The Sad Case of the Patient Protection and Affordable Care Act

[joecct]

Re: The Sad Case of the Patient Protection and Affordable Care Act

les you're trying to reason with idiots. Rule #1 in life: There's no reasoning with idiots. Inevitably somebody will spout some libertarian nonsense about repealing the law that hospitals have to treat everybody which has zero chance of getting enacted. Someone else will post some handy platitudes about "we all need to be responsible" blah blah blah. Finally you'll get the ol' "tort reform will solve all the problem" argument.

But, and the end of the day, the "Repeal and Replace" chant suffers one fatal flaw. What exactly is the "Replace" part going to be?

Have no idea, but the new health care law should be thought out and not put together in the middle of the night. I think the 1099 requirement has already been struck. There are probably a few more that will be discovered as the law's provisions (and regulations) become effective.

Remember, "It seemed like a good idea at the time..."

[bronconick]

Re: The Sad Case of the Patient Protection and Affordable Care Act

So after years of 10-15% premium increases, this year's insurance premiums for state of Iowa employees are set to remain flat or even drop by up to 7%, depending on the plan. We just got the spiel from our HR director since the open enrollment period starts monday.

But I'm guessing the ACA had nothing to do with that, amirite?

Why aren't you giving Steve King his proper credit for keeping your premiums down?

*****http://i1237.***********.com/albums/ff464/storm_count/troll-face_design.png******

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Have no idea, but the new health care law should be thought out and not put together in the middle of the night. I think the 1099 requirement has already been struck. There are probably a few more that will be discovered as the law's provisions (and regulations) become effective.

Remember, "It seemed like a good idea at the time..."

Until the 'new' Healthcare law is put together what is the plan. It took decades to get any Bill passed. The legislative branch has no interest in working on anything together. I want to hear what the people who want to enact these changes predict will happen, not just blindly follow along and pretend there will not be a list of sequelae that will impact the entire health system. At this point I hear no foresight or consideration of what the impact will be. If they have a stopgap I might feel more comfortable

[joecct]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Until the 'new' Healthcare law is put together what is the plan. It took decades to get any Bill passed. The legislative branch has no interest in working on anything together. I want to hear what the people who want to enact these changes predict will happen, not just blindly follow along and pretend there will not be a list of sequelae that will impact the entire health system. At this point I hear no foresight or consideration of what the impact will be. If they have a stopgap I might feel more comfortable

Les -- we need Tip O'Neill or (waiting for the vomit) Newt Gingrich to lead the House and a Mike Mansfield to lead the Senate. But politics has changed a lot in the last 20 (or more) years. The middle grounders on both sides are getting tossed aside for the radicals.

That said -- if we could get Tax Reform in the 80's, we can get a better plan. We survived without one for many, many years. Why are many thinking that the PPACA is the cure all (pun intended) for everything that ails the health care industry? Could it be that too much regulation has stifled creative solutions? Somebody needs to be daring -- and creative.

I don't know, but the way the PPACA was passed left a bad taste in a lot of peoples' mouths. Surely they can do better.

Side thought -- I wonder what would happen if they turned the TV cameras off in the Congre$$ for a session? 99% of what is said is grand standing to the cameras. Maybe they'll think less with their mouths and more with their brains.

[leswp1]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Les -- we need Tip O'Neill or (waiting for the vomit) Newt Gingrich to lead the House and a Mike Mansfield to lead the Senate. But politics has changed a lot in the last 20 (or more) years. The middle grounders on both sides are getting tossed aside for the radicals.

That said -- if we could get Tax Reform in the 80's, we can get a better plan. We survived without one for many, many years. Why are many thinking that the PPACA is the cure all (pun intended) for everything that ails the health care industry? Could it be that too much regulation has stifled creative solutions? Somebody needs to be daring -- and creative.

I don't know, but the way the PPACA was passed left a bad taste in a lot of peoples' mouths. Surely they can do better.

Side thought -- I wonder what would happen if they turned the TV cameras off in the Congre$$ for a session? 99% of what is said is grand standing to the cameras. Maybe they'll think less with their mouths and more with their brains.

I don't think I know anyone who thinks it is the cure. Almost every one I know who approves of it thinks it is the beginning step. When they ask people about the components without asking about the bill the vast majority approve of the concepts in the bill. I truly do understand why people object.

I am baffled about the people who want to 'throw it out and start again'. I can't find anyone who wants the repeal who has actually thought of what consequences there would be to the action. The cost would be huge. Maybe I am not understanding this but why can't they adjust certain things? I thought that was the intent when it passed.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Mrs. Les,

One of the problems we have to deal with is inaccurate information.

The Big Lie: people with pre-existing conditions can't get coverage under the current system. Not quite true: if you have pre-existing conditions and want coverage, you merely have to get hired by a company that provides health insurance, you are automaticaly covered as long as you enroll when first eligible.

The Truth can Set You Free: use that insight; you don't need a mandate (which now is unconstitutional on the federal level anyway*); what you need is Open Enrollment Windows (hmm...like the existing health plan for Federal employees...). If we break the link between employment and health insurance coverage, everyone who wants health insurance can buy it no questions asked as long as they do it during the open enrollment period, insurance companies can price it properly. The problem is merely exacerbated by PPACA (as it now stands) because it still allows people to buy insurance after they get sick.

Another Big Lie: if health care costs go up faster than inflation, we must have a problem.

Not completely true; much of health care is elective, and you'd expect people to consume more of it as their incomes rise. If I'm poor and my kids have crooked teeth, too bad for them....if I have some discretionary income I can send my kids to the orthodontist. If I'm poor and I need glasses, I get a cheap functional pair; if I have some discretionary income, I can get contact lenses or designer frames.

I could continue this list for awhile....PPACA is all command-and-control, "anything not mandatory is forbidden." There is no incentive for innovation, no incentive for cost control. A far better solution would be to sever the link between health insurance and employment, allow a combination of high-deductible insurance and a HealthCare Spending Account (FSA) that can be rolled over from year to year (how stupid is it that if we don't use our FSA this year we forfeit the money?), have periodic open enrollment windows, and while that doesn't "solve" the problem of a person with no coverage using the emergency room, it surely helps mitigate it substantially.





* apparently, many people don't realize that there is a huge difference between what states are allowed to do and what the federal government is allowed to do. States do have the authority to regulate people directly; states can impose a mandate if they want. It is now clear that the federal government does not have the power to regulate people; the mandate is unconstitutional, the federal government can only regulate behavior.

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Side thought -- I wonder what would happen if they turned the TV cameras off in the Congre$$ for a session? 99% of what is said is grand standing to the cameras. Maybe they'll think less with their mouths and more with their brains.

It would be great. Nothing done in front of cameras in Congress is sincere. I would not even include deliberations or floor speeches in the Congressional Record -- no more "unanimous consent to revise and extend my remarks" -- just the text of bills and the voting record. And I'd ban TV completely from Congressional business. If they want to call pressers afterwards to read their talking points, sure, whatever.

There are a lot of idiots in the House, and a few in the Senate, but when the cameras roll everybody plays an idiot to appeal to the boob tube. Public viewing of the legislative record is essential, but public viewing of the debates just turns them into derp sessions.

Seriously, after getting legalized bribery out of politics this is the single most effective thing we could do to improve our government.

[Rover]

* apparently, many people don't realize that there is a huge difference between what states are allowed to do and what the federal government is allowed to do. States do have the authority to regulate people directly; states can impose a mandate if they want. It is now clear that the federal government does not have the power to regulate people; the mandate is unconstitutional, the federal government can only regulate behavior.

Ummmm....Fishy, we just had a court decision on this one. The mandate is Constitutional under the taxing authority of congress. What part of "The SCOTUS valildated the law requiring Americans to have coverage or pay a penalty" are you having trouble understanding?

[bronconick]

Re: The Sad Case of the Patient Protection and Affordable Care Act

That explains why he keeps bumping this thread that was created to be a giant circle jerk of celebration at the "Death of Obummercare" months after the ruling was released.

[FlagDUDE08]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Ummmm....Fishy, we just had a court decision on this one. The mandate is Constitutional under the taxing authority of congress. What part of "The SCOTUS valildated the law requiring Americans to have coverage or pay a penalty" are you having trouble understanding?

The mandate is not Constitutional, because you are not required to purchase. You may pay a tax in absence of purchase. However, one question: Does that tax have the $200K/$125K-if-married caveat to it? I know the additional funding, which comes through investment income, is subject to the aforementioned caveat.

[Kepler]

Re: The Sad Case of the Patient Protection and Affordable Care Act

That explains why he keeps bumping this thread that was created to be a giant circle jerk of celebration at the "Death of Obummercare" months after the ruling was released.

I always read the title as it being "Sad" for the likes of FF and the other GOP water carriers, who bet everything on scaring everybody one more time (hey, it worked for 70 years) and have now been completely exposed as empty vessels.

So sad for them. Really. Have a hanky.

[joecct]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Ummmm....Fishy, we just had a court decision on this one. The mandate is Constitutional under the taxing authority of congress. What part of "The SCOTUS valildated the law requiring Americans to have coverage or pay a penalty" are you having trouble understanding?

The mandate is not Constitutional, because you are not required to purchase. You may pay a tax in absence of purchase. However, one question: Does that tax have the $200K/$125K-if-married caveat to it? I know the additional funding, which comes through investment income, is subject to the aforementioned caveat.

My take is that if you choose not to have health insurance you have to pay a tax. However, the IRS will not go after you if you refuse to pay.

What disturbed me about the SCOTUS decision was the the Court codified that Congress has the power to tax just about anything, at any time, for any purpose. If they wanted to tax me for owning a McMansion, they can. If they want to tax me for not owning a firearm, they can. If they want to tax me for eating Yodels instead of Granola bars, they can. What is the check on the Congress? Surely it is not the voters who return 90%+ (and the radicals) every time.

[Rover]

The mandate is not Constitutional, because you are not required to purchase. You may pay a tax in absence of purchase. However, one question: Does that tax have the $200K/$125K-if-married caveat to it? I know the additional funding, which comes through investment income, is subject to the aforementioned caveat.

Flag that makes no sense. The law was written that either you get insurance or pay a tax. Roberts didn't make up a new paragraph saying "oh by the way you don't have to have insurance but you have to pay a tax if you don't". The mandate is constitutional because the penalty associated with it is constitutional (paying a tax if you don't comply).

joecct, the IRS doesn't have to "enforce" anything. You aren't writing a check to the gubmint. Your deductions just go down. If you choose to cheat on your taxes you can take that risk, just like you can on a variety of other sections in your filing but if you get caught you're screwed.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Ummmm....Fishy, we just had a court decision on this one. The mandate is Constitutional under the taxing authority of congress. What part of "The SCOTUS valildated the law requiring Americans to have coverage or pay a penalty" are you having trouble understanding?

You are flat out wrong in part of your assertion, and correct in another part of your assertion.

Read the actual ruling:
1) The mandate is unconstitutional
2) However, the Court should defer to Congress, and when possible, even if the law is unconstitutional under one clause, discern whether it can be upheld in another manner.
3) Even though the mandate is unconstitutional, the law can still be upheld under Congress' power to tax
4) Even though the mandate is unconstitutional, the law will be upheld anyway. Althought here is no longer a mandate, there is now a "choice" instead; and there is no longer a "penalty". Instead, the "penalty" is now interpreted to be a "tax."

Roberts' language is very clear and very precise. read it.

So you are right that the law was upheld under the taxing authority of Congress; you are wrong when you say the mandate was upheld. read the ruling, Roberts is very clear and unequivocable. Also read Ginsberg's "concurrence": she disagrees with Roberts about the mandate; she argues that it should be constitutional.

It was a 1 - 4 - 4 ruling; five Justices voted to uphold the law, five Justices voted that the mandate was unconstitutional.

[FreshFish]

Re: The Sad Case of the Patient Protection and Affordable Care Act

Flag that makes no sense. The law was written that either you get insurance or pay a tax. Roberts didn't make up a new paragraph saying "oh by the way you don't have to have insurance but you have to pay a tax if you don't". The mandate is constitutional because the penalty associated with it is constitutional (paying a tax if you don't comply).

You are wrong. Did you read the ruling?

If not, read it and then get back to us.

The way Roberts wrote his opinion, he states very clearly: You have an option, either you buy health insurance or you pay a tax. There is no "penalty." Roberts re-interpreted the law so that it could remain in force. He explains very clearly (1) why he is reinterpreting it, and (2) how he is reinterpreting it.


Here are quotations word-for-word from the actual ruling:

CHIEF JUSTICE ROBERTS concluded in Part III–A that the individual mandate is not a valid exercise of Congress’s power under the Commerce Clause and the Necessary and Proper Clause

CHIEF JUSTICE ROBERTS concluded in Part III–B that the individual mandate must be construed as imposing a tax on those who do not have health insurance...The most straightforward reading of the individual mandate is that it commands individuals to purchase insurance. But, for the reasons explained, the Commerce Clause does not give Congress that power. It is therefore necessary to turn to the Government’s alternative argument: that the Law may be upheld as within Congress’s power to “lay and collect Taxes."

Because “every reasonable construction must be resorted to, in order to save a statute from unconstitutionality,” Hooper v. California, 155 U. S. 648, 657, the question is whether it is “fairly possible” to interpret the Law as imposing such a tax, Crowell v. Benson, 285 U. S. 22, 62. Pp. 31–32.

Neither the Affordable Care Act nor any other law attaches negative legal consequences to not buying health insurance, beyond requiring a payment to the IRS.

Don't believe me, take Justice Roberts' word for it instead, okay?