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Healthcare Bill Part III; Obamacare
Topic Started: Mar 3 2014, 02:20 PM (48,573 Views)
kbp

I'm amazed that the talking points still directly conflict with the case the administration's attorneys have presented to the courts. It is so weak that she makes statements that conflict with the law as she handles it!
Quote:
 

http://www.cnsnews.com/news/article/susan-jones/burwell-we-are-implementing-obamacare-it-was-intended

Burwell: 'We Are Implementing' Obamacare 'As It was Intended'

Two days after President Obama said laws should be interpreted based on their intent, Health and Human Services Secretary told Congress the Obama administration is implementing Obamacare "as it was intended."

The administration says everyone who qualifies should get federal tax-credit subsidies, regardless of whether they purchased their health insurance on the federal or state exchanges. The law, as written, says that only exchanges "established by the State" may offer subsidized health insurance. The Supreme Court ruling will come this month.

"I think you know we believe that we are implementing the law as it was written, as the statute is written -- as it was intended, as CBO (Congressional Budget Office) has scored it for all these years, as recent articles have reflected that those who were part of writing the law indicate it should be," Burwell told the House Ways and Means Committee on Wednesday.

"The idea that citizens in the State of New York should receive federal subsidies that taxpayers contribute to and citizens in the State of Texas should not is not what we think the law intended," she added. New York established its own exchange, while Texas let the federal government do it.....
Where do you start???

If they (she) "are implementing the ...statute is written -- as it was intended," then why did the law allow states like New York to decide to participate with Medicaid expansion while states like Texas would not?

Was the intent of Congress to evenly provide health care for ALL those within 100-400% of the poverty level, as Congress allowed states to determine if those under 100% of the poverty level received the FREE health care?

What changed the "INTENDED" outcome here as Congress was writing the statute?
.
Edited by kbp, Jun 12 2015, 08:47 AM.
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Baldo
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This article about the TPP is much more than this snippet but this applies to Medicines

Business Leaders React With Dismay to Defeat of Trade Bill

....concerns that the pact could limit access to generic drugs, noting that the overwhelming majority of prescriptions filled in the United States were for generic medications, despite strong intellectual property laws in this country.

Generic drug industry officials hailed the vote, however.Heather Bresch, the chief executive of Mylan, a generic drug maker, applauded the defeat on Friday by the House, saying it would give her more time to lobby against the trade pact. She and other leaders in the generic drug industry have argued that the pact goes too far in protecting the patents of the brand-name drug industry and would block access to generic drugs around the world.

“I think it’s scary and dangerous that the president is looking for this kind of authority on a trade bill that I think has serious flaws in it,” she said. “It’s setting the global generic industry back 30 years.”...snipped

http://www.nytimes.com/2015/06/13/business/business-leaders-react-with-dismay-to-defeat-of-trade-bill.html?_r=0


It's DC and money talks to both partys
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kbp

Baldo
Jun 13 2015, 11:05 AM
This article about the TPP is much more than this snippet but this applies to Medicines

Business Leaders React With Dismay to Defeat of Trade Bill

....concerns that the pact could limit access to generic drugs, noting that the overwhelming majority of prescriptions filled in the United States were for generic medications, despite strong intellectual property laws in this country.

Generic drug industry officials hailed the vote, however.Heather Bresch, the chief executive of Mylan, a generic drug maker, applauded the defeat on Friday by the House, saying it would give her more time to lobby against the trade pact. She and other leaders in the generic drug industry have argued that the pact goes too far in protecting the patents of the brand-name drug industry and would block access to generic drugs around the world.

“I think it’s scary and dangerous that the president is looking for this kind of authority on a trade bill that I think has serious flaws in it,” she said. “It’s setting the global generic industry back 30 years.”...snipped

http://www.nytimes.com/2015/06/13/business/business-leaders-react-with-dismay-to-defeat-of-trade-bill.html?_r=0


It's DC and money talks to both partys
...it would give her more time to lobby against the trade pact

Limiting knowledge of WTH was in the proposed laws probably involved an effort to delay or avoid such lobbying.
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Baldo
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Meredith Whitney's Interview by Steve Forbes On The Future Of Muni Bonds has many nuggets in it

Forbes: Obamacare. What’s that going to do to states’ finances?

Whitney: It’s an interesting question because it’s a what Obamacare does is and what it’s doing now is it’s luring the governors in by saying, “We’re going to give you this great, new, fancy car. Don’t make payments for two years. And then in two years then, you’re going to pick up the payments.”

Forbes: Sounds like a subprime mortgage.

Whitney: It’s exactly sounds like a subprime mortgage. So who really would say no to that. And you’re finding some governors say, “Absolutely we’re not going to get caught into this cliff effect which it becomes.” And other governors I think governors who have surprised me have done it. Saying, “Yeah, yeah, we can take it. We can take that balloon payment in two years.” And it’s going to be really difficult. I think it’s going to be a big problem for the system....snipped

http://www.forbes.com/sites/steveforbes/2013/06/04/meredith-whitney-on-the-future-of-muni-bonds/3/

Too often the Obamacare debate was concentrated on services, plans, etc.

But what it is going to do to the States' finances may be the biggest problem
Edited by Baldo, Jun 14 2015, 03:27 PM.
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kbp

Lots of headlines predicting hints at how SCOTUS will rule. Most are hoping Kennedy may be worried about what would happen to states blah blah blah.

Of course if that happens, it would mean Kennedy decided to ignore the law as it is written, as he has mentioned, and go along with the 'better outcome' provided thru a RE-write of the law by an agency of the government.

Most pro-Obamacare reporters fail to mention that fact.

I do need to be ready for some detailed reading if they decide to keep it as is!
.
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kbp

A very good column...

http://www.yalejreg.com/blog/king-v-burwell-a-potential-gift-to-tax-lawyers-by-andy-grewal

King v. Burwell:A Potential Gift to Tax Lawyers?
by Andy Grewal

JREG Notice and Comment - Thursday, June 11, 2015

  • “If there are any tax attorneys in the courtroom today, I think they probably wrote down what you just said.”
    Justice Alito, referring to Solicitor General Verrilli’s comments on the legislative grace canon
.

* * *

In a few weeks, we can expect the long-anticipated Supreme Court ruling in King v. Burwell. Much of the ensuing media coverage will focus on the ultimate holding: Do you get tax credits when you buy a policy on Healthcare.gov? But the Supreme Court’s method of reasoning, and not only its holding, may have significant implications for the tax system.

In King v. Burwell, one lurking issue relates to the Court’s handling of the so-called “legislative grace” canon of statutory construction. Under that canon, courts usually put a thumb on the scales against taxpayers when they claim tax benefits, concluding that Congress only reluctantly provides those benefits. Taxpayers must thus clearly establish their right to a credit or deduction, and tax benefits may not be inferred.

King v. Burwell reflects an interesting flip-flop. That is, the IRS, and not the taxpayers, argues that Section 36B should be read expansively. The government believes that Section 36B’s seemingly clear language, referring to credits for policies purchased on an Exchange “established by the State,” should be broadened by nontax statutes, like Section 1321 of the ACA.

This type of argument would be risky for a taxpayer to make. Courts actively employing the legislative grace canon are already hostile when something in the tax code itself supports the taxpayer’s position, and relying on a nontax statute would present additional dangers. Showing that a tax benefit comes implicitly via a nontax statute usually seems almost impossible, even if the nontax statute is part of the same Act as the tax provision.

If the Court finds for the government in King v. Burwell, it could be in the awkward position of dismissing the legislative grace canon while supporting a pro-taxpayer outcome. At oral arguments, there was an interesting exchange on this point, which I’ve edited down to focus on the relevant parts:

  • JUSTICE KENNEDY: (I)t seems to me our cases say that if the Internal Revenue Service is going to allow deductions . . . it has to be very, very clear.

    GENERAL VERRILLI: Your Honor raised this point about the need for clarity in a tax deduction. [T]here is a learned treatise that describes that as a false notion.

    JUSTICE ALITO: If there are any tax attorneys in the courtroom today, I think probably they wrote down what you just said. When we get future tax cases, the United States is going to argue that . . . there should be no presumption that a tax credit is [not] provided by that statute.

Justices Kennedy and Alito, at least, seem interested in addressing the relationship between the government’s arguments and the legislative grace canon. Because Justice Kennedy is likely to be in the majority, regardless of how the case turns out, this increases the chance that the controlling opinion will address the canon. If the Court holds against the government, the IRS might have received a taste of its own medicine -- the Court might use the legislative grace canon to reject the government’s preferred position. But even if the Court holds for the government, it might explain why the legislative grace canon does not apply and it would therefore weaken the canon, hurting the IRS in future litigation.

The government’s merits brief offers a potential way out, but its approach doesn’t make much sense. At Page 58, the government argues that the legislative grace canon should not apply to Section 36B because a narrow reading of that statute would limit tax obligations under other statutes, like Sections 4980H and 5000A, relating to employer and individual penalties. In other words, the challengers’ reading would be consistent with construing benefit-granting provisions narrowly, but only insofar as Section 36B was concerned. Their reading would lead to reduced tax collections under other statutes and the canon should not apply.

But the government’s argument, if accepted, would eviscerate the legislative grace canon. Almost any time the IRS offers a narrow construction of a tax provision, some taxpayers will actually benefit. (I’ll leave the details to a footnote.)* Consequently, if a taxpayer can avoid the legislative grace canon by using the same device that the government uses -- that is, by arguing that a favored interpretation would lead to mixed results -- any good tax lawyer will be able to slay the canon.

As I’ve previously noted, I have no objections to the slaying of the legislative grace canon. Scalia & Garner, in Section 63 of their treatise on statutory interpretation, nicely explain how that canon has been stretched beyond its modest origins and has essentially become a tool to inappropriately load the dice against taxpayers. As much fun as it might be to see the canon thrown back in the IRS’s face, I don’t want the canon to be used to hold for the challengers. I’d rather the Court discard it entirely, and reach its result in King v. Burwell based on its good faith reading of all relevant statutes.

I don’t suspect, however, that the Court will definitively address the legislative grace canon in King v. Burwell. The current Justices seem quite adept at deferring on issues, and I don’t expect any broad statements on the canon’s validity. Nonetheless, the end-of-term cases, with their various concurrences or dissents, seem to address far more issues than the rifle-shot opinions we see issued early in the Term. Consequently, we might see a substantive footnote in a majority opinion or possibly some lengthy commentary in a secondary opinion.

Tax lawyers should follow Justice Alito’s advice and pay close attention here. They may find something to rebut the IRS’s aggressive invocation of the canon in other contexts.


By Andy Grewal

*Consider, for example, the tax treatment of expenses. Taxpayers usually prefer to deduct an expense rather than capitalize it, and the IRS thus frequently argues that deduction-granting provisions must be construed narrowly. But some taxpayers would benefit from capitalization. They may be in a low tax bracket in the year of any allowable deduction or might otherwise be unable to use the deduction. They might thus prefer that an amount be capitalized such that gains in some future year would be reduced. In other words, it’s not always the case that deduction is preferable to capitalization, and a narrow reading of Section 162 might actually benefit some taxpayers.
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kbp

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http://www.politico.com/story/2015/06/gop-rife-with-tensions-over-obamacare-scotus-response-119040.html

GOP rife with tensions over Obamacare-SCOTUS response

The Republican senators running for president could stymie the party’s response to an anti-Obamacare ruling.


Senior Republicans who are worried they’ll be blamed for killing health insurance for millions of Americans have been busy assembling a range of options if the Supreme Court strikes down the law’s subsidies in 34 states.

But the GOP senators running for president — starting but not ending with firebrand Ted Cruz — threaten to stymie their leaders’ carefully hatched plans. Any whiff that the GOP’s Plan B is a continuation of Obamacare is bound to spark furious protests from the conservative base, putting pressure on the presidential hopefuls to respond. Cruz, for one, would press for a wholesale repeal of the law — or to allow states to opt out of Obamacare — if the high court provides the opening.

“Things can’t be turned on a dime,” said Senate Majority Whip John Cornyn of Texas. “People can run for president, but we’ve actually got to solve a problem.”

[...]
A "problem" we must solve?

Who wrote the solution law in the first place?

We do see some advantage from the timing of the ruling happening when the Rep's are running in the primary.

On another issue... It may not have much to do with how SCOTUS will rule, but lately the pro-Obamacare media has just about entirely avoided the argument that the law supports the subsidies. They're stuck arguing what is the right way to do it or some off-hand precedent that should force the Justices to allow the text of the law to be ignored for the greater good.

.
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LTC8K6
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Assistant to The Devil Himself
And now Barry and Michelle have banned trans fats altogether...

Getting rid of most of them voluntarily apparently wasn't enough...

Have we gotten a lot healthier in the years since trans fats were drastically reduced?

https://www.yahoo.com/food/obama-administration-cracking-down-on-trans-fats-121670950811.html
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Baldo
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Feds Can’t Verify $2.8 Billion in Obamacare Subsidies
CMS does not know if subsidies went to ‘confirmed enrollees, in the correct amounts’


The federal government cannot verify nearly $3 billion in subsidies distributed through Obamacare, putting significant taxpayer funding “at risk,” according to a new audit report.

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) released an audit Tuesday finding that the agency did not have an internal system to ensure that subsidies went to the right enrollees, or in the correct amounts.

“[The Centers for Medicare and Medicaid Services] CMS’s internal controls did not effectively ensure the accuracy of nearly $2.8 billion in aggregate financial assistance payments made to insurance companies under the Affordable Care Act during the first four months that these payments were made,” the OIG said.

“CMS’s system of internal controls could not ensure that CMS made correct financial assistance payments,” they said.

The OIG reviewed subsidies paid to insurance companies between January and April 2014. The audit found that CMS did not have a process to “prevent or detect any possible substantial errors” in subsidy payments...snipped

http://freebeacon.com/issues/feds-cant-verify-2-8-billion-in-obamacare-subsidies/

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chatham
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LTC8K6
Jun 16 2015, 10:40 AM
And now Barry and Michelle have banned trans fats altogether...

Getting rid of most of them voluntarily apparently wasn't enough...

Have we gotten a lot healthier in the years since trans fats were drastically reduced?

https://www.yahoo.com/food/obama-administration-cracking-down-on-trans-fats-121670950811.html
Unfortunately it took so long for trans fats to express their problems. It will take at least a generation to find out if doing away with them helps people's health.

Animal studies suggest it will help by doing away with trans fats. But then again cancer has been cured many times using animal studies.

Trans fats are like plastic. They do not just go from mouth to poop. They are incorporated into ones cells and alter normal function.
Edited by chatham, Jun 16 2015, 03:49 PM.
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kbp

Baldo
Jun 16 2015, 02:26 PM
Feds Can’t Verify $2.8 Billion in Obamacare Subsidies
CMS does not know if subsidies went to ‘confirmed enrollees, in the correct amounts’


The federal government cannot verify nearly $3 billion in subsidies distributed through Obamacare, putting significant taxpayer funding “at risk,” according to a new audit report.

The Department of Health and Human Services (HHS) Office of Inspector General (OIG) released an audit Tuesday finding that the agency did not have an internal system to ensure that subsidies went to the right enrollees, or in the correct amounts.

“[The Centers for Medicare and Medicaid Services] CMS’s internal controls did not effectively ensure the accuracy of nearly $2.8 billion in aggregate financial assistance payments made to insurance companies under the Affordable Care Act during the first four months that these payments were made,” the OIG said.

“CMS’s system of internal controls could not ensure that CMS made correct financial assistance payments,” they said.

The OIG reviewed subsidies paid to insurance companies between January and April 2014. The audit found that CMS did not have a process to “prevent or detect any possible substantial errors” in subsidy payments...snipped

http://freebeacon.com/issues/feds-cant-verify-2-8-billion-in-obamacare-subsidies/

The $1.8 trillion trust system!
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LTC8K6
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Assistant to The Devil Himself
chatham
Jun 16 2015, 03:48 PM
LTC8K6
Jun 16 2015, 10:40 AM
And now Barry and Michelle have banned trans fats altogether...

Getting rid of most of them voluntarily apparently wasn't enough...

Have we gotten a lot healthier in the years since trans fats were drastically reduced?

https://www.yahoo.com/food/obama-administration-cracking-down-on-trans-fats-121670950811.html
Unfortunately it took so long for trans fats to express their problems. It will take at least a generation to find out if doing away with them helps people's health.

Animal studies suggest it will help by doing away with trans fats. But then again cancer has been cured many times using animal studies.

Trans fats are like plastic. They do not just go from mouth to poop. They are incorporated into ones cells and alter normal function.
Well, Oreo cookies were never any good to me when the recipe was changed.

I'll never forgive them for that. :)

Thank goodness they can't ban the natural trans fats.

The tendency to use palm oil as a substitute is probably the next target.

The government should just inform, not regulate.

Chik-fil-a voluntarily went trans fat free in 2007, for example. It certainly didn't do their business any harm.
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kbp

http://www.cato.org/blog/more-bad-news-obamacare-enrollees-see-little-benefit-medicaid-expansion

More Bad News for ObamaCare: Enrollees See Little Benefit from Medicaid Expansion
By Michael F. Cannon

As President Obama gears up to deliver a major address on the supposed successes of the Affordable Care Act, a study by one of the nation’s top health economists is pouring cold water on the ACA’s main engine for expanding health-insurance coverage: its expansion of Medicaid to cover able-bodied, childless adults.

MIT’s Amy Finkelstein has won a slew of awards, including the prestigious John Bates Clark Medal, for her work in health economics. In “The Value of Medicaid: Interpreting Results from the Oregon Health Insurance Experiment,” Finkelstein, Nathaniel Hendren, and Erzo Luttmer, used various econometric methods to quantify the benefits that enrollees receive from Medicaid. They drew from the Oregon Health Insurance Experiment, on which Finkelstein was a lead investigator.

The trio found that Medicaid enrollees receive very little benefit from each dollar spent on Medicaid. The absolute minimum enrollees receive is 15 cents of benefit per dollar spent. The authors’ best guess is that enrollees receive somewhere around 20-40 cents of benefit per dollar spent. The maximum is 90 cents–that is, no matter how the authors sliced the data, Medicaid’s costs exceed the benefits to enrollees. If the government just gave enrollees the money, Medicaid is such a bad deal that enrollees would not buy Medicaid coverage with it.

Medicaid spends, non-enrollees receive about 60 cents of benefit. The authors don’t identify who Medicaid’s real beneficiaries are, but they likely include those who receive Medicaid subsidies (hospitals, insurance companies, pharmaceutical companies, doctors, device manufacturers) and people who would otherwise make charitable contributions to provide medical care to enrollees. In other words, Medicaid’s actual beneficiaries are different from its intended beneficiaries.

That’s something to keep in mind when President Obama says, “There are outcomes we can calculate” like “the number of newly insured families” and that “those numbers add up to success.”
Edited by kbp, Jun 16 2015, 10:22 PM.
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kbp

Quote:
 
http://www.philly.com/philly/health/20150616_HHS_conditionally_approves_insurance_exchanges_in_Pa___Del_.html

HHS conditionally approves insurance exchanges in Pa., Del.


The Obama administration on Monday gave Pennsylvania and Delaware a head start in the scramble to save residents from losing health insurance coverage, the possible result of a U.S. Supreme Court ruling expected this month.

The action - conditional approval to establish state-based insurance marketplaces - moves forward both states' efforts to preserve health insurance subsidies for their citizens.

Pennsylvania Insurance Commissioner Teresa Miller described it as a "contingency plan" with the potential to help more than 300,000 residents who had bought subsidized insurance. The plan was "put together to protect these consumers," Miller said earlier in the day.

[...]

Pennsylvania is the only state that replaced a Republican governor with a Democrat last year, and Gov. Wolf decided that a state-based marketplace would be the best way to proceed, officials said.

Delaware has been under Democratic control but is such a small state that rather than run its own exchange, it opted for a "partnership" with the federal government that would likely not qualify for subsidies if the Supreme Court were to rule against preserving them for states without their own exchanges.

Both states met the June 1 deadline to submit applications for exchanges this year. The Department of Health and Human Services had until Monday to respond. HHS Secretary Sylvia M. Burwell sent letters to the governors of each state granting conditional approval, which is just one step in a lengthy process.

Among other things, legislative approval will likely be required. Republicans in Harrisburg have kept their distance from the proposal, saying there was no reason to act until the Supreme Court ruled.

Though huge federal grants were given to set up state exchanges early on, that money no longer is available.

Wolf administration officials have said they expect to be able to rely on the existing federal technology. Funding would come from the same assessment on insurance plans that currently goes to the federal exchange.

"I'm pretty optimistic even though I'm preparing for the worst," Miller said. "Pennsylvania is going to be in a great position to transition quickly."
Not too promising of a result, just 2 states.

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kbp

http://www.yalejreg.com/blog/did-the-irs-already-admit-defeat-in-king-v-burwell-by-andy-grewal

Did the IRS Already Admit Defeat in King v. Burwell?

In researching Section 4980H assessable payments, commonly referred to as the ACA employer penalty, I came across some potentially significant statements in IRS Notice 2011-36, dated May 23, 2011. The Notice, which reflects an official statement of the IRS, solicits public comments related to regulations under Section 4980H.

In describing the statutory scheme, the IRS seemed to acknowledge that Section 36B premium tax credits and Section 4980H penalties are allowed or assessed only for policies purchased on exchanges established and operated by the States, and not for the Federally-facilitated exchanges (the i>King v. Burwell issue). Specifically, the IRS referred to “premium tax credits to assist individuals in purchasing coverage through State Exchanges.” The IRS also contemplated that a penalty applies to employers when an employee obtains “health insurance through a State Exchange.” The reference to only State Exchanges seems consistent with the arguments of the challengers in King v. Burwell, who argue that credits and penalties do not apply for purchases on Federally-facilitated Exchanges.

[...]
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