On Saturday morning Lidiane Carmo woke up in Florida, where she was attending a church conference with her father, mother, and sister. Carmo was the youngest in her family, and they had traveled to Florida with her pastor father, her aunt, uncle and cousins as well as several other other church members.

On Sunday morning, Lidiane woke up in a Florida hospital with broken bones and internal injuries after the van they were traveling in was involved in Sunday's horrendous highway pileup on I-75 near Gainesville, Florida. Her father, mother, sister, uncle, aunt and cousin were killed. She is the sole survivor in her immediate family.

Lidiane's parents came to the United States from Brazil 12 years ago, bringing five-year old Letiticia and three-year old Lidiane with them. They had legal visas which have since expired.

Lidiane is now an orphan. She has no health insurance. She has no legal status to remain in this country. And she has no family beyond those remaining members of her father's church. She is the sole survivor.

If we had a DREAM Act in place, Lidiane could petition for citizenship here since she entered the country legally. But we don't, and because of Republicans' insane need to pander to bigots and racists, we're unlikely to see it without a completely different Congress.

I'm writing about Lidiane because she puts a very human face on what they're doing when they block the DREAM Act. I wonder if any of these crazy Republican candidates could gaze into her frightened, hurting eyes, and tell her she has to go back to a country she doesn't even know. I think they could, and that should concern us all.

Congress forced a clause into the Affordable Care Act which excluded undocumented immigrants from coverage. The exclusion wasn't simply from federal funds for subsidies. They are barred from purchasing insurance on the state-based exchanges and the national exchange. Barred. Even if they pay with their own funds. Barred.

Today a 15-year old child is in a hospital in Florida, suffering from severe injuries, bereft of her family, in Rick Scott's state. What will become of her?

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Fox News has been in full-blown Mitt Romney rehabilitation mode Tuesday. Beginning with Gretchen Carlson through every hour up to this segment on Megyn Kelly's show, they've worked very hard to convince viewers that Mitt Romney's gaffe, "I like to fire people," was taken out of context and unfairly depicts what he said.

We could simply say that what is good for the goose is good for the gander. It's fair game, right? After all, he said those words in that order. Yes, he did, and even in context, he could have said "I like to choose service providers," or something similar. Instead he chose to employ CEO-speak; that is, authoritarian, emperious words that no one likes to think about, much less experience. Being fired sucks. As one who spent a long time in a career as a service provider, I'll vouch for that. Whether it's a client leaving or a boss firing, it's a rotten thing. Still, I believe it's fair to put his remarks in context, and even inside that context, he's wrong. Very wrong, very cynical, and it's actually worse when placed into the context he intended it.

Before I continue, let's stipulate that the very best way to handle health care costs would be single payer. I agree with all of you who say that. But this post is not about that. It is about what we have or are about to have and what Mitt Romney thinks we should have. And firing people.

As the clip at the top shows, Romney was talking about health care, and presumably about how he would change Obamacare after he repealed it, as he has promised to do. Here's the full quote:

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Even with its imperfections, the Affordable Care Act (aka Obamacare) is a lifeline for people like me and my family, and it's worth giving credit to the Democrats and the President for getting it done. Every time I hear one of the Republicans in the primary clown car talk about repealing it, my resolve to re-elect the President and save Obamacare and Dodd-Frank strengthens.

It's all about the pre-existing conditions. It always has been and it always will be. Like the young mother who was told most people with pre-existing conditions brought them on themselves, I also have a son with pre-existing conditions, and those conditions would, under the system we have today, make it impossible for him to pursue his chosen career or possibly even to function.

The Past

In the summer of 2009, our college-age son suddenly became ill. At first we thought it was just a case of the flu, but it went on for weeks, and came with rapid weight loss. He's not really a towering giant to begin with and always had difficulty keeping weight on, but he lost nearly 40 pounds in six weeks. I had been laid off from my job in December, 2008 and our COBRA payments were $1700 per month for our family. My husband was self-employed and we were unable to get any insurance from any insurer anywhere. It was then that our COBRA administrator notified us that our coverage was canceled, claiming they'd received my payment one day late.

There we were with no insurance, a very sick son, and little in the way of resources to help him.

After draining a chunk of my 401k for doctor bills, he was diagnosed with ulcerative colitis. It's a horrible disease with genetic causes. There is no lifestyle change he made that "brought it on himself." It's autoimmune and genetic. Worse yet, the medications for ulcerative colitis caused him to become diabetic. While it's likely that he may have already had unknown glucose tolerance issues, the medications exacerbated it to the point where he was forced to inject insulin to keep his glucose levels in check. He was nineteen years old, a musician majoring in jazz studies with hopes to move on to a career in music education and performance once he finished school, wrestling with life-threatening chronic conditions.

Musicians are self-employed as a general rule. His medications were $600 per month, plus test strips and syringes for the insulin. And no hope for insurance.

That was 2009. Since January of 2010, the ulcerative colitis has been in remission, he's regained his lost weight and managed to wean off the colitis medications and with it, the insulin injections. Also, my spouse had gotten a job with health insurance that would at least cover catastrophic illness with an attached health savings account.

Because of the Affordable Care Act, we were able to keep our son on our policy and are grateful that we'll be able to through 2014, when he will be able to get his own insurance. But it doesn't end there.

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At a town hall in Bedford,New Hampshire on Monday, Mitt Romney encountered an uninsured voter who pressed him on his opposition to universal healthcare.

The uninsured voter, a woman who seemed desperate for some words of hope regarding her lack of healthcare insurance. Instead of any hint of compassion - or even an actual response to her need for healthcare - Romney brushed the woman off with a grin and what seemed to be a jab at Obamacare before he cast his gaze elsewhere.

"When you signed into law Romneycare, I was excited," the woman said. "You seemed proud to do that. And then when the country copied you, it just seemed like there was hope for people like me."

"How have you done since then?" Romney asked flippantly, talking over her.

"I don't have health care, sir, and I'm scared," she said.

“That tells you something doesn’t it?” Romney said. “Tells you something.”

Indeed.

Number 15 in our countdown is a tie between several related videos. We like to call it "debate hate."

The video at the top is from the September 22, 2011 debate, where a gay soldier asked Rick Santorum whether he would roll back the repeal of DADT and the progress gays have made in the military under President Obama. Before Santorum could answer, some in the audience booed the soldier loudly. No candidate spoke up.

But that isn't the first time debate hate has reared its ugly head. On September 7th, the audience cheered Rick Perry's record of executing a record number of prisoners in Texas, including at least one who was innocent.

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By almost any measure, the 2006 universal care law Governor Mitt Romney championed in Massachusetts has been a clear success. A bipartisan bill which Ted Kennedy worked closely with Romney to pass, the law has reduced the ranks of the uninsured from 10 percent to a national low of two percent. Massachusetts residents overwhelmingly favor the popular health care law there by a 3 to 1 margin.

But in his desperate quest to win over conservative Republican primary voters, Mitt Romney has turned his back on his signature achievement which he once boasted was a health care model for the nation. And to do it, Romney has been lying for months by telling voters "Obamacare is about taking over 100 percent of the people's insurance in this country."

A year ago, Politifact declared the Republican description of President Obama's Affordable Care Act as a "government takeover of health care" its 2010 Lie of the Year. Nevertheless, Mitt Romney has put a variant of this long ago debunked "Pants on Fire" lie at the center of his claim that "Romneycare" and "Obamacare" are entirely different. His latest attempt at misdirection came during Saturday night's Republican presidential forum hosted by Mike Huckabee. As Mitt tried to explain to a clearly skeptical Ken Cuccinelli, Attorney General of Virginia:

"Am I proud of what we did for our state? Yes. But what the president has done is way beyond what we envisioned. We were trying to take of the 8 percent of the population that didn't have insurance. The President is not just worried about the people without insurance. Obamacare is about taking over 100 percent of the people's insurance in this country."

In a September 15, 2011 interview with CNN's Wolf Blitzer, Romney made the same charge:

"The Massachusetts plan was crafted for Massachusetts, for the needs of 8 percent of our population that didn't have insurance, not for the 92 percent that did. Obamacare is a plan that takes over 100 percent of the people in the country and their health care, and that's one of the reasons why people don't want it."

Sadly for Mitt Romney, repetition of a lie doesn't make it any more true.

The Affordable Care Act passed by Congress and signed by President Obama in the spring of 2010 targets the 17 percent of people (over 50 million people) who are uninsured. As Politifact explained in deeming Romney's fraud another "Pants on Fire" lie:

According to the Census Bureau, the percentage of Americans without health insurance nationally was slightly under 17 percent in 2009, the year Obama began pushing for the bill. According to a Congressional Budget Office estimate, the number was about the same in 2010, when the measure was signed into law. Other estimates have pegged the national number at about 15 percent.

As Henry Aaron, a senior fellow with the centrist-to-liberal Brookings Institution right noted, comparing 8 percent to 17 percent "would have been apples to apples" when it comes to the impact of the individual mandate at the center of both the Massachusetts and national plans.

But Romney's chicanery (which Politifact branded "a felony case of comparing apples and oranges") hardly ends there:

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I wonder how many people drained their savings to cover COBRA payments because they thought they'd soon find a new job. That's why the new healthcare law, as flawed as it is, is a big step toward building a safety net:

The millions of Americans who lost their jobs and their health benefits during the recession often had no way to regain affordable health coverage, leaving them and their families at risk of financial ruin, according to a new report from The Commonwealth Fund.

The spate of layoffs during the recession catapulted 9 million more Americans — or 57% of those who had had health insurance in a job that evaporated over the last two years — into the ranks of the millions already uninsured.
In addition, 19 million people anxiously seeking private coverage over the last three years were either turned down or could not find a plan that was affordable and met their needs, the report found.

The Biennial Health Insurance Survey also found a whopping 60% increase in skipped care due to cost in the past decade. The survey reported that medical debt problems and out-of-pocket spending costs were on the rise as well, with 29 million Americans using up their entire life savings to pay for medical bills and millions more unable to afford food, heat and rent due to medical payments.

"The report tells the story of the continuing deterioration of health care accessibility, efficiency, safety and affordability over the past decade," Commonwealth Fund president Karen Davis said during a noon press conference Tuesday. All this despite the fact that the United States spends more than any other country on health care, she added.

"Most recently it has failed the millions of Americans who lost their jobs during the recession and lost health benefits as well, leaving them with no place to turn for affordable health care coverage," Davis said.

The Commonwealth Fund report focused on the struggles of the 43 million adults under 65 who have lost their health insurance along with their job over the past two years.

"The silver lining is that the Patient Protection and Affordable Care Act has already begun to bring relief to families," Davis added. "Once the new law is fully implemented, we can be confident that no future recession will have the power to strip so many Americans of their health security."

If you missed any of this, be sure to watch both videos in this post. It's definitely some of the most spontaneous and revealing television I've seen in a very long time. Keith Olbermann brought together Michael Moore and Wendell Potter in a segment about how the health insurance industry mobilized to smear both Moore and "Sicko" ahead of its release, fearing it would get traction and start a "grass roots uprising" for single payer health insurance.

It's not that it's a surprise. We all know this is the standard tactic. But what comes through on these videos is how truly angry and passionate Moore is about this effort to discredit work that he viewed as essential to the debate. If memory serves me, they did succeed at marginalizing it, at least to the extent that it was not as relevant to the general debate as death panels were to become.

Partial transcript follows...

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In what can only be described as a fairly stunning display of hypocrisy, Freshman Rep. Richard Nugent (R-FL) says he will pay $9,000 to keep his health insurance through his "employer", not through the FEHBP plan for members of Congress because he might have an accident and need treatment he couldn't otherwise afford.

NUGENT: I will tell you this, what I will pay for insurance to get through my employer, not through the House, will be almost — will costs me $9,000 more a year. But I wan to remain with that, because I think it’s the right thing to do. Because I think that when you have Americans that are struggling, why should I get a cost saving because I just got elected to the United States House of Representatives?

How nice for Rep. Nugent. He has options, like keeping that insurance through his 'employer'. Only, isn't his employer the House of Representatives now? I paid a visit to his website to see who employed him before he was elected. It seems he was the Sheriff of Hernando County. In fact, in all of the literature I've been able to find about him, I cannot find any evidence that he has ever been employed by a business. He was in the military, and then in law enforcement.

It's possible he worked for the Sheriff's department long enough to have earned the right to keep his health insurance with them until he is Medicare-eligible, in fact, since his bio indicates he began his public safety career in 1972.

If so, then what we have here is a guy who is a career public servant with a public pension and a right to health insurance without fear of being dropped for pre-existing conditions, with a nice fat paycheck from the US government to help pay the premiums. And he would never, ever go without health insurance, right?

Here's another freshman Republican Representative who may be even more of a hypocrite than Nugent -- Rep. Michael Grimm, (R-NY). He's upset because he couldn't get on the Congressional plan fast enough and is quoted in a print article as saying this:

"What am I, not supposed to have health care?" Grimm told the New York Daily News (the article hasn't appeared online, only in print). "It's practicality. I'm not going to become a burden for the state because I don't have health care and, God forbid I get into an accident and I can't afford the operation...That can happen to anyone."

God forbid. Which is why Rep. Grimm thinks it's a great idea to repeal that access for everyone else. Got it.

In a somewhat predictable but still annoying move, U.S. District Judge Henry Hudson refused to dismiss Attorney General Ken Cucinelli's lawsuit seeking to challenge the constitutional grounds for the Affordable Care Act. The key language in the 32-page ruling (PDF) is this:

While this case raises a host of complex constitutional issues, all seem to distill to the single question of whether or not Congress has the power to regulate -- and tax -- a citizen's decision not to participate in interstate commerce. Neither the U.S. Supreme Court nor any circuit court of appeals has squarely addresses this issue. No reported case from any federal appellate court has extended the Commerce Clause or Tax Clause to include the regulation of a person's decision not to purchase a product, notwithstanding its effect on interstate commerce. Given the presence of some authority arguably supporting the theory underlying each side's position, this Court cannot conclude at this stage that the complaint fails to state a cause of action."

Or, stated more simply, the judge has decided to allow Virginia to challenge the Affordable Care Act in its entirety based on a challenge to the individual mandate. The court (and Ken Cucinelli) should be careful what they wish for. If the court's logic is deemed sound and this case were to be challenged all the way to the Supreme Court, a foundation will have been laid for Congress to pass Medicare For All under precedents established when Medicare was passed and challenged 45 years ago.

Just so we're clear on agendas, know that these court challenges have nothing to do with the individual mandate and everything to do with insurers' objections to the Affordable Care Act ending insurers' right to exclude for pre-existing conditions. That has been, and will continue to be, the core of corporate objections to the Affordable Care Act.

The judge's ruling was purely procedural; that is, he did not consider the merits of Virginia's argument, only whether the case should be allowed to proceed. The White House fired back a response and a shot across the bow:

After all, over 70 years of settled law is on the side of the Affordable Care Act. In order to make health care affordable and available for all, the Act regulates how to pay for medical services – services that account for more than 17.5% of the national economy. This law came into being precisely because of the interconnectedness of our health care costs. People who make an economic decision to forego health insurance do not opt out of the health care market, but instead shift their costs to others when they become ill or are involved in an accident and cannot pay.

We do not leave people to die at the emergency room door – whether they have insurance or not. Those costs – $43 billion in 2008 alone – are borne by doctors, hospitals, insured individuals, taxpayers and small businesses, in Virginia and throughout the nation. According to a recent study, this cost-shift added on average $1,100 to family premiums in 2009 and roughly $410 to an individual premium.

Bottom line: This ruling doesn't really mean much, but conservatives will use it as a crowing point during the summer recess to stoke up the teabag machine and grind out nightly Fox News blurbs.