Obamacare 5 years later. Crow, anyone?

[Olowkow]

Scalia is a right-wing hack. But that's not news to anyone.

Yeah, but he also often seems to be not very smart about legal matters for a judge. We expect this from politicians, but his opinions always strike me as not very "lawyeristically sound", more like sour grapes opinion pieces.

Just heard McConnell spouting the same tired old republican talking points about ACA, but hinting that it will be "much harder" now to repeal. Sounds like he's setting the stage for his people to admit defeat.

What a bunch of clowns these conservative politicians. If they had reasoned, logical arguments, that would be one thing, but they frequently just talk to hear their own voices and to reassure low information voters.

 

[ponderingturtle]

Yeah, but he also often seems to be not very smart about legal matters for a judge. We expect this from politicians, but his opinions always strike me as not very "lawyeristically sound", more like sour grapes opinion pieces.

Just heard McConnell spouting the same tired old republican talking points about ACA, but hinting that it will be "much harder" now to repeal. Sounds like he's setting the stage for his people to admit defeat.

That is strictly true as they are going to have to get legislation passed to change the ACA instead of depending on the courts to do it. As such they will also have to take ownership of the consequences.

 

[Giordano]

Fox is sounding like an asylum full of nut jobs...more than the normal nutty stuff. I wonder what all presidential hopeful "Obamacare repealists" will have to say with 70% of Americans favoring subsidies. Scalia chides everyone for protecting Obamacare because....who knows? Sounds like he's accusing the court of playing politics. He and Thomas are not really qualified to be on a high court.

The reaction of the right-wing only intensifies my pleasure with the Supreme Court decision even further. Let there be even more weeping and gnashing of teeth on Fox- it makes me ecstatic. And although Fox's anger may play to their target audience, I believe that it will further alienate the majority who have benefited from Obamacare. I had and continue to have very good health insurance (before and after "Obamacare") but many of its provisions have directly benefited me and my family. And it gives me pleasure that other people, not so lucky with employment or with their employers, have benefited even more.

 

[Giordano]

Yeah, but he also often seems to be not very smart about legal matters for a judge. We expect this from politicians, but his opinions always strike me as not very "lawyeristically sound", more like sour grapes opinion pieces.

Just heard McConnell spouting the same tired old republican talking points about ACA, but hinting that it will be "much harder" now to repeal. Sounds like he's setting the stage for his people to admit defeat.

What a bunch of clowns these conservative politicians. If they had reasoned, logical arguments, that would be one thing, but they frequently just talk to hear their own voices and to reassure low information voters.

I agree. I do not typically like or always agree with decisions by conservative judges. But in most of these judges I simply recognize a human tendency to focus on the legal precedents that support their political bias. Some I go further and sincerely respect them for their intelligence and legal reasoning, even if it opposes my political views. But Scalia and Thomas take this to another level entirely, and often rule with very little or no relationship to the laws involved. And not very intelligently at that. They have been given this chance to be a king, and they are going with it.

 

[Meadmaker]

What was your take on the actual legal question at hand?

I ask because I am so bothered by how often a person's opinion of what is good policy lines up so well with their legal interpretation.

My own take on the legal question here is in line with Justice Roberts' opinion.

Congress clearly meant to do one thing, and the decision upholds what they intended to do.

This whole case involved the possibility that something had slipped by an editor and the legislature had passed something which could be interpreted to not do what they clearly intended to do. The court upheld that a strictly literal reading of one passage in the law made no sense in the context of the law. It's a good ruling.

 

[Biscuit]

I am very relieved to learn I will not be losing access to affordable health insurance as I am sure many self employed people across the country are today.

I had this pipe dream fantasy that the court would rule against it and we would get single payer instead.

 

[Olowkow]

Just look at an interview with Sandra Day O'Connor some time, and compare with Scalia or Thomas. She is a totally class act and comes across as what to me is at times painfully logical, almost like Mr. Spock. She is obviously liberal, but convincingly and easily argues conservative points when they comport with the law--if one respects the law, that is what is needed. That lady oozes intelligence and fairness, IMHO of course.

I picture Supreme Court Judges sitting around a drawing room lined with bookshelves, sipping brandy, consulting in depth with experts on a subject they must understand in order to make a legal decision, and having eloquent productive conversations--not hanging out with Rush Limbaugh.

 

[thaiboxerken]

When is the SCOTUS going to rule on the constitutionality of the Obamacare death-panels?

 

[Biscuit]

Marco Rubio was just laying out the same lazy talking point about people having low premiums but when they go to the hospital they are hit with a $4,000.00 deductible bill! Demonstrating that he either doesn't understand what a deductible is or he is deliberately lying.

 

[eeyore1954]

My own take on the legal question here is in line with Justice Roberts' opinion.

Congress clearly meant to do one thing, and the decision upholds what they intended to do.

This whole case involved the possibility that something had slipped by an editor and the legislature had passed something which could be interpreted to not do what they clearly intended to do. The court upheld that a strictly literal reading of one passage in the law made no sense in the context of the law. It's a good ruling.

Exactly.

As much as I may not agree with the law it should not be invalid because of some poor wording when it is pretty clear what the intent was.

 

[eeyore1954]

Marco Rubio was just laying out the same lazy talking point about people having low premiums but when they go to the hospital they are hit with a $4,000.00 deductible bill! Demonstrating that he either doesn't understand what a deductible is or he is deliberately lying.

Can you enlighten me on this?

 

[johnny karate]

This is actually a win for Republicans.

They get the benefit of joining their malcontented base in shaking their fist and grumbling, while at the same time avoiding the calamitous political fallout of causing millions of people being denied access to healthcare.

 

[Meadmaker]

Marco Rubio was just laying out the same lazy talking point about people having low premiums but when they go to the hospital they are hit with a $4,000.00 deductible bill! Demonstrating that he either doesn't understand what a deductible is or he is deliberately lying.

I've heard right wing yappers talking about the high deductible problem all year, and I have a question.

Are we talking about HSA based plans here? I suspect we are.

For those not familiar, my employer offers multiple plans. One of them is based on a Health Savings Account. You pay a very low premium, but you have a very high deductible, at least a few thousand dollars annually. You also get to open up a Health Savings Account, which is a tax free account. You pay no tax on anything you put in, as long as you spend it on health care. Also, unlike the Flexible Spending Account with which it is often confused, you don't lose the unspent money. It stays yours forever.

If you are young and healthy, and your employer offers it, you are foolish if you don't choose that plan.

Now, the interesting thing about all of this is that HSA plans were driven entirely by the right wing. They love them. It's private enterprise. They help keep costs down. They're exactly what the right wing ordered......but now the yappers are whining that those plans are available under Obamacare?

So, just to get the facts straight, are there plans out there that have $3,000 deductibles, but aren't HSA based? If they are, as I suspect, HSA plans, then the right wing is whining about something they invented themselves.

 

[thaiboxerken]

So, just to get the facts straight, are there plans out there that have $3,000 deductibles, but aren't HSA based? If they are, as I suspect, HSA plans, then the right wing is whining about something they invented themselves.

I believe many of the HDHP's have HSA as an option.

 

[pgwenthold]

For those not familiar, my employer offers multiple plans. One of them is based on a Health Savings Account. You pay a very low premium, but you have a very high deductible, at least a few thousand dollars annually. You also get to open up a Health Savings Account, which is a tax free account. You pay no tax on anything you put in, as long as you spend it on health care. Also, unlike the Flexible Spending Account with which it is often confused, you don't lose the unspent money. It stays yours forever.

Yes, we have an HSA. As you note, the "premiums" have dropped like a rock. We pay very little in premiums. However, what we do is to basically take the difference between premiums now and our out-of-pocket costs before (when we were on a co-pay plan) and put them in the HSA. Then we pay all of our medical bills from that account.

So far, it's been a huge savings to us, because when we started budgeting it, we were basing our contributions on our costs for when the kids were 0 - 4 years old (lots of office visits) and now that they are older, they don't go nearly as much. Now, that does mean that the money we put in the HSA is tied up (without penalty), but then again, it is being saved up for that event where we have to pay the full deductible.

Second, as you say, another feature of the HSA is that it is completely tax deductible, without having to worry about hitting a floor. Therefore, we pay all of our medical expenses - prescriptions, dental, eyecare - out of the HSA and we don't pay taxes on it.

 

[Giordano]

When is the SCOTUS going to rule on the constitutionality of the Obamacare death-panels?

Oh, I sooo hope that they are approved (they would have to be created and approved by Congress first, of course, not being part of the current Obamacare law)! I want to serve on one! Can we do thumbs up and down, too?

 

[Emily's Cat]

What was your take on the actual legal question at hand?

I know you didn;t ask me, but I'm going to answer anyway. My opinion is that the legal question was baloney. Contextually, it was abundantly clear that subsidies were intended to apply at any exchange, and be administered at the state level. When you actually read the bill, where it says "state exchange", it is contextually clear that this is intended as "state level of exchange" as opposed to "state run exchange". It was a stupid case from the get-go.

My policy opinion is that ACA is just about the worst possible way to marginally improve a broken system. It's better than the morass we had before... but they gained that teensy improvement through about the most ridiculous approach they could have. Basically, ACA pretty much sucks, but it sucks slightly less than pre-ACA.

I will say, however, that several of the bits that were undefined in the bill itself have been implemented surprisingly well. Risk Adjustment, de minimus ranges around metallic levels, Reinsurance, and a few others have been developed in a pretty sound fashion.

 

[Emily's Cat]

Marco Rubio was just laying out the same lazy talking point about people having low premiums but when they go to the hospital they are hit with a $4,000.00 deductible bill! Demonstrating that he either doesn't understand what a deductible is or he is deliberately lying.

Why do you say so? I don't follow you here.

This is actually a concern of mine - some Bronze plans have $4000 or $5000 deductibles. Sure the premium is low, but if you end up in the ER or admitted to the hospital, you WILL get a massive bill. So I'm not really sure what you think a deductible is, and how it works...

 

[Emily's Cat]

So, just to get the facts straight, are there plans out there that have $3,000 deductibles, but aren't HSA based? If they are, as I suspect, HSA plans, then the right wing is whining about something they invented themselves.

Yes, there exist some plans with very high deductibles that are NOT HSA-Qualified plans. HSA qualifications include a whole host of benefit elements aside from just deductible.

All HSA-qualified plans are High Deductible plans; Not all High Deductible plans are HSA-qualified plans.

 

[jhunter1163]

Why do you say so? I don't follow you here.

This is actually a concern of mine - some Bronze plans have $4000 or $5000 deductibles. Sure the premium is low, but if you end up in the ER or admitted to the hospital, you WILL get a massive bill. So I'm not really sure what you think a deductible is, and how it works...

True, but $4,000 or $5,000 is better than the full freight you'd have to pay if you didn't have insurance. I agree that the ACA is an improvement, but only a small one. I do see it as a step towards single-payer, which is (IMO) a consummation devoutly to be wished.