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Major Blow Dealt To Obamacare

LETTER OF THE LAW COMES BACK TO BITE BARACK …  Last November, guest columnist Nathan Mehrens of Americans for Limited Government wrote that “President Obama’s socialized medicine law has a big problem on its hands – something much more serious than a botched website or a broken political promise.” He…

LETTER OF THE LAW COMES BACK TO BITE BARACK … 

Last November, guest columnist Nathan Mehrens of Americans for Limited Government wrote that “President Obama’s socialized medicine law has a big problem on its hands – something much more serious than a botched website or a broken political promise.”

He was referring to the Halbig v. Sebilius  case, in which the ability of U.S. President Barack Obama’s signature legislation to disburse roughly $700 billion in subsidies in nearly three dozen states was challenged.

The basis of that challenge?  That Obamacare – which its namesake keeps changing on the fly – explicitly limited the availability of these subsidies “through an Exchange established by the State.”

Thirty-six states rejected such state-run exchanges … only fourteen adopted them.

“If Obamacare is to be taken at its word – then the law’s subsidies and penalties do not apply in two-thirds of the country ,” Mehrens wrote.  “And if that’s the case, then Obamacare is a ‘Dead Law Walking’ – incapable of sustaining itself without hundreds of billions of dollars in deficit spending.”

Well guess what …

In a surprise 2-1 ruling, the U.S. Court of Appeals for the District of Columbia ruled against  the government in the Halbig case (now dubbed Halbig v. Burwell ) – arguing that the Internal Revenue Service (IRS) exceeded its authority by extending subsidies through the federally run exchange.

“We reach this conclusion, frankly, with reluctance,” the court wrote.  “At least until states that wish to can set up Exchanges, our ruling will likely have significant consequences both for the millions of individuals receiving tax credits through federal Exchanges and for health insurance markets more broadly.”

Obama’s administration immediately announced its intention to appeal the decision – which has the potential to sink the massive socialized medicine legislation under the weight of hundreds of billions of dollars in new deficit spending.

A “potentially lethal blow” is how NBC described it.

How many people does the ruling impact?  According to health care policy analyst Michael Cannon of The Cato Institute, the ruling frees “8.3 million individuals from (Obamacare)’s individual mandate.”

“Left-leaning groups and media outlets that defend the IRS are attempting to portray a potential ruling for the Halbig  plaintiffs as catastrophic, because it would put an end to the subsidies roughly 5 million individuals enrolled in federal Exchanges are currently receiving,” Cannon wrote just prior to the ruling.  “As I explain in detail, those commenters ignore three crucial facts. One, a victory for the Halbig plaintiffs would increase no one’s premiums. It would merely stop the IRS from unlawfully shifting the cost of those overly expensive PPACA premiums from enrollees to taxpayers.  Two, if federal-Exchange enrollees lose subsidies, it is because the courts will have found those subsidies are, and always were, illegal . And three, if the Halbig  plaintiffs prevail, the winners in the 36 states with federal Exchanges would outnumber the losers by more than ten to one.”

Good …

With this case headed for the U.S. Supreme Court, we will soon find out once and for all whether chief justice John Roberts is still in the tank for Obamacare … 

UPDATE: Obama administration to defy court ruling.

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98 comments

tomstickler July 22, 2014 at 12:58 pm

Beware citing anything from the Cato Institute.

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jes July 22, 2014 at 1:01 pm

How about citing the court ruling from a liberal federal court?

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Tom July 22, 2014 at 1:26 pm

This was a three Judge Panel two Republican appointees and one Judge Appointed by Democrats. The Two Republican are of course the ones who made the ruling and the Democrat dissented.

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Smirks July 22, 2014 at 1:39 pm

The facts! They burn!

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Sandy Burglar July 22, 2014 at 2:02 pm

So does this bad law!

Smirks July 22, 2014 at 2:07 pm

This issue has a simple fix, patch the law so that subsidies are unquestionably applied to all exchanges.

Oh, but you don’t want to fix any part of the law, do you? :)

Sandy Burglar July 22, 2014 at 2:17 pm

No, I don’t because it was completely unnecessary and has caused millions to lose or make much more outrageously expensive coverage plans that met their needs. Never mind the fact the law was sold and marketed through complete falsehoods and blatant lies. The people pushing it lied through their teeth about it. Any public policy that must be lied about may not be good public policy, no?

Smirks July 22, 2014 at 2:42 pm

because it was completely unnecessary

We spend more on health care per capita than ANYONE else. In fact, we put second place to shame.

http://en.wikipedia.org/wiki/List_of_countries_by_total_health_expenditure_%28PPP%29_per_capita

We are one of the few first world countries that do not have universal health care, something that nations far poorer than us manage to provide to their citizenry.

http://www.theatlantic.com/international/archive/2012/06/heres-a-map-of-the-countries-that-provide-universal-health-care-americas-still-not-on-it/259153/

Medical debt is a leading cause for bankruptcy, and even plagues the insured.

http://www.cnbc.com/id/100840148#.

Are you really saying health care reform is unnecessary? Do you really find all of the above acceptable?

caused millions to lose or make much more outrageously expensive coverage plans that met their needs

And yet the uninsured rate keeps falling.

http://www.gallup.com/poll/167798/uninsured-rate-continues-fall.aspx

Also, I don’t mourn the loss of the junk insurance plans that have gone by the wayside thanks to the ACA.

Never mind the fact the law was sold and marketed through complete falsehoods and blatant lies.

So, offer up legislation to make good on those promises.

Oh, right, you don’t want to fix any part of the law. I keep forgetting, sorry.

Sandy Burglar July 22, 2014 at 2:52 pm

I never said health care reform was unnecessary. That’s one of your typical strawmen. What I said was this particular law was unnecessary and unlawful, as we are finding out now that people are actually reading it to find out what’s in it.
Why do you find it acceptable that politicians and bureacrats lie and tell out and out falsehoods in order to pass legislation? And just who made you the arbiter and judge of what current plans were so-called “junk insurance” plans? I’m sure your opinion will put those who lost their plans at total ease, since you are the expert in their lives.

Scooter July 22, 2014 at 8:09 pm

We damn sure don’t.

CL July 22, 2014 at 1:27 pm

Beware those utilizing argumentum ad hominem.

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tomstickler July 22, 2014 at 7:16 pm Reply
Jackie Chiles July 22, 2014 at 1:10 pm

I really don’t know how they get around this without ignoring the words of the law.

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Jack July 22, 2014 at 1:30 pm

What this means unless overturned is that middle income people will pay more for insurance in states run by Republicans who refused to establish exchanges than similarly situated persons in states run by Democrats where the states established exchanges. Most of those same states also refused expanded Medicaid leaving their working poor without coverage. Why is not surprising, that poor and middle income citizens are screwed in Republican states.

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Smirks July 22, 2014 at 2:02 pm

If you consider that this must be reviewed by the district court as a whole (which does lean left), and then must go to the Supreme Court, this is going to take a while to get hashed out. That means the people already on the exchange will have had their insurance for quite some time, not to mention the potential for more people to gain insurance.

If the subsidies for the states that didn’t start their own exchanges goes away, that’s a lot of people who are going to find their insurance much more expensive, possibly even unaffordable. Both parties will spin it, but either way it is spun, it’s a simple problem to fix: you just have to apply a simple patch to the law to change the wording. Obviously Democrats will push for it, and obviously Republicans are going to try and obstruct it.

I don’t think Republicans are going to win that battle.

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Jackie Chiles July 22, 2014 at 2:54 pm

Imagine that the statute meant what it says (that subsidies are only available for exchanges set up by the states) and that was also the intent of Congress. How was congress supposed to draft the section to make it “unambiguous.” The only answer is can come up with is ridiculous like adding something along the lines of “no seriously, we mean it.”

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Native Ink July 22, 2014 at 3:29 pm

They why not ask the drafters of the law what they meant? Most of them are still around, after all. It’s pretty clear they did not want the subsidies restricted to state-run exchanges. Has any politician involved in drafting the ACA ever come out in favor of that?

So far the score on this issue is 4 decisions for Obama, 1 against. That sounds like the last scorecard the courts racked up before the Supreme Court sided with Obama 5 to 4. If Roberts wasn’t willing to trash his own legacy then, I doubt he would be now.

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Jackie Chiles July 22, 2014 at 11:31 pm

You think the Court’s going to call to testify 535 people to get their separate opinions on what they individually thought a certain provision in a law meant when they voted for it? Might as well do away with the judiciary at that point and just let Congress revote on what it actually meant when it wrote the law.

Scooter July 22, 2014 at 8:06 pm

Stay tuned.

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CL July 22, 2014 at 1:30 pm

I guess someone should tell Pelosi this is why you find out what is in the legislation before you pass it.

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Jackie Chiles July 22, 2014 at 1:40 pm

Reading the 4th circuit’s opinion upholding the subsidies, I now think there’s a strong chance the subsidies will be upheld along party lines.

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CL July 22, 2014 at 2:07 pm

I am rarely surprised at how quickly judges are to disregard the law (and I am not optimistic of the full DC Cir affirming), but the 4th Cir panel seems to be embarrassed by what they are doing. Gregory keeps conceding that the “common sense” reading of the statute (code for “clear and unambiguous”) offered by Plaintiffs, before moving on to twisting it into a pretzel to find another meaning other than the plain one.

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Jackie Chiles July 22, 2014 at 2:48 pm

It’s true. The 4th circuit’s opinion seems reasonable at first, if, say that the statute meant what it says (that subsidies are only available for exchanges set up by the states), and that was also the intent of Congress. How was congress supposed to draft the section to make it “unambiguous”? The only answer is can come up with is ridiculous like adding something along the lines of “no seriously, we mean it.”

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Native Ink July 22, 2014 at 3:19 pm

If the Supreme Court overturns this section of Obamacare, they would be overturning dozens of their own precedents. The Supreme Court typically defers to the plain intentions of a law passed by Congress, even if certain wordings are not entirely airtight and unambiguous. Supposedly this is the reason why Chief Justice Roberts balked at declaring Obamacare unconstitutional. I’m sure conservatives would love to have a Supreme Court that ignores decades worth of precedents, but so far they only have 4 justices willing to go that far.

CL July 22, 2014 at 4:26 pm

You don’t even realize you are making the case against the administration by citing the need to defer to the law as passed by Congress. The DC court did not overturn any aspect of the Affordable Care Act. It found an IRS REGULATION to exceed the authority granted by the plain language of the act. So it was the DC court deferring to the plain language of the statute as passed by Congress, and Obama asking the Court to go above the clear language and decipher some hidden meaning.

Jackie Chiles July 22, 2014 at 11:29 pm

You fail to understand the difference between the 4th circuit’s opinion and the DC opinion.

CL July 23, 2014 at 10:00 am

The 4th Cir opinion hinges upon the notion that there was no reason for the statute to only allow subsidies to states. But that is not true. The feds clearly wanted the subsidies to induce as many states as possible to sign up so the feds did not have to run exchanges for every state. It was only when, a year an 1/2 later and few states were agreeing to set up exchanges, that the IRS proposed this regulation. Why the delay, if it was always the intent that federal exchanges would receive the same subsidies as the state exchanges? It was a panic move caused by the drafters’ failure to perceive just how unpopular the exchanges would be with the states given the future unfunded liabilities that came with accepting the money in the short term.

It would have taken a couple of words to give such authority, while, as you note, it is hard to come up with an unambiguous provision that would limit it to state exchanges given the court’s willingness to ignore the plain meaning – excuse me, the “common sense” reading – of the statute.

CL July 25, 2014 at 7:22 am

Watch this video of one of the architects of the language admit, before lawyers starting filing legal challenges to the IRS guidelines, that the law was specifically crafted so that only state created exchanges would get the subsidies. The idea was that Obamacare (and the subsidies) would be so popular with the people, that state politicians would be crazy to refuse to set up an exchange:

“What’s important to remember politically about this is if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits—but your citizens still pay the taxes that support this bill.”

This admission completely erodes the already shaky foundation (under Chevron) of the the 4th Circuit opinion. Of course, now this clown, once his (and Obama’s) hubris has been exposed by reality, claims that the language was all a drafting error.

http://reason.com/blog/2014/07/24/watch-obamacare-architect-jonathan-grube

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The Colonel July 22, 2014 at 1:40 pm

+10 CL!

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Sandy Burglar July 22, 2014 at 2:00 pm

EXACTLY, CL. None of those fucking libtard idiots read any of those 2,700 pages of pure garbage before ramming this crapola down the throats of the public who didn’t want it to begin with. And, lo and behold, it’s come back to bite them in ass. Those chickens have come home to roost. Karma sure is a bitch.

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a face in the crowd July 22, 2014 at 2:31 pm

Nothing has come home to roost. The case will be appealed directly.

We now need to make sure we can get the thousands of kids coming in from South and Central America fully covered.

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Sandy Burglar July 22, 2014 at 2:46 pm

With whose money?

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idcydm July 22, 2014 at 2:25 pm

I just don’t understand, you would think with 2,700 pages of law and over 18,000 pages of regulations everything would be covered. Hypothetical…Maybe the Republicans read it and that’s why they didn’t vote for it.

CL got it right, Pelosi and the rest of the Democrats that voted for it should have read it first.

Unintended consequences, funny how they always happen.

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Yep! July 23, 2014 at 11:16 am

It’s the ongoing demonstration of the failure of central planning as a philosophy.

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Rocky July 22, 2014 at 1:48 pm

Oops. Another court upheld them. Oh the confusion. Never mind, if you live in SC you’re screwed with insurance anyway. Can’t get a subisdy, can’t get Medicaid.

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Jan July 22, 2014 at 1:58 pm

Let me give you an example of what this means. Our maid works her ass off cleaning houses. She works 40+ hours a week making about $10 and hour. Her husband lost is manufacturing job about 8 years ago. Since then he has been working in a convenience store making about $9 dollars and hour. They have two children. Her husband is 50 and has a preexisting medical condition. He lost his insurance when he lost his job. Until the ACA they had no health insurance. They could not afford it, and the husband could not qualify. Last year they got insurance through the exchanges for the first time in 8 years. It was subsidized. Now they will lose the subsidy. They will not be able to afford to keep the insurance. How can you people find this acceptable??.

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Sandy Burglar July 22, 2014 at 2:01 pm

You should have told your people to write a better law. One that is lawful, for instance.

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Jan July 22, 2014 at 2:06 pm

What law would you prefer? The only problem is that Republicans are blocking the coverage by refusing to establish exchanges. If they lived in a state with an exchange they would be fine. Its not the law its ass hole Repugnuts who are taking their coverage away.
Laugh if you want, but I think when people figure out they are being screwed by Republicans you want be laughing so hard.

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Smirks July 22, 2014 at 2:23 pm

They don’t want reform at all. Mostly because the old system hadn’t fucked them over (yet).

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Jackie Chiles July 22, 2014 at 2:53 pm

You seem dumb.

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Jan July 22, 2014 at 3:08 pm

You are dumb.

Cosmo Kramer July 22, 2014 at 4:58 pm

He thinks hes clever.Hes not.

Jackie Chiles July 22, 2014 at 11:28 pm

Excellent post.

Scooter July 23, 2014 at 9:11 pm

All you can come up with is the Reps. this and the Reps. that. Dumb ass voting Democrat that wants everyone else to keep them and their friends up. You should be ashamed.

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anonymous July 22, 2014 at 2:03 pm

Very good comment, and it’s not acceptable.

The way the politicians in South Carolina are dealing with the ACA is at best, a disgrace.

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Smirks July 22, 2014 at 2:15 pm

How can you people find this acceptable?

Because politics.

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Jackie Chiles July 22, 2014 at 2:53 pm

The law was poorly written.

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Sandy Burglar July 22, 2014 at 2:57 pm

Of course it was Jackie. But central planners and welfare kings like Jan and Smirks didn’t care…they just knew SOMETHING had to be done. No matter how shitty the law, no matter that it was sold on lies, SOMETHING had to be done.

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Jan July 22, 2014 at 3:35 pm

Health care is not welfare. Everyone is entitled to reasonable health care. Yes something did have to be done, and Republicans offered no ideas and blocked all the good ones.

Now they are again blocking health care for millions of middle class citizens and working poor in states run by Republicans.

This will not kill the ACA act as you hope. It will still exist and the cost will go down, because all the benefits will only go to people in New York, California, Pennsylvania, etc. People in the back water red states will end up with no insurance, paying more for insurance, and substandard care, while our tax dollars pay for the benefits provided by the ACA in those other states.

Sandy Burglar July 22, 2014 at 4:22 pm

They didn’t block anything Jan. The law was poorly written and you would have known that if you – and Pelosi – had READ it before cramming down our throats.

Jan July 22, 2014 at 4:47 pm

If the ruling stands the only people whose insurance cost will go up will be people in states run by Republicans. You can say its not the fault of the Republicans running those states if you want to, but they are the reason the insurance premiums are going up. They can prevent that from happening, as can the Republicans in the House of Representatives any time they want to. They are refusing to establish state exchanges and refusing to expand Medicaid to the working poor. That means their people will suffer and those in states run by Democrats will not. They will keep their insurance and their subsidies. The people of SC for instance will subsidize the insurance of people in other states and will have no access to insurance themselves, because they are unfortunate enough to live in a state run by Republicans.

There is no upside to anyone from this ruling except people who want to try to spin this as a negative for the act. How will anyone benefit from this ruling?

Scooter July 22, 2014 at 8:00 pm

Where do you want to start cutting?

Regulate everything & everyone July 23, 2014 at 11:19 am

It’s tough planning every aspect of everyone’s lives via code, but that doesn’t seem to stop them from trying.

Pretty soon 2700 page bills will be the norm, instead of the old days when more than 1 page was the exception.

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Mark Petereit July 22, 2014 at 2:23 pm

That’s what Medicaid is for.

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Smirks July 22, 2014 at 2:43 pm

Without the expansion, Medicaid only covers the extremely destitute.

If you’re saying America is better off forcing people into abject poverty before offering health care, that’s… really sad.

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Joe Millionaire's Accountant July 22, 2014 at 5:00 pm

As long as we have a health care system where all the bills are mysteriously paid by some entity other than “me,” health care is going to remain unafordable for the working poor.
But please realize that “unafordable” is NOT the same as “no health care.” I’m looking out my office window at one of the larger not-for-profit regional health facilities in South Carolina. I’m guessing 70% of the patients in those 600 beds will never pay a bill, and they’re getting exactly the same world-class health-care as Joe Millionaire in the next room — except Joe Millionaire will end up paying the bills of just about every other patient on his floor.

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TSIB July 22, 2014 at 7:55 pm

Yeah, that’s actually false, but whatever.

Mark Petereit July 23, 2014 at 10:53 am

More true than you know.

Jan July 22, 2014 at 3:03 pm

They don’t qualify for Medicaid. Why don’t people understand that. They are not disabled. They are working poor. They make too much for Medicaid, but they can’t afford insurance.

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Mark Petereit July 23, 2014 at 10:50 am

By my last count there were over 370 federal, state, local and private charity programs to help people with health care costs. You have to try really, REALLY hard to not qualify for any of them. Or I suppose you could just sit back in your ignorance, not try at all and get the same lack of benefits.

The last resort is to just go ahead and get the care you need and don’t pay for it. Yes, you’re forced into medical bankruptcy but guess what? That’s why we HAVE medical bankruptcy. You get the care you need. Infinitesimally small price to pay for not adequately preparing yourself to meet your family’s needs.

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Scooter July 23, 2014 at 9:14 pm

Next, you will want us to subsidize their purchase of a Mercedes. Woman, where do you stop??

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Sarah Palin Forever! July 22, 2014 at 4:56 pm

You’re for Medicaid?

What kind of damn Socialist are you?

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Mark Petereit July 22, 2014 at 8:40 pm

I’m not for Medicaid. I’m for staying in school, studying your butt off, then working your butt off and earning a good living, and continuing to study your butt off to keep your skillset current so you remain employable in the marketplace. I’m for earning six figures so a great-quality health care plan is easily affordable.

For the rest of the folks that just do enough to get by, think life is supposed to be “fair”, let others tell them what they should do, make foolish decisions, vote for the “cool” candidate, and/or marry poorly there’s Medicaid.

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Scooter July 23, 2014 at 9:16 pm

And get those tattoos and buy those lottery tickets.

Rocky July 22, 2014 at 4:10 pm

Please – this is South Carolina. We don’t care about other people, only ourselves, a few hot women we see in church on Sundays and the pit master at the local BBQ place. You don’t have insurance – too bad. I vote with Sandi.

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CL July 22, 2014 at 4:37 pm

It never ceases to amaze how blindly some convince themselves that their ideas are the only ideas. There are a multitude of ways to tackle health insurance costs. I, along with most Americans, believe Obamacare is a particularly terrible way to approach it. That does not mean, no matter how many times you repeat the lie to yourself, that most Americans are callous and want nothing done.

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Jan July 22, 2014 at 4:58 pm

Again no ideas. Typical Republican response. Just like the Republicans in Congress. No ideas. Tell me your plan for these folks? What should they do? Saying you are not callous does not make it so. Saying you want reform does not make it so.
I have yet to hear one workable Republican idea that will materially impact insurance costs. All of their ideas are ideas they know will never work or be passed.

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Jan July 22, 2014 at 5:38 pm

I want to correct my last post. There have been a few Republican ideas for health care reform worth considering.

http://ivn.us/2013/09/27/obamacare-was-originally-proposed-by-republicans/

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Scooter July 22, 2014 at 8:03 pm

I think that you have bought into the Obama BS and have rulled every thing else out.

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Jan July 23, 2014 at 12:28 pm

And, I think you have drunk the Fake News, Rush, Beck, Kool Aid.

Squishy123 July 23, 2014 at 12:56 pm

So where do you get your information? From the unbiased women on The View?

Jan July 23, 2014 at 3:45 pm

I work in the field. I don’t need to get my information from TV.

CL July 23, 2014 at 7:59 am

From past experience, I think we both know that you will dismiss any market based reforms out of hand. Suggestions like approved policies that are portable across state lines would go a long way to reducing costs by encouraging competition. But when you decide that only your ideas count as “ideas” then I guess your answer starts to look less like a lie and more like the delusion of an extremely close minded partisan. But I am happy to discuss several options that would be preferable IMO to Obamacare.

As a starting point, Obamacare is worse than the status quo. So doing nothing would have been an improvement over what we have now from a cost perspective. But that does not satisfy your statist assumption that government must always “do something,” even if history shows that politicians frequently make problems worse because of the problem of knowledge.

From a statist perspective, a straightforward Medicaid expansion to cover the chronically uninsured would have been preferable, since it would have cost less and not required the government to take over 1/6 of the economy.

My personal idea (I have not seen the latter part suggested anywhere else) to bypass the mandate was to create a risk pool of the chronically unisured and then draw in young healthy people into the pool by tying the receipt of any form of federal financial aid for education to a requirement that the recipient purchase insurance through the government program. This would be a better mechanism than the IRS leveling penalties for ensuring actual participation, and it has the important benefit of being constitutional (since it is entirely voluntary to accept financial aid). I have seen estimates that 2/3 of all undergrads receive such aid, which would be 14 million people based upon the 2011 enrollment numbers. Add in the graduate students receiving Perkins loans or other subsidized aid, and you dwarf the Obamacare enrollment goals.

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Jan July 23, 2014 at 12:27 pm

So you want to force parents struggling to pay for college and needing student loans and grants to do so, to buy health insurance from a high risk pool or forgo the education of their children. In other words let low and middle class citizens fund this health insurance problem. People who can write a check for their children’s education or who have no children should not be involved. Obviously saying you are not callous, out of touch, or uncaring does not make it so.
We already had high risk pools. The cost to buy insurance from those pools is very high. In fact it was so high almost no one other than wealthy people can afford it, and parents of children on financial aid cannot afford to buy this type of insurance, just so rich people do not have to participate in the problem.
Finally, what market based approaches are you saying would work? You cannot make a profit selling insurance to people who cannot afford insurance. There is no market. Without some form of subsidy insurance is simply not affordable for millions of people at a level that will allow private insurance companies can make a profit.
And I am not even going to address your Medicaid expansion point. Obviously Republicans were never going to support that, so please don’t pretend that was ever an option. What did we just go through in this state over Medicaid expansion.
Once again you have offered no workable ideas, and can’t point to one offered by the Republican party. Go ahead list the market based ideas for insuring the working poor you believe will work.

CL July 23, 2014 at 3:00 pm

Obviously you do not even know what you are defending. My idea is essentially Obamacare without the coercion. You rely on the same young, healthy people to fund this problem as my proposal does, only you do it through force. Its called the individual mandate. So you are pushing a more coercive version of what I am talking about and then have the gall to accuse me of being callous. it would be funny if it was not so sad.

Counterfactuals are always tough, but I suspect Obama could have peeled off a few Republicans early in his administration if he had tried something more straightforward. He certainly could have appealed to the conservative Democrats who were actually holding up the process (I am sure you are forgetting that Dems had the House and a filibuster proof Senate majority and STILL had trouble ramming this mess through).

And we absolutely do have insurance markets* – there are 50 inefficient ones saddled by a host of state mandates. Having policies that can be sold anywhere open up those markets.

* Because of government intrusion, by the way. Government caused the cost problems, yet you treat any skepticism that government can fix it as callousness.

Jan July 23, 2014 at 4:02 pm

Are you nuts? The ACA allows people to keep their kids on their group policy until Age 26. This is not the same group at all. The ACA helps people afford college for their kids, your plan would kill people with kids in college. It would be the parents who are forced to pay for their kids insurance under your plan. Where as its college graduates and those who are working who are incented to buy coverage under the ACA.
And since when is threatening to take away their kid’s funds for college if parents don’t buy an expensive insurance policy not coercion. The individual mandate is a lot less coercive than your plan. If you don’t comply with the ACA its cost a whopping $1000. Under your scenario families who did not buy an expensive policy would lose thousands of dollars in education funding for their kids. It could ruin their lives. You are truly totally out of touch with reality.
And only a Republican would think its ok to target poor and middle income people to pay for the problem, excluding the wealthy from the cost altogether.
There is absolutely no evidence forcing large states to adhere to the rules set up by insurance commissions in small states would reduce the cost of insurance. In fact it may cause the cost to the state to go up, as small states are more likely to allow weak insurance companies to operate within their boarders making bankruptcy by the company more likely. You can’t expect a state like California to have the same insurance rules, and reserve requirements as the state of Wyoming, where cows outnumber people. Not even big Republican states would agree to that.

CL July 24, 2014 at 7:54 am

Again, you can call me nuts all you want, but you are the one living in fantasy land about the system you are defending. You seem to think that dependent coverage is free. So under your precious Obamacare, their parents have to pay to carry these “kids” on their insurance until they are 26. And that is more expensive coverage. The WSJ has reported that 71% of employers raised dependents’ premium contributions in recent years because of the ACA requirements. Since you like anecdotes, my employer plan charges over $1,200 per month for full family. Children only coverage is, I believe, around $800 or $900 per month. That has gone up each year since ACA passed, by the way. And in my years of going to school, dependent coverage was way more expensive than just getting your own basic policy as a healthy 18 year old through the university.

“And since when is threatening to take away their kid’s funds for college if parents don’t buy an expensive insurance policy not coercion. The individual mandate is a lot less coercive than your plan.”

You do not even understand what the Constitutional objection is. The mandate is troublesome because there is no way to opt out. My mechanism is voluntary, in the way that block grants to states are voluntary. They are only “coercive” in the sense that if you offer enough just about any rational person will take it. But NO ONE HAS TO TAKE IT. And if the proposal makes someone reconsider getting themselves into a form of indentured servitude in the pursuit of a higher degree, since those loans can never be discharged in bankruptcy and can leave the prospects for 23 year old art history majors rather bleak.

Again I find it ironic that you sit on your high horse about targeting the powerless. ACA is premised upon taking one of the least economically and politically powerful groups, young people, and forcing them to disproportionately bear the burden for financing insurance to others. You think that is just dandy, but when I come up with a more effective mechanism for doing the same thing you start getting the vapors. Every person that would have to sign up for my proposal would already be forced to obtain insurance under ACA – yes even those poor you pretend to care about when you can use them as a cudgel against those who dare to disagree with you.

Do some quick math. ACA had 8 million sign ups, only 28% of which were in the target demographic. And all estimates are that there will still be tens of millions of uninsured Americans for the foreseeable future. My plan has a pool of around 15 million which forms a 2:1 ratio to the total uninsured population that ACA was supposedly intended to help. Not everyone will participate on either side of that ratio, but I have a lot of room to drop and still be able to blow the doors off of ACA’s participation rate (and thus its costs). That means the plans will be cheaper. How they compare precisely to the cost to add dependents to their parents plan will need actuarial study. But So for some it would probably go up, for others like those at my firm, they would probably go down.

Jan July 24, 2014 at 5:23 pm

Ok I’ll go with your crazy idea if we make it more fair.

My personal idea (I have not seen the latter part suggested anywhere else) to bypass the mandate is to create a risk pool of the chronically unisured and then draw in young healthy people into the pool by tying the receipt of any form of state license or permit to a requirement that the recipient purchase insurance through the government program. This would be a better mechanism than the IRS leveling penalties for ensuring actual participation, and it has the important benefit of being constitutional (since it is entirely voluntary to apply for a license or permit). This plan would dwarf Obamacare enrollment goals, and would not target lower income and middle class families to pay all the cost.

Way better than your plan, right? And totally not coercion or unconstitutional, right?

CL July 25, 2014 at 7:11 am

LOL. Take Con Law (or just a civics class on federalism) and get back to me when you understand the structural problem with your scenario. But then again, Justice Roberts seems open to just about anything you want to do in the guise of taxation, so maybe this could be a ground breaking area of legal jurisprudence. But not surprising that your instincts take you to a more sweeping and invasive plan that will not work as well. Sort of sums up your whole world view.

Tom July 22, 2014 at 5:30 pm

“There are a multitude of ways to tackle insurance cost”??? So what are they, how long would they take to work? If insurance cost subsidies are bad, why did Ryan propose them in is bid to kill Medicare?

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CL July 23, 2014 at 8:04 am

That is a lie about killing Medicare. Ryan proposed a reform you do not like. It takes a special kind of narcissism (which sadly seems to infect modern liberalism) to think only your ideas can be considered viable. The only thing that will kill Medicare is the status quo. The Obama administration has admitted that the long term path it is on is not sustainable. Ironically, given the silly claims in this thread that Republicans have no answers, it was Secretary Geitner who answered Ryan’s questions about unfunded entitlement liabilities with the following: “You are right to say we’re not coming before you today to say we have a definitive solution to that long-term problem. What we do know is, we don’t like yours.”

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Tom July 23, 2014 at 12:07 pm

First, replacing Medicare with vouchers for private insurance is killing Medicare. Medicare is guaranteed affordable health insurance. Ryan’s plan is not that and therefor is something other than Medicare. So yes his plan was to kill Medicare and replace it with something that would not guarantee you affordable health insurance.
Finally you did not answer the question. If subsidizing the cost of health insurance is so bad, why did Ryan propose it?
There are plenty of ways to work on Medicare and make it stable for the next 50 years without killing it. But Republicans are not interested in that. The want to cut taxes and they want to fund those cuts by eliminating Medicare benefits and replacing them with an ever decreasing voucher to subsidize the cost of private insurance. They want to go a route no other nation on earth has chosen. Leaving the care of old sick people to the whims of the private Insurance industry that does not want to insure them.

CL July 23, 2014 at 2:48 pm

First, no one under 55 (since those over 55 would have continued under the identical plan you falsely claim Ryan’s plan would kill) would have gotten a voucher under his most recent plan. Full stop. The only way to claim his plan would “kill” Medicare is if you claim any serious reform would be murder. His plan required that the private insurers include the current Medicare benefits levels. The competition came in how efficiently they could deliver those benefits and what additional benefits they would offer at the best price. The legitimate objections to the plan were in the annual increases, but then we are getting a long way from murder.

Second, when did I say subsidizing health care was per se bad? The mechanism is the key. Markets and competition historically trump command and control. You can structure subsidies (kind of like Ryan’s premium support plan) in a way that allows competition to take place.

Finally (and for the umpteenth time), no one was proposing ” Leaving the care of old sick people to the whims of the private Insurance industry that does not want to insure them.” Old people get Medicare, and no politician with any self-preservation instinct would try to kill it, even if they were so inclined. I understand wanting to avoid this reality, given how hard it is to defend ACA on the merits. Better to fight straw men.

Scooter July 22, 2014 at 7:58 pm

Jan, whey don’t we insure the world? I am sorry about your maid and her husband. but this country can’t take care of everything. Maybe, if we cut out some of the foreign aid and other entitlements, things could be better. You libs can’t have everything. I know that I can’t. Don’t tell me that we have no compassion as that is no so. You have to be practical.

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Jan July 24, 2014 at 6:10 pm

We are already paying for it, anyway. This just spreads the cost more. What don’t you understand about that?. People with insurance are paying for people without insurance through higher and higher insurance premiums.

Everyone is entitled to reasonable health care. It is an essential part of our right to life and the nation has an obligation to provide it for those who cannot afford it. It is amazing that the US, the first to recognize the inalienable right to life is the only first world nation to not guarantee reasonable health care to all its citizens.

This we can’t afford that is BS. Our taxes are at 50 year lows and we are close to running an annual surplus.

And it has nothing to do with your fantasy about people wanting the government to pay for cars. A typical Republican BS no Ideas answer. Right up there with the real Republican response which is “let them die” before you ask me to help.

Do I think you have compassion for people who are doing their best, working hard, and can’t afford insurance? No, I really don’t. I think you are fine with averting your eyes and leaving that problem to someone who gives a crap.

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GrandTango July 22, 2014 at 2:29 pm

Tax breaks for the non-payers (which is really just more welfare.)

Why do you Liberals and Liberal-Tarians never complain about that?

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Smirks July 22, 2014 at 2:47 pm

Maybe the non-payers can just come and beg in the comments section for health care. You know, just like you come here to beg for visitors to your blog.

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Tom July 22, 2014 at 3:06 pm

I complain about tax brakes for takers alt the time, like Exxon, Halliburton, Mitt Romney, Mark Sanford, Boeing, the Pharmaceutical industry, you, etc. etc.

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Medicaid July 22, 2014 at 3:53 pm

You’ll be fine, daddio.

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Scooter July 22, 2014 at 8:11 pm

Because they are the takers.

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eewwwwwwwww July 22, 2014 at 3:46 pm

Major blow to Lindsey Graham’s butt fuck buddy.

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Sandy Burglar July 22, 2014 at 4:34 pm

No worries from this lawless bunch however. You statists, central planners and welfare kings (and queens) won’t have to wait long before Barry Soetoro just re-writes the law, as he’s unconstitutionally done multiple times now, to make sure everybody has “subsidized” health care. And to make sure it helps them in the next election, which is what this “law” is really all about.

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Scooter July 22, 2014 at 8:14 pm

That is all that it is about. Pandering to the masses for their votes. Hunker down and give them heck.

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cuvinny July 22, 2014 at 5:50 pm

The 4th Circuit Court unanimously ruled on this same issue today and said the bill stands. Also the DC ruling will need to go before all the judges instead of just 3 where it will also probably be ruled legal. As for the Supreme Court, who knows but I kind doubt they will review a ambiguous sentence in a huge bill. In the past such ambiguity has been for the executive branch to decide.

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Thomas July 22, 2014 at 5:58 pm

What’s for dinner?

“If I ask for pizza from Pizza Hut for lunch but clarify that I would be fine with a pizza from Domino’s, and I then specify that I want ham and pepperoni on my pizza from Pizza Hut, my friend who returns from Domino’s with a ham and pepperoni pizza has still complied with a literal construction of my lunch order…”-Senior Judge Andre Davis, 4th Circuit, concurring

Brilliant legal mind Davis has (not)…LoL

The IRS in 2012, two years after the Patient Protection and Affordable Care Act was signed into law, wrote a rule saying “regardless of whether the exchange is established and operated by a state” thus authorizing premium subsidies in states without federal exchanges is in fact unconstitutional violating the 9th and 10th amendments.

I will put it this way:

If Barry Soetero was born a mullato with XY chromosomes and Michael Robinson was born with XY chromosomes, then changing their names and acting out sexually as wash women does not make them XX chromosome females. Even though the Supreme Court says they can get special rights that are endowed for XY and XX couples in matrimony, they still put their schlongs into an exit, not an entrance.

Right?

Typical quality news analysis you will never find at SC Political Digest

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Thomas July 22, 2014 at 6:17 pm

BTW, wipe the Whip Creme off your faces. The D.C. Court is neither XY or XX, rather it is a shape shifting reptile. They decide if their cases go to the Supreme Court. The nuclear option Majority Reid detonated last winter packed three sObamites to the D.C. Court without the advice and consent of the Senate. Was the 4th’s ruling the ringer? Is the fix in? I say yes…the subsidies will remain…unless…to be continued.

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TSIB July 22, 2014 at 7:58 pm

“blah blah blah thus authorizing premium subsidies in states without federal exchanges is in fact unconstitutional violating the 9th and 10th amendments. blah blah blah stupid schlong joke blah blah”

Yeah, no.

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RHood2 July 22, 2014 at 7:25 pm

It was upheld unanimously in a three-judge panel in another circuit. Supremes will almost have to take it. Take ’em both and resolve the issue. Though it has not done that on some issues.

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