The Sad Case of the Patient Protection and Affordable Care Act

[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?

 

[Rover]

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

Fishy you just proved my point for me, so thanks for digging up the quotes. He said the mandate is unconstitutional under the commerce clause (a 5-4 decision) but constitutional under the taxing power. So, its constitutional. The law was written so that those who didn't comply (as in get insurance) would have to pay a penalty (a tax for Roberts purposes). The law didn't advocate jail or beatings for non-compliance, just what was upheld - a monetary payment for not carrying insurance.

What I laugh and laugh about is the continued "heads we win, tails you lose" mindset out of conservatives on this one. As the law was envisioned, you will either get insurance or pay for noncompliance. That's what Roberts agreed with. Whether he did so due to Commerce or Tax clause reasons is irrelavent for all practical purposes. Upon Obama's re-election the ACA will be enacted in full. Even the more sane cons like joecct are falling into this absurd trap, in that case with the notion that there's a penalty that won't be enforced, sorta like jaywalking fines. Uh, no. If this "loss" was really a victory for you guys, why is Scalia still going berserk over it?

 

[FreshFish]

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

Two big employers are planning a radical change in the way they provide health benefits to their workers, giving employees a fixed sum of money and allowing them to choose their medical coverage and insurer from an online marketplace.

...


"It's a fundamental change…the employer is saying, 'Here's a pot of money, go shop,' " said Paul Fronstin, director of health research at the Employee Benefit Research Institute, a nonprofit. The worry for employees is that "the money may not be sufficient and it may not keep up with premium inflation."

Neither Sears nor Darden would say how much money employees would receive to buy health insurance. Darden says its sum would rise as health-care costs rise. Sears declined to disclose details of its contributions strategy.

Darden did say that employees will pay the same contribution out of their own pockets that they currently do for approximately the same level of coverage. Employees who pick more expensive coverage will pay more from their paychecks to make up the gap. Those who opt for cheaper insurance, which may involve bigger deductibles or more limited networks of doctors and hospitals, will pay less

http://online.wsj.com/article/SB100...0640220260374.html?mod=WSJ_hps_LEFTTopStories

 

[FreshFish]

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

....

When your only tool is a sledgehammer, everything looks like it should be smashed.....

 

[LynahFan]

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

The way I like to think about it is:

1. Everyone has to pay an additional health insurance tax.
2. You can get a tax credit equal to the full value of the new tax by purchasing a qualified private health insurance plan.

I don't think that's the reasoning Roberts used or what the tax forms will really look like, but it makes more sense to me than saying that the only people who have to pay the tax are the ones who don't buy health insurance.

 

[FlagDUDE08]

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

The way I like to think about it is:

1. Everyone has to pay an additional health insurance tax.
2. You can get a tax credit equal to the full value of the new tax by purchasing a qualified private health insurance plan.

I don't think that's the reasoning Roberts used or what the tax forms will really look like, but it makes more sense to me than saying that the only people who have to pay the tax are the ones who don't buy health insurance.

Actually, I think that's the only way that they actually can do it on the 1040.

 

[FreshFish]

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

The way I like to think about it is:

1. Everyone has to pay an additional health insurance tax.
2. You can get a tax credit equal to the full value of the new tax by purchasing a qualified private health insurance plan.

I don't think that's the reasoning Roberts used or what the tax forms will really look like, but it makes more sense to me than saying that the only people who have to pay the tax are the ones who don't buy health insurance.

That's a sensible approach...I wonder how it affects people on Medicare, though....you don't "buy" Medicare, you "enroll".....at least for now, anyway. Does the tax only apply to people under age 65?

 

[Rover]

The way I like to think about it is:

1. Everyone has to pay an additional health insurance tax.
2. You can get a tax credit equal to the full value of the new tax by purchasing a qualified private health insurance plan.

I don't think that's the reasoning Roberts used or what the tax forms will really look like, but it makes more sense to me than saying that the only people who have to pay the tax are the ones who don't buy health insurance.

A reasonable take on it...

Fishy, if you want to spout nonsense I will sledgehammer it. If you don't like that give Mitt Romney a call and ask him how many untruths he's managed to get away with this campaign season. I'm thinking his answer will be "not much" as we will call conservatives on the carpet every time.

Mandate = constitutional, otherwise you wouldn't have to pay the penalty for noncompliance.

I'm not saying you have to like the ruling, just that's what it was.

 

[FlagDUDE08]

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

That's a sensible approach...I wonder how it affects people on Medicare, though....you don't "buy" Medicare, you "enroll".....at least for now, anyway. Does the tax only apply to people under age 65?

Considering the retirement age is now 67, that'd be a sweet deal.

 

[LynahFan]

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

A reasonable take on it...

That could literally be the first time you've ever considered one of my posts to be reasonable!

 

[LynahFan]

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

That's a sensible approach...I wonder how it affects people on Medicare, though....you don't "buy" Medicare, you "enroll".....at least for now, anyway. Does the tax only apply to people under age 65?

Good catch - I suppose my #2 bullet should be amended to say that you can get the tax credit in a number of ways: private insurance, Medicare, Medicaid, VA benefits, etc.