Obamacare is Open for Business

Today marks a huge milestone in the implementation of the Affordable Care Act. Health insurance marketplaces opened this morning and millions of Americans, many of whom are currently uninsured and may never before have had access to coverage, began shopping for a quality, affordable health plan.

CREDIT: HEALTHCARE.GOV

In fact, President Obama said today that interest in the insurance marketplaces had exceeded all expectations. While this enormous amount of interest has led to some glitches (which the president said officials were working to address as quickly as possible), things are moving along in states across the country:

National website: A senior Obama administration officialreported that just three hours after Obamacare’s open enrollment period launched, the national Healthcare.govsite had one million visitors. That’s five times more users on the site than the number of users who have ever visitedMedicare.gov at the same time.

California: The Golden State celebrated its first Obamacare enrollee at 8:45 am Pacific Standard Time. Since then, state residents have tweeted that they’re “impressed” with how easy it is to use the exchange’s app, and the site is “working like a charm for Californians.”

Colorado: In Colorado, the exchange site opened for business at 8:00 am Mountain Standard Time. Three hours later, state officials had completed the first enrollmentsand the site had logged over 34,500 unique visitors.

Connecticut: Despite a few initial glitches with its website, Connecticut signed up its first Obamacare enrolleeby 9:30 am. And at that point, 764 other people had active applications for the state’s exchange. “For a site that’s been up for 25 minutes, it’s not bad,” the CEO of Connecticut’s new insurance marketplace, Kevin Counihan,noted. By about 11:30 am, the state had logged 10,000 visitors to its website. By about 2:00 pm, state officialsreported that they had fielded 17,000 phone calls from residents and enrolled 44 people for coverage.

District of Columbia: DC’s exchange opened for business at 8:00 am. By noon, about 1,500 DC residents had created accounts, according to a spokesperson for the exchange. Creating an account is the first step for people who want to shop for coverage and eventually buy a new plan under Obamacare. The District hasn’t yet experienced any issues with its website.

Florida: MSNBC reports that community health care clinics in Orlando are experiencing long lines as low-income people are visiting to learn more about their options under Obamacare. The CEO of a community clinic in Miami that primarily services uninsured Floridians told MSNBC that Tuesday represents a “new day” for low-income patients who can now gain affordable coverage.

Illinois: By noon on Tuesday, more than 42,000 people had visited the website for Illinois’ exchange.

Kentucky: Kentucky is the only Southern state that’s chosen to participate fully in health care reform by both expanding Medicaid and operating a state-level exchange. So far, it’s paying off. Between midnight and 10:30 am on Tuesday, Kentucky’s website had more than 24,000 visitors. The employees working to manage the exchange processedmore than 1,000 applications for health insurance by 9:30 am.

New York: In the first two hours that New York’s exchange website was open to the public, 2 million people visited the site. That’s a huge chunk of the population that stands to benefit from Obamacare. Approximately 2.6 million New York residents are currently uninsured, according to the Kaiser Family Foundation.

Rhode Island: After Kaiser Health News solicited feedback from people trying to sign up for Obamacare, a Rhode Island resident responded with a positive experience. “Rhode Island site working fine. So many choices at so many price points! Something 4 everyone. I’m ecstatic,” Annabelle Leigh tweeted.

Virginia: Paula Thornhill, a 31-year-old mother of seven, was the first person to apply for a new plan in Prince George’s County. Her husband has health insurance through his job, but they couldn’t afford to pay the extra premium costs to cover her as well. “I’m relieved that they did come out with this affordable health care,” she told the Washington Post. “I’m relieved.”

All of this comes in spite of the GOP’s multi-year effort to derail, delay and destroy Obamacare, which has now culminated in Republicans shutting down the federal government in a spiteful and desperate bid to stop millions of Americans from gaining the security of quality, affordable health care.

Want to get in on the Obamacare party? Here’s four things you can do right now:

• Visit HealthCare.gov: This is the central hub for all things health care and will help you locate more information and sign up for coverage through one of the new marketplaces. As President Obama said today, check it out and “then show it to your family and your friends and help them get covered, just like mayors and churches and community groups and companies are already fanning out to do across the country.”
• Call the Obamacare hotline: Trained counselors are standing by at 1-800-318-2596 and can help callers in more than 150 different languages.
• Help educate yourself and your friends, family and coworkers: ThinkProgress put together 20 questions you have about Obamacare and are afraid to ask. Find answers to your own questions and then share this post on Facebook and Twitter.
• Show your support on social media: VisitGetCoveredAmerica.org and change your avatar on Twitter or your profile picture on Facebook to help spread the word that Obamacare is open for business and it’s time to #GetCovered.

BOTTOM LINE: Obamacare is the law of the land, isn’t going anywhere, and is working. Republicans may have closed down the government but the Obamacare insurance marketplaces are open for business and it’s time to get covered.

“You are here because now is the single best time we have to defund Obamacare. This is a fight we can win.”SENATOR TED CRUZ, speaking in August to a Heritage Action gathering in Dallas

WASHINGTON — Shortly after President Obama started his second term, a loose-knit coalition of conservative activists led by former Attorney General Edwin Meese III gathered in the capital to plot strategy. Their push to repeal Mr. Obama’shealth care law was going nowhere, and they desperately needed a new plan.

Out of that session, held one morning in a location the members insist on keeping secret, came a little-noticed “blueprint to defunding Obamacare,” signed by Mr. Meese and leaders of more than three dozen conservative groups.

It articulated a take-no-prisoners legislative strategy that had long percolated in conservative circles: that Republicans could derail the health care overhaul if conservative lawmakers were willing to push fellow Republicans — including their cautious leaders — into cutting off financing for the entire federal government.

“We felt very strongly at the start of this year that the House needed to use the power of the purse,” said one coalition member, Michael A. Needham, who runs Heritage Action for America, the political arm of the Heritage Foundation. “At least at Heritage Action, we felt very strongly from the start that this was a fight that we were going to pick.”

Last week the country witnessed the fallout from that strategy: a standoff that has shuttered much of the federal bureaucracy and unsettled the nation.

To many Americans, the shutdown came out of nowhere. But interviews with a wide array of conservatives show that the confrontation that precipitated the crisis was the outgrowth of a long-running effort to undo the law, the Affordable Care Act, since its passage in 2010 — waged by a galaxy of conservative groups with more money, organized tactics and interconnections than is commonly known.

With polls showing Americans deeply divided over the law, conservatives believe that the public is behind them. Although the law’s opponents say that shutting down the government was not their objective, the activists anticipated that a shutdown could occur — and worked with members of the Tea Party caucus in Congress who were excited about drawing a red line against a law they despise.

A defunding “tool kit” created in early September included talking points for the question, “What happens when you shut down the government and you are blamed for it?” The suggested answer was the one House Republicans give today: “We are simply calling to fund the entire government except for the Affordable Care Act/Obamacare.”

The current budget brinkmanship is just the latest development in a well-financed, broad-based assault on the health law, Mr. Obama’s signature legislative initiative. Groups like Tea Party Patriots, Americans for Prosperity and FreedomWorks are all immersed in the fight, as is Club for Growth, a business-backed nonprofit organization. Some, like Generation Opportunity and Young Americans for Liberty, both aimed at young adults, are upstarts. Heritage Action is new, too, founded in 2010 to advance the policy prescriptions of its sister group, the Heritage Foundation.

The billionaire Koch brothers, Charles and David, have been deeply involved with financing the overall effort. A group linked to the Kochs, Freedom Partners Chamber of Commerce, disbursed more than $200 million last year to nonprofit organizations involved in the fight. Included was $5 million to Generation Opportunity, which created a buzz last month with an Internet advertisement showing a menacing Uncle Sam figure popping up between a woman’s legs during a gynecological exam.

The groups have also sought to pressure vulnerable Republican members of Congress with scorecards keeping track of their health care votes; have burned faux “Obamacare cards” on college campuses; and have distributed scripts for phone calls to Congressional offices, sample letters to editors and Twitter and Facebook offerings for followers to present as their own.

One sample Twitter offering — “Obamacare is a train wreck” — is a common refrain for Speaker John A. Boehner.

As the defunding movement picked up steam among outside advocates, Republicans who sounded tepid became targets. The Senate Conservatives Fund, a political action committee dedicated to “electing true conservatives,” ran radio advertisements against three Republican incumbents.

Heritage Action ran critical Internet advertisements in the districts of 100 Republican lawmakers who had failed to sign a letter by a North Carolina freshman, Representative Mark Meadows, urging Mr. Boehner to take up the defunding cause.

“They’ve been hugely influential,” said David Wasserman, who tracks House races for the nonpartisan Cook Political Report. “When else in our history has a freshman member of Congress from North Carolina been able to round up a gang of 80 that’s essentially ground the government to a halt?”

On Capitol Hill, the advocates found willing partners in Tea Party conservatives, who have repeatedly threatened to shut down the government if they do not get their way on spending issues. This time they said they were so alarmed by the health law that they were willing to risk a shutdown over it. (“This is exactly what the public wants,” Representative Michele Bachmann of Minnesota, founder of the House Tea Party Caucus, said on the eve of the shutdown.)

Despite Mrs. Bachmann’s comments, not all of the groups have been on board with the defunding campaign. Some, like the Koch-financed Americans for Prosperity, which spent $5.5 million on health care television advertisementsover the past three months, are more focused on sowing public doubts about the law. But all have a common goal, which is to cripple a measure that Senator Ted Cruz, a Texas Republican and leader of the defunding effort, has likened to a horror movie.

“We view this as a long-term effort,” said Tim Phillips, the president of Americans for Prosperity. He said his group expected to spend “tens of millions” of dollars on a “multifront effort” that includes working to prevent states from expanding Medicaid under the law. The group’s goal is not to defund the law.

“We want to see this law repealed,” Mr. Phillips said.

A Familiar Tactic

The crowd was raucous at the Hilton Anatole, just north of downtown Dallas, when Mr. Needham’s group, Heritage Action, arrived on a Tuesday in August for the second stop on a nine-city “Defund Obamacare Town Hall Tour.” Nearly 1,000 people turned out to hear two stars of the Tea Party movement: Mr. Cruz, and Jim DeMint, a former South Carolina senator who runs the Heritage Foundation.

“You’re here because now is the single best time we have to defund Obamacare,” declared Mr. Cruz, who would go on to rail against the law on the Senate floor in September with a monologue that ran for 21 hours. “This is a fight we can win.”

Although Mr. Cruz is new to the Senate, the tactic of defunding in Washington is not. For years, Congress has banned the use of certain federal money to pay for abortions, except in the case of incest and rape, by attaching the so-called Hyde Amendment to spending bills.

After the health law passed in 2010, Todd Tiahrt, then a Republican congressman from Kansas, proposed defunding bits and pieces of it. He said he spoke to Mr. Boehner’s staff about the idea while the Supreme Court, which upheld the central provision, was weighing the law’s constitutionality.

“There just wasn’t the appetite for it at the time,” Mr. Tiahrt said in an interview. “They thought, we don’t need to worry about it because the Supreme Court will strike it down.”

But the idea of using the appropriations process to defund an entire federal program, particularly one as far-reaching as the health care overhaul, raised the stakes considerably. In an interview, Mr. DeMint, who left the Senate to join the Heritage Foundation in January, said he had been thinking about it since the law’s passage, in part because Republican leaders were not more aggressive.

“They’ve been through a series of C.R.s and debt limits,” Mr. DeMint said, referring to continuing resolutions on spending, “and all the time there was discussion of ‘O.K., we’re not going to fight the Obamacare fight, we’ll do it next time.’ The conservatives who ran in 2010 promising to repeal it kept hearing, ‘This is not the right time to fight this battle.’ ”

Mr. DeMint is hardly alone in his distaste for the health law, or his willingness to do something about it. In the three years since Mr. Obama signed the health measure, Tea Party-inspired groups have mobilized, aided by a financing network that continues to grow, both in its complexity and the sheer amount of money that flows through it.

A review of tax records, campaign finance reports and corporate filings shows that hundreds of millions of dollars have been raised and spent since 2012 by organizations, many of them loosely connected, leading opposition to the measure.

One of the biggest sources of conservative money is Freedom Partners, a tax-exempt “business league” that claims more than 200 members, each of whom pays at least $100,000 in dues. The group’s board is headed by a longtime executive of Koch Industries, the conglomerate run by the Koch brothers, who were among the original financiers of the Tea Party movement. The Kochs declined to comment.

While Freedom Partners has financed organizations that are pushing to defund the law, like Heritage Action and Tea Party Patriots, Freedom Partners has not advocated that. A spokesman for the group, James Davis, said it was more focused on “educating Americans around the country on the negative impacts of Obamacare.”

The largest recipient of Freedom Partners cash — about $115 million — was the Center to Protect Patient Rights, according to the groups’ latest tax filings. Run by a political consultant with ties to the Kochs and listing an Arizona post office box for its address, the center appears to be little more than a clearinghouse for donations to still more groups, including American Commitment and the 60 Plus Association, both ardent foes of the health care law.

American Commitment and 60 Plus were among a handful of groups calling themselves the “Repeal Coalition” that sent a letter in August urging Republican leaders in the House and the Senate to insist “at a minimum” in a one-year delay of carrying out the health care law as part of any budget deal. Another group, the Conservative 50 Plus Alliance, delivered a defunding petition with 68,700 signatures to the Senate.

In the fight to shape public opinion, conservatives face well-organized liberal foes. Enroll America, a nonprofit group allied with the Obama White House, is waging a campaign to persuade millions of the uninsured to buy coverage. The law’s supporters are also getting huge assistance from the insurance industry, which is expected to spend $1 billion on advertising to help sell its plans on the exchanges.

“It is David versus Goliath,” said Mr. Phillips of Americans for Prosperity.

But conservatives are finding that with relatively small advertising buys, they can make a splash. Generation Opportunity, the youth-oriented outfit behind the “Creepy Uncle Sam” ads, is spending $750,000 on that effort, aimed at dissuading young people — a cohort critical to the success of the health care overhaul — from signing up for insurance under the new law.

The group receives substantial backing from Freedom Partners and appears ready to expand. Recently, Generation Opportunity moved into spacious new offices in Arlington, Va., where exposed ductwork, Ikea chairs and a Ping-Pong table give off the feel of a Silicon Valley start-up.

Its executive director, Evan Feinberg, a 29-year-old former Capitol Hill aide and onetime instructor for a leadership institute founded by Charles Koch, said there would be more Uncle Sam ads, coupled with college campus visits, this fall. Two other groups, FreedomWorks, with its “Burn Your Obamacare Card” protests, and Young Americans for Liberty, are also running campus events.

“A lot of folks have asked us, ‘Are we trying to sabotage the law?’ ” Mr. Feinberg said in an interview last week. His answer echoes the Freedom Partners philosophy: “Our goal is to educate and empower young people.”

Critical Timing

But many on the Republican right wanted to do more.

Mr. Meese’s low-profile coalition, the Conservative Action Project, which seeks to find common ground among leaders of an array of fiscally and socially conservative groups, was looking ahead to last Tuesday, when the new online health insurance marketplaces, called exchanges, were set to open. If the law took full effect as planned, many conservatives feared, it would be nearly impossible to repeal — even if a Republican president were elected in 2016.

“I think people realized that with the imminent beginning of Obamacare, that this was a critical time to make every effort to stop something,” Mr. Meese said in an interview. (He has since stepped down as the coalition’s chairman and has been succeeded by David McIntosh, a former congressman from Indiana.)

The defunding idea, Mr. Meese said, was “a logical strategy.” The idea drew broad support. Fiscal conservatives like Chris Chocola, the president of the Club for Growth, signed on to the blueprint. So did social and religious conservatives, like the Rev. Lou Sheldon of the Traditional Values Coalition.

The document set a target date: March 27, when a continuing resolutionallowing the government to function was to expire. Its message was direct: “Conservatives should not approve a C.R. unless it defunds Obamacare.”

But the March date came and went without a defunding struggle. In the Senate, Mr. Cruz and Senator Mike Lee, a Utah Republican, talked up the defunding idea, but it went nowhere in the Democratic-controlled chamber. In the House, Mr. Boehner wanted to concentrate instead on locking in the across-the-board budget cuts known as sequestration, and Tea Party lawmakers followed his lead. Outside advocates were unhappy but held their fire.

“We didn’t cause any trouble,” Mr. Chocola said.

Yet by summer, with an August recess looming and another temporary spending bill expiring at the end of September, the groups were done waiting.

“I remember talking to reporters at the end of July, and they said, ‘This didn’t go anywhere,’ ” Mr. Needham recalled. “What all of us felt at the time was, this was never going to be a strategy that was going to win inside the Beltway. It was going to be a strategy where, during August, people would go home and hear from their constituents, saying: ‘You pledged to do everything you could to stop Obamacare. Will you defund it?’ ”

Heritage Action, which has trained 6,000 people it calls sentinels around the country, sent them to open meetings and other events to confront their elected representatives. Its “Defund Obamacare Town Hall Tour,” which began in Fayetteville, Ark., on Aug. 19 and ended 10 days later in Wilmington, Del., drew hundreds at every stop.

The Senate Conservatives Fund, led by Mr. DeMint when he was in the Senate, put up a Web site in July called dontfundobamacare.com and ran television ads featuring Mr. Cruz and Mr. Lee urging people to tell their representatives not to fund the law.

When Senator Richard M. Burr, a North Carolina Republican, told a reporterthat defunding the law was “the dumbest idea I’ve ever heard,” the fund bought a radio ad to attack him. Two other Republican senators up for re-election in 2014, Lamar Alexander of Tennessee and Lindsey Graham of South Carolina, were also targeted. Both face Tea Party challengers.

In Washington, Tea Party Patriots, which created the defunding tool kit, set up a Web site, exemptamerica.com, to promote a rally last month showcasing many of the Republicans in Congress whom Democrats — and a number of fellow Republicans — say are most responsible for the shutdown.

While conservatives believe that the public will back them on defunding, a recent poll by the Kaiser Family Foundation found that a majority — 57 percent — disapproves of cutting off funding as a way to stop the law.

Last week, with the health care exchanges open for business and a number of prominent Republicans complaining that the “Defund Obamacare” strategy was politically damaging and pointless, Mr. Needham of Heritage Action said he felt good about what the groups had accomplished.

“It really was a groundswell,” he said, “that changed Washington from the outside in.”

61-year-old Butch Matthews, left, with his wife Debbie

Butch Matthews is a 61-year-old former small business owner from Little Rock, Arkansas who used to wake up every morning at 4 A.M. to deliver canned beverages to retailers before retiring in 2010. A lifelong Republican, he was heavily skeptical of the Affordable Care Act when it first passed. “I did not think that Obamacare was going to be a good plan, I did not think that it was going to help me at all,” he told ThinkProgress over the phone.

But after doing a little research, Matthews eventually realized how much the law could help him. And on Tuesday, his local Blue Cross Blue Shield (BCBS) provider confirmed that he would be able to buy a far better plan than his current policy while saving at least $13,000 per year through Arkansas’ Obamacare marketplace.

Matthews was self-employed between 1997 and 2010, meaning he had to purchase his own plan on the individual market. He chose a Blue Cross Blue Shield plan for himself and his wife that charged a $250 per month premium and had a $2,000 deductible. But the price of that policy kept rising even as it covered fewer of his costs, eventually devolving into his current rate of $1,069 per month with a $10,000 deductible. At this point, it doesn’t even cover his medication or doctors’ visits — particularly concerning considering he had to have two stents placed in his heart in 2006.

“I do not work now, I’m 61, and we do have assets saved up. But still, to come up with that $1,069 per month….” he said, trailing off. “I went to Blue Cross Blue Shield, and they don’t even sell that plan anymore, but I could not change it to anything else. So I was locked in with it.”

That all changed once Obamacare’s state-level marketplaces opened to the public on Tuesday. Matthews knew that, at his income level, the law would help him pay for insurance. But even he might not have expected just how good of a deal he could get: his new coverage will cost him absolutely nothing in monthly premiums after factoring in federal subsidies, and has a deductible of $750.

“Which is a lot different from $10,000,” he pointed out, laughing.

The mid-level “Silver” policy that he picked out also offers a significantly better benefits package. “It’s a lot better plan,” Matthews said. His old plan was considered to be “Bronze” and had much higher co-pays. Under Obamacare, when Matthews visits a doctor, it will no longer cost him around $150. It will cost $8.

So what would Matthews tell other Americans who are skeptical about Obamacare? “I would tell them to learn more about it before they start talking bad about it,” he noted. “Be more informed, get more information, take your time and study and not just go by just what you hear on one side or the other. Actually check the facts on it.”

“I still am a very strong Republican, but this… I’m so happy that this came along,” he continued. “Our home is paid for, vehicle’s paid for, this is our expense that we have. We have more expense on medical care than everything else put together, so this is going to be a great help for us.”

*******

Now that Obamacare’s new insurance marketplaces are open to the public, some uninsured Americans are eager to sign up. However, many others likely remain confused about their options under health reform, particularly as Obamacare continues to get caught in the political crossfire. In order to bridge the education gap about the health law, advocates are ramping up their enrollment efforts in creative ways. For instance, you can now text ENROLL to Planned Parenthood to receive information about health reform.

But nonprofit and government groups can’t do it all on their own. Here are seven large companies that are currently joining in on the effort and helping to spread the word about the new insurance options available under Obamacare:

1. Trader Joe’s

CREDIT: RICHARD B. LEVINE/NEWSCOM

Last month, Trader Joe’s announced that it was dropping coverage for its part-time employees working less than 30 hours a week — a move that Obamacare critics were quick to interpret as a sign that the health reform law puts too much of a burden on big companies. But the grocery chain actually decided to eliminate part-time benefits because the options under Obamacare are more generous than the plans the company had been offering. And now, it’s encouraging part-time employees to sign up for a plan on Obamacare’s newly-open insurance marketplaces. An internal memo provided to the Huffington Post last week encourages workers to figure out what a plan under Obamacare would cost for them, and suggests that Trader Joe’s may help offset the cost even further by covering part of that premium.

2. TurboTax

CREDIT: TURBOTAX

TurboTax, one of the most popular tax preparation software packages in the country, is helping to spread the news about what Obamacare’s new insurance marketplaces may mean for their customers’ finances. The front page of its website currently displays a section about “how the new health reform law affects you,” and directs people to get more information about the federal subsidies available to help them buy insurance. Last week, TurboTax sent an email to its customers entitled “Health Care Reform & Your Taxes” that includes a link to TurboTax’s “Health Care Eligibility Calculator,” which helps people figure out what their subsidy will be if they want to enroll in one of Obamacare’s new plans.

3. CVS

CREDIT: CVS

It makes sense that pharmacies would be invested in promoting big changes in the health insurance industry. “Families throughout our country look to their pharmacy as a place they can go to for honest, straightforward advice they can trust,” HHS Secretary Kathleen Sebelius noted in a blog post last month. That’s exactly why CVS officials are promoting Obamacare in 7,400 of their U.S. stores to teach uninsured Americans more about their options for getting coverage. The pharmacy chain will also invite “navigators,” the employees trained to help Americans enroll in Obamacare plans, into their stores to connect with people who need insurance. And CVS is currently prominently displaying brochures entitled “Affordable Care Act Answers” that answer common questions about health reform.

4. Walgreens

CREDIT: WALGREENS

In July, Walgreens announced that it would partner with Blue Cross Blue Shield, one of the largest health insurance companies in the country, to promote Obamacare. The two companies launched a new website to answer customers’ questions about the health reform law. Walgreens will also have informational materials about health reform available in each of its 8,000 stores.

5. Rite Aid

CREDIT: RITE AID

Last month, Rite Aid became the third large pharmacy chain to agree to publicize the changes under the health reform law. The company is hosting licensed insurance agents, who are available to help people sign up for Obamacare at no additional cost to them, at 2,000 of its stores across the country. It’s not necessary to make an appointment to meet with the agents, who have received “specific training” to offer guidance on Obamacare. They’ll be able to answer questions about Obamacare’s insurance marketplaces as well as Medicaid eligibility in the states that have opted to expand the program.

6. WebMD

CREDIT: WEBMD

WebMD, the largest online health website in the country, released a consumer guide to Obamacare in August. “WebMD has more than a decade of expertise in providing health insurance information. The Health Care Reform Center builds on this expertise at a time when there is an immense need for trusted, objective information about complex legislation,” the company’s interim CEO David Schlanger explained at the time. Now, on the front page of its site, WebMD is prominently displaying a widget that gives Americans more information about the health reform options in their state. “Learn about plans, benefits, and costs in your state’s Marketplace,” the site notes.

7. Giant Food

CREDIT: DAN GLEITER/THE PATRIOT-NEWS

Giant has partnered with Maryland’s state-run insurance marketplace, Maryland Health Connection, to help spread the word about Obamacare. The grocery chain is displaying information about the plans on the state’s new marketplace in 100 of its stores. The company will also work with Maryland Health Connection to plan outreach events, like enrollment fairs to help Giant customers sign up for Obamacare plans with the help of a navigator. Maryland has been particularly creative about promoting Obamacare, and is also partnering with the Baltimore Ravens to publicize health reform.

*****

It’s become a cliché at the beginning and end of each Supreme Court term to comment on how important the term is or will be, and how the justices are hearing a myriad of major cases. And certainly after two terms featuring high profile cases on health care, immigration, voting rights and marriage equality — in addition to under the radar decisions blasting worker and consumer rights — there can be little doubt of the Court’s immense power to do harm (and its less frequently exercised power to do good).

The term that begins this fall, however, has the potential to be even more significant that the previous two. By this time next year, fair housing law could be neutered, unions could be hobbled, billionaires could be free to spend millions to put their favorite candidates in office, and the right to choose an abortion could be meaningless. With a wave of their hand, five conservative justices could achieve outcomes that Scott Walker, Rick Perry and Sheldon Adelson could never dream of accomplishing even at the height of their power.

Here’s a taste of what’s at stake in the next Supreme Court term:

Abortion

The Supreme Court has not heard a major abortion case since 2007, when the conservative justices limited reproductive freedom in part because “some women come to regret their choice to abort.” Next term, they could hear two. The first, McCullen v. Coakley, concerns a Massachusetts law that prohibits people who don’t have business at a “reproductive health care facility” — most often, abortion protesters — from congregating within a buffer zone around the clinic’s entrance, exit or driveway. In what the lower court labeled an argument that “elevates hope over reason,” abortion opponents claim that the buffer zones violate Citizens United and a bevy of other First Amendment decisions. If five justices ultimately agree with this argument, it could not only wipe out the Massachusetts law, but also potentially endanger a federal law ensuring women can access clinics without intimidation, depending on the breadth of the Court’s decision.

While McCullen concerns how much harassment a woman may be subjected to before they can obtain an abortion, another case potentially strikes at the core of the right to choose. Although the specific issue at stake in Cline v. Oklahoma Coalition for Reproductive Justice concerns whether states can ban off-label use of abortion drugs, the case tees up the issue of how far states can go in restricting abortions by enacting laws ostensibly directed at making them safer. The Constitution quite correctly permits states to enact laws ensuring abortions are performed safely — otherwise, a state could not require surgical abortions to be performed by trained surgeons or ensure that operating rooms are sterile. Abortion foes, however, routinely use this power as a fig leaf to enact laws that can be spun as safety regulations, but which really exist for the sole purpose of restricting abortion. Common examples are bills requiring clinics have extra-wide hallways or to only employ doctors with irrelevant credentials. Extreme examples could force doctors to complete a 10,000 hour course before they can perform an abortion, or forbid an abortion clinic from operating unless it also qualifies as a level I trauma center.

Because of an unusual procedural issue involving a question the justices want the Oklahoma Supreme Court to answer, it is possible that the justices will not ultimately decide this case. Should they do so, however, they could potentially permit abortion foes to enact laws that make it literally impossible for abortion clinics to operate.

Campaign Finance

The Supreme Court’s Citizens United decision allowing corporations to spend unlimited money to shape the outcomes of elections is widely viewed as the high water mark in the justices’ willingness to allow big money to influence elections. Yet, after the Court hands down its opinion in McCutcheon v. Federal Election Commission — a case whose plaintiffs’ include the Republican National Committee — Citizens Unitedcould look quaint.

Although Citizens United permits unlimited donations to third-party groups such as SuperPACs which are ostensibly separate from candidates or political parties, the conservative justices have not yet struck a six-figure cap on total donations to candidates, political party committees and similar organizations. As the lower court explained in upholding this cap, “Eliminating the aggregate limits means an individual might, for example, give half-a-million dollars in a single check to a joint fundraising committee . . . because party committees may transfer unlimited amounts of money to other party committees of the same party, the half-a-million-dollar contribution might nevertheless find its way to a single committee’s coffers.” In other words, this case could conceivably allow billionaires to launder massive dollar donations to single candidates — who would no doubt feel very grateful to those billionaires should they win their election.

Separation of Church and State

Retired Justice Sandra Day O’Connor long provided the fifth vote to strike down government efforts to promote religious views. As she warned in one of her final opinions on the bench, due to the “violent consequences of the assumption of religious authority by government . . . Those who would renegotiate the boundaries between church and state must therefore answer a difficult question: Why would we trade a system that has served us so well for one that has served others so poorly?”

In Town of Greece v. Galloway, the Supreme Court’s new majority will have the opportunity to trade a system that has served us so well for one that has served others so poorly. Justice O’Connor’s opinions relied on her view that government can neither endorse a religious view nor convey a “message of endorsement to the reasonable observer.”Galloway, however, tees up the question of whether such endorsements will now be permissible because O’Connor is no longer around to protect her legacy.

Housing Discrimination

Discrimination is often subtle. Indeed, discrimination lawsuits rarely uncover a smoking gun document where the defendant announces a racist intent. Nevertheless, there can be little doubt that race discrimination exists. In the housing sphere, a recent study on behalf of the Department of Housing and Urban Development found that black and Asian homeseekers are shown or told about 15 to 19 percent fewer homes than whites with similar credit qualifications and housing interests. During the subprime lending boom, African Americans with good credit scores were 3.5 times as likely as whites with good credit scores to receive higher-interest-rate loans, and Latinos were 3.1 times as likely to receive such loans. And the Federal Reserve found that in 2009, African Americans were twice as likely to be denied a loan, even controlling for income and other qualifying criteria.

These disproportionate impacts have become increasingly crucial to policies and legal challenges that seek to address housing discrimination, and proving discrimination through “disparate impact” has beenaccepted by all nine federal appeals courts to consider the question. This past January, HUD even issued a regulation interpreting the Fair Housing Act as allowing claims of disparate racial impact. But the Township of Mount Holly, New Jersey is now asking the Supreme Court to reverse all of that — a risk given the Roberts Court’s hostility to the Voting Rights Act, affirmative action, and other means for rooting out racial discrimination.

In 2011, future Secretary of Labor Tom Perez averted a Supreme Court ruling on this issue by asking the city of St. Paul, Minn. drop its appealafter and preserve existing precedent. Once again, this case may not make it to a Supreme Court ruling, as the parties are reportedly close to a potential settlement.

Affirmative Action

Last term, the justices surprised many court-watchers by leaving affirmative action jurisprudence in place, but not before warning that lower court judges better apply a whole lot of scrutiny in analyzing any race-based college admissions policy. This term, they have another opportunity to take a cut at policies that diversify universities and workplaces — and at least two U.S. Supreme Court precedents on race. While the justices last term considered whether universities can considerrace in selection, they will this time consider whether states can banconsideration of race in university admissions.

The U.S. Supreme Court made clear in several previous cases that states cannot force minorities to jump through special hoops to pass laws that benefit them as a group. The state ban does just that. Because it is a constitutional amendment, it requires nothing less than a second constitutional amendment to repeal — a burden that places affirmative action advocates on unequal footing. As the appeals court judges explained it, this means that a student seeking to be admitted because family member is an alumnus of the school could appeal directly to the university, while a minority student seeking to reinstate affirmative action has no other choice but to “attempt to amend the Michigan Constitution—a lengthy, expensive, and arduous process—to repeal the consequences of Proposal 2.” The lower court’s opinion continued: “The existence of such a comparative structural burden undermines the Equal Protection Clause’s guarantee that all citizens ought to have equal access to the tools of political change.”

The Future of Unions

Until last July, the most important case facing the justices this term appeared to be National Labor Relations Board v. Noel Canning, a case that could have potentially rendered much of federal labor law unenforceable and left the right to organize completely toothless. The National Labor Relations Board has exclusive authority to enforce much of the law protecting workers and unions, and a series of decisions by conservative court of appeals judges declaring President Obama’s recess appointments to this board unconstitutional threatened to shut the board down. In July, Senate Republicans agreed to stop preventing anyone from being confirmed to this Board thanks to Democrats’ threat to invoked the so-called “nuclear option,” effectively removing the risk that American labor law would shut down entirely for as long as the Board’s current members sit. Nevertheless, an important remaining question in the Noel Canning case is whether the decisions reached by Obama’s recess appointees before Republicans lifted their blockade on confirmations are valid. If the Court holds that they are not, literallyhundreds of decisions could be invalidated and would need to be relitigated.

With Noel Canning somewhat defanged by the confirmation of new NLRB board members, the most important labor case facing the justices this term is probably Unite Here Local 355 v. Mulhall. Unite Here concerns the future of “neutrality agreements,” agreements where an employer agrees to remain neutral on a union’s attempt to organize its workforce, and sometimes provide other concessions to the union, rather than face a potentially contentious process that can divide a workforce and generate animosity with the union that may ultimately represent its workers. Non-union shops are notoriously difficult to organize under existing federal labor law, so the presence of a neutrality agreement often determines whether a unionization effort will be successful. According to a 2007 paper examining neutrality agreements, less than one-fifth of newly organized employees were unionized under the NLRB elections process that typically applies in the absence of an agreement. By contrast, “the Service Employees, the Needletrades, textile, Hotel and Restaurant Employees, and the Autoworkers all report that a plurality or majority of newly organized members have come” after a contractual agreement with the employer to remain neutral.

Several years ago, anti-union advocates developed a legal argument that could potentially shut these agreements down, or, at least, limit the ability of unions and employers to reach such agreements. Citing an anti-bribery law enacted in 1947, which forbids employers from paying “any money or other thing of value” to a labor union seeking to represent its workers, these advocates claim that neutrality agreements violate this ban on companies bribing unions. Initially, this argument did not meet with much success. Indeed, then-Judge Michael Chertoff, who later became Homeland Security Secretary under President George W. Bush, wrote that anti-union advocates are “unable to provide any legal support for the remarkable assertion that entering into a valid labor agreement governing recognition of a labor union amounts to illegal labor bribery.” That all changed last year, however, when the United States Court of Appeals for the Eleventh Circuit embraced the anti-union advocates’ reading of federal anti-bribery law, at least in some cases. If the Supreme Court sides against neutrality agreements in this case, it could eliminate the single most potent vehicle many unions can utilize to organize new workplaces.

Clean Air

Environmental regulation is the epitome of interstate and even inter-country regulation. Pollution to the air, water, and soil of one state inevitably runs into others, and not always the way we’d expect it to. Because of wind patterns, there are some states whose pollution contributes more to poor air quality in other states. Addressing this issue, and aiming to prevent 34,000 premature deaths and 400,000 asthma attacks each year, the Environmental Protection Agency imposed a rule to require 28 “upwind” states to not only ensure that their own air quality complies with federal standards, but also to mitigate their contribution to pollution in other downwind states.

Even the conservative U.S. Court of Appeals for the D.C. Circuit has made clear that this sort of regulation is needed. In fact, the D.C. Circuit ruled in 2008 that old EPA rules did not sufficiently protect downwind states from pollution. But they have since swung the other way, in what has been dubbed a “Goldilocks Conunudrum.” Last year, the D.C. Circuit ruled that EPA’s newest solution regulates downwind pollution too much and doesn’t defer enough to states’ own proposals for solving the problem. This is the ruling the Supreme Court will review this time around.

Versions of these rules have been wending their way through the courtsfor decades, during which time pollution has been regulated under outdated, ineffective standards, even though the court and EPA agree that the Cross State Air Pollution plan would be more effective. A U.S. Supreme Court ruling upholding the latest D.C. Circuit opinion would send EPA back to the drawing board yet again, and “seriously impede the EPA’s ability to deal with a grave public health problem.” It would also conveniently continue to spare the most polluting businesses from compliance. But don’t be surprised if the court’s five conservative justices who sometimes espouse judicial restraint reach out to question the judgment of an agency in fulfilling its own mandate.

Human Rights v. Corporate Immunity

Last term, the U.S. Supreme Court struck a blow to both human rights and corporate accountability when it narrowed the scope of a 200-year-old statute intended to address egregious human rights violations abroad. Shortly after that ruling, the court announced it would take another case dealing with the same statute.

The plaintiffs in this case allege that car manufacturer DaimlerChrysler acted in cahoots with the Argentine military during the “dirty war” in arresting and detaining workers, some of whom disappeared. They are seeking to hold DaimlerChrysler accountable for this alleged life-threatening exploitation of workers through the Alien Tort Statute, which allows lawsuits by “aliens” — meaning non-U.S. parties. Even under this statute, however, parties have to meet general court rules about jurisdiction, meaning they must have some connection to the United States. Federal court decisions before last term’s Kiobel ruling allowed lawsuits that challenged torture abroad by two foreign actors to proceed in U.S. courts because the defendants had lived or were living in the United States. DaimlerChrysler has claimed that the plaintiffs do not have jurisdiction to sue them in the United States, because DaimlerChrysler is based in Germany and is suing over actions in Argentina. But the U.S. Court of Appeals for the Ninth Circuit ruled that DaimlerChrysler’s California subsidiary was sufficient to establish jurisdiction in California.

The ruling could clarify the scope of last term’s ruling, and whether many corporations with a major presence in the United States who profit from exploiting more permissive countries will be even better insulated from liability. Some commentators wonder whether the Supreme Court took this case to narrow the scope of U.S. Courts’ jurisdiction over corporations more generally, and not just under this one statute.

Whether Treaties Can Be Enforced

As President Obama struggles to enforce international norms forbidding the use of chemical weapons in Syria, the justices will turn their eyes to a much smaller violation of those norms. A vengeful spouse named Carol Anne Bond stole toxic chemicals from her employer and applied them to her husband’s mistress’ mailbox, car doors, and her house’s doorknob in an attempt to poison the mistress. This violated the federal law implementing the 1993 Chemical Weapons Convention, which makes it a crime to “receive, stockpile, retain, own, possess, use, or threaten to use” a chemical weapon.

Nearly a century ago, the Supreme Court held that, when the United States enters into a valid treaty, “there can be no dispute about the validity of the statute [implementing the treaty] under Article 1, Section 8, as a necessary and proper means to execute the powers of the Government.” Bond now asks the Roberts Court to repudiate this holding, or at least to limit it enough to allow her to avoid prosecution for her use of the stolen poison under the statute implementing the chemical weapons treaty. If the justices take her up on this request, they could potentially curtail America’s ability to meet its treaty obligations to a significant degree.

If they do reach such a result, it would not be the first time the Roberts Court cut into our nation’s ability to meet our international obligations. In 2008 — in a case argued by future Sen. Ted Cruz (R-TX) — the Court held that Texas could ignore a treaty requiring foreign nationals arrested within the United States to be informed of their right “to request assistance from the consul of his own state.” Even North Korea honored this treaty in 2009 when it took two American journalists captive, although Texas did not.

Privacy And The Police

With new-technology questions swirling about the ability of the Fourth Amendment to protect against secret surveillance, a case next term will answer a more fundamental question about police power to search the home of a suspect. The home has always been particularly sacrosanct under the Fourth Amendment, but one of the ways police can get around the usual search warrant requirement is by getting consent to search a suspect’s home. Under current case law, if the police come to your door without a warrant and you’re not home, your roommate can give an officer consent to perform a search of the home on your behalf. But what if you have previously told the police that they are not authorized to search your home? Can they come back later when you’re not home and try again? In this case, police took advantage of that scenario. They came to the defendant Walter Fernandez’s apartment, and Fernandez said they had no right to search his home. Recognizing a tattoo on Fernandez as matching that of a burglary suspect, they arrested Fernandez. They visited the apartment an hour later — with a guarantee that Fernandez would no longer be there to decline the search — and Fernandez’s girlfriend gave her consent for police to search the home.

There are obvious reasons to worry about allowing others to waive your Fourth Amendment rights. But this concern is heightened where a suspect has explicitly rejected a search, and police are incentivized to arrest that suspect simply to gain access to that person’s home. With surveillance tactics threatening to collect even more from the Internet than police might find in someone’s home, questions about consent may also tell us how willing the justices will be to defend our privacy from government intrusion.

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