTALA Problem, Not A General Healthcare Problem

Maybe a guy who can't count shouldn't mess with your health insurance.

One good estimate of the cost of uncompensated hospital and doctor care in 2008 was just $43 billion, or 5.7% of a hospital care economy of $750 billion that year. But total spending on health care is much higher than that. For example, for 2011 the total size of the healthcare economy has been estimated at $2.7 trillion.

Consistent with that, Megan McArdle recently cites an Urban Institute estimate here for the following year, 2009, showing costs of all uncompensated care, not just for hospitals and doctors, at $62 billion, saying "this is a relatively small amount of overall health spending ... in the trillions."

She's right. $62 billion is just 2.3% of a $2.7 trillion healthcare economy.

The spread between those two numbers for 2008 and 2009 is $19 billion. Assuming a 4% increase in the costs of the hospital/doctor portion only from 2008 to 2009, the spread declines to $17 billion. That's the non-hospital side of the free-rider problem in 2009, less than 1% of all healthcare spending in 2011. Passing ObamaCare to fix that is like firing a bazooka to kill a gnat.

Clearly the bulk of the free-rider problem has been in the hospitals, which will continue to experience problems with uncompensated care despite Obama's Affordable Care Act.

That problem exists because of Ronald Reagan's 1986 signature on EMTALA, requiring hospitals to provide care regardless of citizenship, legal status or ability to pay. It drove up visits to emergency rooms over 26% in the first 15 years, and uncompensated cost totals over 600% since 1983, when they were just $6 billion compared with over $45 billion today. Those costs have been paid by all of us over time in a variety of ways, not the least of which have been increased healthcare insurance premiums, higher taxes, and longer waits in fewer available ERs.

While we're at it trying to overturn ObamaCare, EMTALA should be scrapped with it.

Gov. Mitt Romney Is Exposing The Liberalism Of Presidents Reagan And Bush

Gov. Mitt Romney is forcing us to consider seriously how Ronald Reagan and George W. Bush got carried away by liberal impulses and got us into troubles.

I think Romney was not a fan of Ronald Reagan in the 1990s because he realized Reagan's program was fiscally irresponsible, cutting taxes while increasing military spending to defeat Soviet Communism. The result was the largest increase in the US public debt since WWII. As a business man who can read a spread sheet, Mitt Romney can recognize fiscal insanity when he sees it.

Now a leaked video of a private fundraiser Romney addressed in Florida in May is being attacked by the left in recent hours. It shows Mitt Romney not too happy with the liberal consensus which uses the tax code as a form of welfare, primarily through the mechanism of tax credits combined with statutory tax rates which nullify income tax liability. This was not a bug in the law. It was a feature intended all along. Romney is signaling that he's not entirely on board with this form of liberalism.

The idea of getting people off welfare was an ingenious one under Reagan, effectively rebating their Social Security contributions when they went to work, instead of collecting a check directly from the federal government while unemployed. But it was fundamentally a compromise with liberalism, and the Earned Income Tax Credit later took on a life of its own, being notably expanded under Bill Clinton and under George W. Bush. Combined with the Child Tax Credit, the two credits represent transfer payments far in excess of the cost of the mortgage interest deduction, the drumbeat against which gets louder by the day. To take away the mortgage interest deduction would yield the government about $80 billion a year in new revenue. But eliminating the two tax credits would end a direct federal government expenditure in excess of $110 billion a year.

If you want to know in what world liberals like Nancy Pelosi under a liberal president like Barack Obama would find it thinkable to consent to a deliberate underfunding of Social Security, liberalism's signature program, by rolling back payroll taxes to help the working poor during the Great Recession, look to Ronald Reagan, who did basically the same thing for poor people through the EITC way back in the 1980s. In making Social Security contributions rebateable to the working poor, Reagan was nothing if not a liberal trendsetter.

Another innovation and accommodation with liberalism by Ronald Reagan was EMTALA, part of the tax reform of 1986, which made it the law that emergency rooms had to provide services regardless of ability to pay. That unfunded mandate costs approximately only $50 billion a year today. I say "only" because lying about the severity of that problem became the heart of the healthcare debate which gave us ObamaCare. The Heritage Foundation may have authored the idea of the individual healthcare mandate in 1989, but once again it was Ronald Reagan who paved the way and provided the cover for accommodating what eventually became ObamaCare's liberal tyranny.

Romney's remarks also question George Bush's two-state solution to peace in Israel, which is nothing but another unrealistic aspiration of liberalism which thinks you can put a chicken and a hungry snake in the same pen and enjoy a quiet Sunday afternoon. To this Romney wisely prefers the unsteady truce of the status quo. In doing so his realism is shining through.

Mitt Romney's looking better all the time, and conservatives should reconsider whether voting for him is such a bad idea after all. 

It Turns Out, The Cost Of Free-Riding Is A Straw Man Argument For ObamaCare

Thanks to Ronald Reagan's signature on EMTALA in 1986, hospitals must by law provide service to anyone, regardless of ability to pay among other things.

It turns out that the costs of this beneficence have indeed grown into a big problem, but it is nowhere near as big a problem as advocates of ObamaCare would like to make out.

Here's the government's best estimate of the problem, from the Congressional Budget Office, which everyone has known about since 2008 (italics added):

"A recent study by Hadley and others, which used that analytic approach, examined a sample of medical claims for uninsured individuals and projected that they would receive about $28 billion in uncompensated care in 2008. That study also examined cost reports from hospitals and a survey of doctors and generated a different estimate: The gross costs of providing uncompensated care would be about $43 billion in 2008, of which $35 billion would come from hospitals and $8 billion from doctors. Total spending on hospital care in 2008 is estimated to be about $750 billion, so those figures would imply that uncompensated care accounts for about 5 percent of hospital revenues, on average. Those findings are consistent with CBO’s analysis of uncompensated hospital care (cited above), which found that a sample of for-profit and nonprofit hospitals incurred costs for such care that averaged between 4 percent and 5 percent of their operating revenues."

So there you have it. The government has known all along that this  has been a problem in the neighborhood of 5 percent of the gross costs of care overall, yet it is preparing under ObamaCare to spend $200 billion annually to bring in the uninsured, almost 5 times as much as the problem warrants, wrecking insurance for everyone else in the process.

Justices Appointed By Republican Presidents Have Been Opponents Of Conservatism

In the attack on the traditional values of the American people, Republican presidents bear heavy responsibility for betraying them by their Supreme Court appointments.

Reagan is a particular disappointment. In the history of conservatism, he should assume the status more of "Democrat in recovery" than "conservative." And if it weren't for his signature on the 1986 law known as EMTALA, we might not be in this mess today.

So don't get your hopes up about Roberts and Alito on ObamaCare, let alone Kennedy.

Consider Roe v. Wade, 1973:

"In disallowing many state and federal restrictions on abortion in the United States, Roe v. Wade prompted a national debate that continues today, about issues including whether and to what extent abortion should be legal, who should decide the legality of abortion, what methods the Supreme Court should use in constitutional adjudication, and what the role should be of religious and moral views in the political sphere. Roe v. Wade reshaped national politics, dividing much of the United States into pro-choice and pro-life camps, while activating grassroots movements on both sides."

In the majority were:

Blackmun (NIXON APPOINTEE, 1970),

joined by

Burger (NIXON APPOINTEE, 1969),

Douglas,

Brennan (EISENHOWER APPOINTEE, 1956),

Stewart (EISENHOWER APPOINTEE, 1958),

Marshall,

Powell (NIXON APPOINTEE, 1971).

Or consider Lawrence v. Texas, 2003:

"In the 6-3 ruling, the Court struck down the sodomy law in Texas and, by proxy, invalidated sodomy laws in the thirteen other states where still existed, thereby making same-sex sexual activity legal in every U.S. state and territory."

In the majority were:

Kennedy (REAGAN APPOINTEE, 1988),

joined by

Stevens (FORD APPOINTEE, 1975),

Souter (BUSH APPOINTEE, 1990),

Ginsburg,

Breyer,

with concurrence by O'Connor (REAGAN APPOINTEE, 1981).

The sheep will get in line and follow their shepherd Romney this year. But if you believe that as president he will appoint anyone substantively different than this lot, fuhgehtaboudit. The Senate would never confirm such a person anyway, especially its Republican members, as disgraceful and disreputable a lot as you'll find anywhere in America.

Emergency Rooms: Ronald Reagan's Illegal Immigrant Magnets

The Emergency Medical Treatment and Active Labor Act (EMTALA) is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.

Ronald Reagan Was No Conservative: He's Responsible For The Healthcare Mess

Treatment regardless of ability to pay is all his fault, along with a number of other things:

The Emergency Medical Treatment and Active Labor Act (EMTALA) is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment.

EMTALA applies to "participating hospitals." The statute defines "participating hospitals" as those that accept payment from the Department of Health and Human Services, Centers for Medicare and Medicaid Services (CMS) under the Medicare program. However, in practical terms, EMTALA applies to virtually all hospitals in the U.S., with the exception of the Shriners Hospitals for Children, Indian Health Service hospitals, and Veterans Affairs hospitals. The combined payments of Medicare and Medicaid, $602 billion in 2004, or roughly 44% of all medical expenditures in the U.S., make not participating in EMTALA impractical for nearly all hospitals. EMTALA's provisions apply to all patients, and not just to Medicare patients.