Posted on 03/04/2015 1:57:17 PM PST by E. Pluribus Unum
Supporters of the Affordable Care Act gather in front of the U.S Supreme Court during a rally Wednesday. The court heard arguments in the case and is expected to announce its decision in June.
The Supreme Court heard arguments Wednesday in a case that could end Obamacare subsidies for policyholders in a majority of states, including Texas, Florida, Illinois, Pennsylvania and Ohio. If the court sides with the plaintiffs, it would mean millions of people could no longer afford health insurance.
The challenge to the Obamacare subsidies comes in the case King vs. Burwell. The plaintiffs point to a passage in Affordable Care Act that suggests that the federal government can only offer premium subsidies in Obamacare exchanges established by the states.
Only 16 states and the District of Columbia established their own systems. The rest are run by the federal government. In most cases, that's because Republican governors and legislatures refused to create a state system.
If the court upholds the challenge to the subsidies, an estimated 8 million people, including Melissa Trudeau, her husband and four children could lose their insurance.
"We'd probably just have to maybe only insure the kids," she says. "There's no way we could afford to do all of us, insure all of the entire family."
Trudeau and her family live near Tyler, Texas, and pay about $500 a month for coverage in the federally run exchange there. Without subsidies the cost would be $1,100.
"I'm really worried about it because we pretty much live paycheck to paycheck and we have a little bit extra coming in here and there but nothing we can really count on," Trudeau says. "If they take away the subsidies, I really don't know what we're going to do then."
But Christine Eibner, an economist at the RAND Corporation, a think tank, says it's not just the people getting subsidies who will be hurt.
"It's important to keep in mind that this ruling could have implications beyond the number of people losing subsidies," she says.
"When younger and healthier people drop out of the market because they no longer have access to subsidies, that causes premiums to increase."
If the court rules that the subsidies are illegal, even people in the individual insurance market who do not get subsidies would see their premiums rise — including people who bought their insurance outside the federally run marketplaces.
"We see premiums increasing by about 47 percent," Eibner says.
She says that's because removing subsidies would cause the youngest and healthiest people in the federally run exchanges to drop their insurance. "And when younger and healthier people drop out of the market because they no longer have access to subsidies, that causes premiums to increase," Eibner says.
Because older and sicker people need more health care, they will do everything they can to hang on to their insurance. That raises costs for insurance companies and they raise their premiums in response.
"It would be a staggering blow," says Andy Carter, CEO of the Hospital and Healthsystem Association of Pennsylvania. He says it would be a blow to those getting subsidies in the federally run Pennsylvania exchange and a blow to hospitals, which would lose revenue. Carter says 4 out of 5 Pennsylvanians in the ACA exchange there get subsidies.
"The subsidies themselves represent a keystone to the whole Affordable Care Act structure," he says. "You lose those subsidies, and the whole thing just collapses."
U.S. hospitals have filed friend-of-the-court briefs in support of the subsidies. Carter says he's optimistic the Supreme Court will rule the subsidies are legal, but he is talking to Pennsylvania state officials about setting up a state-run exchange just in case. However, he says, opposition in the state legislature remains a hurdle.
Eibner, of the RAND Corporation, says states that didn't set up their own exchanges would take an economic hit by giving up the federal subsidies.
"The subsidies are bringing about [$400] million a month into the state of Florida and [$200] million a month into the state of Texas," she says. "Over the course of the year, this translates into billions of dollars."
The Supreme Court is expected to announce its decision in June. So far, the Obama administration says it has no plan and no executive-branch power to undo the effects of a negative ruling.
The consequences are not any greater than what zerOcare now incurs.
I scored a “picket fence” on my ASVAB, but I became a combat engineer (light, no construction, infantry-related type). So the ASVAB lied. I wasn’t so smart after all!
;-)
Somehow despite Republican control of the House and Senate, NPR continues to be funded.
...
That’s because the Uniparty is in control. See my tagline.
NPR is defended by layers of barb wire, sandbags and machine guns
The way to disrupt NPR is to have republican governors retake their state funded and operated public radio stations. rather than attempt a frontal attack on an extreme strongly defended position, a flank attack on public radio can be successful by governors
It's that pesky Constitution again.
Note bene the camera angle. There are probably 20-40 people protesting tops and they got in their cars and drove to warmth right after the cameras left.
You stopped too soon. Wickard v. Filburn threw all that jurisprudence out. Stare decisis is so 19th century.
https://supreme.justia.com/cases/federal/us/317/111/case.html
Using terms like “some concept” and “implicit,” here is what was left of the 10th Amendment after FDR’s activist justices got finished with it in Wickard v. Filburn.
“In discussion and decision, the point of reference, instead of being what was “necessary and proper” to the exercise by Congress of its granted power, was often some concept of sovereignty thought to be implicit [emphases added] in the status of statehood. Certain activities such as “production,” “manufacturing,” and “mining” were occasionally said to be within the province of state governments and beyond the power of Congress under the Commerce Clause.”—Wickard v. Filburn, 1942.
FDR’s thug justices had essentially reduced the 10th Amendment to a wives’ tale imo.
Totally agree, but now imagine the CC in the hands of a conservative AG and POTUS. I think you could undo a lot of state laws that interfere with interstate commerce.
So the revolutionaries fought to over through a national tyranny only to invoke a state tyranny?
If licensing physicians is so tyrannical, why haven't any of the 50 states done it differently? Maybe you're advocating chaos. Just because you don't like it doesn't make it tyrannical.
Why not a hospital across the street from another hospital?
Baptist, St. Thomas, Centennial(HCA), Vanderbilt and VA are all within a 5 block radius in Nashville. There is actually 25 hospitals in Nashville. 10 in the downtown area.
There are indeed boards that regulate it. But if you know your economics, you know that in any industry with sufficient profits, that profit is eventually driven to zero and probably negative, before industry rationalization kicks in and some competitors drop out. You don't want that with hospitals. You don't want to go to a hospital on the verge of bankruptcy.
So to attract the kind of intense capital investment that hospitals require, they do limit the competition some. But that's a state thing, not a federal thing. All you need to do is find a state that doesn't do that.
It probably stems from when Medicare reimbursed hospitals on a cost basis.
OK, Danny. You’re right. Free market competition in medicine would lead to a disaster.
Think man, think.
Which anti-trust laws would you apply and how did they make things better historically?
Also, what if a medical caregiver had to, by law (because fraud must always be illegal) (fraud defined here: http://definitions.uslegal.com/f/fraud/ so that we are discussing using like terms) had to declare whether they had gone to medical school, which medical school and whether they were licensed to practice in said state, would that be a good law?
Also, what if a medical caregiver had to, by law (because fraud must always be illegal) (fraud defined here: http://definitions.uslegal.com/f/fraud/ so that we are discussing using like terms) had to declare whether they had gone to medical school, which medical school and whether they were licensed to practice in said state, would that be a good law?
No. You didn't get rid of the licensing, so by implication you're proposing that they make that information available because they will now be competing against people who didn't go to school. That's not a good law because it allows people who are not qualified to hold themselves out as doctors. People who aren't qualified shouldn't be practicing medicine, period.
Let’s hold off on the first part with all the new laws you’d like to see put in place and just focus on the second.
Under a free market the consumer is king. Your issues, along with most of the country’s, are that lack of free market competition and transparency.
So under my scenario a medical caregiver had to, by law, declare whether they had gone to medical school, which medical school and whether they were licensed to practice in said state.
Isn’t that just consumer choice?
You and I both have a back ache, that won’t go away. We both go look for a person to treat it.
Under my law we find two doctors: Dr. A and Dr. B.
Dr. A declares that he attended NW Medical and was duly licensed by the state. He presents the proof. He states that he’ll treat your back ache for $500.00.
Dr. B declares that he too attended NW Medical, but is not licensed by the state. He presents the proof. He states that he will treat your back ache for $150.00.
They’re equal in all other ways.
Which doctor do you choose and why?
Licenses do more than just show they attended school. They still have to pass the boards indicating that they actually know what was taught. And licenses can be revoked for incompetence or misbehavior.
Unlicensed people should not be practicing medicine.
And the rates should be public, in most cases people don’t have a clue until they get the bill.
To sum up;
In other words the fix was in, it's a done deal, and government is going to do what the hell it wants.
The pattern repeats itself over and over.
I understand your position. It’s that no one should practice medicine (and perhaps any other trade) without government testing and licensing, correct?
Here’s my example and I’m genuinely interested in your answer:
You and I both have a very bad and persistent back ache.
We both go look for a person to treat it.
Under my law we find two doctors: Dr. A and Dr. B.
Dr. A declares that he attended NW Medical College, passed all the necessary classes and was duly licensed by the state. He presents the proof and it’s the truth. He states that he’ll treat your back ache for $500.00.
Dr. B declares that he too attended NW Medical College and passed all the necessary classes, but is not licensed by the state. He presents the proof of all the foregoing. He states that he will treat your back ache for $150.00.
They’re equal in all other ways.
Which doctor do you choose and why?
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