SCOTUS vs ACA

Update VII: Well, he’s wrong about this:

Boehner: “What I’m concerned about is a law that’s driving up the cost of health care, and making it harder for employers to hire people.”

1.) The LAW doesn’t drive up the cost of health care.  Rather, it does absolutely nothing to rein costs in.  That’s what makes it such a bad law- it’s every Republican’s wet dream, including the opportunity to now call it a tax!  It will now become the new political football between the parties, replacing the abortion bugaboo that’s just about run its course.  You could say that like Roe v. Wade, the ACA is also one of those laws that is incomplete and doesn’t address the underlying issues but will be used as a proxy until we all cry uncle in 40 years.  Except for the individual mandate, it doesn’t follow any of the principles of good health care policy which would include increased competition and cost controls.

2.) Employers find it hard to hire people because employees insist on getting paid.  Many Republican politicians come from states that once didn’t pay people as a matter of principle.

Boehner: “The number one concern for families and small business people is the cost of health insurance, and the Republican health care reforms will in fact lower health care costs.”

HOW does that work, John?  You guys don’t have a plan that doesn’t leave every man, woman and child vulnerable to high cost insurance plans or no plan at all.  Come to think of it, this is what ACA does too, except now more people will have the opportunity to hand over their small personal fortunes and savings accounts to insurance companies.  What is it Republicans have to be angry about?  You’ve got nearly everything you ever wanted.  Was it because a plan than no one but a Republican could love was forced upon you?
I want to move to Micronesia.

Update VI: I find myself hating the ACA because of the individual mandate even though in principle, I know that universal coverage is needed for a health care policy to be effective.  The reason is that with the ACA, we have disincentivized competition and cost controls.  Without those two pieces in the policy, this thing is going to feel like an albatross around the neck for the consumer and the Democratic party.  Sure, you can go without a high cost policy but when you do end up going to the hospital for some emergency that could have been treated with a lower cost insurance plan, you’re going to get socked with a tax when you are least able to pay it.

The characteristics of good health care policy are not a mystery and yet, this president and his party has declined to implement them in this law.  (See this excellent Frontline episode on what those characteristics are and how our elected officials have completely f^*(ed us over with the ACA)

As Lambert says, you can’t buff a turd.  This is the worst of all worlds for the vast majority of people who are forced to buy insurance on the individual market.  You’re made to feel irresponsible if you don’t put paying your health insurance the very first priority among a long list of monthly expenses.  There is no public option, insurers are not required to offer a reasonably priced option, no Tricare, no Medicare for All, no mandatory expansion of Medicaid. And zero cost controls on hospitals or providers. You’re either a “have” or a “have-not” now.

Bottom line: Poor policy is no substitute for no policy, especially now that it has been “decided” and is “over”.

Thanks Dems.  You deserve everything that’s coming to you.

Can we have Hillary now?!

BTW, Lambert has a very insightful post on what the new socio-political landscape now looks like.

Update V:

Obama: For those who don’t currently have health insurance, “this law provides an array of quality affordable private health insurance plans to choose from.”

Define “affordable” and “quality”, or “array”.  For that matter, why can’t we have a public option?

Obama: “Today the Supreme Court also upheld the principle People who can afford health insurance should take the responsibility to buy health insurance”

Has he seen what individual policies cost in NJ where the “array” starts at about $1000/month for a basic, high deductible policy??  Who the hell can afford that?!

Update IV: Here’s a snippet of Democratic party reactions from a NYTimes summary of the impact of the ruling:

“This decision is a victory for the American people,” said Representative Nancy Pelosi, the Democratic leader in the House. “With this ruling, Americans will benefit from critical patient protections, lower costs for the middle class [Really?  That’s not what my source in the health insurance business is saying.  She says more consolidation among big companies, less competition], more coverage for families and greater accountability for the insurance industry.”

Jim Kessler, the senior vice president of Third Way, a liberal research group in Washington, said the president’s campaign team and his Democratic allies now had a challenge ahead of them to explain the ruling.

“I think it’s a big win for Obama if they handle it right,” Mr. Kessler said. “What they need to be saying is to declare that the fight is now over. It’s been decided by Congress. It’s been decided by the courts. This is now over. It’s in the past.”

You gotta give the Democrats credit for utter cluelessness.  No one does it better.  Yes, let’s craft an expensive, inadequate bill that burdens average Americans with private sector insurance premiums at a premium or slap them with a tax when they don’t pay it, and “tell them tough titties if they don’t like it because it’s over, looooosers.  We’re done talking about conservative non-plans or medicare for all or public options.  Did you hear us, nation?  It’s OVER!  Get in line, let’s Unify.  “People all over the world, join hands, get on a LOVE train, LOVE train…”

(Karl Rove sits in a corner and smiles like a Cheshire Cat.)

In a way, this concretizes (is that a word?) all of the worst aspects of insurance into law. There will be no competition.  Sure, the insurance companies will gripe about not being able to deny coverage mercilessly but they’ll get over it.

{{damn}}  I was really hoping for Tricare.

Update III: IANAL but this tweet by Dave Dayan concerns me greatly:

David Dayen ‏@ddayen

SCOTUSBlog: “rejection of Commerce Clause and Nec. and Proper Clause… a major blow to Congress’s authority to pass social welfare laws”

Is there a poison pill slipped into this ruling?

Update II:  Ok, I think I see how this is going to play out on Fox:

Supreme Court Rules that Obamacare Tax is Legal.

Well, that didn’t take long:

Sarah Palin ‏@SarahPalinUSA

Obama lied to the American people. Again. He said it wasn’t a tax. Obama lies; freedom dies.

Update: The ruling came down a couple of minutes ago.  The NYTimes editors are reading it now.  You can follow it at the Elections 2012 page.  Also, follow coverage live at SCOTUSblog.

Andy Carvin tweets:

Andy Carvin ‏@acarvin

SCOTUSblog: “The individual mandate survives as a tax.” Does that mean the commerce clause version is dead, but a tax version conceivable?

Yes, this makes sense to me.  In a way, we are all forced to pay into the medicare system even if we can’t use it until we get older.  We pay for it with payroll taxes.  So, if the universal mandate is to stand, it has to be through a similar tax.  Otherwise, the ACA would force people to purchase insurance at whatever price the market would bear, which is what is happening now.  So, would this push us *closer* to medicare for all?? What are the chances that this SCOTUS would actually do something positive for the public?

Or, are they anticipating a firestorm from the private sector and libertarians, as Digby has suggested?  This might actually put Obama in more of a pickle this year if the answer is to raise taxes and spurn the free market.  No one would be happy except the uninsured.

And who cares about them, right?

{{sneaky bastards}}

Other questions:

1.) If you don’t have a job, how can you pay the tax?

2.) Would there be a mechanism to pay the tax at time of service?

3.) Would this make it more or less likely that employer provided health insurance benefits would continue?

Amy Howe of SCOTUSblog sums it up this way:

In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding.

Soooo, is this a win for Romney?  Or Obama?  Does this mean that we still have to pay through the nose?  Because that would be a loss for all of us, unless we get to pay a tax at the point of service, which wouldn’t be so bad if you set aside funds to cover it, I guess.  But what kind of money are we talking about here?

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The ruling should be out sometime this morning and, presumably, all hell will break loose.  If it stays intact, Romney will have to figure out a way of condemning pretty much the same healthcare bill he signed into law in Massachusetts.  If it is rejected, in whole or in part, Obama is going to have to figure out how to run on a new “accomplishment”.

Either way, we’re stuck with outrageous health insurance bills.

So, to the poll:

What’s that you say, Bernie?  Medicare for all?  It’s short, it’s got a good beat, you can dance to it:

And the military has socialized medicine.  {{snort!}}  Yep, pretty much.  I was raised on socialized medicine.

Jeffrey Toobin weighs in.  He thinks the individual mandate is in jeopardy based on oral arguments.