Supreme Court Health Care Decision Thread

[Twiggett]

I'm sure I will catch flak from some for this but my take on a few things:

Shameless.

ETA: Their headline now shows Obama signing the bill; over the picture they write:
Guess
what's
now a...
'TAX'

To be fair, though not to Fox News as I am of the belief that they ought to replace the backdrop of their logo with the RNC one, it isn't all that inaccurate. Obama himself claimed that it is not in an interview with ABC (link below) during the debate leading up to the passing of the bill, although to be as accurate as possible, he did use the words tax increase and not just tax.

I personally find it more than a little ironic that the very thing he claimed it is not was the main basis, if I understood it correctly, for which the majority opinion let the mandate stand.

For the record, I was and still am neither overly for or against the bill itself. There are issues that give me pause such as the exemptions and requirements for employers based on their number of employees in the sense that it is not inconceivable that some employers may be highly resistant to crossing the thresholds which will trigger extra costs to them or even worse, decide that it is better for their bottom line to just drop coverage entirely and pay the fees:

-Assess employers with 50 or more full-time employees that do not offer coverage and have at least one full-time employee who receives a premium tax credit a fee of $2,000 per full-time employee, excluding the first 30 employees from the assessment. Employers with 50 or more full-time employees that offer coverage but have at least one full-time employee receiving a premium tax credit, will pay the lesser of $3,000 for each employee receiving a premium credit or $2,000 for each full-time employee, excluding the first 30 employees from the assessment. (Effective January 1, 2014)

-Exempt employers with up to 50 full-time employees from any of the above penalties.

-Require employers with more than 200 employees to automatically enroll employees into health insurance plans offered by the employer. Employees may opt out of coverage.

Also the obviously (to me) transparent attempt to give out good things that people will like right away, while tucking the things they won't (individual mandate) away til after this Nov's election (bold type and ?? are my additions):

Good
-Provide dependent coverage for children up to age 26 for all individual and group policies. (Effective six months following enactment)

Bad
Require U.S. citizens and legal residents to have qualifying health coverage. Those without coverage pay a tax penalty of the greater of $695 per year up to a maximum of three times that amount ($2,085) per family or 2.5% of household income. The penalty will be phased-in according to the following schedule: $95 in 2014, $325 in 2015, and $695 in 2016 for the flat fee or 1.0% of taxable income in 2014, 2.0% of taxable income in 2015, and 2.5% of taxable income in 2016. Beginning after 2016, the penalty will be increased annually by the cost-of-living adjustment. Exemptions will be granted for financial hardship, religious objections??, American Indians, those without coverage for less than three months, undocumented immigrants, incarcerated individuals, those for whom the lowest cost plan option exceeds 8% of an individual’s income, and those with incomes below the tax filing threshold (in 2009 the threshold for taxpayers under age 65 was $9,350 for singles and $18,700 for couples).

The good of the bill, again to me, is covering those who for various reasons are unable to obtain coverage under the system that was in place.

As for it reigning in the costs of healthcare, I am undecided as to whether I believe it will do so or not. I am taking the wait and see approach on that count.

All in all, I would feel a heck of a lot more comfortable if the decision was 9-0 or as close as 7-2 instead of the usual 5-4 we seem to get on every major decision these days.

Links:
ABC News
http://abcnews.go.com/blogs/politics/2009/09/obama-mandate-is-not-a-tax/

Healthcare Reform Summary
http://www.kff.org/healthreform/upload/8061.pdf

 

[Skeptic Ginger]

Yeah, but you have to be enrolled in a high deductible health plan to get one. Then you use that money to pay for health expenses, up to the deductible.

See that doesn't make sense to me either. 20 years ago (I've been self employed the last 20 years) I had a job with full benefits. But we could still designate money for our HSAs. The deal was any money from your paycheck you directed to your HSA was essentially untaxed income. There were limits to what you could spend it on, had to be on the health care spending list, and if you didn't use it all, at the end of the year you lost it.

No "high deductible plan" requirement was involved.

 

[Skeptic Ginger]

You are probably thinking of a Flexible Spending Account. With an FSA, you contribute money to a plan. It isn't taxed, and you use it for health care. If you don't use it in a given year, it's lost.

An HSA is a bit different. ....

Hmmm. I see.

 

[This is The End]

OK. I buy that. Well done, Justice Roberts.

I literally did not think it was possible for Chief Justice Roberts to do anything that would improve my opinion of him. I was absolutely stunned today.

 

[RandFan]

I think this might have had something to do with it.

Poll: Americans Overwhelming Believe Ideology Drives Supreme Court Decisions

 

[RandFan]

Waiting for Bill O'Reilly to apologize for being an idiot...

...his words not mine.

O'Reilly Says He'll "Apologize For Being An Idiot" If Supreme Court Upholds Health Care Reform Law

He is so damn smug and arrogant.

 

[Skeptic Ginger]

From channel surfing the news, it's a battle between talking points of 'government control of health care' and the benefits individuals can relate to the AHCA (mainly insuring kids 26 and under and people with preexisting conditions).

The 13 million person rebate on health insurance premiums is a political coup for Obama. I got my letter today saying my health insurer did not spend excessively on bonuses and CEO salaries so I have no rebate coming. But those 13 million other people are going to get some money and a letter saying it's a rebate mandated by the AHCA because your insurance carrier had been ripping you off.

That's an incredible coup.

 

[Foolmewunz]

...his words not mine.

O'Reilly Says He'll "Apologize For Being An Idiot" If Supreme Court Upholds Health Care Reform Law

He is so damn smug and arrogant.

This message will self-destruct and I'll deny I ever said it.

O'Reilly is actually marginally sane... compared to Hannity. I'm not sure if that's because O'Reilly is mellowing or if it's just that Hannity's unctuousness makes that much less palatable, but O'Reilly actually sounded almost moderate when they phoned him (he's on vacation) from the studios. Hannity? Not so much. He's totally ignored that he was the biggest mouthpiece for the idea that it was a foregone conclusion that the Supremes would throw the law out. He's just jumped in right behind Karl and Sarah and is toeing the Murdoch / Tea Party line... "It's a Tax! It's a Tax! It's a Tax!"

 

[Brainster]

Hmmm, looking here for any calls to pack the court, or impeach Roberts, and so far not finding any except Ben's call for the former when the initial news was that the mandate was overturned. Couldn't find any such calls on the conservative blogs, either. Politico claimed that "blog chatter" was calling for the latter, but if you read the story, it was blog comment chatter, which is not quite the same thing.

IMPEACH JUSTICE ROBERTS,” wrote a commenter at Hot Air.

“And Roberts? Really? I expect this of Kennedy but him? Yet another stealth socialist/statist as other contributors have pointed out,” added a commenter at Michelle Malkin’s blog.

Personally, I'm glad that the ever-expanding Commerce Clause is apparently starting to get fenced in. It will be interesting to see how they handle the Medicaid problem with the states; that's likely to be a real problem for the Feds.

 

[triforcharity]

Here's my biggest, and really only problem.

(Take into considering that I am for the AHCA, for the most part)

Justice Roberts, in his opinion said "makes going without insurance just another thing the Government taxes, like buying gasoline or earning income. And if the mandate is in effect just a tax hike on certain taxpayers who do not have health insurance, it may be within Congress’s constitutional power to tax.”

My problem with this is simple. It's a tax on nothing. I received no product or service, and I would be taxed on...nothing.

If I buy gas, I pay the tax. But, I received something in return, 1 gallon of gas.
If I buy milk, I pay the tax. But, I received 1 gallon of milk.

If I don't buy health insurance, I am taxed. But, I purchased nothing and received no services.

I am taxed for NOT doing something. Should I also be taxed because I don't do something else? What if the government wants all old cars replaced with newer, greener, more fuel efficient vehicle. I mean, surely that will help everyone, right? Less fuel consumed, less Co2 emissions, etc. But, I love my old Explorer. Should I have to pay a fine for not upgrading? Seems silly to me.

I just see punishing me for NOT purchasing something, seems.....unfair.


(This doesn't really affect me, as I have health insurance provided through my employer)

Maybe I am off base though, because I really haven't looked into this whole thing, and don't fully understand it quite yet. But, I am learning.

 

[triforcharity]

I saw one story on my smartphone that a number of people are so upset with the Supreme Court's upholding "socialized medicine" that they have said they plan to move to Canada.

I first thought the story HAD to be from The Onion. But it may be legitimate.

For those who want to try coming to Canada, I say: Go for it. I did. You might learn something. I did.

Edited to add: Another link showing the outrage.

LOL!! Stundie worthy almost!!

Person 1 - I don't want socialized medicine!! I'm moving!

person 2 - How 'bout Canada?

Person 1 - Sure!!! I've always like gravy and french fries!

Bystander - Uh.....morons.....bad news for you....Do you know one of the 90 different languages spoken in Ethiopia by chance? How about Somali?? Those are two good choice for you two dunces!!



Sorry, hilarious!!

 

[Korren]

My problem with this is simple. It's a tax on nothing. I received no product or service, and I would be taxed on...nothing.

You receive a health care system and infrastructure that stands ready to handle any medical emergencies you might have. Sure, that system already exists -- but people are no longer allowed to be freeloaders on it. (ETA: That's not to say you're getting the medical treatment in exchange for the tax -- you're just getting the guarantee that treatment will be available.) Also, you receive a guarantee that you will be able to buy insurance in the future, regardless of any chronic diseases or pre-existing conditions you might pick up before that.

 

[triforcharity]

You gotta fight for your right to be a free-loader, I guess.

What some folks seem to be overlooking is that governmental power to compel people to contribute (or to buy broccoli) DOES exist, according to Chief Justice RobertsEmphasis mine.)

The problem that I personally see with that line of reasoning, is I am not taxed because I have minimal clothes, and haven't replaced my wardrobe in many years.

I also am not taxed because I do not have a vehicle. Nor am I taxed if I do not buy a house. I'm not taxed because I don't buy any vegetables, ( I grow much of my own, and haven't bought a vegetable from a supermarket in over 6 years)
I'm not taxed because I use a lot of solar power in my house, and average less than $100 a month for electricity.

I WOULD be taxed if I didn't buy health insurance. Doesn't that seem wrong to you?

 

[triforcharity]

I've been riding the fence on this thing the whole time...mainly because no one seems to have the answer to this question:

What is this going to cost me?

I make about $35k, and get insurance through work. Is my premium going up, down, nowhere? Am I going to have to pay an increased tax to help cover others health care even more so than now?

What should I expect?

I've heard all kinds of opinions...that this is going to cost middle-class Americans dearly in the long run...that it's going to shove America right back into deep recession...etc. etc.

It's all Greek to me right now. I honestly only like the parts where kids can stay on til 26 and that no one can be denied/dropped because of an illness/condition. But that's kind of where I stop. But I will also admit that I'm naive to most of what Obamacare is.

I honestly don't believe anyone really knows for certain yet. It's DESIGNED to lower your premiums, and makes sense that it WOULD, but insurance companies are known for being shysters....

I am with you though. I don't know a whole lot about this whole thing yet, but I am afraid of what will come.

Similar income, work provided insurance, etc....I am in the same boat sir....

 

[triforcharity]

You receive a health care system and infrastructure that stands ready to handle any medical emergencies you might have. Sure, that system already exists -- but people are no longer allowed to be freeloaders on it.

Ok, makes a little sense. Only one problem: The government doesn't provide those facilities, for the most part.

I have 3 different health care "companies" in my county. Health First, Wuesthoff Health, and Parrish Medical Systems.

All three of them are NPO's, and owned by privately run companies. So, the government doesn't run those companies.

Does a large portion of this tax go towards supporting those NPO's? If so, I am ok with that. All three are good facilities.

(Here's the irony- I work in the healthcare industry....)

(ETA: That's not to say you're getting the medical treatment in exchange for the tax -- you're just getting the guarantee that treatment will be available.) Also, you receive a guarantee that you will be able to buy insurance in the future, regardless of any chronic diseases or pre-existing conditions you might pick up before that.

I love the fact that pre-existing conditions cannot be excluded. I know many people that cannot get health insurance because of PEC.

Again, does the USG supplement the NPO's like the ones in my area? Is that their primary source of funding? I'm asking, I honestly don't know.

(I hate politics......)

 

[JFrankA]

Here's an interesting article from AP. This is where states stand on implementing health care law.

http://m.apnews.mobi/ap/db_6776/contentdetail.htm?contentguid=S4ha0QCe

I also have a question. Someone said to me under this new law, someone can choose to not have insurance, pay the tax, yet get a credit so that offsets the cost of the tax. Personally, I haven't seen that (he said he read it in the Wall Street Journal but won't sight the source).

Has anyone heard of this offset and what are the details of it?

 

[JFrankA]

Ok, makes a little sense. Only one problem: The government doesn't provide those facilities, for the most part.

I have 3 different health care "companies" in my county. Health First, Wuesthoff Health, and Parrish Medical Systems.

All three of them are NPO's, and owned by privately run companies. So, the government doesn't run those companies.

Does a large portion of this tax go towards supporting those NPO's? If so, I am ok with that. All three are good facilities.

(Here's the irony- I work in the healthcare industry....)

Quick, off the cuff (and possibly wrong ) answer:

The government doesn't own the company you buy milk from, either, yet you're taxed there too. And the tax goes towards the government health programs (such as Medicare) and some sort of subsidy.

Anyone who knows better, please correct me if I'm wrong, but that's I understand it.

 

[cwalner]

You are probably thinking of a Flexible Spending Account. With an FSA, you contribute money to a plan. It isn't taxed, and you use it for health care. If you don't use it in a given year, it's lost.

An HSA is a bit different. Many companies, including mine, offer an HSA based insurance plan. In it, the premiums are very low compared to traditional plans, and the deductibles are very high. For example, in our company, the premium for the "traditional" plan was around 250 per month, and there was a 1000 dollar deductibel. In the HSA, the premium was around 60 dollars per month, and there was a 3,000 dollar deductible. In other words, until you racked up 3,000 dollars in medical bills, the insurance company didn't pay one red cent.

Meanwhile, you get to open up an HSA. Money you put into it is tax deductible, and there's no tax if you spend it on medical expenses. Unlike an FSA, if you haven't spent it by the end of the year, you keep it, and can spend it in future years. As long as you evenually use it for health care, there's no tax.

The company was obviously pushing us to join the HSA plan, so I did the math as to which one would cost more depending on what sort of medical expenses, and the HSA was always cheaper for me. That puzzled me until I thought about it a bit more. Why would the company want me to take a plan that provides the same benefits to me, but at lower cost? The answer is that ever since I joined the HSA, I actually pay attention to how much I'm spending. Until I hit 3,000 bucks, which in most years, I don't, that's my money I'm spending. Now, when the doctor gives me a prescription for a test, I try to find a lab that will do the same test more cheaply, or I simply ask the doctor how much it costs and is it really necessary.

Basically, it replaces traditional insurance with catastrophic insurance, which, frankly makes a lot of sense.

The odd thing is that for me the benefit is because I am at the other end of the spectrum.

For you, who appear to be in good health, the lower premiums and the ability to put aside money each year that can used for unexpected expenses is the benefit.

For me, with many chronic conditions, the benefit is that the HSA has a lower out of pocket cap than the PPO or HMO plans that my company offered.

 

[Brown]

While we're talking about spin here, has anybody noticed that all three opinions (by Roberts, Ginsburg and Scalia) ....

Actually, the last of the opinions is not officially authored by Justice Scalia. Scalia's name is merely listed first, because he is the most senior. The opinion begins: "JUSTICE SCALIA, JUSTICE KENNEDY, JUSTICE THOMAS, and JUSTICE ALITO, dissenting."

Parts of this opinion read like Scalia wrote it, or at least part of it (e.g., "The Court regards its strained statutory interpretation as judicial modesty. It is not."); but according to reports the one who read from this opinion was Justice Kennedy. Justice Ginsburg refers to this group of four as "the joint dissenters."

And in truth, the opening sentences of the dissenting opinion sound a hell of a lot more like Kennedy than Scalia: "Congress has set out to remedy the problem that the best health care is beyond the reach of many Americans who cannot afford it. It can assuredly do that, by exercising the powers accorded to it under the Constitution." (Emphasis mine.) The recognition that there IS a legitimate way for the Congress to address health care difficulties, without a need to amend the Constitution, sounds more like Kennedy than Scalia (or Justices Thomas or Alito).

There is a string of thought that the four-justice dissent was at one time expected to be the MAJORITY opinion. When discussing Justice Ginsburg's remarks on the Commerce Clause, the joint dissenters refer to her opinion as "the dissent." Maybe it's not exactly wrong, but it is strange for dissenters to refer to an opinion with which they totally disagree as "the dissent."

 

[DavidJames]

I WOULD be taxed if I didn't buy health insurance. Doesn't that seem wrong to you?

Think of it as a penalty being collected as a tax.