| Healthcare Bill Part III; Obamacare | |
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| Tweet Topic Started: Mar 3 2014, 02:20 PM (48,678 Views) | |
| kbp | Apr 15 2014, 02:24 PM Post #406 |
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The case I'm hoping will solve the problem, and Tony Soprano adds his two cents! http://www.nationalreview.com/bench-memos/375691/halbig-v-sebelius-making-states-offer-they-cant-refuse-jonathan-keim Halbig v. Sebelius: Making States an Offer They Can’t Refuse By Jonathan Keim The IRS and its defenders in Halbig v. Sebelius, one of several cases challenging IRS’s interpretation of the Affordable Care Act, have raised questions about whether Congress really meant to deny tax subsidies to taxpayers if their states didn’t set up insurance exchanges. As we shall see, this was one of several mechanisms to “encourage” states to set up exchanges by threatening their residents with the loss of benefits if they didn’t join the party. The central issue in Halbig, you’ll recall, is whether insurance plan tax subsidies established under 26 U.S.C. § 36B apply only to plans purchased on an exchange “established by the State,” as the statute says, or whether the subsidies also go to plans purchased on a federally-established exchange. The IRS issued a regulation taking the latter point of view, roughly doubling the number of states in which plans will receive subsidies. After the plaintiffs brought suit, the trial court refused to strike down an IRS regulation that relies on the interpretation, so the case is now before a D.C. Circuit appeals panel. At oral argument in March, the majority seemed to be leaning in favor of the challengers. Judge Edwards, a Carter appointee, by contrast, seemed firmly against the challengers’ position. The challengers’ attorney, Michael Carvin, argued that the text, structure, and legislative history of the ACA supported the plain meaning, while Stuart Delery, the DOJ lawyer defending the regulation, at one point argued that the court should construe the statute in accordance with the purpose stated in its title: to make care affordable. Let’s assume for the moment that finding the general purpose of a vast, convoluted statute like the ACA resolves a significant portion of the interpretive questions. What evidence is there that Congress purposely constructed the tax subsidies so they would not go to residents of states that declined to set up exchanges? Quite a lot, as it turns out. First, let’s revisit how the tax subsidy works. The ACA applies tax penalties to certain individuals who don’t have health insurance or purchase it on an exchange. For individuals who purchase insurance on an exchange, the ACA applies a variable tax subsidy which is supposed to make insurance plans more affordable. According to Section 36B of the Internal Revenue Code, the subsidy goes to qualified health plans that were “enrolled in through an Exchange established by the State under [Section] 1311” of the ACA. Section 1311 (codified at 42 U.S.C. § 18031) sets out procedures for a state to set up its own exchange, whereas a different section (Section 1321, codified at 42 U.S.C. § 18041) sets out procedures for the federal government to set up an exchange. Generally speaking, it’s clear that the ACA intended states to play an integral role in carrying out the ACA and was not shy about saying so. The ACA explicitly directs that states “shall” set up exchanges, even though this mandate would not be enforceable in light of anticommandeering doctrines established in Printz v. United States and New York v. United States. The ACA also uses carrots and sticks, such as funding cutoffs and startup funds, as financial incentives for states to set up their own exchanges. In other portions of the ACA, the ACA applied punitive measures to states that refused to get with the program: Congress initially tried to secure expansion of state Medicaid programs by conditioning Medicaid funding on each state’s expansion of its Medicaid program. This, the Supreme Court held in NFIB v. Sebelius, was an unconstitutionally coercive “gun to the head.” Think for a moment about how the Medicaid expansion incentives would have worked. Medicaid funds do not go to state treasuries for general purposes, but are rather used for the state Medicaid program’s services, training, and administration. If the federal government suddenly turned off the funding spigot (which averages 57% of state program funding), the state would be forced to scale back its programs. This effectively increases pressure on the state officials to do whatever is necessary to restore federal money, so as to avoid accusations that they were selling out their poor citizens, public employees, and so forth. Fundamentally, then, financial pressure from the federal government was supposed to produce a political response by the officials of the targeted states, and if all else fails, by the people of the state. That, of course, is coercion. You can almost hear Tony Soprano saying, “Say, that’s a nice Medicaid program you got there. It’d be a shame if anything happened to it.” As it turns out, the same sort of maneuver also appears in 26 U.S.C. § 36B(f)(3), which sets out a seemingly innocuous reporting requirement. This provision, added in the reconciliation bill that Congress used to dodge the Origination Clause, requires state and federal exchanges to tell each purchaser how much they are paying in premiums and how much (or how little) they are receiving in subsidies. There are several legitimate functions of this provision, such as allowing HHS to collect data about how the program is working. But it just so happens that the reporting requirement also gives HHS the opportunity to appeal directly to citizens of non-cooperating states. Although more subtle than the unconstitutional Medicaid expansion, (f)(3)’s reporting requirement is both stick and carrot. In states that declined to set up exchanges (and thus blocked the tax subsidies), the federal exchange would send a letter to residents of the state telling them how much their insurance costs ((f)(3)(B)), that the subsidy is zero ((f)(3)(C)), and that, by the way, state officials can trigger the subsidy by opting into the ACA ((f)(3)(E)). Judge Randolph picked up on this issue during oral argument (at 1:18:55), construing the reporting requirement primarily as a stick:
As a side note, this is yet another reminder that broad purposivism doesn’t really make sense for complicated statutes like the ACA. It is Congress, not the President or the courts, that makes choices about means and ends. Yet when judges use a general purpose (like affordability) as a justification to override a specific purpose that is identified clearly in a statute, they are effectively privileging their own general preference for how the statute should work over how Congress specifically said it must work. That approach is not only highly manipulable, but undermines democratic self-government. It’s not the courts’ job to save Congress from itself, even when its legislation is unnecessarily punitive or fails to accomplish its stated goals. Edited by kbp, Apr 15 2014, 02:24 PM.
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| kbp | Apr 15 2014, 02:38 PM Post #407 |
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http://www.foxnews.com/politics/2014/04/14/survey-shows-obamacare-sending-premiums-rising-at-fastest-clip-in-decades This may have already been posted. |
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| LTC8K6 | Apr 15 2014, 03:04 PM Post #408 |
Assistant to The Devil Himself
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http://www.nytimes.com/2014/04/16/us/politics/census-survey-revisions-mask-health-law-effects.html Census Survey Revisions Mask Health Law Effects WASHINGTON — The Census Bureau, the authoritative source of health insurance data for more than three decades, is changing its annual survey so thoroughly that it will be difficult to measure the effects of President Obama’s health care law in the next report, due this fall, census officials said. The changes are intended to improve the accuracy of the survey, being conducted this month in interviews with tens of thousands of households around the country. But the new questions are so different that the findings will not be comparable, the officials said. An internal Census Bureau document said that the new questionnaire included a “total revision to health insurance questions” and, in a test last year, produced lower estimates of the uninsured. Thus, officials said, it will be difficult to say how much of any change is attributable to the Affordable Care Act and how much to the use of a new survey instrument. “We are expecting much lower numbers just because of the questions and how they are asked,” said Brett J. O’Hara, chief of the health statistics branch at the Census Bureau. With the new questions, “it is likely that the Census Bureau will decide that there is a break in series for the health insurance estimates,” says another agency document describing the changes. This “break in trend” will complicate efforts to trace the impact of the Affordable Care Act, it said. ... |
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| Baldo | Apr 17 2014, 08:23 AM Post #409 |
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Brain Surgery Patient's Obamacare Plan Denies Meds, Drops Doctors A New York woman suffering from a neurological disease that has required four brain surgeries has been dropped by all of her doctors and denied medications due to her Obamacare plan. "I've been vomiting. I lost 22 pounds. The pain is unbearable," said Margaret Figueroa, 49, on Wednesday. "My medication helps me function during the day." Figueroa suffers from a disease known as Arnold Chiari Malformation and Syringomyelia. Even though the Obamacare plan she purchased assured her that she was covered, her insurance card was denied when she went to fill her prescriptions. Then she learned that none of her doctors accept her Obamacare plan. Figueroa says she cannot find a doctor who accepts her Obamacare plan; indeed, there are only six doctors in all of Staten Island who take her plan, none of whom she's been able to get appointments with. Figueroa's congressman, Rep. Michael Grimm (R-NY), intervened to help her obtain some of her vital prescriptions. Grimm says he's already received calls from at least a dozen Staten Island residents facing the same problem with Obamacare's "narrow networks" – extreme restrictions to doctor and hospital access imposed by Obamacare. "Even though the insurance company cashed your check, it doesn't mean it (the policy) has been implemented," said Grimm at a Wednesday press conference with Figueroa. "That's the problem – that the back end of Obamacare hasn't been fully built. You can go on the front end of an application and look at a list of plans, but what they don't tell you is that many of those plans don't have doctors yet." Figueroa is not alone. As Breitbart News reported in January, the Washington Post warned that "Obamacare's narrow networks are going to make people furious – but they might control costs." Breitbart News contributor Scot Vorse learned the hard way about Obamacare's narrow networks when the nearest dentist who accepted the mandatory dental plan he was required to purchase for his children was over 100 miles away. Obamacare's narrow networks have also shut out access to top cancer centers. The Associated Press says just 4 of 19 nationally recognized comprehensive cancer centers offer Obamacare access through all insurance plans in their state Obamacare exchanges, and a McKinsey and Co. study revealed 38% of all Obamacare plans only allow patients to pick from just 30% of the largest 20 hospitals in their areas. Experts say the narrow network horror stories will only grow as more and more Obamacare customers attempt to use their Obamacare insurance only to realize its harsh realities. Obamacare remains deeply unpopular nationally. The latest USA Today/Pew Research poll finds that just 37% of Americans now support Obamacare http://www.breitbart.com/Big-Government/2014/04/16/Brain-Surgery-Patient-s-Obamacare-Plan-Denies-Meds-Drops-Doctors This is what we have been warning about. Obama-care doesn't mean Healthcare |
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| kbp | Apr 17 2014, 10:04 AM Post #410 |
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http://www.foxnews.com/opinion/2014/04/16/shocking-secret-behind-obamacare-enrollment-numbers/ The shocking secret behind ObamaCare enrollment numbers By Michael Cannon Barack Obama wants you to know he enrolled 7.5 million Americans through ObamaCare’s health insurance Exchanges. What he doesn’t want you to know is how. Federal courts may soon rule that President Obama induced the majority of those enrollees to enroll by offering them taxpayer dollars he has no legal authority to spend. If the courts put a stop to that unauthorized spending, a majority of Exchange enrollees would suddenly face the full cost of ObamaCare coverage, and enrollments would plummet. Under the Patient Protection and Affordable Care Act, states have the option of establishing an Exchange themselves, or letting the federal government do it. The Act also authorizes subsidies that can require taxpayers to cover nearly the entire premium for Exchange plans. Among the eligibility criteria for those subsidies is a requirement that recipients enroll “through an Exchange established by the State.” snip Confounding supporters’ expectations, 34 states declined to establish Exchanges. Under the plain terms of federal law, subsidies are therefore available in the 16 Exchanges established by states, and not available in the 34 Exchanges established by the federal government. snip In 2011, however, the Obama administration unilaterally announced it would force taxpayers to subsidize insurance purchased through federal Exchanges as well. It cited no statutory authority for its decision, and has stubbornly refused to follow its own law despite immediate and sustained criticism. In January of this year, the Obama administration began spending billions of dollars of unauthorized subsidies to induce Americans to enroll in the 34 Exchanges established by the federal government. The president is literally forcing taxpayers, without any legal authorization, to subsidize two out of every three Exchange enrollments. Fortunately, unlike other ways President Obama has unilaterally rewritten the health care law, this one faces credible court challenges. Under the PPACA’s many interrelated provisions, those subsidies trigger penalties against millions of employers and individual taxpayers, who have filed suit asking the courts to put a stop to both. Last month, one of those lawsuits – Halbig v. Sebelius – went before a skeptical three-judge panel of the D.C. Circuit. After years of not articulating any statutory basis for its decision, the administration assured the court that the PPACA “makes clear that Congress expected the federal premium tax credits to be available on the federal exchange.” How? Through “a system of nested provisions that when you walk through them lead to the conclusion that the federal Exchange stands in the place of a state exchange.” Oh. No one disputes the purpose of a federal Exchange is to stand in the place of a state-established Exchange. The problem is the administration’s logical leap that an Exchange established by the federal government is somehow “established by the State.” Judge Thomas B. Griffith, a George W. Bush appointee considered the panel’s swing vote, somewhat comically forced the administration to admit the tautology that an Exchange established by the federal government is not “established by the State.” He then explained, “the key language is who establishes the Exchange, and you just keep coming back to well, the Secretary establishes it.” The D.C. Circuit likely will issue a ruling sometime in the coming months, as will the 4th Circuit, which will hear oral arguments in King v. Sebelius on May 14, another challenge to the legality of the subsidies. Two similar challenges, filed by the attorneys general in Oklahoma (Pruitt v. Sebelius) and Indiana (Indiana v. IRS), await consideration in federal district courts. A ruling for the plaintiffs would uphold part of ObamaCare the president is trying to repeal all by himself. And it would expose that the president is inducing millions of Americans to enroll in ObamaCare under false pretenses. |
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| kbp | Apr 17 2014, 10:50 AM Post #411 |
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I learned something new today, if this is accurate! |
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| kbp | Apr 17 2014, 02:46 PM Post #412 |
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Obama live... with inaccurate claims. Mainly, it succeeded and we need to "move on." ...before the election! Edited by kbp, Apr 17 2014, 02:47 PM.
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| kbp | Apr 17 2014, 04:23 PM Post #413 |
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Just watched The Five idiots debate issues from Obama's speech. The biggest issue of the many I saw with Barry's speech was when he claimed the false information from Republicans was 'they said we couldn't afford it' (paraphrased). The last link of my "signature" below takes you to the latest CBO showing the "Effects on the Cumulative Federal Deficit, 2015 to 2024" (page 14). Obamacare creates a $1.383 trillion dollar DEFICIT. How are the Republicans wrong? Is it Barry's opinion we can afford MORE deficit in the future? |
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| kbp | Apr 18 2014, 09:15 AM Post #414 |
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Using Barry's math, an addition of a $1.383 trillion dollars to our DEFICIT is affordable. I guess the factor which added that success was the February 2014 CBO report had the deficit at $1.487 trillion dollars to our DEFICIT ....so it could have been worse! Edited by kbp, Apr 18 2014, 09:24 AM.
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| kbp | Apr 18 2014, 09:47 AM Post #415 |
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Obama on ACA: "...But we now know for a fact that repealing the Affordable Care Act would increase the deficit, raise premiums for millions of Americans, and take insurance away from millions more -- which is why, as I've said before, I find it strange that the Republican position on this law is still stuck in the same place that it has always been." Obama on passing amnesty: "... I also know that there are businesses around the country that could be growing even faster, that our deficits could be coming down faster, that we would have more customers in our shops, if we get this thing resolved." A math genius! . |
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| Baldo | Apr 21 2014, 05:26 PM Post #416 |
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Whoops! Half of Georgia’s Insurance Enrollees Haven’t Paid Yet. Georgia insurers received more than 220,000 applications for health coverage in the Affordable Care Act’s exchange as of the official federal deadline of March 31, state officials said Wednesday. Insurance Commissioner Ralph Hudgens, though, said premiums have been received for only 107,581 of those policies, which cover 149,465 people. “Many Georgians completed the application process by the deadline, but have yet to pay for the coverage,” Hudgens said in a statement Wednesday. Half? Half? Sure, the nonpayment rates will be a lot lower in other places. But this indicates how much skepticism is warranted for the administration’s much-touted enrollment figures. When Progressives insist that we’re wrong and Obamacare is more popular than it seems, they’ll point to the enrollment numbers. They dismiss the national surveys, but there’s some indication that Obamacare’s meager support in the polls is actually worse than we think, because it’s being artificially boosted by respondents that are eager to declare the whole thing a success, no matter how their state exchange is actually performing. A couple of lessons from this bit of polling research by Jonathan Easley at the Morning Consult: Healthcare.gov is uniquely and perhaps disproportionately disliked by survey respondents, and some people just tell pollsters what they want to be true, not what is actually true: In a testament to how political affiliation potentially colors an individual’s view of the law, Morning Consult polling from November through April found that people reported more positive experiences in states with largely broken exchanges versus people who used the federal exchanges. And that includes states where the exchanges never were fully operational… We separated states into three different groups to do this analysis. The “broken” state exchange group included Hawaii, Maryland, Massachusetts, Minnesota, Nevada, Oregon and Vermont. (While it is an inexact measurement, we put states where healthcare officials struggled throughout the enrollment period to fully launch their exchanges into the “broken” category.) The second group of states—those with relatively well running exchanges—included Washington, Rhode Island, New York, Kentucky, Colorado, Connecticut, California and the District of Columbia. All other states where included in our third group, as they used the federal exchange website to enroll customers....snipped http://www.nationalreview.com/campaign-spot/376152/whoops-half-georgias-insurance-enrollees-havent-paid-yet-jim-geraghty Reported on The Bret Baeir Show that the Feds still have NOT released how many enrollees for Obama-care haven't paid. They say they don't know. Robert Laszewski, noted industry critic, said that is basically a lie. Each Insurance Company knows exactly who is paid at the start of each month The troubling aspect of Georgia's report is that many of those who are not paying are receiving subsidies. |
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| Baldo | Apr 21 2014, 06:26 PM Post #417 |
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Dem Congressman on Obamacare: The Worst Is Yet to Come, It’s ‘Going to Hit the Fan’ Video: https://www.youtube.com/watch?v=TbwCU22xfiU Massachusetts representative Stephen Lynch isn’t just worried about the negative impact Obamacare will have on his party’s performance this fall — he also thinks its worst effects on our health-care system are still to come. Lynch, who voted against the Affordable Care Act in 2010, warned that the situation is “going to hit the fan” when the law’s delayed provisions go into effect down the road. “There are parts of Obamacare, or the Affordable Care Act, that were postponed because they are unpalatable,” he told the Boston Herald. The “Cadillac tax” that goes into effect in a few years and taxes employer health plans over a certain value, he said, will be “the first time in this country’s history that we have actually taxed health care.” Repeal is now impossible, he says, because of the number of Americans who’ve signed up for the law’s exchanges. Democrats will take big political hits on the law this fall anyway, Lynch said. “We will lose seats in the House,” he said. “I am fairly certain of that based on the poll numbers that are coming out from the more experienced pollsters down there, and I think we may lose the Senate.” http://www.nationalreview.com/corner/376191/dem-congressman-obamacare-worst-yet-come-its-going-hit-fan-andrew-johnson?utm_source=twitterfeed&utm_medium=twitter |
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| kbp | Apr 21 2014, 07:00 PM Post #418 |
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There will be plenty that only pay 1 to 2 months of their premiums and then the provider is stuck with the problem when the insurance doesn't pay over the 90 days it takes to cancel the policy. The provider networks may take a hit before election time. I wonder how the actuaries will make an allowance for higher provider prices in that situation? |
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| LTC8K6 | Apr 21 2014, 07:32 PM Post #419 |
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Assistant to The Devil Himself
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http://twitchy.com/2014/04/19/people-really-need-this-much-hand-holding-government-reminds-citizens-to-pay-their-premiums/ ‘People really need this much hand-holding?’: Government reminds citizens to pay their premiums |
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| wingedwheel | Apr 21 2014, 08:33 PM Post #420 |
Not Pictured Above
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It would have been hand holding to get them to pay before 0bamacare pass. And remember it was a cheaper product then. Now the government has the IRS gun to their head. |
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