Obamacare

Only Democrats Are to Blame for Obamacare Chaos

King vs. Burwell is a challenge to enforce Obamacare as written, not a challenge to Obamacare as written

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If the Supreme Court were to decide not to allow retroactive legislating and uphold Obamacare as written, terrible things would happen to America. We might, for instance, find out what health insurance in fabricated, state-run "marketplaces" actually costs.

The Kaiser Family Foundation estimates that the 37 states that have declined to set up exchanges would see an average spike of 287 percent should the King v. Burwell decision not go the Obama administration's way. It would be 650 percent in Mississippi—an amount that only proves that exchanges have not made insurance markets more competitive or more affordable as promised. Actually, the cost of insurance in federally run exchanges is already 287 percent higher. The difference is picked up by taxpayers.

And you know who's to blame for that, right?

Here is Vox: "What a Supreme Court ruling against Obamacare would look like, in 3 maps."

Here is The Washington Post: "Map: Health-care premiums could spike as much as 650 percent if this Obamacare challenge succeeds."

Now, technically, King v. Burwell isn't a "challenge" to Obamacare. It's a challenge to uphold Obamacare rather than allow the administration to implement the law in any manner it sees fit. There are compelling arguments on both sides, but the case is well within the purview of the U.S. Supreme Court. The coverage of the debate, though, has already been irrevocably distorted.

In the past few years, any SCOTUS decision that potentially disrupts liberal policy aims has been depicted as an unprecedented and extraordinary partisan overreach that threatens civic order and the norms of democracy. If the president is willing to berate SCOTUS for protecting the First Amendment, you can imagine what we're in for should something unpleasant happen to the signature achievement of the new progressive era.

So SCOTUS can issue pro-same-sex marriage opinions that "challenge" over 200 years of American law and upend a traditional institution, but ending a concocted subsidy that's only been around for a few years would, according to White House press secretary Josh Earnest, create bedlam:

"We continue to be very confident in the legal case we have to make. What's also true is that if the Supreme Court were to throw the health care system in this country into utter chaos, there would be no easy solution for solving that problem, because it would likely require an act of Congress in order to address that situation."

Not a single Republican voted for Obamacare. Most, in fact, cautioned that passing the largest health care reform in American history—written by one party, jammed through using reconciliation, and haphazardly implemented—could be problematic as not only an ideological matter but a practical one. Now they have to act?

It's widely contended that the GOP has some kind of obligation to rescue Obamacare—whether for moral reasons or for self-preservation. In addition to the administration's position, Sen. Chris Murphy (D-Ct.) actually stood on the Senate floor with a "shruggie" symbol to criticize the GOP for not formulating a plan in response to King v. Burwell. This would be the equivalent of seeing Sen. Ted Cruz demanding that Democrats come up with a strategy to resuscitate the Defense of Marriage Act. It is preposterous.

So predictably, a number of Republicans are working on plans. Wisconsin Sen. Ron Johnson's scheme would allow exchange participants to keep their Obamacare subsidies until August 2017 (which, I've argued before, needlessly confers the GOP with ownership of a problem it didn't create). The thought is that Obamacare will be on life support until a Republican president takes office and the legislation can be repealed and replaced. Johnson, as you can see, exhibits completely unwarranted faith in his party.

Johnson's bill would also repeal the individual mandate (which, last anyone checked, is still decidedly unpopular) and the employee mandate. Democrats didn't believe they had to find a single Republican to compromise when passing the Affordable Care Act, so it's improbable they'd capitulate on the mandate and penalty that hold the entire law together. But it certainly couldn't hurt to make them reject the idea.

Because without state subsidies, Obamacare would struggle and the debate is likely to settle along the same contours it's been on for years. And according to The Wall Street Journal, there will be significant insurance premium increases coming next year—somewhere between 25 and 50 percent in a number of states—now that insurance company subsidies are running out, as well. As always, there are an array of reasons, but The Wall Street Journal points to high medical costs incurred by people newly enrolled in Obamacare. The disconnect consumers have from prices is only growing under Obamacare.

The Kaiser Health Policy News Index says 59 percent of Americans aren't paying any attention to news stories about King v. Burwell. A mere 16 percent have been following the story. So you can imagine the overwhelming appeal to emotion Democrats and the media would roll out if millions were to lose their subsidies. The fight would be over whom the public blames for whatever chaos would ensue. The culpability for that chaos would belong in one place.

© Copyright 2015 by Creators Syndicate Inc.

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  1. There are compelling arguments on both sides,

    Well, not compelling legal arguments.

    The legal issue is pretty straightforward: Did the IRS have statutory authority to adopt a rule extending tax credits to insurance purchased on both state and federal exchanges?

    The statute authorizes tax credits only for insurance purchased on a state exchange.

    The only compelling legal argument is that the IRS doesn’t have the authority to adopt a rule that is not authorized by statute. The other side is arguing that (a) the statute doesn’t mean what it says and/or (b) the IRS doesn’t need statutory authority to adopt rules. Those are more appalling legal arguments than compelling legal arguments.

    The rest is all handwaving about judicial deference, the policy impacts of striking down credits through the federal exchanges, etc.

    1. “The rest is all handwaving about judicial deference, the policy impacts of striking down credits through the federal exchanges, etc.”

      Special pleading; we DESERVE this since we meant well!

    2. I’m having a hard time maintaining any optimism about this decision.

      SCOTUS has taken as its main priority, I believe the preservation of the status quo with whatever minimal tweaks are needed. That status quo is (as we saw in the Sebelius case) a federal government with plenary, not limited, authority over our economic lives. That status quo is also an administrative state with virtually unlimited scope (as institutionalized in Chevron deference to administrative agencies).

      Its going to be very difficult for SCOTUS to overturn the IRS rule without attacking the status quo of the administrative state. I don’t think they have the balls for it, not in a case of this magnitude, anyway.

    3. I would say there are no truly compelling arguments for the ACA at all, legal/intellectual/practical or otherwise.

      -So many steps along the path to implementation have been of (at best) questionable legality.
      -The whole notion that forcing people to pay for a service will bring down the price of that service is intellectually dishonest for anyone with a basic grasp of economics.
      -In practice, this law hasn’t actually done anything positive. We have a few million new insurance customers with copays that they can’t afford — great job!

      The only argument anybody is actually making, although you have to read between the lines, is that the ACA is Obama’s only “accomplishment” as President, and that makes it a hill worth dying on for the left.

      1. We have a few million new insurance customers with copays that they can’t afford — great job!

        Not to mention that we’re on pace to increase Medicare/Medicaid outlays from last year, so they can’t even claim that it’s saving the taxpayers money.

  2. You have to fix the law that Team Blue knew would be a problem even though they didn’t read it. – derp/journalist/propagandist

  3. Yes, I’d really like to blame the Republicans for allowing this POS legislation to become reality,and not doing a better job at fighting it. But then, they are half of the group responsible for creating the alleged 2-Party system in the first place. So, lose-lose?

    1. What else could they have done? They nominated members who got elected to Congress & all opposed it & then voted against it.

  4. I’m so happy that my wife’s policy got dropped for non-compliance to Obamacare, forcing us onto the marketplace where we were only able to afford a comparable plan by signing up for the subsidy. At least I’ll be able to warm myself at night with the thought that some douchebag “artist” with a pre-existing condition was able to get cheap insurance.

  5. The subsidies aren’t going anywhere, even if the court sides with the ACA opponents. Voters will flip out if they have to pay the full……300 or 500 (?) dollars a month for insurance premiums.

    But if the court upholds Obamacare as written, it will be yet another reminder that it was hastily written law that was passed without serious discussion.

    Lots of people already had medicaid equivalents and insurance before ACA. The quality of healthcare and waiting times (I speak from experience) has not changed ONE IOTA since the passage of ACA. I bet half of the people who support ACA have not really benefited from it in a tangible way. But they can’t convince themselves that their ideology and Obama can be wrong. Classic identity politics.

    Expanded medicaid technically gives you more options, but you have to find the hospital that offers them.

    1. For a family of three or four, it’s more like 700-900.

    2. Voters will flip out if they have to pay the full……300 or 500 (?) dollars a month for insurance premiums.

      Well, some voters will.

      There’s two ways to solve that, you know. The high-probability bet is that we’ll just throw money at them, of course.

      But, we could also get rid of the individual mandates, and the other mandates driving up the cost of insurance (community rating, no medical underwriting, that kind of thing).

    3. Expanded medicaid technically gives you more options, but you have to find the hospital that offers them.

      I don’t know of any hospitals that don’t take Medicaid. When you get into Medicaid managed care plans, some of those are limited networks, but there’s always a hospital in your network. And you can always force a hospital to give you free care by going to the ED.

      Nah, the problem with Medicaid isn’t access to hospitals. Its access to doctors.

      1. I was thinking more like mental health services and things like that were not guaranteed in previous medicaid.

        There were hospitals around my area that didn’t participate in medi-cal after ACA passed, but that might have changed now.

    4. Per capita medical spending is about $10000/year right now, so $500 isn’t going to cut it for the “full premiums” in the long run. Think more like $1000/month/person.

  6. I am just now personally experiencing the horror that is the ACA. My spouse and I are now self-employed and make too much for subsidies, so we have to foot the whole bill. The amount that we will have to shell out for ACA-approved insurance that will likely never pay a dime for medical care for us is ridiculous. I looked at short term medical insurance plans (i.e. ACA non-compliant plans), And they are 1/3 of the price for similar coverage (or half the price for better coverage). If these short-term plans had guaranteed re-issue (even if it cost a little more), and I weren’t subject to a 2% penalty next year, I’d just avoid the ACA altogether. Unfortunately, becasue progs hate any form of self-determination, I’m stuck in this shitpile of a health insurance market.

    1. I completely feel your pain.

    2. Our situations sre similar. The ACA has a provision for certain “life events” that let you off the hook for the 2% penaltax. haveing a disconect notice from your electricity provider is one. That is easy enough to manufacture. Even if the short term plan isn’t automatic reissue I don’t think you can be turned down for another policy can you ?

      With the preexisting condition aspect it might just make sense to wait until one is really sick before buying any plan. I believe their is no enrollment window for the short term plans.

  7. The disconnect consumers have from prices is only growing under Obamacare.

    Here’s the problem with democracy, and ‘light’ socialism and general government intrusion. Most people are divorced from the immediate consequences, but long term, there is no escape. Beyond that, most people are so ignorant that even when the consequences do hit, they won’t be blaming the people responsible – those in government.

    1. they won’t be blaming the people responsible

      MARKET FAYLYOOR!!!!!!11!

      Plus – KOCHTOPUS!!111!

  8. You mean Dems are responsible for the “law” they passed and implemented, with no support from anyone else?

    Yeah – that makes sense.

    I blame Bush.

    ^^ WHAT DEMOCRATS ACTUALLY BELIEVE!!!

    1. You mean Dems are responsible for the “law” they passed and implemented, with no support from anyone else?

      [Democrat] But they were trying to compromise with the GOP! Without the GOP, they could have passed single payer, and all our problems would be solved!

  9. Possible plan: The GOP comes up with a bill eliminating most or all of the insurance mandates. Or at least, allowing people to opt out them. This would lower the cost of plans enough that the loss of subsidies would matter less, and highlight the reality that all the “free birth control” etc. crap is part of what is raising the cost of the plans.

    Maybe Obama would veto it, and maybe Congress couldn’t force HHS to do it. But at least the anti-ACA folks would be able to say: “Well, we tried to lower the cost of the plans, but Obama and the Democrats wouldn’t let us. They insist the plans be expensive, so don’t blame us.”

  10. Democrats claim they are pro-choice but favor mandates like Obozocare.

    When I wrote such a thing on puffingtonpost – before I was booted off, the stock progressive communist reply was – well – you are required to have car insurance so what’s the problem with Obamacare?

    Well, Mr Commie – the mandate for car insurance is from a state which is a requirement if you purchase a car. You are not born with a car – you are not required to have a car.

    The Obozocare mandate is from the federal government to insure my body. I am born with a body – a body is not an option. The US Constitution does not give government any authority to mandate that my body have health insurance.

    Oh yea – but the Supreme Court says you are – so there. Just deal with it !!

    Oh Mr commie – just because the Supreme Court ruled in favor of Obozocare does not make it just. The Supreme Count once ruled ( Buck v. Bel) in favor of compulsory sterilization of the unfit, including the intellectually disabled, “for the protection and health of the state”.’ Was that just?

    Just deal with – it’s for your own good.

    1. It is not heartening to remember that Buck v. Bell remains – at least technically, if not necessarily in practice – the law of the land.

    2. the part of auto insurance that is mandatory is liability – you are liable for the medical expenses of other people involved, and for damage to the car still owned by the bank. You are not required to cover your own medical expenses or damage to a car that you own free and clear.

  11. The Kaiser Health Policy News Index says 59 percent of Americans aren’t paying any attention to news stories about King v. Burwell. A mere 16 percent have been following the story. So you can imagine the overwhelming appeal to emotion Democrats and the media would roll out if millions were to lose their subsidies.

    Because that is what they do, in lieu of rationality and intelligence.

  12. There is video of J. Gruber outlining the intent – that only state/non-federal exchanges would receive the subsidies.

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  14. Where in the hell is Grover Norquist? If he could make those Republican bastards agree to no tax increases can’t he get them to agree to never, under any circumstances, aid and abet the continuation of Obama’s bastard child.

  15. Here is Vox: “What a Supreme Court ruling against Obamacare would look like, in 3 maps.”

    And judging by the usual quality of Vox’s maps, they’ll use a misleading color chart and make a bunch of apples to oranges comparisons.

    1. Choropleth maps with bad methodology…a favorite tool of liars everywhere. First map uses numbers not normalized against population, distorting the impact per state. Second map lists percentage range of increases but excludes what the actual premium increases would be in each of those states. Third map doesn’t illustrate anything except states that had exchanges (most of which are now on the federal system and would be affected by the ruling) and states that have used the federal system since the beginning.

      Apparently Sarah Kliff never bothered to take a basic course on proper use of statistics in ArcGIS.

      1. Why does she need a course? Seems to me Sara Kliff is (mis)using GIS in exactly the right way for her political purposes.

  16. The problem is even if they manage to get the law held to what is written the party in charge is still expected to “do something”.

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  26. If Obamacare is repealed, I’m anxious to see how it affects the substance abuse treatment industry. Could be catastrophic since the Heroin epidemic has grown so large across the United States.

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