Insiders Detail Culture of Secrecy at California’s Obamacare Exchange

Sharyl Attkisson /

Aiden Hill’s introduction to the secretive culture at Covered California came in his first days on the job. He had just been hired to head up the agency’s $120 million call center effort when he emailed a superior April 18, 2013, and got a text message in reply:

Please refrain from writing a lot of draft contract language in government email … And don’t clarify via email … No email.

Later, concerned about contractor performance, Hill conducted an Internet search for “best practices” information to forward a superior. Afterward he got this text:

Aiden—Please stop using government email for your searches.

Hill saw the text messages as a deliberate effort to avoid a paper trail subject to public disclosure. And he says some higher-ups grew increasingly upset by his efforts to flag alleged incompetence and waste.

“They stuck their head in the sand and pretended the contractors could fix things by the launch date, which they couldn’t and didn’t,” says a former Covered California call center manager who worked under Hill and asked not to be named to protect his status at a different state job. “It was always say that everything was fine and we’re going to make it through the process.”

The officials allege it was conflicts of interest that led some executives to tolerate “egregious taxpayer waste.”

“None of us wants to see … pockets lined of contractors that didn’t do what they were supposed to do but got paid every dime,” says a third Covered California official who still works at the agency.

An Associated Press report in 2013 found that millions in no-bid Covered California contracts went to firms with professional ties to agency Executive Director Peter Lee. At the time, a spokesman told AP that Covered California “was under pressure to move fast” to meet tight federal deadlines and “needed specialized skills.” Covered California would not answer our questions about potential conflicts of interest.

AP also found Covered California uniquely positioned to keep its spending details secret—“the most restrictive” among the 16 state exchanges with “authority to conceal spending on contractors performing most of its functions … potentially shielding the public from seeing how hundreds of millions of dollars are spent.”

Aiden Hill

Aiden Hill (Photo courtesy of Aiden Hill)

After Hill escalated his concerns about contractors, Covered California abruptly terminated his contract in August 2013. He left determined to expose the dysfunction, and did so during an unusual presentation at a public board meeting.

“I’m here to tell the board and the public that Covered California executives have been engaging in a cover up,” declared Hill at the Feb. 20, 2014, meeting, speaking from the audience during a question-and-answer period.

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“They knew back in August of 2013 that there were serious readiness issues with Covered California. … When I and others persisted in challenging these contractor performance issues, our own contracts were prematurely terminated and we were threatened with legal action if we spoke out.”

After that public display, Covered California hired a law firm to conduct an independent investigation into allegations that management “engaged in a cover-up” and “knowingly allowed two contractors to engage in waste, fraud and abuse.”

The firm conducted 45 interviews with 25 witnesses. Last December, Covered California notified Hill that the independent probe concluded “the evidence did not support” any of his claims.

Hill calls the inquiry a sham and says investigators failed to interview key witnesses he suggested. Covered California declined to answer our questions on this topic, or any other.

WATCH: Aiden Hill’s February 2014 statement at Covered California board meeting

Covered California: A Sales Organization

Kevin Knauss is a certified Covered California insurance agent and Affordable Care Act supporter. In spring of 2013, he says he was “jazzed” about the promise of Obamacare and began blogging “happy stuff.”

Since then, he has seen many success stories. One is a San Francisco graduate student with AIDS who had trouble getting insured until Obamacare. In December 2013, he not only was able to get a policy on the Covered California exchange, but he also got a tax dollar subsidy to help buy it. The very first week the policy took effect, he ended up with a two-week emergency hospital stay.

Kevin Knauss, Certified Covered California Agent

Kevin Knauss, certified Covered California agent (Photo courtesy of Kevin Knauss)

“He still had to pay the deductible, but he would have ended up owing a lot more money without insurance,” says Knauss. “And San Francisco General Hospital got paid.”

But Knauss has also seen a flip side. He’s been shocked by the amount of time he’s spent helping weary Covered California consumers.

“Early on, it wasn’t unusual to spend four hours during the day on hold with Covered California just trying to resolve minor issues,” he says.

Today, there’s less hold time but daily examples of confusion.

“I’ve got one family … their Covered California account shows three different effective dates.” In another case, “I found out a woman’s plan had been terminated, but they couldn’t tell me why.”

Knauss’ once-cheerful blog has turned into a consumer chronicle of Covered California’s tribulations. He says the agency is masking its shortfalls because it is, in essence, a sales organization.

“I know their enrollment numbers aren’t right. They’re marketing themselves [to] generate fees.”

To some degree, state health insurance exchanges are forced to market themselves. After starting up using over a billion federal tax dollars, the law requires them to be self-supporting this year. To do so, Covered California collects commissions.

Evelena Hohl of Anderson smiles at Peter Lee, executive director of Covered California, after a group photograph on Tuesday, Nov. 18, 2014, as the Covered California bus tour came to Lake Redding Park in Redding, Calif., to promote and raise awareness to the program. Hohl is in the process of getting health insurance through the program. (Photo: Redding Record Searchlight/ZUMA Wire/Newscom)

Evelena Hohl of Anderson smiles at Peter Lee, executive director of Covered California, on Nov. 18, 2014. Hohl was in the process of obtaining health insurance through the program. (Photo: Redding Record Searchlight/ZUMA Wire/Newscom)

The agency wouldn’t answer questions on this topic, but previously indicated it planned to charge a 3 percent fee on premiums in 2014 and later hoped to reduce that to 2 percent. Because too few people enrolled, published reports say Covered California could not reduce its 2015 fee, and maintained it at $13.95 per person each month.

“I didn’t think it would turn into as much of a marketing machine and corporate entity. I thought there would be more transparency,” says Knauss.

Computer Bugs

Marketing Covered California can be tricky considering formidable obstacles still dragging it down.

Design flaws involving the $454 million computer system are responsible for giant backlogs, misinformation and poor interface with California’s version of Medicaid coverage for the poor.

Computer glitches forced a delay in adult family dental plans and caused a confounding flurry of mail. One family reportedly received 18 notices in one day; 14 said they were covered and four said they were not. Consumer advocates found a customer who got 40 notices in less than a month.

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And when tax season rolled around, 100,000 customers got inaccurate tax forms—or none at all. That mirrored similar problems at HealthCare.gov, which sent 800,000 incorrect tax statements.

Covered California wouldn’t answer our questions about various computer snafus. A spokesman previously told reporters, “We are dealing with a multitude of information that is going back and forth. … There can be discrepancies between what’s on our record and what is on the health plans’ records.”

The Big Picture

We asked Covered California to describe its accomplished goals, but the agency declined to do so. In a recent press release, the agency said that 800,000 households received federal subsidies last year to make health care more affordable. Subsidies averaged $436 per month.

“The assistance provided through the Affordable Care Act helped bring health coverage within reach for more than a million people, and it changed lives across the state,” Executive Director Lee said in a statement.

There’s little doubt that Covered California has improved circumstances for many formerly uninsured, like the graduate student with AIDS. But few predicted that would come at the expense of so many others now paying more for fewer choices and less coverage.

“In my case, it’s not looking good,” says Hill, the former Covered California project manager.

“While my coverage went down [due to Obamacare], my premium went up—by 71 percent,” he says. “So much for competition.”

sharyl_notices_sidebar-800K

More rate increases are ahead. A recent study found the vast majority of Covered California customers—84 percent—face premium hikes this year.

Nonetheless, current and former Covered California officials we spoke to who criticize the agency’s conduct still endorse the idea of the Affordable Care Act.

“I am a supporter of Obamacare, before and now,” says one official. “I would rather see it in place, even though crippled, as it is a start.”

Meantime, Covered California continues its marketing job. Lee recently said that 94 percent of those who renewed their Covered California insurance this year kept their same policies, meaning “those plans having the right mix of doctors, the right mix of care options for them, and the right one they wanted to stay with.”

However, like a lot of Covered California’s statements, it’s a good dose of spin. In fact, 35% of Covered California’s 2014 customers dropped their Covered California policies in 2015. That’s one of the worst retention rates among states.

sharyl_notices_sidebar-hikes

“I think it’s too big,” says insurance agent Knauss. “Health care reform is not addressing doctors and hospitals and the games they play. And health insurance companies are 10 steps ahead of anything the government is doing … Maybe we just can’t do this.”

Covered California declined to respond to our questions but issued this statement:

Covered California is proud that it has been the portal for nearly four million people to find coverage through one of our participating health plans or through low cost/no cost Medi-Cal; is helping more than a million people access financial assistance to lower their monthly health insurance premiums; through the Affordable Care Act has reduced the number of uninsured in California by half.

>>> This is the second of two parts in The Daily Signal’s series, “Uncovering Covered California.” Yesterday, in part one, several senior-level officials integral to the launch of Covered California spoke about what they view as gross incompetence and mismanagement.

The Terrorist Threat Is Alive and Well - The Daily Signal

The Terrorist Threat Is Alive and Well

Sharyl Attkisson / Rachel Zissimos / Jennifer Guthrie /

On April 19, 1995, Timothy McVeigh detonated a truck bomb in front of the Alfred P. Murrah Federal Building in Oklahoma City. The attack killed 168 people, including 19 children and a large number of federal employees. McVeigh sought revenge against the federal government, which he held responsible for the lives lost during the Waco Siege that had occurred exactly two years prior. Now, twenty years after the Oklahoma City bombing, the threat of homegrown terrorism is still alive and well.

U.S. security and intelligence officials just foiled three terrorist plots in the course of three weeks. While this stands as a testament to how much intelligence capabilities have improved since 1995, the frequency of attempts also demonstrates the seriousness of the threat. The arrest of John T. Booker on April 10 marked the 66th Islamist terrorist plot against the U.S. homeland since 9/11, with at least 55 of those plots being homegrown. ISIS and al-Qaeda continue to motivate and facilitate homegrown terrorism, and global dependence on cyberspace provides a new arena in which malicious actors can target U.S. interests.

Although the security environment has dramatically changed since the 1995 attack, counterterrorism capabilities must be continually renewed and improved. The 1995 attack, considered the most deadly homegrown terrorist attack in U.S. history, together with 9/11 and other deadly terror attacks in the past two decades, prove that the costs of terrorism are too high to tolerate complacency.

In order to stay ahead of the evolving threat, the U.S. must continue to bolster its counterterrorism capabilities by implementing a variety of reforms, including streamlining U.S. fusions centers, refocusing the Department of Homeland Security’s intelligence capabilities, maintaining essential counterterrorism tools, and facilitating information sharing with state, local, and private-sector partners.

History teaches us the dangers of having a reactive approach to terrorism. The U.S. must embrace a proactive approach to prevent future Timothy McVeighs and 9/11 hijackers from attacking our homeland.

—Rachel Zissimos and Jennifer Guthrie are currently members of the Young Leaders Program at The Heritage Foundation. For more information on interning at Heritage, please click here.

Obama Lawyer Struggles to Defend Immigration Plan’s Implementation as Case Goes Through Courts - The Daily Signal

Obama Lawyer Struggles to Defend Immigration Plan’s Implementation as Case Goes Through Courts

Sharyl Attkisson / Rachel Zissimos / Jennifer Guthrie / Hans von Spakovsky /

The Obama administration’s lawyer, Benjamin Mizer, the acting assistant attorney general of the Civil Division at the Justice Department, did not have an easy time in his argument last Friday before a three-judge panel of the Fifth Circuit Court of Appeals in the immigration lawsuit filed by 26 states.

He was questioned about all of the claims being made by the government, from the administration’s argument that the states don’t have standing to file a lawsuit to the assertion that everything President Obama has done is within the administration’s prosecutorial discretion.

The substantive merits of district court Judge Andrew Hanen’s Feb. 16 injunction order was not before the panel; just the government’s request that the Fifth Circuit stay (or lift) the injunction while the appeal is pending.

Every seat in the courtroom was taken, and the court fed an audio of the arguments into two additional courtrooms, while pro-administration supporters protested outside the federal courthouse in New Orleans. Oral arguments before the Fifth Circuit normally take 40 minutes, but the arguments on Friday lasted for two-and-a-half hours.

The Obama Administration’s Strange Logic

As I listened to Mizer responding to questions from the judges, I was shaking my head at some of his answers. One of his justifications for the president’s actions towards the beginning of the argument was so strange, I wasn’t sure I heard it correctly.

Judge Jerry Smith asked Mizer if the president’s plan wasn’t distinct from the “exercise of prosecutorial discretion” because it “confers benefits.” The plan, for example, provides not only deferred action to illegal aliens, but provides them with “Employment Authorization Documents” or work permits.

Mizer said there were “good reasons to grant” such permits because it would allow an individual with a work permit “to work on the books rather than off the books.” Since it is a “third-party crime” for an employer to employ an illegal alien, providing the work permits “is actually reducing crime by reducing the third-party crime.”

In other words, rather than enforcing federal immigration law that prohibits employers from employing any noncitizen who doesn’t have a work permit, it is better for the government (without authority) to issue work permits to illegal aliens so employers won’t break the law the administration doesn’t want to enforce. The government has to break the law so employers won’t have to.

That is an example of the twisted logic being used by the Justice Department to defend this case.

Case Won By EPA Helps States Opposing Obama’s Immigration Actions

Another issue brought up by Judge Smith was quite ironic, given the administration’s push on global climate change. While Mizer was arguing that the states have no standing to challenge the president’s immigration plan and his nonenforcement of federal immigration laws, Judge Smith pointed out that this case seems similar to Massachusetts v. EPA (2007).

In that case, the U.S. Supreme Court held that the states had standing to challenge the EPA’s then-nonregulation of so-called greenhouse gases. Based on that decision, the states would seem to have standing in this case according to Smith.

Obama Lawyer Stumped By Question About Precedent for Preserving Status Quo

Mizer also did not have a good answer to the argument made by Texas Solicitor General Scott Keller, who said that the injunction simply maintains the status quo on immigration law that has existed for decades.

Judge Jennifer Elrod said the court was “big about [preserving] the status quo” as was the Supreme Court “in the middle of cases.” She asked Mizer if it would not be a “logistical mess” if the Fifth Circuit lifted the stay and the government proceeded with issuing work permits and tax benefits, but then the states ultimately won the lawsuit. Illegal aliens who are legalized by the president’s program “could end up with a big check and you’d need to knock on their door and ask for it back.”

Mizer’s only answer to that was that the government would be faced with “additional logistical steps” and illegal immigrants probably would not be able to collect tax credits during the time the courts were deciding this case because there are “a lot of hoops that an individual had to jump through.”

The Justice Department has also argued that even if the injunction is not lifted in its entirety, it should at least be geographically narrowed to only apply to Texas or the other states in the lawsuit. But when Judge Stephen Higginson asked Mizer if he had any prior court decisions that found a preliminary injunction was not narrowly tailored because it applied too broadly geographically, Mizer could not name a single case directly on point. Higginson said he had not been able to find a single case supporting that proposition either.

Was Obama’s Immigration Plan Really Not Subject to This Law?

Throughout his argument, Mizer kept saying that the president’s plan was unreviewable and was not subject to the Administrative Procedure Act (APA), which requires that all new regulatory policies by federal agencies be promulgated with advance notice and the opportunity for comment by the public and interested parties. This was a key finding in Judge Hanen’s injunction order.

Judge Elrod then asked Mizer a question related to this claim that almost had Mizer dancing a jig to avoid answering it. She asked Mizer whether the states could challenge the Deferred Action for Parents of Americans and Lawful Permanent Residents program if it gave “voting rights” to aliens: “would that be reviewable and would that be unconstitutional?”

Mizer clearly did not want to answer that question, saying that was not the situation before the court. “I’m asking you a hypothetical” insisted Judge Elrod. “Would that be subject to APA [Administrative Procedure Act] notice and comment if it gave voting rights or just substantively unconstitutional and illegal?” Judge Elrod asked Mizer again.

She had to ask Mizer the question four times before he finally said that it was “possible” that a challenge could be brought by the states under such circumstances, but that this situation was completely different. The fact that Mizer did not want to directly answer that question about voting and that Judge Elrod had to keep after him to try to get an answer was odd to say the least.

If the three-judge panel denies the government’s request for a stay, the Justice Department can file an emergency appeal with the U.S. Supreme Court. If the Fifth Circuit (or the Supreme Court) grants the request, then there is no doubt that the administration will move as quickly as possible to implement the president’s amnesty plan while the case is pending in the Fifth Circuit.

That would ensure that if the states were to ultimately prevail, trying to reverse what the Department of Homeland Security would do in the interim would be a “logistical mess.”

How Schools Use Medicaid Money to Pay for Truancy Officers, Deans and Healthy-Eating Magnets - The Daily Signal

How Schools Use Medicaid Money to Pay for Truancy Officers, Deans and Healthy-Eating Magnets

Sharyl Attkisson / Rachel Zissimos / Jennifer Guthrie / Hans von Spakovsky / Melissa Quinn /

At a school board meeting in Henrico County, Va., two months ago, a panel of school district officials and board members had been left speechless.

School district officials were in the midst of crafting the district’s budget for 2016, and the five-member board had just heard a presentation from Assistant Superintendent for Finance Terry Stern, who outlined a $1.1 million plan to fund more than a dozen positions at various schools.

The proposal shocked the board members, who expressed their gratitude toward Stern and her team for crafting the plan.

“That’s incredible,” board member Lisa Marshall said. “Thank you. Did you pull that one out of your hat?”

“I find that remarkable and exciting,” John Montgomery Jr., the board’s chair, said.

The additional $1.1 million came from coffers unknown to the school board, but tapped by school districts across Virginia and the country: Medicaid reimbursements.

Stern proposed using the money to hire three psychologists, three social workers, five part-time truancy workers, five part-time deans of students and reimbursements for mileage.

“To the extent that they’re used for [the Medicaid] population, it allows you to bill for additional services and increase your revenue,” Stern said at the February board meeting.

Schools provide many health and social services to students, including those who are Medicaid-eligible. Some districts shoulder the costs of these services, but can actually use Medicaid funding to pay for these services and request reimbursements.

Henrico County, located in southeastern Virginia, first began accepting Medicaid reimbursements in fiscal year 2012. That year, the district received roughly $98,000 in reimbursements. This year, officials estimate reimbursements from the federal program will total more than $1.1 million.

Guidelines for Funding

Medicaid is jointly funded by the federal and state governments, but states are in charge of administering the program. States adhere to Medicaid plans—an agreement between the state and federal government.

Schools can obtain Medicaid reimbursements through three different types of claiming, the most popular being administrative claiming. The administrative claiming program allows states to submit reimbursement claims for administrative activities that “directly support the Medicaid program.”

In order for activities to be reimbursable, they must be “found necessary by the secretary for the proper and efficient administration” of a state Medicaid plan.

Dennis Smith, former director of the Center for Medicaid and State Operations at the Centers for Medicare and Medicaid Services during President George W. Bush’s administration, told The Daily Signal that states are supposed to provide guidance to schools as to how they can use Medicaid reimbursements.

In Colorado, for example, schools must submit a plan for how they want to use the reimbursement funds. That blueprint must then be approved by the state.

However, Smith said it’s unknown whether they’re requiring school districts to adhere to guidelines governing how reimbursements are used.

John Hill, executive director of the National Alliance for Medicaid in Education, said schools are given a good deal of flexibility in how they use Medicaid reimbursements.

“The bottom line is if they wanted to put new bleachers at the football stadium, they can do that. I wouldn’t like to see that happen, but there’s nothing that could prevent it from happening,” said John Hill.

“They can be used for whatever they want to use it for,” Hill told The Daily Signal. “The bottom line is if they wanted to put new bleachers at the football stadium, they can do that. I wouldn’t like to see that happen, but there’s nothing that could prevent it from happening.”

>>> Commentary: Why Expanding Medicaid Isn’t Compassionate

In Henrico County, Stern told school board members that legally, there is nothing binding the funds to a specific purpose. However, the district’s school board agreed the dollars should be used for health and social services.

Smith contends that in specific instances, use of Medicaid reimbursements can be beneficial to students and within the spectrum of what Medicaid should be used for. For example, a school may be a good place for a student with developmental disabilities to receive physical therapy. Smith said it would be reasonable for a large district like Henrico to use reimbursements to hire a physical therapist.

However, administrative claiming opens the door for more abuses of Medicaid dollars. Smith said it would be questionable for a school to use reimbursements to hire deans and truancy officers.

“Medicaid should be paying for treatments and therapies,” he said. “There are bright lines that should be drawn for these things—what clearly Medicaid should and shouldn’t be paying for.”

CMS did not return The Daily Signal’s request for comment.

Controls Put in Place

Despite a claiming guide released in 2003 and guidance provided by states, Smith noted that abuse of Medicaid reimbursements is often found through independent audits conducted by the Centers for Medicare and Medicaid Services and state agencies.

As a result of such audits, school districts have been forced to return money.

In November 2013, an audit conducted by CMS of California’s administrative claiming program examined three educational entities.

The audit found that two of those three—Turlock Unified School District and Turlare County Office of Education—received improper reimbursements from 2010 to 2011.

In one instance, at Turlock Unified School District, two preschool teachers billed Medicaid and indicated that they spent every hour of their workday conducting Medicaid outreach. However, the government found they spent 50 percent of their time on school-related activities and the remaining time on Medicaid administrative activities.

The district alone had filed claims totaling $3.4 million.

According to EdSource, a website that tracks education in California, reimbursements also served to fill budget shortfalls.

Following the audit, CMS requested the state return more than $4 million in “unsupported school-based administrative costs.”

Similarly, a 2000 report from the Government Accountability Office found that “poor controls over what constitutes an allowable administrative activity cost claim have resulted in improper Medicaid reimbursements.”

In Colorado, some districts are using the reimbursements to fund wellness efforts.

Adams 12 Five Star, which serves students in the northeastern part of the state, received $1.2 million in reimbursements in 2013. The money paid for things like suicide prevention training, nursing hours and outreach to students who were uninsured.

Academy District 20, which serves Colorado Springs, used the Medicaid dollars to pay for magnets stamped with healthy snack suggestions.

“It’s been a very consistent and growing source of revenue for districts,” Bridget Beatty, coordinator for health strategies for Denver Public Schools, told Chalkbeat Colorado in 2013. “It is one of the only sources that has been increasing in the last few years.”

Hill of the National Alliance for Medicaid in Education said schools filing claims for Medicaid reimbursements “ebbs and flows” depending on a variety of different factors. However, he noted that the number of schools requesting the funds has held steady over the last four to five years.

When districts find themselves strapped for cash, Hill said, they begin exploring Medicaid reimbursements more deeply.

To rein in Medicaid reimbursements for things outside the program’s realm, Smith, the former CMS administrator, said the lines of what is and what isn’t Medicaid’s responsibility need to be brightened.

“It’s not Medicaid’s job to fund the schools,” he said.

>>> Commentary: The Results Are In: Obamacare is Driving Up Medicaid Rolls

Here’s the Deal on the Court Fight Over Obama’s Carbon Regulations - The Daily Signal

Here’s the Deal on the Court Fight Over Obama’s Carbon Regulations

Sharyl Attkisson / Rachel Zissimos / Jennifer Guthrie / Hans von Spakovsky / Melissa Quinn / Alex Anderson /

The United States Court of Appeals for the District of Columbia Circuit recently heard oral arguments in two cases challenging a signature aspect of President Obama’s energy plan.

In June 2014, the Environmental Protection Agency proposed a Clean Power Plan, intended to cut carbon-dioxide emissions 30 percent, from 2005 levels, by 2030.

Critics of the proposed plan say these regulations would radically transform the energy sector, effectively banning the construction of new coal-fired power plants—a reliable energy resource that currently generates more than 39 percent of the country’s electricity.

Proponents of the plan say the regulations are needed to curb planet-warming carbon emissions.

Because the states filed their lawsuit before the EPA has finalized their plan, there is a chance the judges could determine the lawsuit premature.

Hans von Spakovsky, senior legal fellow at The Heritage Foundation, said that if the states lose they will most likely appeal the decision to the United States Supreme Court or refile the lawsuit once the EPA finalizes the rule.

Learn more about what’s expected to be a long legal fight in the video above.

 

Children Raised By Same-Sex Couples May Do Worse When the Couples Marry - The Daily Signal

Children Raised By Same-Sex Couples May Do Worse When the Couples Marry

Sharyl Attkisson / Rachel Zissimos / Jennifer Guthrie / Hans von Spakovsky / Melissa Quinn / Alex Anderson / Gene Schaerr /

For decades social science has found that there is an optimal family structure for a child’s intellectual, emotional and physical flourishing:  being raised in a home by her biological, married parents.

All other arrangements—cohabiting biological parents, marriage with one step-parent, two adoptive parents or single parents—do not generally provide the same level of benefit.

But the rise of same-sex couples has led to a curious development. By their very structure, same-sex couples cannot meet what has been shown to be the gold standard of family structures for children.

Yet in recent amicus briefs in the pending Supreme Court marriage case, the American Psychological Association and the American Sociological Association claim that the science is “settled” that there is no difference between married, biological parents and same-sex parents for child outcomes.

How can that be?

An amicus brief filed in that case by the American College of Pediatricians and several well-known social scientists explains the paradox. In short, the American Psychological Association and American Sociological Association’s conclusions are driven by a political agenda and rely upon studies that on any other issue would be rejected on methodological grounds.

Children raised by same-sex couples are more likely to be unemployed, receive public assistance and to have an extramarital affair.

In fact, as shown below, when these methodological errors are corrected, this same body of studies reinforces what we’ve long known—that no other home situation compares with one headed by two married, biological parents.

And when the errors in one previous large-sample study are corrected, the study actually suggests that allowing same-sex couples to claim the status and benefits of marriage may lead to worse outcomes for the children in such families than if the couple did not marry.

Many of the Touted Studies Are Methodologically Inadequate

To draw valid population inferences, social science must follow certain methodological standards.  Most fundamentally, a study must have a sufficient number of observations to detect true differences between groups, and those observations must be randomly selected in order to allow generalizations to the larger population. These standards are well known even to undergraduates engaged in social science research.

So it is surprising that, of the dozens of studies cited to support the so-called “scientific consensus” that the American Psychological Association claims, only eight meet scientific standards for population inference. The rest tell us nothing about the population at large.

People protesting Dolce and Gabbana. (Photo: Mark Esper/Polaris/Newscom)

People protesting Dolce and Gabbana. (Photo: Mark Esper/Polaris/Newscom)

Of these eight, the four older ones found no disadvantages for children raised by same-sex couples compared to other family structures. But as the recent American College of Pediatricians amicus brief shows, all four studies suffer an incurable flaw:  about half (40-60 percent) of the children they report as being raised with same-sex parents are actually children with opposite-sex parents, either because of coding errors, or problems with the census data on which the studies relied.

In the end, this “dirty data” problem either invalidates their findings, or makes relying on them extremely problematic.

Same-Sex Family Structures Are Not as Beneficial

This leaves only four studies that are methodologically sound. And as the American College of Pediatricians brief shows, all four—the four most recent—find that children do not fare as well when raised by same-sex couples as when raised by married, biological parents.

To the contrary, such children often experience significantly higher levels of events or conditions such as being arrested, using marijuana, being depressed, having a learning disability or other psychological or developmental problem—and are less likely to graduate from high school.  As adults, they are more likely to be unemployed, receive public assistance and to have an extramarital affair.

Children raised by married same-sex couples showed markedly higher rates of depression, unhappiness, fear and anxiety than those raised by unmarried same-sex couples.

This is not surprising, and it doesn’t mean that people in same-sex relationships are bad parents.  To the contrary, many of them are wonderful parents individually.

But a same-sex couple simply cannot provide a child with the benefits of biological connections and gender diversity that her own two, married biological parents can provide.

And that is the fundamental problem with any policy—including recognition of same-sex marriage—that tends to encourage or facilitate a parent’s decision to raise her biological child in a household that does not include the other biological parent.

Marriage May Do More Harm Than Good to Children of Same-Sex Couples

But it gets worse.  Advocates of same-sex marriage have assumed that the benefits to children from man-woman marriage would automatically transfer in both degree and kind to children raised by same-sex couples—if those couples could only marry.

But assumptions are not science. As the American College of Pediatricians brief shows, when one of the four studies mentioned above (finding “no difference” between same-sex and opposite-sex family structures) was corrected for coding errors, the study actually showed something else:  In several important respects, children’s outcomes were worse when raised by married same-sex couples than if they were not married at all.

Specifically, children raised by married same-sex couples showed markedly higher rates of depression, unhappiness, fear and anxiety than those raised by unmarried same-sex couples.  The results are shown in the following chart:

420chart1

As the American College of Pediatricians brief explains, this is directly contrary to the pattern for opposite-sex couples, where marriage typically leads to improved outcomes for children.

The reasons for the disparity aren’t clear. Perhaps a parent’s marriage to a same-sex partner clearly signals to the child that she will likely never achieve her hope of one day being raised by the two people who brought her into the world, thereby triggering the trauma that increases the child’s risk of depression, unhappiness and fear.  But given this study, at best it is uncertain whether in the aggregate marriage will really benefit the children of same-sex couples at all.

That is all the more reason why the Supreme Court should not wade into a policy issue that needs more time and science to settle.

This article has been modified.

Fewer Americans Are Working Two Jobs - The Daily Signal

Fewer Americans Are Working Two Jobs

Sharyl Attkisson / Rachel Zissimos / Jennifer Guthrie / Hans von Spakovsky / Melissa Quinn / Alex Anderson / Gene Schaerr / Salim Furth / Mitchell Tu /

Is a job a necessity or an opportunity? Earlier this month, Dylan Matthews provocatively challenged the bipartisan tradition of praising work. In Matthews’ view, work ought to be optional for Americans. We disagree, both because work is ennobling and because the alternative is to force others to work for you. But we are also interested in whether Americans’ work habits are driven more by necessity or opportunity. Most Americans of working age have one job, but some have two or more. Do these multiple job holders work more because they need to or because they can?

About 6 percent of people with college degrees worked multiple jobs, but less than 4 percent of those with only a high school degree did so.

It’s well-established that people with less education earn lower wages, face higher unemployment rates, work fewer hours, and enjoy more leisure time than those with high education. Highly educated people earn more and thus have less necessity for a second job than less educated people, but they also have more opportunity to obtain one.

So which factor is more important? A new paper by economist Etienne Lalé found that highly educated people are measurably more likely to hold multiple jobs than people with fewer years of education. About 6 percent of people with college degrees worked multiple jobs, but less than 4 percent of those with only a high school degree did so. And just 2.5 percent of high school dropouts worked two or more jobs.

That’s good news: Multiple job-holding in the U.S. is more often a product of opportunity than necessity. On the other hand, according to Lalé, since 1994, the percent of individuals holding multiple jobs has declined to about 5 percent of the working-age population from about 6.5 percent in the second half of the 1990s. The trend does not seem cyclical and there is no apparent response to either of the recessions during the period Lalé studied. The author also notes that the decline cannot be explained by demographic trends. The research indicates that single jobholders are less likely to take a second job, so the “entry rate” to multiple job-holding is lower than it used to be. But those currently working multiple jobs are no less likely to quit one of the jobs than before.

So, fewer Americans seem to be taking advantage of the opportunity to have a second job. On the other hand, it’s likely that fewer Americans face the necessity of a second job as well. What should policymakers do in such a situation? Promote a free and flexible labor market, where anyone who wants to work can find a job—or two.

Mitchell Tu is currently a member of the Young Leaders Program at The Heritage Foundation. For more information on interning at Heritage, please click here.

Two Weeks to Make a Soldier: A Ukrainian National Guard Unit Trains to ‘Fight to the Death’ - The Daily Signal

Two Weeks to Make a Soldier: A Ukrainian National Guard Unit Trains to ‘Fight to the Death’

Sharyl Attkisson / Rachel Zissimos / Jennifer Guthrie / Hans von Spakovsky / Melissa Quinn / Alex Anderson / Gene Schaerr / Salim Furth / Mitchell Tu / Nolan Peterson /

KYIV, Ukraine—At its training camp on the outskirts of Kyiv this past weekend, the Ukrainian National Guard Azov Regiment held its Spartan Test—a grueling three-hour rite of passage meant to test the mental and physical strength of both new recruits and battle-hardened veterans.

The ordeal is the capstone to a two-week-long whirlwind military training program, after which many recruits travel to the front lines for the first time. The regiment, which began as a civilian volunteer battalion after the Maidan revolution last year, is stuck balancing the competing interests of building a military unit from scratch while sustaining continued combat operations.

With little time or resources available to mold civilians into soldiers, the Azov Regiment’s training program focuses on developing the most essential skills and traits necessary to keep soldiers alive.

The director of the program is Mikael Skillt, a 38-year-old Swedish sniper who has been fighting in Ukraine for 14 months. Skillt said that pushing a recruit to his mental and physical limit is an effective way to predict how he will react under the pressures of combat.

“We put them through stress tests to induce panic, and we see how they handle themselves,” Skillt said. “We have to see how they react to stress before we send them into combat.”

Along with a small cadre of Azov combat veterans chosen to be instructors, Skillt uses techniques such as burying soldiers alive for up to 20 minutes, pepper spray and water boarding to induce panic in the recruits.

Each class starts with about 50 trainees, and the attrition rate is about 10 percent. The most recent class began with 55 recruits, 50 of whom completed training this past weekend. One of the dropouts was a French paratrooper, Skillt said.

The Spartan Test is a series of physical challenges—including a 10-kilometer run, obstacle course and wrestling match—all of which recruits must complete in under three hours.

Forty soldiers, comprising both recruits and soldiers returned from the front (as well as four Russians) participated in Saturday’s Spartan Test. Only 23 finished.

“All 40 will go to the East,” Skillt said. “But 23 will go a little taller, a little prouder.”

The Spartan Test is a rite of passage for the Azov Regiment. Its completion is not a prerequisite for front-line service, but a source of pride within a unit that eschews traditional military chains of command and calls its organizational structure a “brotherhood.” Those who successfully complete the Spartan Test receive a pin and are eligible for specialized training programs like sniper school.

The Azov Regiment comprises foreign fighters from 19 different countries, including two Americans currently serving in the unit, according to Azov personnel. Because the rules of the most recent cease-fire ban the use of foreign fighters on both sides of the Ukraine conflict, most of Azov’s foreign soldiers have either returned home or left the battlefield to continue serving as trainers.

The Kyiv training camp is in an abandoned industrial park on the city’s outskirts. The owners of the property allow the Azov Regiment to use a section of the facility in exchange for protection against looters. The Azov camp is basic, with instructors living in residential trailers similar in size and shape to the Containerized Housing Units (CHUs) the U.S. military used on bases in Afghanistan and Iraq. And while the camp is within Kyiv’s city limits, the area has been designated a special “tactical area,” allowing for live-fire training under special circumstances.

The makeshift camp was a flurry of activity this past weekend. Girlfriends and other supporters came out to cheer on Spartan Test participants while local volunteers were busy constructing camp facilities. After the event was over, there was a cookout sponsored by civilian supporters of the regiment.

“It helps morale to see this kind of civilian support,” Skillt said.

Skillt is a former sniper in the Swedish military. While he has received media coverage in the past for his alleged far-right political ideology, he said images of Ukrainian protestors being gunned down by snipers in Kyiv during the 2014 Maidan revolution spurred him to fight in Ukraine.

“I don’t hate Russians, only Putin,” he said.

The Azov Regiment has also come under scrutiny due to accusations of promoting Nazi ideology, with many pointing to the similarity of the group’s symbol to the Nazi Wolfsangel.

After finishing their training course, new recruits to the Ukrainian National Guard Azov Regiment goof around. (Photo: Dmitry Lipavskiy/EPA/Newscom)

After finishing their training course, new recruits to the Ukrainian National Guard Azov Regiment goof around. (Photo: Dmitry Lipavskiy/EPA/Newscom)

The regiment has downplayed the claims, calling them Russian propaganda. Skillt acknowledged that some of Azov’s members held far-right political beliefs, but said they were not representative of the group as a whole.

“All of them are willing to die for their country,” Skillt said. “Does their support mean any less if they are nationalistic?”

Skillt joined the Azov Regiment when the unit was still a civilian volunteer battalion with 120 soldiers—only two of whom had any military experience.

“We were a rough bunch,” he added. “At first we just had shotguns and other small arms.”

“In the beginning we only had pistols,” said Ivan Kharkiv, an Azov Regiment soldier in an earlier interview with The Daily Signal. “Now the National Guard gives us all we need.”

“We need weapons,” he added. “But instructors are more important.”

The unit was officially incorporated into the Ukrainian National Guard earlier this year, tightening government oversight on combat operations and training. Soldiers now receive a salary and government benefits for their service, and the government has also begun to equip the Azov Regiment with armored fighting vehicles and tanks.

The unit is still mostly autonomous, however. It retains control of its own training program and still independently plans and executes its combat operations in most circumstances. And unlike regular Ukrainian military units, which are heavily composed of draftees, Azov’s soldiers are volunteers.

Skillt said the volunteer mentality has made Azov more effective than most regular army units, despite its equipment and weapons shortfalls, and reliance on civilian donations for funding.

“I think this is how it was in World War II in America,” Skillt said. “Ordinary people who would never have been in the military under normal circumstances are ready to die for their country. These guys would do anything for their brothers; you will never see them running away from a fight.”

The unit currently has about 1,000 soldiers and is training 50 new personnel every two weeks to achieve its desired force strength of 1,200, which is the benchmark required by the Ukrainian government for additional armored equipment delivery.

The unit’s rapid growth has spurred its ad hoc training program, which Skillt was tapped to organize due to his prior military experience and performance on the battlefield.

“We’re not some fancy military school like West Point,” Skillt said. “It’s all beta testing, basically.”

Despite its manpower goals, Azov remains selective about its recruits. Some are turned away for psychological reasons, and with the help of the SBU (Ukraine’s equivalent of the FBI) background checks are completed to weed out potential Russian spies.

One of the key challenges of creating soldiers from scratch in two weeks is educating them with the discipline and knowledge to operate according to the laws of war, as well as within the terms of the Feb. 12 cease-fire. In the opening months of the war, when Azov was not under formal government oversight, the group’s conduct in battle was self-policed according to a “warrior code.”

But a string of separatist executions of captured Azov soldiers has left many on the Ukrainian side with little faith in their chances of survival if taken prisoner. In one instance, Skillt described, separatists forced a captured Azov soldier to call his grandmother on his cell-phone so that she could listen to his execution.

“Now there is no surrender,” Skillt said. “If we are wounded we fight to the death.”

Incompetence, Mismanagement Plague California’s Obamacare Insurance Exchange - The Daily Signal

Incompetence, Mismanagement Plague California’s Obamacare Insurance Exchange

Sharyl Attkisson / Rachel Zissimos / Jennifer Guthrie / Hans von Spakovsky / Melissa Quinn / Alex Anderson / Gene Schaerr / Salim Furth / Mitchell Tu / Nolan Peterson / Sharyl Attkisson /

California’s health insurance exchange, established under the Affordable Care Act, has been held out as a national model for Obamacare. In some ways—not all of them good—it is. Whether it’s falling far short of 2015 enrollment goals or sending out 100,000 inaccurate tax forms, Covered California is struggling with its share of challenges.

Now, several senior-level officials integral to the launch of Covered California—who enthusiastically support the Affordable Care Act—are speaking about what they view as gross incompetence and mismanagement involving some of the $1 billion federal tax dollars poured into the state effort.

‘Somebody Must Have Been Smoking Something’

Consultant Aiden Hill became a “foxhole convert” to Obamacare in July of 2010 when he lost his insurance, had a serious medical issue and couldn’t get a new policy.

“I lived through a health care nightmare. That’s one reason why I took a cut in my pay rate to work for Covered California.”

In March 2013, Hill was hired as project manager over Covered California’s massive $120 million call center effort. In just six short months, it would face an avalanche of customers seeking insurance mandated under the new law.

But five months on the job converted Hill from avid supporter to disenchanted whistleblower. He says the secretive and dysfunctional culture was more interested in cheerleading than real results. After he persistently raised concerns, Covered California abruptly terminated his contract. He says the experience drove him to raise allegations about waste and cover ups at a Covered California board meeting.

Aiden Hill (Photo: Courtesy of Aiden Hill)

Aiden Hill (Photo: Courtesy of Aiden Hill)

Covered California quietly launched an independent investigation into Hill’s grievances. Nine months later, the results were summarized in four sentences stating that evidence did “not support” Hill’s complaints. Hill calls the probe a sham and says the inquiry didn’t include interviews with many witnesses he suggested.

Today, Hill describes himself as disgusted by the process—and soured on Obamacare.

“I really believe that we’ve created a monster—and it’s an unaccountable monster,” Hill told The Daily Signal.

Covered California declined comment on Hill’s allegations.

Other officials integral to Covered California’s efforts concur with Hill’s assessment. One of them headed the largest call center.

“They started this way too late for what they needed to do,” says the official who was hired in April 2013, five months before the website’s launch. He has since left that position and asked not to be named to protect his current job status.

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“This program had to touch 58 counties, 11 federal agencies, all medical carriers and all advocates. To have a system that would be integrated seamlessly—somebody must have been smoking something if they thought that was going to happen.”

Disappointing Enrollment

It’s against that backdrop that Covered California finds itself now grappling with a big disappointment: low enrollment growth. California ranked near the bottom in overall growth, with a scant 1 percent increase over last year.

“It’s a tiny fraction of the growth they were expecting,” says an official who helped implement the Affordable Care Act and examined California’s numbers.

As recently as last fall, the official says, California hoped to increase enrollment by 500,000 this year. But only an additional 7,098 have “selected a plan” for 2015.

“Their total enrollment is a step in the right direction but nowhere near what anyone thought it would be for the largest state in the country.”

Covered California would not answer our questions about enrollment figures.

Another telling statistic is Covered California’s poor retention rate. Even though people are required by law to have health insurance, only 65 percent of Covered California’s 2014 customers reenrolled in 2015. The rest dropped off.

Covered California would not address our questions about lackluster retention and growth.

Last month, the agency issued a press release touting a younger and more diverse mix of customers.

“New enrollment for 2015 coverage is strong and has brought in consumers who our marketing and outreach targeted,” said Covered California Executive Director Peter Lee, overlooking the fact that his organization’s retention of last year’s customers was among the lowest in the country.

Hoping for a bump, California followed the lead of the federal HealthCare.gov effort and repeatedly extended this year’s enrollment deadline. The Feb. 15 cutoff was pushed back to Feb. 20 and then Feb. 22. Now, it’s been extended to the end of this month.

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Call Center Chaos

The devastating crash of Covered California’s website and call centers on Oct. 1, 2013 was “the canary in the coalmine, an early warning of deep dysfunction,” according to Hill.

Pre-launch testing had proven disastrous. As with the national HealthCare.gov website, “it was breaking at the first click of the button,” says the former call center manager who worked under Hill. “Behind the scenes, states were worried. I know we were worried.”

Covered California contractors projected 10,000 calls the first day. The call center manager says he knew they were way off. “I and my training manager, who had launched call centers before, projected 20,000. We had 21,000 on day one. Our contractors were wrong.”

The HealthCare.gov website was on a parallel trajectory. It, too, suffered under hasty development and failed performance tests days before launch—all while the Obama administration put on a positive public face.

HealthCare.gov during it's opening day. (Photo: Newscom)

“Everybody knew it wasn’t going to function,” says a third Covered California official. “Calls start coming in and within the first hour, the entire system went down—phone and web.”

“The train was coming off the rails,” adds Hill. “The call center was going into meltdown.”

The meltdown lasted for months and fixes proved costly. Covered California would not provide a tally of expenses, but the agency ended up asking the federal government for an extra $155 million. That put the cost of Covered California at more than $1.06 billion federal tax dollars.

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Enrollment Exaggeration?

Covered California’s disastrous debut triggered a house of cards. When the website crashed, consumers were directed to fill out paper applications; they were 33 pages long and took at least an hour to complete. What’s more, they couldn’t be coordinated with the electronic version because of a major design flaw. The forms didn’t match.

But Covered California counted duplicate applications as if they were enrollments, giving the impression that more people had successfully signed up. (The Obama administration did the same with national HealthCare.gov applications.)

For example, Covered California’s Lee publicly touted 30,000 successful enrollments for the first month. Hill says the actual number was closer to 4,000.

“A lot of the information that came out of Covered California was misleading or outright lies,” Hill insists.

A customer service agent at Covered California's Concord call center waves a flag for technical assistance during the opening day of enrollment of the Patient Protection and Affordable Care Act in Concord, California October 1, 2013. (Photo: Stephen Lam/Newscom)

A customer service agent at Covered California’s Concord call center waves a flag for technical assistance during the opening day of enrollment in Concord, Calif. on Oct. 1, 2013. (Photo: Stephen Lam/Newscom)

Another Covered California official agrees.

“There’s no way he didn’t know he wasn’t telling the truth,” says an official, who still works at the agency and asked not to be identified. “We were fully aware that those numbers were inflated. It was horrible … morale busting. Things were being said that were blatantly untrue.”

The Daily Signal asked for Lee’s side of the story, but Covered California declined to make him available.

Hill says misinformation was aided and abetted by an uninformed press. In the midst of Covered California’s fiasco, he was stunned to read a New York Times article claiming the Golden State was an Obamacare utopia: the crown jewel of the health care reform effort.

On Nov. 24, 2013, Paul Krugman of The New York Times gushed:

What would happen if we unveiled a program that looked like Obamacare, in a place that looked like America, but with competent project management that produced a working website? Well, your wish is granted. Ladies and gentlemen, I give you California. … The California authorities have been especially forthcoming with data tracking the progress of enrollment. And the numbers are increasingly encouraging.

That assessment was far from the reality, say the Covered California officials who spoke to The Daily Signal.

Covered California declined to respond to our questions but issued this statement:

Covered California is proud that it has been the portal for nearly four million people to find coverage through one of our participating health plans or through low cost/no cost Medi-Cal; is helping more than a million people access financial assistance to lower their monthly health insurance premiums; through the Affordable Care Act has reduced the number of uninsured in California by half.

>>> This is the first of two parts in The Daily Signal’s series, “Uncovering Covered California.” Tomorrow, in part two, insiders expose Covered California’s “culture of secrecy” and allegations that it promoted egregious waste of taxpayer dollars.

Should Buying Bath Salts Land You in Jail? Four Cases the Supreme Court Will Hear in April - The Daily Signal

Should Buying Bath Salts Land You in Jail? Four Cases the Supreme Court Will Hear in April

Sharyl Attkisson / Rachel Zissimos / Jennifer Guthrie / Hans von Spakovsky / Melissa Quinn / Alex Anderson / Gene Schaerr / Salim Furth / Mitchell Tu / Nolan Peterson / Sharyl Attkisson / Tiffany Bates / Elizabeth Slattery /

The Supreme Court justices will be hard at work churning out decisions through the end of June, but April brings to a close oral arguments for the 2014-2015 term. Over the next two weeks, the justices will hear oral arguments in seven cases, including cases involving criminal law, overregulation, same-sex marriage and the death penalty.

1. McFadden v. United States: Bath & Body Works enthusiasts take note: Buying or selling bath salts could land you in prison. Stephen McFadden ran an online business selling overstocked goods from bulk suppliers, and he added to his inventory bath salts that could be burned and used for aromatherapy. Federal law criminalizes “knowingly or intentionally” selling a “controlled substance” or an analogue (knock-off) that has a “substantially similar” chemical structure and effect to a controlled substance.

It turns out that bath salts can have similar effects to cocaine and methamphetamine if ingested, and McFadden was convicted of distributing a controlled substance analogue. He appealed his conviction, arguing that the government didn’t prove that he knew the bath salts were substantially similar to illegal drugs.

The government recorded phone calls between McFadden and a Drug Enforcement Administration informant in which McFadden compared the effect of his bath salts to illegal drugs. Is that enough? The Supreme Court will decide soon.

2. Horne v. United States Department of Agriculture: Under a New Deal era marketing order intended to maintain profits for domestic raisin producers, farmers are required to sell their raisin crops to raisin handlers. Handlers then remove a portion of the crop from the market for the federal government to destroy or sell overseas at bargain barrel prices, and the government sets the compensation price that the producers are to be paid for the surrendered raisins.

The Fifth Amendment’s Takings Clause requires that the government pay “just compensation” when it “physically takes possession of an interest in property.” For 2002-2003, the government set the compensation price for raisins below the cost of production and required the farmers to hand over 47 percent of their crop; in 2003-2004, the government set the price at zero dollars for 30 percent.

At that point, California raisin farmers Marvin and Laura Horne challenged the scheme. The U.S. Court of Appeals for the Ninth Circuit ruled against the Hornes, holding that the takings rule only applies to real property (e.g., the Hornes’ farm), but not personal property (e.g., the Hornes’ raisins). This is the Hornes’ second trip to the Supreme Court. In 2013, the justices held that the Hornes had standing to sue the government, and now the Court will evaluate whether the government’s raisin scheme violates the Constitution.

3. Obergefell v. Hodges: Does the Constitution require states to license same-sex marriages? Must states recognize same-sex marriages lawfully performed in another state? Since the Supreme Court’s decision in United States v. Windsor striking down the Defense of Marriage Act’s federal definition of marriage, traditional marriage laws and constitutional amendments have fallen across the country.

Same-sex couples in Kentucky, Michigan, Ohio and Tennessee challenged the states’ definition of marriage and refusal to recognize same-sex marriages performed in other states, claiming this violates their rights under the Equal Protection and Due Process Clauses of the 14th Amendment.

Last November, the U.S. Court of Appeals for the Sixth Circuit became the first federal appellate court to uphold traditional marriage laws, ruling that there is no constitutional right to same-sex marriage and the issue should be left to the customary political process. It’s one of the biggest legal showdowns of the year, and the justices will hear two and a half hours of extended oral argument.

 4. Glossip v. Gross: Since 2011, the European Union has banned exporting sodium thiopental and several other barbiturates used for lethal injection. Amid this drug shortage, some states have experimented with other legal injection drug protocols. But following a string of botched executions, states’ use of lethal injection has come under increased scrutiny.

Oklahoma administers three drugs when carrying out the death penalty, the first of which (midazolam) is a sedative meant to prevent substantial pain caused by the other drugs. Several Oklahoma death-row inmates claim the state’s use of midazolam violates the Eighth Amendment’s prohibition on “cruel and unusual punishment” because the drug is not a reliable sedative.

Oklahoma claims, and the lower courts agreed, that because it uses such a high dosage of midazolam, it is a “virtual certainty” that its use would render a person unconscious. Oklahoma maintains that midazolam is “the most humane form of execution available.”  In Baze v. Rees (2008), the Supreme Court reaffirmed that the Eighth Amendment neither prohibits capital punishment nor “demand[s] the avoidance of all risk of pain.”

However the Supreme Court rules, this won’t be the last you hear about the death penalty. The Supreme Court recently agreed to hear several death penalty cases next term.

Check out the other big cases of this term.