Now that Paul Ryan is the presumptive new leader of the House of Representatives, what happens next? The single biggest domestic policy issue the country faces is Obamacare. So far, Republicans in Congress haven’t done anything very useful in addressing it. The House has voted 54 times to repeal some or […]
The Supreme Court’s ruling in King vs Burwell has some parallels to PPACA in general and the subsequent ruling on the individual mandate “penalty vs tax” issue in 2012, in the way in which it may influence policy decisions downstream. In the case of the 2012 ruling, Judge Roberts really provided us with two legal choices: obtain the kind of coverage the government deems appropriate OR pay penalty (I mean tax).
The K v B ruling, albeit another judicially illogical head-scratcher from Chief Justice Roberts, does not create any political emergencies or policy conundrums which could lead to the adoption of hasty “remedies”; remedies that would even be harder to undo when they miss their mark. For this small positive, those of us that favor Insurance market-friendly public policy alternatives to PPACA can be grateful.
As noted by Justice Antonin Scalia in a scathing dissent, the Court rules that the term “established by the State,” which appears seven times in the statute, can also mean “not established by the State.”
For those of us opposed to the economic catastrophe that is PPACA, this ruling may be a blessing in disguise. More tomorrow on the intended and unintended consequences of the SCOTUS ruling.
But for starters, here is something to think about. We now know (per Gruber and many others) the portion of the law that ties subsidies to formation of State Exchange was intentional and DEFINITELY NOT an oversight as Judge Roberts as other apologists for PPACA would have us believe – leaving him “no choice” but to intervene in order to prevent chaos…. as if there was no other financial option besides the subsidies as prescribed and ineptly administered by the ObamaCare mandate.
Certainly, reasonable people can disagree about whether Obamacare is, on balance, a good law, and improves upon the dreadful state of the U.S. healthcare regime. But it’s vexing to see so many liberals cheering the utter death of the Court’s ability to rebuke lawmakers when they put forth nonsensical laws. Roberts’ decision gives a lot more power to Congress, obligating the Court to ignore the plain text of laws “if at all possible.”
Well, anything is possible. Is the preservation of limited government so universally unimportant—and the protection of Obamacare so paramount—that it was worth the utter subjugation of the Court (hereafter known as the Legislative Subcommittee on Wording Tweaks) to the will of Congress?
If subsidies are threatened, there will likely be television ads showing people who are in the middle of cancer treatment, Orient notes. The media blitz will be paid for by special interests—the ones benefiting directly from the “safety net”: such as insurance companies, hospitals, and pharmaceutical companies.
“It would be far less expensive to buy actual care for the few who need it than to subsidize outrageously expensive, mandate-larded coverage for all,” she stated.
“Those who don’t need care will have more money if they drop coverage they don’t like and might not have bought, despite subsidies, if ObamaCare didn’t threaten to punish them.”
States have the option of licensing low-cost, true insurance plans that are not ACA-compliant. And such plans might have a burgeoning market if millions of potential customers were free of ObamaCare threats.
According to a Heritage Foundation survey, 69 percent agree that “passing new legislation to continue the Obamacare subsidies doesn’t fix the problem—it just prolongs it.”
President Obama recently stated that, “Congress could fix this whole thing with a one-sentence provision.” True: Repealing Obamacare in its entirety would only take one sentence. However, that is not likely what he meant. Congress would have the opportunity to propose changes to Obamacare, but they would have to be signed by a reluctant president who will never again face the voters.
Now that both chambers of Congress have Republican majorities, any legislative response will surely include eliminating the individual mandate, the most unpopular feature of the law. Victory for King would make Obamacare policies in most of the country “unaffordable” and thereby relieve 11.1 million people of the individual mandate. Any “fix” that re-imposes the mandate would be political kryptonite for this Congress.
However, the most popular provision of the law is the prohibition against health insurers taking pre-existing conditions into account when setting premiums or scheduling benefits. Obamacare’s supporters insist the two features go hand in glove. Because the law forces health insurers to accept any applicants without taking pre-existing conditions into consideration and charge everyone (except tobacco users) the same age the same premium, it must be coupled with an individual mandate.
If not coupled with a penalty (or fine or tax) for not having health insurance, people would simply wait until they get sick or injured and then buy health insurance. This leads to a so-called death spiral as health insurers increase their premiums in response to individuals’ behavior. It is an impeccable theory, but it does not hold up in a system run by politicians.
One of the victims of these failures and potential failures in these states is the Small Business Health Options Program (SHOP), a program that was designed as part of the PPACA to help small businesses access affordable health insurance for their employees.
In late May, Hawaii’s health insurance exchange became the latest one to bite the dust, taking its SHOP with it. The federal Centers for Medicare and Medicaid Services (CMMS) began restricting grant funds to the state’s Health Connector two months ago, after telling state officials that the program was out of compliance with the Affordable Care Act due to fiscal instability and ongoing IT issues. One of these IT issues involved SHOP. According to a May 15 article published by Fox News, “The Connector’s Small Business Health Options Program, targeted at small business owners, sent garbled data to insurers, preventing them from signing up small businesses and their employees.”
In mid-May, Hawaii’s Health Connector began making contingency plans in case the system did shut down entirely (which it did a week later), to transition operations to the federal government. The plan directed that no new enrollees would be accepted by the local exchange after May 15. In addition, outreach services were set to conclude May 31, and the 73-member workforce will be laid off by February 28, 2016.
The Fox News article noted that the exchange was riddled with trouble from the start. “The web portal never worked properly, despite the state spending $74 million on a contract to build and maintain it. The exchange experienced tremendous staff turnover, with three executive directors appointed in two years.”
In addition, enrollment reached just over 8,500 in the first year, and, as a result, the Hawaii exchange ended up being ranked as the most costly in the nation, at almost $24,000 per person.