Saturday, December 15, 2018

Is the ACA Toast?

'Twas the week before Christmas, and the Grinch paid a visit....
In this morning's news was this little surprise , at least it was a surprise to me. From the article:

"The Affordable Care Act could be headed back to the Supreme Court for the third time after a federal judge in Texas ruled Friday that the law is unconstitutional.
Judge Reed O’Connor of the U.S. District Court for the Northern District of Texas issued the opinion in a lawsuit brought in February by Republican officials in 20 states led by Texas Attorney General Ken Paxton. Those officials contended that the entire law should be stricken because Congress earlier this year repealed the fines known as “shared responsibility payments” that people without health coverage had to pay under the Affordable Care Act’s individual mandate. O’Connor agreed."


"...If the ruling stands, the Affordable Care Act’s insurance regulations would disappear and, along with them, the health coverage for millions of people who gained private
insurance or Medicaid coverage under the 2010 law signed by President Barack Obama. Specifically, the law’s guarantee of coverage for people regardless of their pre-existing conditions, financial assistance for private insurance, rules establishing a basic minimum set of benefits insurance policies must cover and more would vanish. Since O’Connor’s ruling throws out the entire statute, the rest of the ACA, such as its expansion of Medicaid to low-income adults, also is stricken."

I'm reading it as a Catch-22, or at least an attempted one:
"Obama’s Justice Department maintained that the mandate went hand-in-hand with the rules protecting people with pre-existing conditions and the insurance subsidies the law provides, and that the mandate could not be eliminated without scrapping the entire law. Chief Justice John Roberts based his majority opinion on the case in part on this line of reasoning when he wrote that the mandate is constitutional as part of Congress’ power to tax."

So do millions of Americans end up with a lump of coal in their stockings, and no insurance?  Of course it will be appealed, but it adds a further element of instability to the healthcare scenario.
President Trump had this to say in a tweet:
  “As I predicted all along, Obamacare has been struck down as an UNCONSTITUTIONAL disaster! Now Congress must pass a STRONG law that provides GREAT healthcare and protects pre-existing conditions,”

10 comments:

  1. Christian Farias of the NYTimes doesn't seem to think the ruling will survive crossing the borders of Texas:

    ttps://www.nytimes.com/2018/12/15/opinion/obamacare-unconstitutional-texas-judge.html?action=click&module=Opinion&pgtype=Homepage

    The real bad news in his analysis is this:
    "The ruling ... is not a model of constitutional or statutory analysis. It’s instead a predictable exercise in motivated reasoning — drafted by a jurist with a history of ruling against policies and laws advanced by President Barack Obama."

    "The reason the judge, Reed O’Connor, gets these cases isn’t a mystery: Texas and its allied states know the game and shop these lawsuits right into Judge O’Connor’s courtroom."

    There have always been political judges. And there have always been even more judges whose keen analysis of The Law is colored by their subconscious politics. But our system of checks and balances, with three branches of government including the independent judiciary, only works because we pretend those facts of history are not true. Our Constitution is like Santa Claus; it only produces toys as long as you believe in it. Both parties with their promises to tilt the Supreme Court, have been tearing down faith in Santa, and Brett Kavanaugh's hearings left the poor boy naked and reindeer-less. But this is true: If we stop pretending to believe in the independence of the judiciary and its ability to find a real meaning in The Law, we may as well call off elections as well because we'll end up the the same place.

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  2. Chip. Chip. Chop. Chop.

    If all elected and appointed federal, state and municipal lawmakers (including judges and SCOTUS Justices) could only enroll in the same level of medical plan that is available to the unwashed hoi polloi (with no off the books or taxable supplemental plans), we might start to see better levels of health care in this country. I have excellent VA coverage and one advantage that the VA has over the ACA is negotiable prescription drug prices from the manufacturers.

    But none of this is new news and I don't see any relief for the UHP in the foreseeable future.

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  3. See also:

    What the Lawless Obamacare Ruling Means
    It’s not based on a solid legal argument. It’s an exercise in raw judicial power.
    By Jonathan H. Adler and Abbe R. Gluck

    https://www.nytimes.com/2018/12/15/opinion/obamacare-ruling-unconstitutional-affordable-care-act.html?action=click&module=Opinion&pgtype=Homepage

    A Partisan Ruling on Obamacare
    A decision by a judge in Texas striking down the totality of the Affordable Care Act has little basis in law.
    By Cristian Farias

    https://www.nytimes.com/2018/12/15/opinion/obamacare-unconstitutional-texas-judge.html?action=click&module=Opinion&pgtype=Homepage

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  4. The ACA is not toast. I think that the judge is up to something else.

    We can't discount that what the judge did was another attempt by the Republicans to keep the pot boiling by pretending to do something even though they know that it will fail. They have been doing this with abortion for forty years, pretending to address it without actually doing so. (They are doing this with the "Wall" right now as well).

    But what I think the judge is doing is playing a game that is only just beginning in earnest. The main Rightist argument against the individual mandate is, of course, that it's unconstitutional to make people buy something they don't want. But the target here is socialism. Since the Right got thrashed in the last election and since the maggots in their corrupt world are now turning into large fat buzzing flies, they are looking for something new to mobilize their followers and gain new ones. This new thing is that Democrats are socialists (all of them). And of course, socialists are Communists, Nazis, Bolsheviks, Venezuelans, etc etc. It taps into a richer tapestry, so to speak, for them to make this equation and balances out well against their own defense of their corruption of "nobody's perfect".

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    1. On this theory...there will be a Texas court ruling declaring that the use of tax monies to build roads is unconstitutional. How will that go down out there in the yonder territory?

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    2. As you know, the Right is very selective about what our revered forefathers allowed and did not allow in the Constitution. Roads are fine. So are things that limit the liabilities of capitalists, even if these safety nets are supported by taxes. It's not that the Right is opposed to socialism in all cases. Only in cases where it benefits the rank and file.

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  5. Thanks, Patrick. Glad you weighed in on this. I agree that they're probably playing a long game, as well as keeping the pot boiling in the present. It's kind of ironic that commies and socialists (real or imagined) are the bogeymen they mobilize their followers with, but yet their leader is best buddies with Putin, who is a real commie. And who almost certainly interfered in our election.

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  6. A view from ConservativeLand: here is Robert VerBruggen in National Review:

    "A judge has ruled Obamacare unconstitutional. This basically doesn’t mean anything.

    For one thing, there’s no injunction stopping the law in the short term. For another, the suit has little chance of surviving the appeals process because the argument behind it is weak. Even reliable Obamacare opponents in the conservative legal movement have generally distanced themselves from it."

    https://www.nationalreview.com/corner/dont-cheer-or-panic-over-that-obamacare-ruling/

    My guess is that our leaders in Congress don't think this ruling is going to survive, because there is no scrambling going on right now to do anything about it, except to make political hay out of it. Democrats, who believe their electoral success last month was due to attacking Republicans over health care, are now actively trying to pin this judge's ruling on Republicans. Republicans, who apparently think the Democrats' analysis is astute, aren't saying much of anything.

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  7. I think Friday was the last day to sign up for a plan through the ACA. Anyway, a family member thought everything was set, having done the computer work weeks ago. She had already received a set of membership cards in the mail. But she thought she had better check just to make sure everything was in order. Previously they were eligible for a subsidy and also were for 2019. However due to a glitch of some kind the subsidy had not been applied to their premium. It would have been $2800 a month in 2019 if she hadn't thought to double check. She had to spend a long time on the phone to get things straightened out, and was very grateful to a helpful service rep who aided her through the process. Our state now has only one insurance carrier who does ACA plans, and they don't cover anything if you travel out of state (I believe there is an exception for some emergencies).
    Contrast our Medicare/medigap plans which are good anywhere in the US where Medicare is accepted. You can change your extended and drug plans during open enrollment, but you don't have to. Your previous plans are automatically re-enrolled if you do nothing. There is a plethora of carriers to choose from, but they all cover basically the same thing. Seems like the "marketplace" for the ACA plans is deliberately made more Byzantine than it has to be.

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    1. It had occurred to me that this judge's ruling could turn out to be a blessing in disguise if it compelled Republicans and Democrats to work together to come up with an Obamacare 2.0 which addresses the weaknesses and gaps in the current Obamacare. Of course, for the next two years and perhaps beyond, bipartisan cooperation is the only way that anything will get done. But Democrats in the House are not in the mood at the moment for bipartisan cooperation, and Republicans in the Senate aren't showing much appetite for it, either. And of course anything a united Congress managed to accomplish would have to be accepted by our Solomon in the White House.

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