| Today's Features City and School Board Election
Tuesday.
The election of City Council
members and School Board members will be held
next Tuesday, April 3. The following names appear
on the ballot.
R-9 School Board: (vote for
two)
Michael Goolsby, Lee Elliff
Pound, and Sheila VonHolten.
City Council - (vote for one)
Ward 1:
Kirby Newport and
Trevor C. Smith
Ward Two:
Two year term -
Donald McLaughlin
One year term -
Lawrence Q. Chapin
Ward Three:
John Studebaker and
Dustin Blankenship
Ward Four:
Lee Carlson and
Dick Fanning
Ward Five:
Jason T.A. Shelfer
All polling places will be open
from 6 a.m. until 7 p.m. Locations are the same
as in previous years.
Chamber Hires Carthage
Native as President.
The Carthage Chamber of
Commerce announced this week that Carthage native
Mark Elliff has assumed the role of Chamber
President and Carthage Economic Development
Director.
Elliff has worked the last
eleven years for Hometown Bank and has another
twenty years experience at UMB.
According to the Chamber, over
twenty applicants for the position were
considered.
Eliff has previously served as
a Chamber Board member and as the Chariman of the
Board. He is a 1975 graduate of Carthage High
School and graduated from MSSU in 1979.
Battle of the Boiler.
The Jasper County Commission
voted on Tuesday to pay for work on the air
conditions and boiler at the Sheriff’s
Office at 2907 County Road 180. The repairs were
completed in late February and requests for
payment had come from the contractors.
Approximately $13,000 will be
allocated from the Sheriff’s Department
Maintenance fund.
According to the Commission, it
placed $75,000 in the fund for this year, and it
has sufficient funds to pay for the work.
According to Commissioner Darieus Adams, Sheriff
Archie Dunn had requested the money come from the
County emergency fund.
County Attrorney Norman Rouse
told the Commission that all aspects of the
bidding process and completion of the work had
been satisfactory, and the Commission had the
authority to pay the bills from the Maintenance
fund, even if the Sheriff refused to sign off on
the bills.
Missouri Workers Confront
Legislators.
Jefferson City - An estimated
3,000 to 4,000 building tradesmen from across
Missouri, bolstered by members of industrial,
service and retail trades, rallied at the state
Capitol Tuesday to protest the onslaught of
anti-worker bills being considered by the
Missouri legislature.
According to rally
participants, two bills in particular that
severely impact the Missouri construction
industry are efforts to destroy Missouri’s
prevailing wage law and eliminate Project Labor
Agreements, both of which they say, have proven
that they are a major economic benefit to the
state, local communities and the construction
workforce.
A total of eight bills seeking
to change current prevailing wage laws have been
introduced, seven in the House and one in the
Senate. The bills range from total elimination of
prevailing wage to exempting payment in a
disaster area, and school districts, on housing
built with housing tax credits.
The Supreme
Court Arguments.
Today’s special insert in
the Mornin’ Mail represents
approximately twenty-two pages of the 132 pages
of arguments presented last Tuesday in the United
States Supreme Court.
The audio recording and full
text can be found at www.supremecourt.gov
CHIEF JUSTICE ROBERTS: We will
continue argument this morning in Case 11-398,
the Department of Health and Human Services v.
Florida.
General Verrilli. ORAL ARGUMENT
OF DONALD B. VERRILLI, JR., ON BEHALF OF THE
PETITIONERS GENERAL VERRILLI: Mr. Chief Justice,
and may it please the Court:
The Affordable Care Act
addresses a fundamental and enduring problem in
our health care system and our economy. Insurance
has become the predominant means of paying for
health care in this country. Insurance has become
the predominant means of paying for health care
in this country.
For most Americans, for more
than 80 percent of Americans, the insurance
system does provide effective access. Excuse me.
But for more than 40 million Americans who do not
have access to health insurance either through
their employer or through government programs
such as Medicare or Medicaid, the system does not
work. Those individuals must resort to the
individual market, and that market does not
provide affordable health insurance.
It does not do so because,
because the multibillion dollar subsidies that
are available for the, the employer market are
not available in the individual market. It does
not do so because ERISA and HIPAA regulations
that preclude, that preclude discrimination
against people based on their medical history do
not apply in the individual market. That is an
economic problem. And it begets another economic
problem.
JUSTICE SCALIA: Why aren’t
those problems that the Federal Government can
address directly?
GENERAL VERRILLI: They can
address it directly, Justice Scalia, and they are
addressing it directly through this, through this
Act by regulating the means by which health care,
by which health care is purchased. That is the
way this Act works.
Under the Commerce Clause,
what, what Congress has done is to enact reforms
of the insurance market, directed at the
individual insurance market, that preclude, that
preclude discrimination based on pre-existing
conditions, that require guaranteed issue and
community rating, and it uses -- and the minimum
coverage provision is necessary to carry into
execution those insurance reforms.
JUSTICE KENNEDY: Can you create
commerce in order to regulate it?
GENERAL VERRILLI: That’s
not what’s going on here, Justice Kennedy,
and we are not seeking to defend the law on that
basis.
In this case, the -- what is
being regulated is the method of financing
health, the purchase of health care. That itself
is economic activity with substantial effects on
interstate commerce. And -
JUSTICE SCALIA: Any self
purchasing? Anything I -- you know if I’m in
any market at all, my failure to purchase
something in that market subjects me to
regulation.
GENERAL VERRILLI: No.
That’s not our position at all, Justice
Scalia. In the health care market, the health
care market is characterized by the fact that
aside from the few groups that Congress chose to
exempt from the minimum coverage requirement --
those who for religious reasons don’t
participate, those who are incarcerated, Indian
tribes -- virtually everybody else is either in
that market or will be in that market, and the
distinguishing feature of that is that they
cannot, people cannot generally control when they
enter that market or what they need when they
enter that market.
CHIEF JUSTICE ROBERTS: Well,
the same, it seems to me, would be true say for
the market in emergency services: police, fire,
ambulance, roadside assistance, whatever. You
don’t know when you’re going to need
it; you’re not sure that you will. But the
same is true for health care. You don’t know
if you’re going to need a heart transplant
or if you ever will. So there is a market there.
To -- in some extent, we all participate in it.
So can the government require
you to buy a cell phone because that would
facilitate responding when you need emergency
services? You can just dial 911 no matter where
you are?
GENERAL VERRILLI: No, Mr. Chief
Justice. think that’s different. It’s
-- We -- I don’t think we think of that as a
market. This is a market. This is market
regulation. And in addition, you have a situation
in this market not only where people enter
involuntarily as to when they enter and
won’t be able to control what they need when
they enter but when they-
CHIEF JUSTICE ROBERTS: It seems
to me that’s the same as in my hypothetical.
You don’t know when you’re going to
need police assistance. You can’t predict
the extent to emergency response that you’ll
need. But when you do, and the government
provides it. I thought that was an important part
of your argument, that when you need health care,
the government will make sure you get it. Well,
when you need police assistance or fire
assistance or ambulance assistance, the
government is going to make sure to the best
extent it can that you get it -- get it.
GENERAL VERRILLI: I think the
fundamental difference, Mr. Chief Justice, is
that that’s not an issue of market
regulation. This is an issue of market
regulation, and that’s how Congress,
that’s how Congress looked at this problem.
There is a market. Insurance is provided through
the market system -
JUSTICE ALITO: Do you think
there is a, a market for burial services?
GENERAL VERRILLI: For burial
services?
JUSTICE ALITO: Yes.
GENERAL VERRILLI: Yes, Justice
Alito, I think there is.
JUSTICE ALITO: All right,
suppose that you and I walked around downtown
Washington at lunch hour and we found a couple of
healthy young people and we stopped them and we
said, "You know what you’re doing? You
are financing your burial services right now
because eventually you’re going to die, and
somebody is going to have to pay for it, and if
you don’t have burial insurance and you
haven’t saved money for it, you’re
going to shift the cost to somebody else."
Isn’t that a very
artificial way of talking about what somebody is
doing?
GENERAL VERRILLI: No, that -
JUSTICE ALITO: And if
that’s true, why isn’t it equally
artificial to say that somebody who is doing
absolutely nothing about health care is financing
health care services?
GENERAL VERRILLI: It’s, I
think it’s completely different. The -- and
the reason is that the, the burial example is not
-- the difference is here we are regulating the
method by which you are paying for something else
-- health care -- and the insurance requirement
-- I think the key thing here is my friends on
the other side acknowledge that it is within the
authority of Congress under Article I under the
commerce power to impose guaranteed-issue and
community rating forms, to end -- to impose a
minimum coverage provision. Their argument is
just that it has to occur at the point of sale,
and -
JUSTICE ALITO: I don’t see
the difference. You can get burial insurance. You
can get health insurance. Most people are going
to need health care. Almost everybody. Everybody
is going to be buried or cremated at some point.
What’s the difference?
GENERAL VERRILLI: Well, one big
difference, one big difference, Justice Alito, is
the -- you don’t have the cost shifting to
other market participants. Here -
JUSTICE ALITO: Sure you do,
because if you don’t have money then the
State is going to pay for it. Or some -
GENERAL VERRILLI: That’s
different.
JUSTICE ALITO: Or a family
member is going to pay.
GENERAL VERRILLI: That’s a
difference and it’s a significant
difference. In this situation one of the economic
effects Congress is addressing is that the --
there -- the many billions of dollars of
uncompensated costs are transferred directly to
other market participants. It’s transferred
directly to other market participants because
health care providers charge higher rates in
order to cover the cost of uncompensated care,
and insurance companies reflect those higher
rates in higher premiums, which Congress found
translates to a thousand dollars per family in
additional health insurance costs.
JUSTICE ALITO: But isn’t
that a very small part of what the mandate is
doing? You can correct me if these figures are
wrong, but it appears to me that the CBO has
estimated that the average premium for a single
insurance policy in the non-group market would be
roughly $5,800 in -- in 2016.
Respondents -- the economists
have supported -- the Respondents estimate that a
young, healthy individual targeted by the mandate
on average consumes about $854 in health services
each year. So the mandate is forcing these people
to provide a huge subsidy to the insurance
companies for other purposes that the act wishes
to serve, but isn’t -- if those figures are
right, isn’t it the case that what this
mandate is really doing is not requiring the
people who are subject to it to pay for the
services that they are going to consume? It is
requiring them to subsidize services that will be
received by somebody else.
GENERAL VERRILLI: No, I think
that -- I do think that’s what the
Respondents argue. It’s just not right. I
think it -- it really gets to a fundamental
problem with their argument.
JUSTICE GINSBURG: If
you’re going to have insurance, that’s
how insurance works.
GENERAL VERRILLI: A, it is how
insurance works, but, B, the problem that they --
that they are identifying is not that problem.
The -- the guaranteed issue and community rating
reforms do not have the effect of forcing
insurance companies to take on lots of additional
people who they then can’t afford to cover
because they’re -- they tend to be the sick,
and that is -- in fact, the exact opposite is
what happens here.
The -- when -- when you enact
Guaranteed Issue and Community Rating Reforms and
you do so in the absence of a minimum coverage
provision, it’s not that insurance companies
take on more and more people and then need a
subsidy to cover it, it’s that fewer and
fewer people end up with insurance because their
rates are not regulated. Insurance companies,
when -- when they have to offer Guaranteed Issue
and Community Rating, they are entitled to make a
profit. They charge rates sufficient to cover
only the sick population because health -
JUSTICE KENNEDY: Could you help
-- help me with this. Assume for the moment --
you may disagree. Assume for the moment that this
is unprecedented, this is a step beyond what our
cases have allowed, the affirmative duty to act
to go into commerce. If that is so, do you not
have a heavy burden of justification?
I understand that we must
presume laws are constitutional, but, even so,
when you are changing the relation of the
individual to the government in this, what we can
stipulate is, I think, a unique way, do you not
have a heavy burden of justification to show
authorization under the Constitution?
GENERAL VERRILLI: So two things
about that, Justice Kennedy. First, we think this
is regulation of people’s participation in
the health care market, and all -- all this
minimum coverage provision does is say that,
instead of requiring insurance at the point of
sale, that Congress has the authority under the
commerce power and the necessary proper power to
ensure that people have insurance in advance of
the point of sale because of the unique nature of
this market, because this is a market in which --
in which you -- although most of the population
is in the market most of the time -- 83 percent
visit a physician every year; 96 percent over a
five-year period -- so virtually everybody in
society is in this market, and you’ve got to
pay for the health care you get, the predominant
way in which it’s -- in which it’s paid
for is insurance, and -- and the Respondents
agree that Congress could require that you have
insurance in order to get health care or forbid
health care from being provided -
JUSTICE SCALIA: Why do you --
why do you define the market that broadly? Health
care. It may well be that everybody needs health
care sooner or later, but not everybody needs a
heart transplant, not everybody needs a liver
transplant. Why -
GENERAL VERRILLI: That’s
correct, Justice Scalia, but you never know
whether you’re going to be that person.
JUSTICE SCALIA: Could you
define the market -- everybody has to buy food
sooner or later, so you define the market as
food, therefore, everybody is in the market;
therefore, you can make people buy broccoli.
GENERAL VERRILLI: No,
that’s quite different. That’s quite
different. The food market, while it shares that
trait that everybody’s in it, it is not a
market in which your participation is often
unpredictable and often involuntary. It is not a
market in which you often don’t know before
you go in what you need, and it is not a market
in which, if you go in and -- and seek to obtain
a product or service, you will get it even if you
can’t pay for it. It doesn’t -
JUSTICE SCALIA: Is that a
principal basis for distinguishing this from
other situations? I mean, you know, you can also
say, well, the person subject to this has blue
eyes. That would indeed distinguish it from other
situations. Is it a principle basis?
I mean, it’s -- it’s
a basis that explains why the government is doing
this, but is it -- is it a basis which shows that
this is not going beyond what -- what the -- the
system of enumerated powers allows the government
to do.
GENERAL VERRILLI: Yes, for two
reasons. First, this -- the test, as this Court
has articulated it, is: Is Congress regulating
economic activity with a substantial effect on
interstate commerce?
The way in which this statute
satisfies the test is on the basis of the factors
that I have identified. If -
JUSTICE GINSBURG: Mr. Verrilli,
I thought that your main point is that, unlike
food or any other market, when you made the
choice not to buy insurance, even though you have
every intent in the world to self-insure, to save
for it, when disaster strikes, you may not have
the money. And the tangible result of it is -- we
were told there was one brief that Maryland
Hospital Care bills 7 percent more because of
these uncompensated costs, that families pay a
thousand dollars more than they would if there
were no uncompensated costs.
I thought what was unique about
this is it’s not my choice whether I want to
buy a product to keep me healthy, but the cost
that I am forcing on other people if I don’t
buy the product sooner rather than later.
GENERAL VERRILLI: That is --
and that is definitely a difference that
distinguishes this market and justifies this as a
regulation.
JUSTICE BREYER: All right. So
if that is your difference -- if that is your
difference, I’m somewhat uncertain about
your answers to -- for example, Justice Kennedy
asked, can you, under the Commerce Clause,
Congress create commerce where previously none
existed.
Well, yeah, I thought the
answer to that was, since McCulloch versus
Maryland, when the Court said Congress could
create the Bank of the United States which did
not previously exist, which job was to create
commerce that did not previously exist, since
that time the answer has been, yes. I would have
thought that your answer -- can the government,
in fact, require you to buy cell phones or buy
burials that, if we propose comparable
situations, if we have, for example, a uniform
United States system of paying for every burial
such as Medicare Burial, Medicaid Burial, CHIP
Burial, ERISA Burial and Emergency Burial beside
the side of the road, and Congress wanted to
rationalize that system, wouldn’t the answer
be, yes, of course, they could.
GENERAL VERRILLI: So -
JUSTICE BREYER: And the same
with the computers or the same with the -- the
cell phones, if you’re driving by the side
of the highway and there is a federal emergency
service just as you say you have to buy certain
mufflers for your car that don’t hurt the
environment, you could -- I mean, see,
doesn’t it depend on the situation?
GENERAL VERRILLI: It does,
Justice Breyer, and if Congress were to enact
laws like that, we -
JUSTICE BREYER: We would be --
or -
GENERAL VERRILLI: My
responsibility -- and I would defend them on a
rationale like that, but I do think that we are
advancing a narrower rationale.
JUSTICE KENNEDY: Well, then
your question is whether or not there are any
limits on the Commerce Clause. Can you identify
for us some limits on the Commerce Clause?
GENERAL VERRILLI: Yes. The --
the rationale purely under the Commerce Clause
that we’re advocating here would not justify
forced purchases of commodities for the purpose
of stimulating demand. We -- the -- it would not
justify purchases of insurance for the purposes
-- in situations in which insurance doesn’t
serve as the method of payment for service -
JUSTICE KENNEDY: But why not?
If Congress -- if Congress says that the
interstate commerce is affected, isn’t,
according to your view, that the end of the
analysis.
GENERAL VERRILLI: No. The, the
-- we think that in a -- when -- the difference
between those situations and this situation is
that in those situations, Your Honor, Congress
would be moving to create commerce. Here Congress
is regulating existing commerce, economic
activity that is already going on, people’s
participation in the health care market, and is
regulating to deal with existing effects of
existing commerce.
CHIEF JUSTICE ROBERTS: That --
that it seems to me, it’s a -- it’s a
passage in your reply brief that I didn’t
quite grasp. It’s the same point. You say
health insurance is not purchased for its own
sake, like a car or broccoli; it is a means of
financing health care consumption and covering
universal risks. Well, a car or broccoli
aren’t purchased for their own sake, either.
They are purchased for the sake of transportation
or in broccoli, covering the need for food. I --
I don’t understand that distinction.
GENERAL VERRILLI: The
difference, Mr. Chief Justice, is that health
insurance is the means of payment for health care
and broccoli is -
CHIEF JUSTICE ROBERTS: Well,
now that’s a significant -- I’m sorry.
GENERAL VERRILLI: And -- and
broccoli is not the means of payment for anything
else. And an automobile is not -
CHIEFJUSTICE ROBERTS: It’s
the means of satisfying a basic human need, just
as your insurance is a means of satisfying -
GENERAL VERRILLI: But I do
think that’s the difference between existing
commerce activity in the market already occurring
-- the people in the health care market
purchasing, obtaining health care services -- and
the creation of commerce. And the principle that
we are advocating here under the Commerce Clause
does not take the step of justifying the creation
of commerce. It’s a regulation of the
existing commerce.
JUSTICE GINSBURG: General
Verrilli, can we -can we go back to, Justice
Breyer asked a question, and it kind of
interrupted your answer to my question. And tell
me if I’m wrong about this, but I thought a
major, major point of your argument was that the
people who don’t participate in this market
are making it much more expensive for the people
who do; that is, they -they will get, a good
number of them will get services that they
can’t afford at the point where they need
them, and the result is that everybody
else’s premiums get raised. So you’re
not -- it’s not your -- your free choice
just to do something for yourself. What you do is
going to affect others, affect them in -- in a
major way.
GENERAL VERRILLI: That -- that
absolutely is a justification for Congress’s
action here. That is existing economic activity
that Congress is regulating by means of this
rule.
JUSTICE SCALIA: General
Verrilli, you -you could say that about buying a
car. If -- if people don’t buy cars, the
price that those who do buy cars pay will have to
be higher. So you could say in order to bring the
price down, you are hurting these other people by
not buying a car.
GENERAL VERRILLI: That is not
what we are saying, Justice Scalia.
JUSTICE SCALIA: That’s not
-- that’s not what you’re saying.
GENERAL VERRILLI: That’s
not -- not -
JUSTICE SCALIA: I thought it
was.
I thought you were saying other
people are going to have to pay more for
insurance because you’re not buying it.
GENERAL VERRILLI: No. It’s
because you’re going -- in the health care
market, you’re going into the market without
the ability to pay for what you get, getting the
health care service anyway as a result of the
social norms that allow -- that -- to which
we’ve obligated ourselves so that people get
health care.
JUSTICE SCALIA: Well,
don’t obligate yourself to that. Why -- you
know?
GENERAL VERRILLI: Well, I
can’t imagine that that -- that the Commerce
Clause would --would forbid Congress from taking
into account this deeply embedded social norm.
JUSTICE SCALIA: You -- you
could do it. But -- but does that expand your
ability to, to issue mandates to -- to the
people?
GENERAL VERRILLI: I -- I --
this is not a purchase mandate. This is a -- this
is a law that regulates the method of paying for
a service that the class of people to whom it
applies are either consuming -
JUSTICE SOTOMAYOR: General -
GENERAL VERRILLI: -- or -- or
inevitably will consume.
JUSTICE SOTOMAYOR: General, I
see or have seen three strands of arguments in
your briefs, and one of them is echoed today. The
first strand that I have seen is that Congress
can pass any necessary laws to effect those
powers within its rights, i.e., because it made a
decision that to effect, to effect mandatory
issuance of insurance, that it could also
obligate the mandatory purchase of it.
The second strand I see is
self-insurance affects the market, and so the
government can regulate those who self-insure.
And the third argument -- and I
see all of them as different -- is that what the
government is doing, and I think it’s the
argument you’re making today -- that what
the -- what the government is saying is if you
pay for -- if you use health services, you have
to pay with insurance. Because only insurance
will guarantee that whatever need for health care
that you have will be covered. Because virtually
no one, perhaps with the exception of 1 percent
of the population, can afford the massive cost if
the unexpected happens.
This third argument seems to be
saying what we are regulating is health care, and
when you go for health services, you have to pay
for insurance, and since insurance won’t
issue at the moment that you consume the product,
we can reasonably, necessarily tell you to buy it
ahead of time, because you can’t buy it at
the moment that you need it.
Is that -- which of these three
is your argument? Are all of them your argument?
I’m just not sure what the -
GENERAL ,VERRILLI: So, let me
try to state it this way. The Congress enacted
reforms of the insurance market, the
guaranteed-issue and community-rating reforms. It
did so to deal with a very serious problem that
results in 40 million people not being able to
get insurance and therefore not access to the
health care environment. Everybody agrees in this
case that those are within Congress’s
Article I powers.
The minimum coverage provision
is necessary to carry those provisions into --
into execution; because without them, without
those provisions, without minimum coverage,
guaranteed issue and community rating will, as
the experience in the States showed, make matters
worse, not better. There will be fewer people
covered; it will cost more. Now the -- so -
JUSTICE SOTOMAYOR: So on that
ground, you’re answering affirmatively to my
colleagues that have asked you the question, can
the government force you into commerce.
GENERAL VERRILLI: So -- no.
JUSTICE SOTOMAYOR: And there is
no limit to that power.
GENERAL VERRILLI: No. No.
Because that’s -- that’s the first part
of our argument.
The second part of our argument
is that the means here that the Congress has
chosen, the minimum coverage provision, is a
means that regulates the -that regulates economic
activity, namely your transaction in the health
care market, with substantial effects on
interstate commerce; and it is the conjunction of
those two that we think provides the particularly
secure foundation for this statute under the
commerce power.
JUSTICE KAGAN: General,
you’ve talked on -a couple of times about
other alternatives that Congress might have had,
other alternatives that the Respondents suggest
to deal with this problem, in particular, the
alternative of mandating insurance at the point
at which somebody goes to a hospital or an
emergency room and asks for care.
Did Congress consider those
alternatives? Why did it reject them? How should
we think about the question of alternative ways
of dealing with these problems?
Jasper
County Jail Count
162 March 28,
2011
Total
Including Placed out of County
|
