There is only 1 way to be certain the ACA remains the law of the land. Biden wins for president, Democrats win the Senate & hold the House.

In the aftermath of the loss of Justice Ginsberg, talking to Supreme Court lawyers & legal experts. Thread coming. Follow if interested.
A conservative justice to replace RBG would be devastating to voting rights, to money in politics, to rights for minorities & to reproductive health for women.

But the most immediate impact would be to the Affordable Care Act and what it means to Americans who need medical care.
Elimination of the ACA means:
-A loss of all the rules that makes insurance worth anything to you
-Anybody with a prior illness no longer has guaranteed access to insurance
-If you've had COVID, that means coverage for virtually every organ system not covered
-Heart attack, stroke, high blood pressure, kidney problems, mental health issues-- would all be pre-existing conditions
-20 million people would lose coverage, including many low income people
-Hospitals would shut, bankruptcies would increase, rx drug costs for seniors go up
The case has so many problems, but you should assume whoever is nominated to fill RBG's seat, if they hear the case, would be in effect interviewing for the case.

And the list of 40 people on Trump's list includes noted humanitarians like Tom Cotton, Josh Hawley and Ted Cruz.
Not just politicians, but people who could sit on the court for decades.

You will hear many many scenarios: 4-4 ties, partial verdicts, the case being pushed back to the District Court & yes, a possible conservative upholding the ACA. But there are a couple big questions,
1. Does Trump want a vote before the election?

I know his tweet says yes. But he has to act like he wants it. He's down 7 points in the polls. This pick is a big motivator for his base. Naming someone & then blaming Democrats for stalling juices the polls for him.
This puts the stakes very high. It is entirely possible that Democrats can put other procedural roadblocks to slow a vote down. It is also possible that several Republican Senators delay for either principled reasons (Romney, Murkowski) or political ones (Collins).
McConnell and Trump might not fight so hard against that scenario.

If the case is heard November 10th with 8 Justices, Roberts can always decide to hear it again with aa 9th. If it is heard with 8, ACA needs 5 to have a clean win.
2. Is there another conservative vote for the ACA, presuming Roberts is 1?

Maybe. But I wouldn't want to bet millions of lives on it.
3. Do the Democrats have recourse?

Like adding more Justices to the court or some other tact? Maybe, but only if they control the Senate and the White House. And even then, that's not a scenario one could bet on, or would necessarily impact this case.
4. If the ACA falls, is there a chance at a replacement bill?

With Trump in the White House and a GOP Senate, almost certainly not. One thing that happens in this case is the money that pays for ACA subsidies and Medicaid expansion become a giant tax cut.
In that case, Republicans won't put forward anything with close to the amount that would return coverage to people. They would put forward a thin sham bill to get Democrats to vote against it and say they had discharged their duties.
Only in a Democratic sweep is there likely to be a replacement bill using the reconciliation process. That way if the court does overturn the ACA, a replacement bill, including one with improvements would be able to be put forward.

Other scenarios are tenuous.
I never met Ruth Bader Ginsberg. I admired her like so many people. But from what I do know she would say "Mourn me for a day. Then get out there and work to fix this ."

There is a way. There is a way.

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More from @ASlavitt

23 Oct
COVID Update October 22: Europe is having a second wave. How quickly can they bounce back?

Faster than a country that makes no effort: the US. 1/
Despite a lot of wishful thinking, COVID-19 has not gone away.

(Remember the “people have natural immunity” & “the virus died out”, & the “it will disappear” man?)

Sadly wishful fantasies don’t fight the virus. Scott Atlas’s strategy of ignoring the virus doesn’t work. Only we fight the virus. 3/
Read 24 tweets
21 Oct
COVID Update October 21:

A few nights ago I described how we need to do 2 things.

Account for the past
Fight for our future

I wrote about how we need to account for the past. But I haven’t had the words to focus on the future.

Now I think I do. Or will try. 1/
Thinking about the future turns out to be really hard when we are deep in a hole we must climb out from.

Writing about the past— the need for an accountability election— was easy. Here it is if you didn’t see & want to. 2/
But the future. The future. It feels so uncertain right now. It took me some time. And many many stupid sounding drafts. (Yes for the trolls, even stupider than this!) 3/
Read 28 tweets
19 Oct
BREAKING: Data for the month suggests for the first time COVID-19 has moved from a region by region crisis to a national one.

It needs a national solution.

More to follow shortly.
Here is a graph that says a lot. One thing you see is that cases are growing since April. Now that alone doesn’t tell us everything since testing is growing but it does tell us some things.

It’s from @NephronResearch
One thing to note is the number of states where cases are growing by 1000 cases/day.

April: 6
May/June: 6
July: 14 (19 peak)
August: 12
September: 12
October 15th: 25
Read 8 tweets
18 Oct
COVID Update October 18: It is time.

For the past.
And more importantly for the future.

Today: the past. Tomorrow I will write about the future. 1/
Trump has never faced accountability for his actions. His career in bankruptcy is a master class in how to behave when you don't care about others. Take their money, don't pay it back. Take their services, don't pay it back. 2/
Doing everything you can to avoid taxes including hiding money overseas, illegally using a foundation, writing off blackmail payments, trying to outlawyer the tax code. That's not "savvy." Its savage.

It is not patriotic. Yet, to date no accountability. 3/
Read 34 tweets
18 Oct
COVID Update October 17: The Coronavirus is an equal opportunity killer, right? Wrong. Many countries have done better than others.

It is an amazing story. 1/
One might think it has something to do with wealth.

The U.S. is the wealthiest country in the world. 60 per 100,000 have died here.

This compares to 2 in Haiti and 1 in Botsowana (its close to 0 for the continent of Africa) 2/
Other wealthy countries have also had very high mortality rates.

The U.K. (62), Sweden (57), Italy (59) & Belgium (86) have fared as bad or worse than the U.S. overall-- although they all improved dramatically compared to the U.S. starting in May (more on that in a sec) 3/
Read 22 tweets
15 Oct
COVID Update October 15: We started bad but THEN we got worse. Now is our chance.

Since May 10th, when the worst of Italy and the U.S. had passed, we have had 4x the number of deaths/capita. The difference is 80,000 people gone. 1/
Everyone by this time knows what happened in the U.S. in January through March. Trump heard & ignored, the CDC failed, we lacked masks, had no testing, and we lost too many people. 2/
Our first case was the same day as South Korea’s. We started out and could have been South Korea but never contained and cane to grips with the virus. 3/
Read 24 tweets

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