Issue link: https://www.epageflip.net/i/522801
ByMarkSherman The Associated Press WASHINGTON The Su- preme Court could wipe away health insurance for millions of Americans when it resolves the latest fight over President Barack Obama's health overhaul. But would the court take away a benefit from so many people? Should the justices even consider such consequences? By month's end, the court is expected to de- cide a challenge to the way subsidies, in the form of tax credits, are given to people who get their insurance through the Affordable Care Act. The legal issue is whether Congress autho- rized payments regardless of where people live, or only to residents of states that established their own in- surance exchanges. The distinction is po- tentially momentous, since more than two-thirds of the states did not set up their own exchanges. In those states, people rely on the federal healthcare. gov site to sign up for in- surance. The financial ben- efits are substantial, cover- ing nearly three-fourths of insurance premiums on av- erage. 'Obamacare' If the court rules that the subsidies can't be given to people who enrolled on the federal site, 7 million to 9 million Americans would quickly lose their insur- ance, said Nicholas Bagley, a health law expert at the University of Michigan and a supporter of the law known as "Obamacare." "The consequences of a government defeat here are so extraordinary and sweeping," he said. Since the New Deal, the Supreme Court has almost always upheld major new government programs and legislation as allowable un- der the Constitution. That was the case with Social Se- curity in the 1930s, the civil rights legislation of the 1960s and, most recently, the health care law in 2012. "After Social Security gets upheld in 1937 against various constitutional chal- lenges, it then becomes an issue for the voters, but not a second-round judi- cial question for the court," said John Q. Barrett, a law professor at St. John's Uni- versity in New York. But the health law is dif- ferent. It remains a bitter partisan fight, continuing to play out in the courts after efforts to replace Obama in the White House and repeal the law in Con- gress failed. The current dispute turns not on some great constitutional question but a matter of statutory interpretation — or what the words of the law mean. This case comes down to the meaning of four words — "established by the state" — in a law of more than 900 pages. One school of thought holds that the court should look only at what Congress actually wrote into the law, not what it might have in- tended. "When the court is inter- preting a text like it's doing in this case, then it really is not in the business of look- ing at consequences," said Ronald Cass, the former dean of the Boston Univer- sity law school. "If you have a result that seems to be a bad one, that's for the polit- ical branches to say, not for the court to say." The idea that Congress never would have created a system that was essen- tially designed to fail, by making health insurance unaffordable to so many people the law presumably was intended to help, is ir- relevant, Cass said. Different views On the court itself, Jus- tice Antonin Scalia is the most voluble proponent of the view that it's not his job to correct Congress' bad work. "Garbage in, garbage out," he has said. Justice Stephen Breyer, on the other hand, has said Scalia's approach is too limiting because a law's words sometimes are not clear enough to resolve a case, especially when read in isolation. Context mat- ters, and the real-world consequences of a law are part of that context, Breyer has said. Another factor that may be at work is the effect a decision could have on the court's reputation, said Thomas Keck, a political science professor at Syra- cuse University. That kind of institu- tional concern seemed to affect Chief Justice John Roberts' decision to cast the deciding vote to up- hold the health law in 2012, Keck said. Had that case gone the other way, it would have "pulled the court even further into po- litical conflict," he said. In that scenario, five Re- publican-appointed jus- tices would have struck down the Democratic pres- ident's signature domestic achievement during his re- election campaign. The unrelenting law- suits from Republican op- ponents should put the court on notice that its rep- utation could be at stake again in a political fight, Keck said. No one knows how these considerations are weigh- ing on the justices in the back-and-forth of major- ity and dissenting opin- ions now making their way around the courthouse. But there are few compara- ble examples in recent his- tory where the court has taken away a benefit from so many people. SUBSIDIES CHALLENGE Ho w do j us ti ce s we ig h lo ss o f health insurance for millions? ANDREWHARNIK—THEASSOCIATEDPRESSFILE Protesters chant during a health care rally outside the Supreme Court in Washington. TOBY TALBOT — THE ASSOCIATED PRESS FILE A bartender serves beer at a tavern in Montpelier, Vermont. By Lindsey Tanner The Associated Press CHICAGO Alcohol problems affect almost 33 million adults and most have never sought treatment, accord- ing to a government survey that suggests rates have in- creased in recent years. The study is the first na- tional estimate based on a new term, "alcohol use dis- order," in a widely used psy- chiatric handbook that was updated in 2013. Five things to know about the research pub- lished Wednesday in the journal JAMA Psychiatry: The revised handbook, the DSM-5, defines prob- lem drinkers or those with the disorder as people with at least two of 11 symp- toms, including drinking that harms performance at work, school or home, fre- quent hangovers and failed attempts to limit drinking. Mild problems involve two to three symptoms; severe involve at least six symp- toms. The new handbook combined alcohol abuse and dependence, which had been separate disor- ders, added craving as one symptom and eliminated alcohol-related legal prob- lems as another. Researchers from the National Institute on Alco- hol Abuse and Alcoholism asked 36,000 adults during 2012 or 2013 about lifetime drinking habits, including current or within the past year. About 14 percent of adults were current or re- cent problem drinkers, or nearly 33 million nationally, and 30 percent — almost 69 million — had been at some point in their lives. Mild drinking problems were the most common, while 14 per- cent had ever experienced severe drinking problems. Using the old definition, the rates were 13 percent for current or recent prob- lem drinking and 44 per- cent for lifetime prevalence — up from 9 percent and 30 percent in the agency's 2001-02 survey. Nearly 40 percent of adults surveyed said they had engaged in binge drink- ing — downing at least five drinks in a day at least once in the past year, up from 31 percent in the earlier sur- vey. Even heavier drinking also increased but was less common. Drinking problems were most prevalent among men, whites and Native Ameri- cans. Low-income adults, those younger than 30 and those who never married also relatively high rates. Problem drinking also was more common among city dwellers than those in rural areas, while the West and Midwest had higher rates than other regions. Problem drinking aff ec ts 3 3 mi ll io n adult Americans GOVERNMENT SURVEY By Bassem Mroue The Associated Press BEIRUT A U.S. official said Wednesday that more than 10,000 Islamic State fighters have been killed by Ameri- can-led airstrikes in Iraq and Syria in nine months, offering a body count for a campaign that has yet to blunt their advance. Deputy Secretary of State Tony Blinken's figure came after a Paris conference on how to stop the extrem- ists ended without any new strategy to halt their cam- paign. It also comes months after the Pentagon dis- missed such counts as "sim- ply not a relevant figure" in the fight against the Islamic State group. Meanwhile, the Islamic State group launched a ma- jor attack on the predom- inantly Kurdish city of Hassakeh in northeastern Syria, according to activ- ists and Syrian state media. Speaking Wednesday to France Inter Radio a day after the Paris conference, Blinken said the airstrikes have been effective. "We have seen enormous losses for Daesh," Blinken said, using an Arabic acro- nym for the group. "More than 10,000 since the be- ginning of this campaign. That will end up having an effect." Blinken did not offer any figure for civilian casual- ties. In September, the CIA said that Islamic State group has up to 31,500 fight- ers, meaning that could rep- resent a loss of a third of its forces. Despite that, the ex- tremists continue to attract more recruits from around the world who come to fight with the group to expand its self-declared caliphate in Syria and Iraq. It's not clear why Blinken offered the figure, as the U.S. military in conflicts since the Vietnam War has been either hesitant or dis- counted such figures as in- dicators of success. Adm. John Kirby, a Pentagon spokesman, declined to of- fer them in January when asked by a reporter. "The less of these guys that are out there, cer- tainly that's the better, but the goal is to degrade and destroy their capabilities," Kirby said at the time. He added: "It's simply not a rel- evant figure." White House spokes- man Josh Earnest, later asked about Blinken's fig- ure, said he had "no rea- son to believe" the num- ber was inaccurate, saying 1,000 Islamic State fighters were killed in the fight for the Syrian border town of Kobani alone. Meanwhile Wednesday, the Islamic State group targeted Hassakeh in an apparent attempt to re- verse some of the advances made recently by Kurdish fighters in the northeast- ern Syrian province. Kurd- ish fighters have captured dozens of towns and vil- lages there with the help of U.S.-led airstrikes and are getting close to Tel Abyad, a major Islamic State-held border town near Turkey. The extremists launched the push on the city of Has- sakeh, which is split be- tween government forces and Kurdish defenders, on Tuesday night. Syrian state television said extremists are bat- tling for control of a juve- nile prison still under con- struction on Hassakeh's southern edge and have so far attacked it with five sui- cide car bombs. The TV report said gov- ernment warplanes have struck the Islamic State stronghold of Shaddadeh, south of Hassakeh. IRAQ, SYRIA US o ffic ia l: A ir st ri ke s killed 10,000 IS fighters By Andrew Taylor The Associated Press WASHINGTON The GOP- controlled House voted Wednesday to prevent the federal government from blocking state laws that permit the use of medical marijuana. But lawmakers narrowly declined to direct the Jus- tice Department not to in- terfere with states like Col- orado and Washington that permit the recreational use of marijuana. The 242-186 vote on medical pot was a larger margin than a tally last year, when the House first approved it as part of a bill funding the Justice Depart- ment. Wednesday's vote was to renew the pro-pot language as part of a bill providing funding for the coming fiscal year. Most Republicans op- posed the idea and the Senate is in GOP hands this year, so the outcome could still be reversed. But Senate advocates of med- ical marijuana won a test vote in the GOP-controlled Appropriations Committee last month. On Wednesday, 67 Re- publicans, including lib- ertarian-minded lawmak- ers such as Thomas Massie of Kentucky, combined with all but a handful of Democrats in support of states that allow doctors to prescribe pot for med- ical uses. Almost half the states allow medical marijuana, which remains an illegal drug under federal law. FUNDING BILL Ho us e ba ck s st at e me di ca l ma ri ju an a la ws | NEWS | REDBLUFFDAILYNEWS.COM THURSDAY, JUNE 4, 2015 4 B