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http://www.politico.com/story/2015/02/face-of-supreme-court-case-hates-obamacare-and-obama-too-114953.html

Face of Supreme Court case hates Obama, Obamacare

The man who could cripple Obamacare isn’t shy about telling the world that he thinks the president is an “idiot,” posting altered images of the first lady in Middle Eastern clothing and expressing his hatred for the “Democraps” who enacted the health care law.

David M.King, 64, is the lead plaintiff on the Supreme Court case that challenges the government’s right to grant tax subsidies to millions of Americans in certain states to make health insurance more affordable.....

wingedwheel

Feb 7 2015, 11:29 AM

The intent argument immediately falls on it's face just by reading the name of the bill. The Affordable Care Act has driven up costs not made healthcare affordable. The fact is that this is a bad bill. They pulled shenanigans to pass it. They wrote exchange part they way they did so it would score better. They never thought any state would say no to forming their own exchange. If they wouldn't have pulled shenanigans to pass this bill maybe the language in the bill wouldn't have been so bad. Maybe they could have made the bill more palatable to republicans. If republicans would have signed on to this bill they would have been more apt to fix the bad language in the bill.

The bill should stand as written. Any change to this bill should be done by congress. Not by executive order or by the courts.

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http://www.nytimes.com/2015/02/08/sunday-review/insured-but-not-covered.html

Insured, but Not Covered

[...]

The Affordable Care Act has ushered in an era of complex new health insurance products featuring legions of out-of-pocket coinsurance fees, high deductibles and narrow provider networks. Though commercial insurers had already begun to shift toward such policies, the health care law gave them added legitimacy and has vastly accelerated the trend, experts say.

The theory behind the policies is that patients should bear more financial risk so they will be more conscious and cautious about health care spending. But some experts say the new policies have also left many Americans scrambling to track expenses from a multitude of sources — such as separate deductibles for network and non-network care, or payments for drugs on an insurer’s ever-changing list of drugs that require high co-pays or are not covered at all.

[...]

It is true that the Affordable Care Act has erased some of the more egregious practices of the American health insurance system that left patients bankrupt or losing homes to pay bills. Insurers can no longer deny coverage to those with pre-existing conditions, for example. And the new policies cap out-of-pocket spending so long as the patient receives care within the plan. Most important, the act has offered health insurance to an estimated 10 million Americans who did not have any, often by expanding Medicaid or providing subsidies.

But by endorsing and expanding the complex new policies promoted by the health care industry, the law may in some ways be undermining its signature promise: health care that is accessible and affordable for all.

[...]

A study by the Commonwealth Fund this month found that the rise in health insurance premiums in employer-based plans had slowed in 31 states since the passage of the Affordable Care Act (good news, right?). But premiums were still rising faster than median incomes (hmm). More important, perhaps, the researchers found that patients were paying more in health care expenses than ever before, during a time of stagnant wages (not so great). In fact, nearly 10 percent of median household income now goes to pay premiums and deductibles, the study found. And that does not include other kinds of health payments that patients now encounter, such as co-pays and uncovered drugs or services.

A recent New York Times/CBS poll found that 46 percent of Americans said they had trouble affording health care, up 10 percentage points in just one year. Some of the cost problems may ease as patients — now known as health care consumers — learn what to expect and how to choose and navigate their plans.

But other problems may be related to the process by which the plans are created. Under the Affordable Care Act each state was asked to select a benchmark plan as its standard. It had to cover certain “essential health benefits” like maternity care and prescription drugs; it had to have a defined actuarial value depending on the level of plan. Silver plans, for example, had to cover 70 percent of charges, leaving consumers with 30 percent. But within those parameters, competing insurers had leeway to set premiums, co-payments and deductibles, and to create networks by negotiating with doctors and hospitals. Naturally, they created policies that met the core criteria while minimizing their financial risk.

Suddenly there were hundreds of new insurance products that had never been tested in real time. Their shortcomings are now playing out in various ways.

[...]

• 
  
• “It’s been so long since we’ve done a budget nobody can remember how."
  Senator John Boozman - Arkansas (Rep)

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What if I already have other coverage?
If you have coverage through another job, another person’s job, Medicare, Medicaid, the Department of Veterans Affairs (VA), the Indian Health Service, TRICARE, coverage sold through the individual market, or other minimum essential coverage, you don’t need SHOP coverage.

Can I enroll my dependent in SHOP coverage if I have other health insurance?
A dependent can’t enroll in the SHOP Marketplace without an employee enrolling. When coverage is offered, employees and their dependents must enroll in the same plan.

LTC8K6

Feb 9 2015, 11:02 AM

Okay, so we are now having to switch to SHOP coverage, which means I have to get a Healthcare.gov account. Foo!

snip

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http://kaiserhealthnews.org/news/unitedhealthcares-efforts-to-join-california-marketplace-meet-resistance/

UnitedHealthcare’s Efforts To Join California Marketplace Meet Resistance

UnitedHealthcare can’t have its cake and eat it too. That’s the message from the California health insurance marketplace, which turned aside a request from the nation’s largest health insurer to sell statewide on the exchange because it opted not to join when the effort was getting off the ground in 2014.

California is one of a handful of states that adopted policies to encourage insurers to participate in the marketplace by creating waiting periods of up to three years if insurers didn’t participate the first year. Among the others is New York, Oregon, Colorado and New Mexico, according to a study conducted by researchers at Georgetown University for the Commonwealth Fund.

• 
  
• “I think it helps the willingness of carriers to participate over the long haul if they think there’s a level playing field, and it’s good for consumers if the exchange is managing competition and has rules of the road to abide by.”
  Sabrina Corlette, project director at Georgetown University’s Center on Health Insurance Reforms.
  

Last month, California modified its position. Marketplace officials, who had originally said insurers could be locked out for three years if they didn’t join the marketplace in 2014, announced that some insurers — including UnitedHealthcare — could apply to sell in 2016, but only in a few areas that had a shortage of carriers.

[...]

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http://talkingpointsmemo.com/dc/anthony-kennedy-king-burwell-obamacare

How Obamacare Supporters Are Plotting To Win Over Anthony Kennedy

Of the many pro-Obamacare arguments that government lawyers are making to save the law from the Supreme Court, one stands out as particularly tailored to winning the crucial vote of Justice Anthony Kennedy.

The argument is about federalism, long a guiding light for the Reagan-appointed jurist whose vote both sides are working to win in King v. Burwell, a case before the Court that threatens to blow a hole in Obamacare.

"There's no question that Justice Kennedy regards federalism as a central value in the Constitution," Michael C. Dorf, a law professor at Cornell University and former clerk for the justice, told TPM in an email. "Accordingly, he typically votes to sustain challenges to very expansive views of federal power."

Specifically, the law's defenders say it would violate states' rights for Obamacare to deny subsidies for residents of some three-dozen states without a clear warning. Nowhere in the law were states told that eligibility for premium tax credits would hinge on them setting up state-run exchanges, as opposed to letting the federal government handle it.

The states' rights argument — unusual in this instance because it is typically used against the federal government, not in defense of it — was made in a brief filed by 23 attorneys general in states ranging from California and New York to North Dakota and North Carolina.

The AGs wrote that the challengers' view would "violate basic principles of cooperative federalism by surprising the States with a dramatic hidden consequence of their Exchange election." They continued, "Every State engaged in extensive deliberations to select the Exchange best suited to its needs. None had reason to believe that choosing a federally-facilitated Exchange would alter so fundamental a feature of the ACA as the availability of tax credits. Nothing in the ACA provided clear notice of that risk, and retroactively imposing such a new condition now would upend the bargain the States thought they had struck."

The Obama administration's brief makes a similar point, arguing that overturning the IRS rule on subsidies would disrespect "State sovereignty."

"It would be astonishing if Congress had buried a critically important statewide bar to the subsidies under this landmark legislation in subclauses setting forth the technical formula for calculating how much the subsidy should be," the brief, led by Solicitor General Donald Verrilli, said. "The Act should be interpreted to avoid the disrespect for State sovereignty inherent in petitioners' reading."

The conservative challengers know what the Obama administration and its allies are up to, but they say the strategy won't work.

"These arguments are likely aimed at Kennedy (and, to a lesser degree, [Chief Justice John] Roberts), but they involve significant risks to the government," Jonathan Adler, an architect of the legal challenge in King, said in an email. "In my view, states were on notice because the text of the statute is clear. Insofar as states were caught off guard it is because of what they were being told by the federal government, including by the IRS in its regulation."

The challengers allude to states' rights as well in their brief, but their task is harder because a victory for their side would likely be damaging to many states. They argue, "Under the Constitution’s core federalism constraints ... Congress cannot compel sovereign states to create Exchanges." They contend that the law's authors used "carrots" and "sticks" to entice states to set up exchanges, but many refused, as is their right.

In a separate brief, Oklahoma sides with the conservative opponents of Obamacare and says its argument against the tax subsidies is consistent with states' rights.

"Congress's conditioning of the tax credits came as no surprise to the States," wrote Oklahoma's attorney general and solicitor general. "First ... such incentivizing is the norm in cooperative federalism programs. Second, the plain text of Section 36B plainly described the incentive, and other sections of the Act plainly describe the consequences of declining to accept the incentive."

Three former Kennedy clerks — Dorf, Orin Kerr, and Chris Walker — told TPM they weren't sure if the federalism arguments would determine the justice's decision in the case.

Kennedy voted to wipe out Obamacare entirely in 2012, when the Supreme Court heard a constitutional argument against the individual mandate to buy insurance. The new case involves a narrower question of how the language of the law should be read with regard to subsidy eligibility. Oral arguments are set for March 4, and a decision is expected by the end of June.

With the stakes so high, Obamacare legal defenders believe it's worth appealing to Kennedy, and at least some experts believe it will pay off.

"The clear notice objection presented by state officials is the argument most likely to persuade Kennedy and the Court to uphold the IRS interpretation," Frank Colucci, a professor who wrote a book analyzing Kennedy's jurisprudence, told The Washington Post's Greg Sargent. "When the federal government places conditions on funding and programs it offers to states, the Court requires the conditions be expressed unambiguously."

• 
  
• ... The AGs wrote that the challengers' view would "violate basic principles of cooperative federalism by surprising the States with a dramatic hidden consequence of their Exchange election. ... None had reason to believe that choosing a federally-facilitated Exchange would alter so fundamental a feature of the ACA as the availability of tax credits. Nothing in the ACA provided clear notice of that risk ... It would be astonishing if Congress had buried a critically important statewide bar to the subsidies under this landmark legislation in subclauses setting forth the technical formula for calculating how much the subsidy should be ... The Act should be interpreted to avoid the disrespect for State sovereignty inherent in petitioners' reading."

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http://benjaminrushinstitute.org/preparing-for-king-v-burwell/

Preparing for King v. Burwell

[...]

What is most troubling about the legal challenge is how woefully uninformed the public is about the case. A recent Kaiser Health tracking poll shows that 56 percent of Americans says they have heard nothing about the case, and only 5% say they’ve heard “a lot” about the case. This means that many ObamaCare enrollees are likely unaware of the possibility they may lose subsidies. As John Graham recently noted at The Hill, HHS has yet to warn the ObamaCare’s

enrollees of this imminent threat or to inform the public of a contingency plan, should the court rule in favor of the plaintiffs. In an interview with Greg Sargeant of the Washington Post, Laurence Tribe, professor of constitutional law at Harvard, speculates that this may play into Chief Justice Roberts vote that could swing the court’s final ruling. Tribe muses that Justice Roberts decision could be “driven by the institutional damage that would be done to the Court if people saw it [a ruling for the plaintiffs] as pulling the rug out from under both individuals and states without fair warning.”

[...]

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http://www.breitbart.com/big-government/2015/02/11/obama-lectures-staples-for-limiting-part-time-hours-shame-on-them/

Obama Lectures Staples For Limiting Part Time Hours: ’Shame on Them’