U.S. Congress in sprint to fund government, approve COVID-19 emergency aid

By Richard Cowan

WASHINGTON (Reuters) – The U.S. Congress will try this week to end months of indecision and infighting over the federal government’s budget priorities and coronavirus aid, with more than $2 trillion in funding from Washington potentially at stake.

Lawmakers, facing a midnight Friday deadline, will scurry to put the finishing touches on a $1.4 trillion spending bill for the fiscal year that began Oct. 1.

At stake are funds for federally run programs ranging from healthcare, homeland security and military readiness to foreign aid, national parks and nutrition programs. They have been operating on temporary funding since October.

Without a deal, the government must begin shutting non-emergency programs and furloughing many workers.

Members of the Republican-run Senate and Democratic-led House of Representatives, who fear negotiations could extend through the Christmas holiday, have a second major task: deciding the contours of a coronavirus aid bill that could approach $1 trillion amid a worsening pandemic that has claimed the lives of nearly 300,000 Americans.

Some moderate lawmakers on Sunday dismissed suggestions that a $908 billion bipartisan coronavirus aid proposal was languishing.

“The plan is alive and well and there’s no way, no way that we are going to leave Washington without taking care of the emergency needs of our people,” Democratic Senator Joe Manchin told Fox News, saying the proposal would be introduced formally on Monday.

A person briefed on the matter said the authors now planned to divide the measure into two separate proposals, which could be voted on separately. One would be a $748 billion proposal including small businesses, the jobless and COVID-19 vaccine distribution.

The other would include major sticking points such as coronavirus-related liability protections for business, which are backed by Republicans, and $160 billion for state and local governments, a Democratic priority.

Lawmakers are hoping to attach the aid to the government funding measure.

Local public health agencies worry that without a deal on either of the two bills, they will not have enough money to carry out a massive COVID-19 vaccination program.

The first shipments of Pfizer Inc’s newly approved vaccine were delivered on Sunday.

WHO WINS AND WHO LOSES?

With the twin goals of stimulating the struggling U.S. economy and financing purchases of medical supplies, Democrats and Republicans in Congress are faced with deciding who should receive new help from Washington – beyond over $3 trillion appropriated last spring – and who should not.

Democrats have been pushing hard for aid to state and local governments to insure against laying off more workers, including police, firefighters and emergency medical personnel.

Senate Majority Leader Mitch McConnell, a Republican, dismissed that on Friday as a “preposterous” federal handout for Democratic-leaning states that he says do not need it.

But even some of McConnell’s own Republicans disagreed.

Senator Lisa Murkowski of Alaska told reporters her state’s revenues had seen a 33 percent decline during the pandemic in an economy heavily dependent on summertime tourism.

“We’re a state that is really, really hurting right now,” Murkowski said on Friday, adding that many others are in the same situation.

The House’s No. 2 Democrat, Steny Hoyer, offered a glimmer of hope that a breakthrough might be possible, telling CNN on Sunday that Democrats “are not going to get everything we want. We think state and local (aid) is important. And if we can get that, we want to get it. But we want to get aid out to the people who are really, really struggling and are at grave risk.”

Congress also is divided over whether to do a second round of direct payments to Americans to help stimulate the economy.

“We have a history now of going to the 11th hour and 59th minute on all of this and it’s very unfortunate. That’s where we are,” lamented Republican Senator Pat Roberts, who is retiring at year’s end.

(Reporting by Richard Cowan; Additional reporting by Susan Cornwell and David Shepardson; Editing by Peter Cooney)

U.S. Supreme Court takes up Trump bid to revive Medicaid work requirements

By Lawrence Hurley

WASHINGTON (Reuters) – The U.S. Supreme Court on Friday agreed to hear a bid by President Donald Trump’s administration to revive pilot programs adopted by the states of Arkansas and New Hampshire that allow work requirements to be imposed on people who receive healthcare under the Medicaid program for the poor.

The justices took up the administration’s appeals of rulings by a lower court that found the programs unlawful.  Seventeen other states are pursuing similar policies.

The administration said in court papers that the appeals court rulings cast a legal shadow on the efforts in those other states to adopt work requirements for Medicaid, a state-federal program that provides medical insurance for the poor. New Hampshire and Arkansas filed court papers in support of the administration.

The U.S. Department of Health and Human Services in 2018 approved those projects as part of a push to put a conservative stamp on Medicaid, which was expanded in 37 states and the District of Columbia following the 2010 passage of the Affordable Care Act, also known as Obamacare, to help provide coverage to millions more Americans.

The department gave the go-ahead for states to carry out test projects requiring able-bodied people on Medicaid to work or do volunteer work.

(Reporting by Lawrence Hurley; Additional reporting by Nate Raymond; Editing by Will Dunham)

U.S. death toll from COVID-19 nears quarter million as infection rates soar

By Gabriella Borter and Anurag Maan

(Reuters) – The death toll from COVID-19 in the United States approached 250,000 on Wednesday, the day after the country recorded the highest number of victims in nearly four months, a chilling sign for a healthcare system already struggling to cope.

On Tuesday, the pandemic claimed 1,596 lives in the United States, more than on any single day since July 27, contributing to a total of 248,898 confirmed deaths since the pandemic began, according to a Reuters tally.

For weeks, health officials and healthcare workers have warned that hospitals in all regions could soon become overwhelmed, with widespread community transmission of the virus evident in many places.

“I’m the most concerned I’ve been since this pandemic started,” Dr. Tom Inglesby, director of Johns Hopkins Center for Health Security, told CNN on Wednesday.

Nationwide, the number of patients hospitalized with COVID-19 topped 75,000 on Tuesday, setting a new record. The Midwest has become the epicenter, reporting almost a half-million cases in the week ending on Monday. In Wisconsin, 90.6% of Intensive Care Unit beds were occupied as of Wednesday, state data showed.

Forty-one U.S. states have reported daily record increases in COVID-19 cases in November, 20 have registered new all-time highs in coronavirus-related deaths from day to day, and 26 have reported new peaks in hospitalizations, according to a Reuters tally of public health data.

Government officials in at least 18 states, representing both sides of the U.S. political divide, have issued sweeping new public health mandates this month. These range from stricter limits on social gatherings and non-essential businesses to new requirements for wearing masks in public places.

Even officials who initially bristled at the idea of the government imposing social restrictions have changed tune as the virus has spread.

In South Dakota, about 2% of residents currently have COVID-19, according to state data. The city of Sioux Falls voted to institute a mask mandate on Tuesday night, a week after Mayor Paul TenHaken voted the mandate down. TenHaken shifted to supporting the ordinance after the South Dakota State Medical Association urged the city council to mandate masks. State Governor Kristi Noem, a Republican, has continued to oppose government restrictions to curb COVID-19.

White House spokeswoman Kayleigh McEnany on Wednesday called the wave of new restrictions an overreach by state and local officials.

“The American people know how to protect their health,” she told Fox News in an interview. “We don’t lose our freedom in this country. We make responsible health decisions as individuals.”

(Reporting by Gabriella Borter in New York and Anurag Maan in Bengaluru; additional reporting by Susan Heavey and Maria Caspani; Editing by Rosalba O’Brien)

Pfizer ends vaccine trial with 95% success rate, paving way for a shot this year

By Michael Erman and Ludwig Burger

(Reuters) – Pfizer Inc and BioNTech could secure emergency U.S. and European authorization for their COVID-19 vaccine next month after final trial results showed it had a 95% success rate and no serious side effects, the drugmakers said on Wednesday.

The efficacy of the shot was found to be consistent across different ages and ethnicities – a promising sign given the disease has disproportionately affected the elderly and certain groups including Black people.

The U.S. Food and Drug Administration could grant emergency-use approval towards the end of the first half of December or early in the second half, BioNTech Chief Executive Ugur Sahin told Reuters TV. Conditional approval in the European Union could be secured in the second half of December, he added.

“If all goes well I could imagine that we gain approval in the second half of December and start deliveries before Christmas, but really only if all goes positively,” he said.

The success rate of the vaccine developed by U.S. firm Pfizer and Germany’s BioNTech is the highest of any candidate in late-stage clinical trials so far, and experts said it was a significant achievement in the race to end the pandemic.

Pfizer said 170 volunteers in its trial involving over 43,000 people contracted COVID-19 but 162 of them had only been given a placebo, meaning the vaccine was 95% effective. Of the 10 people who had severe COVID-19, one had received the vaccine.

“A first in the history of mankind: less than a year from the sequence of the virus to the large-scale clinical trial of a vaccine, moreover based on a whole new technique,” said Enrico Bucci, a biologist at Temple University in Philadelphia. “Today is a special day.”

BioNTech’s Sahin said the U.S. emergency authorization would be applied for on Friday.

The FDA committee tentatively plans to meet on Dec. 8-10, a source familiar with the situation said, though the dates could still change. The FDA did not respond to requests for comment.

COVID-19 RUNS RAMPANT

The final trial analysis comes a week after initial results showed the vaccine was more than 90% effective. Moderna Inc <MRNA.O> released preliminary data for its vaccine on Monday, showing 94.5% effectiveness.

The better-than-expected results from the two vaccines, both developed with new messenger RNA (mRNA) technology, have raised hopes for an end to a pandemic that has killed more than 1.3 million people and wreaked havoc upon economies and daily life.

The Pfizer-BioNTech shot was found to have 94% efficacy in people over 65 years, which experts said was crucial at a time when COVID-19 is running rampant around the world with record numbers of new cases and hospitalizations.

“This is the evidence we needed to ensure that the most vulnerable people are protected,” said Andrew Hill, senior visiting research fellow at the University of Liverpool’s department of pharmacology.

Global shares rose as the trial results countered concerns around the stubbornly high global infection rate. Pfizer shares were up 1.6% while BioNTech jumped 3.8% in the United States. By contrast, Moderna dropped 4.2%.

Investors have treated vaccine development as a race between companies, although there is likely to be global demand for as much vaccine as can be produced for the foreseeable future.

DISTRIBUTING SHOTS

Pfizer says it expects to make as many as 50 million vaccine doses this year, enough to protect 25 million people, and then produce up to 1.3 billion doses in 2021.

While some groups such as healthcare workers will be prioritized in the United States and Britain for vaccinations this year, it will be months before large-scale rollouts begin in either country.

Pfizer also has agreements with the European Union, Germany and Japan where distribution could begin next year.

Mike Ryan, the World Health Organization’s top emergency expert, said it would be at least 4-6 months before significant levels of vaccination were taking place around the world.

Distribution of a Pfizer-BioNTech shot is complicated by the need to store it at ultra-cold temperatures of -70 degrees Celsius. It can, however, be kept in a normal fridge for up to five days, or up to 15 days in a thermal shipping box.

Moderna’s vaccine can be stored for up to six months at -20C though it is expected to be stable for 30 days at normal fridge temperatures of 2 to 8 degrees Celsius (36°-46°F).

FATIGUE AND HEADACHES

Pfizer said its two-dose vaccine, called BNT162b2, was well-tolerated and that side effects were mostly mild to moderate, and cleared up quickly.

It said the only severe adverse events experienced by volunteers were fatigue and headaches. Out of 8,000 participants, 2% had headaches after the second dose while 3.8% experienced fatigue. Older adults tended to report fewer and milder adverse events.

“These are extraordinary results, and the safety data look good,” said David Spiegelhalter, a professor and expert in risk and evidence communication at the University of Cambridge.

“It would be interesting to see what adverse reactions were reported by the group getting the placebo, since that gives an idea of how much of the adverse effects are due to the vaccination process, and how much is due to the vaccine itself.”

Of the dozens of drugmakers and research groups racing to develop vaccines against COVID-19, the next data release will likely be from AstraZeneca Plc with the University of Oxford in November or December. Johnson & Johnson says it is on track to deliver data this year.

Authorization of vaccines for children will take longer. Only Pfizer has started vaccinating volunteers under the age of 18 in trials, giving shots to children as young as 12. Moderna and Johnson & Johnson have said they hope to start testing the vaccine in younger patients soon.

(Reporting by Michael Erman in Maplewood, N.J.; Additional reporting by Ankur Banerjee in Bengaluru, Caroline Humer in New York, Dan Levine in San Francisco, Elizabeth Howcroft, Kate Kelland and Josephine Mason in London, Emilio Parodi in Milan and Stephanie Nebehay in Geneva; Writing by David Clarke; Editing by Pravin Char)

Georgia Democrats Ossoff, Warnock challenge Republicans to debate in Senate runoff

By Susan Cornwell and David Morgan

WASHINGTON (Reuters) – Democratic candidates in a pair of U.S. Senate runoff races in Georgia on Monday challenged the two incumbent Republican senators to debates ahead of a Jan. 5 vote that will decide control of the Senate.

Democrat Jon Ossoff said he had accepted invitations from six media outlets to debates, and urged Republican rival Senator David Perdue to join him in the forums. He had already called Perdue a “coward” on Twitter Sunday following media reports that Perdue had declined a chance to debate on Dec. 6 at the Atlanta Press Club.

Likewise, Democrat Raphael Warnock issued a separate challenge to Republican Kelly Loeffler to three televised debates, including one at the Atlanta Press Club, also on Dec. 6.

Georgia laws require a runoff if no candidate reaches 50 percent. The Ossoff-Perdue race and the Warnock-Loeffler matchup will determine whether Republicans or Democrats lead the Senate after Democratic President-elect Joe Biden takes office.

Democrats need to win both seats to split the Senate 50-50 and give Vice President-elect Kamala Harris the tie-breaking vote. Georgia has not elected a Democratic senator since 1996, but Democratic President-elect Joe Biden narrowly leads President Donald Trump there by 49.5% to 49.2% in the recent presidential election. A recount is underway.

Perdue campaign manager Ben Fry said in a statement that there had already been two debates in the Georgia Senate race, before the first round of voting Nov. 3.

“In each (debate), Ossoff lied repeatedly … If Ossoff wants to keep lying to Georgians on TV, he will have to use his out-of-state money to pay for it,” Fry said.

There was no immediate response from Loeffler’s campaign.

Ossoff and Warnock appeared together on Sunday for the first time in the runoff campaign, urging voters to head back to the polls just two months after the presidential election. Both men have sustained attacks from their Republican opponents, and the Democrats are expected to step up their joint campaign efforts.

Their campaigns are emphasizing healthcare, COVID-19 relief and Republicans’ response to the pandemic. Perdue and Loeffler’s campaigns meanwhile accuse Warnock and Ossoff of pursuing “socialist” policies on climate change and healthcare.

At the Sunday event in Marietta, Ossoff called out Perdue for declining the Atlanta Press Club debate. “Imagine being a sitting U.S. Senator, too much of a coward to debate your opponent in public,” Ossoff declared.

Warnock, meanwhile, stressed the importance of voters returning to the polls a second time to support the Democrats, saying he had talked to a woman who voted for him on Nov. 3 and “she had no idea that she had to go back again.”

The Atlanta Press Club said in a statement that Perdue had declined to participate in the Dec. 6 debate, but Ossoff confirmed that, “we will proceed with the debate and Sen. Perdue will be represented by an empty podium.”

(Reporting by Susan Cornwell and David Morgan; Editing by Scott Malone and Aurora Ellis)

Philadelphia bans all indoor gatherings as COVID-19 surges across the United States

By Maria Caspani and Sharon Bernstein

WASHINGTON (Reuters) – The city of Philadelphia will ban indoor gatherings altogether and the nearby state of New Jersey will strictly limit their size as U.S. officials struggle to slow a COVID-19 surge that could overwhelm hospitals and kill thousands.

Philadelphia, the nation’s sixth-largest city, is strongly urging residents to shelter at home and “prohibiting indoor gatherings of any size in any location, public or private,” health commissioner Thomas Farley said at a news conference on Monday.

“We need to keep this virus from jumping from one household to another,” Farley said. If “exponential” growth of cases continues, hospitals will soon become overwhelmed and more than 1,000 people could die in Philadelphia over the next six weeks before the end of the year, he said.

In neighboring New Jersey, Governor Phil Murphy on Monday said a maximum of 10 people will be allowed to gather indoors, down from 25. On Nov. 23, the limit for outdoor gatherings will drop from 500 to 150.

“It’s gotten worse and it’s gonna get worse,” the Northeastern state’s Democratic governor said in an interview with MSNBC.

Total U.S. infections crossed the 11 million mark, just over a week after hitting 10 million, the fastest time it took the country to report an additional 1 million cases since the pandemic began. States across the nation have re-imposed restrictions to stem the resurgent virus straining many healthcare systems.

Dr. Alexander Garza, head of the St. Louis Metropolitan Pandemic Task Force, said hospitals in Missouri could run out of capacity in two weeks as cases there continue to rise.

“If this continues, we’re absolutely going to need more staff, more help, more of everything to deal with the crush of patients that we see coming at us,” Garza told CNN on Monday.

HOSPITALISATIONS ALL-TIME HIGH

Forty U.S. states have reported record increases in COVID-19 cases in November, while 20 have seen a record rise in deaths and 26 reported record hospitalizations, according to a Reuters tally of public health data.

The latest seven-day average shows the United States is reporting more than 148,000 daily cases and 1,120 daily deaths. U.S. COVID-19 hospitalizations hit an all-time high on Sunday.

In Ohio, where total cases have increased by about 17% and total hospitalizations have risen by at least 25% in the past seven days, the state’s health department issued a revised order to limit mass gatherings, which takes effect on Tuesday, Governor Mike DeWine said on Monday.

In what she called the re-enactment of the “most heightened level of statewide” coronavirus restrictions, New Mexico Governor Michelle Lujan Grisham instructed residents to stay home for two weeks beginning on Monday, among other curbs.

“We face a life-or-death situation and we cannot fail to act,” Grisham wrote on Twitter.

Michigan and Washington state on Sunday imposed sweeping new restrictions on gatherings, including halting indoor restaurant service.

MODERNA VACCINE 95% EFFECTIVE

The slew of grim records and news was partly offset by Monday’s announcement by drugmaker Moderna that its experimental vaccine was 94.5% effective in preventing COVID-19, based on interim data from a late-stage trial.

Together with Pfizer Inc’s vaccine, which is also more than 90% effective, and pending more safety data and regulatory review, the United States could have two vaccines authorized for emergency use in December with as many as 60 million doses available this year.

Dr. Anthony Fauci, a top U.S. health official, said the Moderna vaccine results were impressive but cautioned the United States could still go through a “dark winter” as COVID-19 fatigue sets in and people grow tired of restrictions.

“It’s a very serious situation,” Fauci said on NBC’s “Today” program. “But the fact that help is on the way should spur us even more to double down on some of the public health measures. … We can do it.”

(Reporting by Maria Caspani in New York and Doina Chiacu in Washington; additional reporting by Anurag Maan in Bengaluru, David Shepardson and David Lawder in Washington; Writing by Maria Caspani; Editing by Jonathan Oatis, Bill Tarrant and Aurora Ellis)

U.S. Supreme Court justices appear unlikely to throw out Obamacare

By Lawrence Hurley and Andrew Chung

WASHINGTON (Reuters) – U.S. Supreme Court justices on Tuesday signaled they are unlikely to strike down the Obamacare healthcare law in a legal challenge brought by Texas and 17 other Republican-governed states and joined by President Donald Trump’s administration.

Chief Justice John Roberts and fellow conservative Brett Kavanaugh indicated skepticism during two hours of arguments in the case toward the stance by the Republican challengers that the entire law must fall if a single key provision, called the individual mandate, is deemed unconstitutional.

That provision originally required people to obtain insurance or pay a financial penalty. Trump signed a law in 2017 that erased the penalty, a change that Republicans then argued eliminated the constitutional justification for the provision as permissible under the power of Congress to levy taxes.

Roberts asked questions suggesting that because Congress did not repeal the entire law, formally known as the Affordable Care Act (ACA), when it eliminated the penalty, all of Obamacare should not be invalidated due to this one change.

If Roberts and Kavanaugh join the court’s three liberals in the court’s eventual ruling due by the end of June, the bulk of Obamacare would survive.

“It’s hard for you to argue that Congress intended the entire act to fall if the mandate was struck down,” said Roberts, who authored 2012 and 2015 rulings that upheld Obamacare in previous Republican legal challenges.

The case represents the latest Republican legal attack on the 2010 law, Democratic former President Barack Obama’s signature domestic policy achievement. Republicans also have failed numerous times to repeal Obamacare in Congress, though Trump’s administration has taken steps to hobble the law.

The justices heard arguments by teleconference in an appeal by a coalition of 20 states including Democratic-governed California and New York and the Democratic-controlled House of Representatives hoping to preserve Obamacare. The court, with three Trump appointees including Kavanaugh, has a 6-3 conservative majority.

After the arguments, President-elect Joe Biden, who served as Obama’s vice president, criticized the “right-wing ideologues” who pursued the “simply cruel and needlessly divisive” litigation.

“This argument will determine whether (the) healthcare coverage of more than 20 million Americans who acquired it under the Affordable Care Act will be ripped away in the middle of the nation’s worst pandemic in a century,” Biden told reporters in Delaware.

Citing a “moral obligation to ensure that here in America healthcare is a right for all and not a privilege for a few,” Biden promised to start building on the Affordable Care Act immediately after succeeding Trump on Jan. 20.

Obamacare expanded public healthcare programs and created marketplaces for private insurance. Without Obamacare, Biden noted, insurers could once again refuse to cover people with any pre-existing medical conditions such as diabetes, cancer, asthma or complications from COVID-19.

Roberts and Kavanaugh appeared to agree that the mandate to obtain insurance can be separated from the rest of the law.

“We ask ourselves whether Congress would want the rest of the law to survive if an unconstitutional provision were severed,” Roberts said.

The fact that Congress in 2017 left the rest of the law intact “seems to be compelling evidence,” Roberts added.

Kavanaugh added that “this is a fairly straightforward case for severability under our precedents, meaning that we would excise the mandate and leave the rest of the act in place.”

LEGAL STANDING

The justices – conservatives and liberals alike – raised questions over whether Texas and the other challengers had the proper legal standing to bring the case, worrying about similar scenarios in which someone might be able to sue over some other government mandate when no penalty exists.

Roberts said such a stance “expands standing dramatically” by enabling people to challenge a whole host of laws without experiencing direct harm.

Justice Amy Coney Barrett, Trump’s most recent appointee, asked skeptical questions about legal standing. Democrats, ahead of Barrett’s Senate confirmation last month, focused their opposition to her appointment on the Obamacare case, fearing she would vote to strike down the law. Her questions did not indicate she would.

Trump’s third appointee, Justice Neil Gorsuch, asked probing questions on standing, though he sounded skeptical about the individual mandate’s constitutionality.

The 2012 ruling authored by Roberts defined the individual mandate’s financial penalty as a tax, thus finding the law permissible under the Constitution’s provision empowering Congress to levy taxes.

The 2017 Republican-backed change eliminating the penalty meant the individual mandate could no longer be interpreted as a tax provision and was therefore unconstitutional, the Republican challengers argued in their lawsuit filed in 2018.

Texas-based U.S. District Court Judge Reed O’Connor in 2018 ruled that Obamacare was unconstitutional as currently structured following the elimination of the penalty.

The New Orleans-based 5th U.S. Circuit Court of Appeals last year also found the mandate unconstitutional but stopped short of striking down Obamacare. The Democratic-led states and House then appealed to the Supreme Court.

(Reporting by Lawrence Hurley and Andrew Chung; Editing by Will Dunham

Conservative U.S. Supreme Court prepares to hear Obamacare challenge

By Lawrence Hurley

WASHINGTON (Reuters) – The U.S. Supreme Court on Tuesday is set to hear arguments in a bid by Republican-governed states backed by President Donald Trump’s administration to strike down the Obamacare healthcare law, even as Joe Biden prepares to replace Trump in January.

Key priorities set by the Democratic president-elect included expanding healthcare access and buttressing Obamacare, the 2010 law formally called the Affordable Care Act that Republicans for years have sought to invalidate. The law was the signature domestic policy achievement of former President Barack Obama, under whom Biden served as vice president.

Although the court now has a 6-3 conservative majority bolstered by the Senate confirmation last month of Trump’s third appointee, Amy Coney Barrett, most legal experts think it would stop short of a seismic ruling striking down the law. The Supreme Court in 2012 and 2015 fended off previous Republican challenges to Obamacare.

Biden and other Democrats have criticized Republican efforts to strike down the law in the midst of a deadly coronavirus pandemic.

If Obamacare were to be struck down, up to 20 million Americans could lose their medical insurance and insurers could once again refuse to cover people with pre-existing medical conditions. Obamacare expanded public healthcare programs and created marketplaces for private insurance.

“Abolishing the Affordable Care Act would be deeply damaging to the American health care system and public health,” Georges Benjamin, executive director of the nonprofit American Public Health Association, said in a statement.

The justices will hear an expanded 80-minute oral argument by teleconference due to the pandemic.

The impetus for the Supreme Court case was a 2018 ruling by a federal judge in Texas that Obamacare as currently structured in light of a key Republican-backed change made by Congress violates the U.S. Constitution and is invalid in its entirety.

The justices in March agreed to hear an appeal filed by a coalition of Democratic-led states and the Democratic-controlled House of Representatives defending Obamacare.

They asked the justices to overturn a ruling by the New Orleans-based 5th U.S. Circuit Court of Appeals that declared that the law’s “individual mandate” that required people to obtain health insurance ran afoul of the Constitution. Republican states led by Texas and backed by Trump’s administration have asked the justices to throw out the law.

If the individual mandate is struck down “then it necessarily follows that the rest of the ACA must also fall,” Trump administration’s lawyers argued in court papers.

The Supreme Court in 2012 upheld most Obamacare provisions including the individual mandate, which required people to obtain insurance or pay a financial penalty. The court defined this penalty as a tax and thus found the law permissible under the Constitution’s provision empowering Congress to levy taxes.

In 2017, Trump signed a Republican-backed law tax that eliminated the financial penalty under the individual mandate, which gave rise to the Republican lawsuit. The tax law meant the individual mandate could no longer be interpreted as a tax provision and was therefore unlawful, the Republican challengers argued.

Democrats made the Republican threat to Obamacare a central feature of their opposition to Barrett’s confirmation to replace the late liberal Justice Ruth Bader Ginsburg.

Barrett, when she was a law professor, previously indicated she backed the challengers in the two previous Obamacare cases that reached the Supreme Court.

In recent cases with conservative justices in the majority, the court has declined to strike down an entire statute just because one part was unlawful.

“Constitutional litigation is not a game of gotcha against Congress, where litigants can ride a discrete constitutional flaw in a statute to take down the whole, otherwise constitutional statute,” conservative Justice Brett Kavanaugh, another Trump appointee, wrote in a ruling earlier this year.

(Reporting by Lawrence Hurley; Editing by Will Dunham)

Harris, fellow Democrats target Trump Supreme Court nominee on Obamacare

By Lawrence Hurley and Patricia Zengerle

WASHINGTON (Reuters) – Democratic senators including vice presidential nominee Kamala Harris on Monday painted President Donald Trump’s Supreme Court nominee Amy Coney Barrett as a threat to the Obamacare healthcare law during a deadly pandemic and denounced the Republican drive to approve her before the Nov. 3 U.S. election.

As the Senate Judiciary Committee began its four-day confirmation hearing for Barrett, Democrats voiced their strong opposition to the nomination even though they have little hope of derailing her nomination in the Republican-led Senate.

Barrett, a conservative appellate court judge nominated to replace the late liberal Justice Ruth Bader Ginsburg, sat at a table facing the senators wearing a black face mask amid the pandemic as senators made opening statements. Barrett removed the mask when she was sworn in and delivered her own opening statement.

“I believe Americans of all backgrounds deserve an independent Supreme Court that interprets our Constitution and laws as they are written,” Barrett said, reading from prepared remarks that had been made public on Sunday, with her husband and seven children sitting behind her.

Barrett’s confirmation would give the court a 6-3 conservative majority that could lead to rulings rolling back abortion rights, expanding religious and gun rights, and upholding voting restrictions, among other issues.

But it was the fate of the 2010 Affordable Care Act (ACA), Democratic former President Barack Obama’s signature domestic policy achievement that has enabled millions of Americans to obtain medical coverage, that was the focus of Harris and her fellow Democrats. Barrett has criticized a 2012 Supreme Court ruling authored by conservative Chief Justice John Roberts that upheld Obamacare.

Harris, the running mate of Trump’s Democratic election opponent Joe Biden, called the confirmation process so near the election “illegitimate.”

“I do believe this hearing is a clear attempt to jam through a Supreme Court nominee who will take away healthcare from millions of people during a deadly pandemic that has already killed more than 214,000 Americans,” Harris said, speaking via a video link.

“A clear majority of Americans want whomever wins the election to fill this seat and my Republican colleagues know that. Yet they are deliberately defying the will of the people in their attempt to roll back the rights and protections provided under the Affordable Care Act,” Harris said.

Barrett could be on the Supreme Court in time to participate in a case due to be argued on Nov. 10 in which Trump and Republican-led states are seeking to invalidate Obamacare.

Barrett will face marathon questioning from senators on Tuesday and Wednesday. The hearing is a key step before a full Senate vote by the end of October on her confirmation to a lifetime job on the court. Republicans have a 53-47 Senate majority so Barrett’s confirmation seems almost certain.

A pivotal Obamacare provision that would be thrown out if the court strikes the law down bars insurance companies from denying coverage to people with pre-existing medical conditions. In the hearing room, Democrats displayed posters of patients who could lose their medical coverage if Obamacare is invalidated, with senators recounting their individual stories.

Repeated Republican efforts to repeal Obamacare in Congress have fallen short, and Republicans have taken the effort to the courts.

Republican Senator Ted Cruz said the Democratic focus on healthcare and other policy issues showed they were not contesting Barrett’s qualifications to serve as a justice.

Republican Senator Lindsey Graham, who chairs the committee, opened the hearing by saying it would be “a long contentious week” but implored senators to make the proceedings respectful.

“Let’s remember, the world is watching,” Graham added.

“This is probably not about persuading each other, unless something really dramatic happens. All Republicans will vote yes and all Democrats will vote no,” Graham said.

‘MAD RUSH’

Democratic Senator Patrick Leahy condemned the Republican “mad rush” to fill the vacancy.

“They see the ability to take the courts from being independent to making them instead an arm of the far right and the Republican Party, with the potential to accomplish in courts what they have failed to accomplish by votes in the halls of Congress. And at the top of the hit list is the Affordable Care Act,” Leahy said.

Graham defended the Republican approach even while acknowledging that four years earlier they had refused to act on Obama’s nominee to fill a Supreme Court vacancy because it was an election year, and that no Supreme Court nominee had a confirmation process so close to an election.

The Senate’s Republican leaders rejected Democratic pleas to delay the hearing over COVID-19 concerns.

Due to the pandemic, Harris and some other senators participated remotely. Republican Senator Mike Lee attended in person nine days after revealing he head tested positive for the coronavirus, arriving wearing a light-blue surgical mask. He took off the mask while giving his opening statement.

Barrett is a devout Catholic who has expressed opposition to abortion. Christian conservative activists long have hoped for the court to overturn the landmark 1973 Roe v. Wade ruling that legalized abortion nationwide.

Democratic Senator Cory Booker said that “Senate Republicans have found a nominee in Judge Barrett who they know will do what they couldn’t do – subvert the will of the American people and overturn Roe v. Wade.”

Republicans sought to portray the Democrats as attacking Barrett on religious grounds, though the Democrats steered clear of doing so. Speaking to reporters in Delaware, Biden said Barrett’s Catholic faith should not be considered during the confirmation process. Biden was the first Catholic U.S. vice president.

“This nominee said she wants to get rid of the Affordable Care Act. The president wants to get rid of the Affordable Care Act,” Biden said. “Let’s keep our eye on the ball.”

(Reporting by Lawrence Hurley, Andrew Chung and Patricia Zengerle; Editing by Will Dunham)

Walmart to sell Medicare plans in latest healthcare push

(Reuters) – Walmart Inc said on Tuesday it would sell Medicare insurance plans in 50 states and Washington D.C. through its broker, marking the U.S. retailer’s latest move into the healthcare space.

Walmart Insurance Services LLC, which was launched in July, will offer policies from health insurers such as Humana Inc, UnitedHealth Group and Anthem Blue Cross Blue Shield from Oct. 15-Dec. 7, the company said.

Medicare Advantage plans cater to Americans older than 65 and those with disabilities.

The company already operates health centers across the United States, offering low-cost services such as dental care and counseling.

Walmart’s move comes at a time when health insurers face rising costs as Americans catch up on less urgent surgeries delayed by the COVID-19 pandemic.

Hospitals rescheduled elective surgeries to reduce the burden on the healthcare system as coronavirus cases surged, while some patients canceled appointments to avoid potential contraction of the respiratory illness caused by the virus.

(Reporting by Noor Zainab Hussain in Bengaluru; Editing by Ramakrishnan M.)