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 Health care ruling: Individual Mandate upheld by SCOTUS 
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Walk On

Joined: September 11th, 2010, 10:19 pm
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Post Re: Health care ruling: Individual Mandate upheld by SCOTUS
wjb21ndtown wrote:
They're not really forcing you to buy anything, they're just taxing you for not having something.

I think it's ridiculous that the administration said all along that this isn't a "tax," yet it was upheld only as a tax. The tax and spending power of Congress really is unlimited, and probably needs a Constitutional amendment to alter that, but how?

Aside from the obvious double speak about it not being a tax, but it is a tax, two things concern me about the opinion -
1) With this opinion States can now opt out of the Medicade expansion. That was supposed to be the mechanism to get all of the "poor" people covered without charging them the "tax." With the current language and 26 States being against the bill (and likely many more after they see how much it is going to cost them at the State level), they don't have to expand their Medicade to cover these people. These people that literally have no way of paying for insurance are not going to get it for free via Medicade, and they're going to get hit with a pretty large penalty (and the SCOTUS already said that the "tax" has to be charged to everyone). They're going to get hit with a huge penalty and increase in their taxes right in the lower middle-class level, right where they were told that it shouldn't cost them one penny. That's going to piss some people off. Unfortunately it won't happen until 2013, but hopefully the Reps can get the point across in the Pres. race and oust Obama. If Obama is gone I think this Bill goes away. I do think the Reps will be successful in getting it repealed, but they have to do it BEFORE it takes effect. It will be too hard to unravel after 2013.

2) There is a line in the opinion regarding the medicade expansion that seems to render the whole Bill invalid. It says something to the effect of "and the inability to expand Medicare invalidates the Bill." It sounded like they upheld the constitutionality of the mandate, but invalidated the Bill. However, that's not how it's being taken/reported.


States won't opt out of the expansion. They're going to be getting money for it (at least for some years... and I suspect there will be additional legislation around that). It took about 15 years for all the states to sign on to Medicaid the first time - so I believe we can expect adoption eventually by all states - especially once people realize they're subsidizing the OTHER states ACA medicaid expansion and not getting the benefit! Elected officials will get the point very quickly that people want healthcare...especially if they're already paying for it!

To be clear, SCOTUS did not say that the mandate was a tax, and actually said the opposite when they agreed to rule on the case under the antiinjunction act. Roberts was forced to seek remedy with the legislation when the commerce clause defense didn't hold up, and when his dissenting counterparts refused to recognize the severability of the key constitutional issues - the conservatives bit themselves in the end, by being "activist" (wanting to squash the entire thing - even the constitutional parts). The admin had also asked the court to consider the non-compliance penalty to be "like" a tax, and so Roberts did. But the penalty isn't completely a tax even though the IRS will handle it operationally - because it doesn't have the same IRS criminal enforcement characteristics. The writers of this legislation walked a VERY thin line in the terminology and approach they used - and it was brilliant, IMO.

To the people saying this is socialist: NONSENSE. A socialist solution would have been a government-sponsored single-payer system, and it would have thrown a giant monkey wrench into the healthcare system at all levels and for all participants. The ACA, on the other hand, goes out of its way to keep the participants in the healthcare system reasonably whole while at the same time keeping the risk pool chock full of low-risk people as well as the higher risk people that are now going to be covered. Insurance companies are scrambling now to figure out how to develop products and make money in the healthcare exchange marketplace - but they are being held accountable to keep overhead at no more than 85% or pay a penalty... which will drive costs out of the system. Medical service providers (docs, hospitals, etc) are Accountable Care Organizations have more incentive than ever to automate, share data and do other things to lower costs. Read what I'm saying - the business of healthcare is reacting, and is not being destroyed - rather, it is going to be a tremendous area for growth, innovation and change.


June 29th, 2012, 6:18 pm
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Post Re: Health care ruling: Individual Mandate upheld by SCOTUS
Quote:
Rick Perry announces Texas opting out of Medicaid expansion

WASHINGTON -- Texas Gov. Rick Perry, joining with several other Republican governors, said Monday that he would not expand Medicaid programs, taking advantage of one element of the Supreme Court’s ruling last week that upheld the Affordable Care Act’s individual mandate but also allowed states to opt out of the law's Medicaid expansion.

“We in Texas have no intention to implement so-called state exchanges or to expand Medicaid under Obamacare,” Perry said in a statement. “I will not be party to socializing healthcare and bankrupting my state in direct contradiction to our Constitution and our founding principles of limited government.”

In a letter to Health and Human Services Secretary Kathleen Sebelius, Perry condemned the “Orwellian-named” Patient Protection and Affordable Care Act.

“Medicaid is a system of inflexible mandates, one-size-fits-all requirements, and wasteful, bureaucratic inefficiencies. Expanding it as the PPACA provides would only exacerbate the failure of the current system, and would threaten even Texas with financial ruin,” he said.

"In 2014, consumers in all fifty states will have access to an Exchange where they can purchase quality health insurance and get tax credits to make that coverage more affordable. We will continue to work with states to ensure they have the flexibility and resources they need to implement the Affordable Care Act," a DHHS spokesman said in response to Perry's remarks.

Other prominent Republican governors, including Florida’s Rick Scott, Louisiana’s Bobby Jindal, South Carolina’s Nikki Haley and Wisconsin’s Scott Walker, have previously declared their states would opt out of President Obama’s healthcare law.

“Neither of these major provisions in ObamaCare will achieve those goals, and since Florida is legally allowed to opt out, that’s the right decision for our citizens,” Scott said in his own announcement.

“We’re going to do everything we can to elect Mitt Romney, to repeal this bad law and then replace it with more patient-centered healthcare reform that puts patients in control,” Jindal said.

The call for Romney’s election is doubly important for governors choosing to ignore the law’s optional provisions, because unless the former Massachusetts governor is elected and follows through with his pledge to repeal his predecessor’s reforms, states must comply with the law in 2014.

Perry, who ran against Romney in an unsuccessful bid for the Republican presidential nomination this year, is no stranger to the anti-Affordable Care Act camp, and labeled the Supreme Court’s 5-4 decision upholding it “a stomach punch to the American economy.”

Healthcare in Texas is currently deemed “weak” for a number of reasons by the Agency for Healthcare Research and Quality, a branch of the DHHS. Texas also boasts the highest percentage of uninsured residents in the country, at 27.6%.

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July 9th, 2012, 5:56 pm
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