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NFT: Appeals court panel deals blow to Obamacare

RicFlair : 7/22/2014 10:48 am
Quote:
WASHINGTON -- A federal appeals court dealt a potentially major blow to President Obama's health care law Tuesday, ruling that participants in health exchanges run by the federal government in 34 states are not eligible for tax subsidies.



http://www.usatoday.com/story/news/politics/2014/07/22/obama-health-care-court-ruling/12482127/ - ( New Window )
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.  
RicFlair : 7/22/2014 1:08 pm : link
CNN Breaking News ‏@cnnbrk 10m

Update: An appeals court rules in favor of Obamacare subsidies, on same day other court ruled against them. http://cnn.it/1wVAQAj
Yep.  
vibe4giants : 7/22/2014 1:11 pm : link
Quote:
The United States Court of Appeals for the Fourth Circuit, in Richmond, upheld the subsidies, saying that a rule issued by the Internal Revenue Service was a permissible exercise of the agencys discretion.
The ruling came within hours of a 2-to-1 ruling by a panel of the United States Court of Appeals for the District of Columbia Circuit, which said that the government could not subsidize insurance for people in states that use the federal exchange.
RE: RE: Buford, the republicans won't allow any votes to change anything  
eclipz928 : 7/22/2014 1:12 pm : link
In comment 11776256 GIANTSr01 said:
Quote:
In comment 11776239 BeerFridge said:


Quote:


anyway. If it's a decree, it's because one side has made it a mission to stop the law altogether. Unilateral changes are all the folks left to implement it can do.



When you ram through a law without input from the other side, you can't then expect the other side to bend over and fix the law.

This is comical - the whole premise and structure of the law was the "other side's" idea to begin with.
RE: .  
njm : 7/22/2014 1:14 pm : link
In comment 11776263 RicFlair said:
Quote:
CNN Breaking News @cnnbrk 10m

Update: An appeals court rules in favor of Obamacare subsidies, on same day other court ruled against them. http://cnn.it/1wVAQAj


Now that the 4th circuit has ruled in favor I hope they head directly to the USSC.
Wow, I was literally just reading  
Enoch : 7/22/2014 1:27 pm : link
the part of PPACA that allows the feds to step in if a state fails to establish an exchange. There really isn't much there-- it was added essentially as an afterthought. The core exchange-design section (1311) runs for several pages, while provision allowing the Feds to take over is about 20 lines long.

I don't know much about PPACA's tax-related provisions, but this seems like a pretty straightforward "plain language versus context of the overall statute" issue. There was clearly no intent for federally-run exchanges to be so fundamentally different from state-run ones.
RE: RE: RE: Buford, the republicans won't allow any votes to change anything  
buford : 7/22/2014 1:29 pm : link
In comment 11776273 eclipz928 said:
Quote:


This is comical - the whole premise and structure of the law was the "other side's" idea to begin with.


I guess that's why they all voted for it.
I don't have a strong enough background  
eclipz928 : 7/22/2014 1:38 pm : link
in political science, or psychology, to be able to explain why a collective group of people in Congress would vote against a policy that their party has recently and historically been in favor of - I can only just state what the facts are.
RE: RE: RE: Buford, the republicans won't allow any votes to change anything  
GIANTSr01 : 7/22/2014 1:39 pm : link
In comment 11776273 eclipz928 said:
Quote:
In comment 11776256 GIANTSr01 said:


Quote:


In comment 11776239 BeerFridge said:


Quote:


anyway. If it's a decree, it's because one side has made it a mission to stop the law altogether. Unilateral changes are all the folks left to implement it can do.



When you ram through a law without input from the other side, you can't then expect the other side to bend over and fix the law.


This is comical - the whole premise and structure of the law was the "other side's" idea to begin with.


Unfortunately Washington is "comical" these days. The "other side" needed to be included just so they could "share" the credit. But the way things went down, they weren't going to get any of the credit if it succeeded, thus they determined it was in their best interest not to fix all the issues that arose.

Basically a giant cluster**** from the beginning by all the clowns involved.
The Republicans had very limited input into this law  
buford : 7/22/2014 1:46 pm : link
the one that passed. They fought for certain things to be added and they were not. So they didn't vote for it.

The idea that this bill, the ACA, was a Republican construct is false. Remember Hillarycare? And what did McCain propose when he ran against Obama in 2008. Did it bear any resemblence to the ACA? No.
RE: Bockman  
Bockman : 7/22/2014 1:48 pm : link
In comment 11776262 cosmicj said:
Quote:
that's interesting to know that you work in this area.

What do you think the equilibrium point will past which major employers begin to dump their employees on to exchanges (public or private)? What should we look for?


From a strictly health care financial point-of-view, we're WAY past the equilibrium already. The employer mandate penalty is $2,000 per employee per year. Purchasing health care is already well over $10,000 per year on average per employee (which includes the cost of covering dependents).

The issue is that the social contract exists that a job comes with benefits. It becomes an employee attraction and retention issue, which complicates impacts to the bottom line.

I personally do a lot of modeling on this exact issue for my clients. We present them all the projected costs of -
1. Doing nothing, maybe pay the Excise Tax in 2018
2. Put in a bare-bones plan that just meets ACA requirements to avoid penalties
3. Stop offering coverage and give employees more salary to make up for it
4. Stop offering coverage and don't pay employees more

It then becomes an internal struggle between HR and Finance. I'm sure you can determine which way each faction leans, and which industries are more likely lean one way or the other as well.
RE: Then Senator Moynihan is an idiot, quite frankly.  
santacruzom : 7/22/2014 1:51 pm : link
In comment 11776204 kickerpa16 said:
Quote:
If he thought he could reform healthcare in 3 paragraphs, he has no earthly idea what he's talking about.


The way I see it, if he said he could reform healthcare in 3 paragraphs, he had a precise earthly idea whom he was talking to.
RE: RE: Buford, the republicans won't allow any votes to change anything  
BeerFridge : 7/22/2014 1:56 pm : link
In comment 11776256 GIANTSr01 said:
Quote:
In comment 11776239 BeerFridge said:


Quote:


anyway. If it's a decree, it's because one side has made it a mission to stop the law altogether. Unilateral changes are all the folks left to implement it can do.



When you ram through a law without input from the other side, you can't then expect the other side to bend over and fix the law.


Very fair point. I've definitely come to realize that this initial transgression contributed mightily to the crazy amount of obstruction that's followed.
Actually, the ACA isn't the old Republican play, nor close.  
manh george : 7/22/2014 1:57 pm : link
Quote:
The final strategy is to just sort of throw up ones hands at the prospect of reasoned debate. Whether the Heritage plan is meaningfully similar to the ACA is just a subjective matter, and if someone says that Paul Ryans plan to voucherize Medicare is a variant of the NHS because theyre both health care policies, whos to say anyones bare assertion is worse than anothers? And, on some level, this is indeed a question that cannot be empirically proven to an absolute certainty. But I fully stand by my accusation of bad faith. Lets consider a counterfactual. Lets say the a liberal think tank developed a proposal identical to the ACA, and Bill Clinton used the power of the bully pulpit to ram in right down Congresss throat in 1993. Barack Obama takes office in 2009 and proposes changing ClintonCare by making employee heath insurance benefits fully taxable, repealing the regulations requiring insurers to cover anything but catastrophic care, throwing many millions of people off Medicaid and devolving it further to the states, and enacting Paul Ryans proposal to end Medicare. Would any of the nominally left critics of the ACA be saying that Obamas proposed changes were no big deal because theyre fundamentally just a minor variation on the Democratic, Liberal Think Tank X plan? Of course not they would be leading riots against the greatest domestic betrayal by any Democratic president in at least a century, and theyd be right. Nobody really thinks that the Hertiage plan and the ACA are meaningfully similar. Its just that some people refuse to compare the ACA to the status quo ante rather than a superior alternative that had no chance of passing, and saying that Obama just signed the Heritage Plan sounds a lot better than being open that your offer to the uninsured and working poor until Congress can pass the Magic Ponies and Unicorns Act of 4545 is the same as the Republican one: nothing.


This link is a good summary of the comparisons. There are dozens of them, if you look, and there never really was a Republican or Conservative plan that was really similar to ACA. Chafee came closest, but he was a liberal Northeastern Republican to begin with, and his plan was never really serious.

The saddest irony of the ACA is that the political damage it did in to the President and his allies from 2010 onward damaged them sufficiently to make fixes almost impossible. And, it handed so many state legislatures to the Republicans, just as the new Census was creating massive gerrymandering opportunities. No game theorist in his right mind would have suggested passing this, just because the window was open.
Link - ( New Window )
cosmicj  
Bockman : 7/22/2014 2:00 pm : link
I forgot to answer your last question - what are the signs?

The signs have already started. Look back to last year when IBM put their pre-65 retirees on a private exchange. Of course, retirees are financially "just a liability on the balance sheet" so it's easier to wipe your hands clean. There will be much more backlash from actively working employees, as well as intense media attention.

My best guess? Wait for a large, well-known corporation to have a few really bad years financially. They'll look at what they spend the most money on. #1 is payroll. #2 is benefits. Tax deductibility and various other figures come into play, but there's no quicker way to shave hundreds of millions of dollars off your expenses.
Thanks Bockman  
cosmicj : 7/22/2014 2:23 pm : link
interesting info.
I don't get this  
TJ : 7/22/2014 2:49 pm : link
The law as passed was chock full of gifts for republicans. Big profits for insurance companies and big pharma. No single payer. No public option. No abortion. People from the left have been clamoring for those things in health care reform for decades but Obama never fought for them. He never even said the words "single payer" after Hillary conceded the nomination. And he jumped in immediately during congressional debate to let it be known he would be glad to sign a bill with no public option. He undercut many elected members of his own party on that.

As for impatience, I think dems decided there was no other way. After discussing health care reform since the 70s it became clear that only large comprehensive bill which would be difficult or impossible to completely roll back would allow the country to move toward reform. I believe republicans know that. Despite all the concessions obama made in an attempt to get any support at all from them, republicans oppose ACA so vehemntly because they know if any shred of obama care survives, it marks the beginning of the inevitable march toward the single payor model most people want.

In any event I think the republicans are beating a dead horse now. They'll never get enough of ACA declared unconstitutional to completely kill it. And each part that is gutted in court will eventually be replaced with something they like even less.
Bockman  
WideRight : 7/22/2014 2:54 pm : link
That will start that companies death spiral. Talent will leave for better employers.

Even if they don't provide the benefit, they would have to provide the cash so the individual can go to the market and buy it.
Single payer is neither inevitable nor likely.  
kickerpa16 : 7/22/2014 2:55 pm : link
We can amass significant deficits and spending targets with our current tax structure because we are a reserve currency.

That is a finite blessing (or curse, depending on which angle you view it from). It's end is coming sooner rather than later.

When that happens (not if), additional deficit spending will be devastating for significant portions of the populace.

It's likely we see a public-private amalgamation of health care, with mandates leading the way instead of direct government provision.
There is no chance people go for single payer now  
buford : 7/22/2014 2:55 pm : link
seeing how f-ed up the Obamacare rollout was and the VA Scandal. It's dead.
This idea that opposition  
Overseer : 7/22/2014 2:59 pm : link
was rooted in some substantive concerns for policy details is just pure fantasy. Maybe if your name is Olympia Snowe, but they conspired to stonewall him regardless of policy agreements/disagreements at every single turn before he even put his hand on the Bible. This is recorded history. And boy did they.

Another example being that while 0 voted for the stimulus (the same amount that voted for the ACA), they still cheerily showed up to tout the pork they delivered to their districts. Brutal.

Tip Oneill is not the only example of Ds working with GOP Prezs. W received significant minority support in several areas, even almost immediately after the extremely contentious 00 election.
Single payer  
WideRight : 7/22/2014 3:02 pm : link
would lead to rationing
I wouldn't put single payer on it's death bed yet. Vermont  
BeerFridge : 7/22/2014 3:02 pm : link
is going to try it. we'll see if they actually do, but if they can, it will be interesting to see how it turns out.
RE: I wouldn't put single payer on it's death bed yet. Vermont  
kickerpa16 : 7/22/2014 3:04 pm : link
In comment 11776631 BeerFridge said:
Quote:
is going to try it. we'll see if they actually do, but if they can, it will be interesting to see how it turns out.


I think I've mentioned it to you before, but if single payer is the route that elements want to go, enact it at state levels (i.e., the opt-in, even though I'm generally in favor of the opposite).

Much more able to be tailored and, depending on how much each state can fine tune it (I think it would have to be much more location specific in bigger states, like California), can have limited success.

I don't think much of what can be shown in Vermont is readily generalizable elsewhere.
Overseer  
WideRight : 7/22/2014 3:08 pm : link
I agree. I'm pretty sure thats what lead to the ACAs passage. Once Dems knew they had the votes, GOP should have welcomed a balanced discussion of the issues, they probably could have won a few Dems and blocked it.
Single payer is right for America  
Overseer : 7/22/2014 3:08 pm : link
in 1935. It is not now. And while it was smart to try to sell it from a political standpoint (not that "giving it up" helped draw in anyone not named Leiberman), even the public option would probably have been counter-productive,
RE: Bockman  
Bockman : 7/22/2014 3:13 pm : link
In comment 11776605 WideRight said:
Quote:
That will start that companies death spiral. Talent will leave for better employers.

Even if they don't provide the benefit, they would have to provide the cash so the individual can go to the market and buy it.


I agree with your last statement - they'd have to compensate the employees to make up for it. However, that would then be a fixed liability (salary), instead of being tied to insurance increases. Also, that company wouldn't have to pay them the whole nut, because there would be government subsidies picking up some of the tab.

As for your first comment, it's possible that the first company to drop coverage won't last due to talent leaving. That is why I'm saying it would be the last resort for a large corporation going down the tubes anyway - they have nothing else to lose.

Then, that first company gives cover for the others that would like to do the same, but without the backlash.

Also, don't forget about the administrative savings. Some of my clients hire my firm just to help them with the paperwork and compliance related to ACA!
RE: This idea that opposition  
Dunedin81 : 7/22/2014 3:14 pm : link
In comment 11776623 Overseer said:
Quote:
was rooted in some substantive concerns for policy details is just pure fantasy. Maybe if your name is Olympia Snowe, but they conspired to stonewall him regardless of policy agreements/disagreements at every single turn before he even put his hand on the Bible. This is recorded history. And boy did they.

Another example being that while 0 voted for the stimulus (the same amount that voted for the ACA), they still cheerily showed up to tout the pork they delivered to their districts. Brutal.

Tip Oneill is not the only example of Ds working with GOP Prezs. W received significant minority support in several areas, even almost immediately after the extremely contentious 00 election.


You seem to suggest that this was entirely one-sided. The spirit of compromise, even collegiality, was not really alive and well in the three or so years that preceded the 2008 election, the idea that a new occupant was not going to get the same treatment from the other side was pretty fanciful in the first place.
Admin savings is key  
WideRight : 7/22/2014 3:17 pm : link
If the health care market works for individuals, and the company can pay the difference in cash and dump admin, thats a win.
No love for Pelosi  
Overseer : 7/22/2014 3:32 pm : link
but stonewalling as a majority party in year 6 of a (by then unpopular) President's term is different from doing so as a minority in year 1. And even then, the extent of said wall was more limited as evidenced by, for instance, the ("here's free money") 2008 stimulus.
This is what you get when you ram through major legislation  
BillT : 7/22/2014 3:48 pm : link
Using reconciliation which was and is unheard of for any kind of major bill. The House and Senate passed different versions of the ACA and to this day haven't voted on the same bill. It's probably the single worst piece of legislation in US history. Nice work everyone.
I'd  
AcidTest : 7/22/2014 3:54 pm : link
be surprised if this wasn't decided by the Supreme Court.

(1) The lower courts are deeply split on the issue. An appeals court in Richmond just ruled that the subsidies are OK for federal exchanges, on the same day a panel for the DC Circuit ruled they are not. The SC is supposed to step in and "smooth" out "bumps" in the law, especially on critically important issues like a national healthcare program.

(2) There is a legitimate legal question, namely the extent to which courts should defer to an agency's interpretation of a statute it has been given authority by Congress to administer. That deference is traditionally substantial, but not limitless. It does not include allowing agencies to rewrite the plain language of a statute. And the plain language of the ACA says that subsidies are only permissible for exchanges established by the states. As Dunedin81 said, the SC could easily rule that extending that to include federal exchanges requires Congress to amend the law.

(3) The original decision to uphold the ACA was a 5-4 decision, with a vigorous dissent. Even Roberts only voted to uphold the law as a tax, not as a valid exercise by Congress of its authority to regulate interstate commerce. Now comes the perfect vehicle for the dissent to effectively overrule that decision without explicitly doing so. They simply need to convince Roberts to reaffirm the principle that when the language of a statute is explicit, that meaning controls, and must be enforced as such, even by the agency charged with enforcing the law.
RE: This is what you get when you ram through major legislation  
Stan from LA : 7/22/2014 3:59 pm : link
In comment 11776734 BillT said:
Quote:
Using reconciliation which was and is unheard of for any kind of major bill. The House and Senate passed different versions of the ACA and to this day haven't voted on the same bill. It's probably the single worst piece of legislation in US history. Nice work everyone.


And it's here to stay despite the haters.
Wrong as usual BillT  
Overseer : 7/22/2014 3:59 pm : link
both welfare reform and the Bush tax cuts were passed using reconciliation. COBRA, Medicare Advantage (I could go on).

Oh sorry, was Welfare reform not "major legislation"? That's one possible way you could back out of your bullshit claim.
Moreover  
Overseer : 7/22/2014 4:00 pm : link
the only reason the ACA had to be passed in the manner it was anyway is because Ted Kennedy got brain cancer and Martha Coakley is a moron.
Here's the list Overseer  
BillT : 7/22/2014 4:16 pm : link
Omnibus Reconciliation Act of 1980
Omnibus Budget Reconciliation Act of 1981
Tax Equity and Fiscal Responsibility Act of 1982
Omnibus Budget Reconciliation Act of 1982
Omnibus Budget Reconciliation Act of 1983
Consolidated Omnibus Budget Reconciliation Act of 1985
Omnibus Budget Reconciliation Act of 1986
Omnibus Budget Reconciliation Act of 1987
Omnibus Budget Reconciliation Act of 1989
Omnibus Budget Reconciliation Act of 1990
Omnibus Budget Reconciliation Act of 1993
Balanced Budget Act of 1995 (vetoed)
Personal Responsibility and Budget Reconciliation Act of 1996
Balanced Budget Act of 1997
Taxpayer Relief Act of 1997
Taxpayer Refund and Relief Act of 1999 (vetoed)
Marriage Tax Relief Act of 2000 (vetoed)
Economic Growth and Tax Relief Reconciliation Act of 2001
Jobs and Growth Tax Relief Reconciliation Act of 2003
The Deficit Reduction Act of 2005
Tax Increase Prevention and Reconciliation Act of 2005


Notice. All tax and budget bills as reconciliation was intended for. Not bills that took control of 1/6 of the economy. But then I guess you could get around that by saying the ACA is just a tax bill. Still the worst piece of legislation ever.
Okay well now you're saying something different  
Overseer : 7/22/2014 4:29 pm : link
Welfare reform is one of several examples of a "major bill" passed via reconciliation.

And it's rather dubious to argue that "oh this is only a tax and/or budget related bill so fine to ram it home". The 2003 tax cuts were extremely consequential (negatively IMV) and passed the Senate with the VP's tie-breaking vote.
Acid  
WideRight : 7/22/2014 4:37 pm : link
The ACA is past repeal; SCOTUS could rule in a manner that would really screw it up, but I seriously doubt they want that on their hands.
The whole "took control of 1/6 of economy" line  
BeerFridge : 7/22/2014 4:40 pm : link
is pretty dumb. It was pretty much under government control before that too. It's just different rules.
BillT's more into hating than facts  
WideRight : 7/22/2014 4:43 pm : link
.
A large problem is that there will be large unintended consequences.  
kickerpa16 : 7/22/2014 4:55 pm : link
Both good and bad, these will undoubtedly be much larger than any of the tax reform or welfare reform legislations of the past due to the size and scope of the reform.

These can be mitigated by future re-examinations of parts of the act.
RE: Acid  
AcidTest : 7/22/2014 4:59 pm : link
In comment 11776843 WideRight said:
Quote:
The ACA is past repeal; SCOTUS could rule in a manner that would really screw it up, but I seriously doubt they want that on their hands.


Don't agree. The dissenters in that case are salivating at the prospect of crippling the law. Scalia, Thomas, and Alito have never hesitated to overrule precedents with which they disagree. And centrist Kennedy was on board with them in the ACA case. They just need Roberts. He could vote to uphold the idea of granting subsidies to those on federal exchanges, but can avoid accusations of flip flopping because the basis for this case is different than his rationale in the original ACA ruling.

A decision saying no to subsides for federal exchanges wouldn't technically overrule the ACA, but it would as a matter of reality.
What facts did I get wrong Wide Right  
BillT : 7/22/2014 5:04 pm : link
I backed up my reconciliation claim with the facts and no one with any sense doesn't realize it's the worst law ever passed. It's a disaster from top to bottom. Increased premiums, decreased coverages, incompetently executed. Did I miss all the good stuff we've gotten from this? Please fill us in.
Thats true  
WideRight : 7/22/2014 5:05 pm : link
and that was true last time. Its Roberts court, he put himself right in the middle of the issue last time, and ruled in favor of the ACA. And his ruling was designed to prevent the Commerce law from being used in this fashion again. Very forward thinking. He's not going back.

When a Congresswoman says" we have to pass the bill  
Blue21 : 7/22/2014 5:07 pm : link
to find out what's in it" you know it's headed to disaster.
Again, this case is never going to make it  
eclipz928 : 7/22/2014 5:07 pm : link
to the supreme court. In reality, it never should have gotten this far. Its a lawsuit based on semantics, not the intent of the law. Under further scrutiny as it becomes reviewed by the other district courts this case will fall apart quickly.
Increased premiums is not a fact.  
kickerpa16 : 7/22/2014 5:07 pm : link
Decreased coverage is also a tenuous claim, considering that you're dealing with a faulty economic recovery concurrently with the law, making it impossible to distinguish how much the law would have increased coverage without the downturn.

Plus, "worst law ever" is simply a subjective claim. Nothing wrong with it, but that doesn't mean that others should ascribe to that viewpoint.
Many premiums have increased, many have decreased.  
kickerpa16 : 7/22/2014 5:12 pm : link
There is no reliable source that as of yet has compiled average premium prices for HI.
RE: Again, this case is never going to make it  
Stan from LA : 7/22/2014 5:24 pm : link
In comment 11776892 eclipz928 said:
Quote:
to the supreme court. In reality, it never should have gotten this far. Its a lawsuit based on semantics, not the intent of the law. Under further scrutiny as it becomes reviewed by the other district courts this case will fall apart quickly.


Exactly. Once it this ruling is overturned by the full panel the SC will not take it.
RE: Again, this case is never going to make it  
Peter in Atlanta : 7/22/2014 6:39 pm : link
In comment 11776892 eclipz928 said:
Quote:
to the supreme court. In reality, it never should have gotten this far. Its a lawsuit based on semantics, not the intent of the law. Under further scrutiny as it becomes reviewed by the other district courts this case will fall apart quickly.


You couldn't be more wrong. Your argument of "intent" is semantics. The suit is based on the actual wording.
Well, he could be more wrong.  
manh george : 7/22/2014 7:19 pm : link
This was a 2-1 ruling by 3 Republican-appointed members of an 11-member Washington DC appeals court, where 7 of the 8 other members are Democratic-appointed, including 4 appointed by Obama. If the full appeals court hears the case and rules as the Virginia court did, then there are no differing appeals court opinions, and the SCOTUS probably won't take it up.

Quote:
The three-judge Virginia appeals court panel unanimously turned aside the argument of Obamacare opponents that the Affordable Care Act only allows assistance for buyers on the state exchanges.

The court said while the language of the law is subject to multiple interpretations, the IRS is entitled to deference in interpreting it to write regulations for the program.

We uphold the rule as a permissible exercise of the agencys discretion, the court said.


So, it comes down to whether the IRS has the right to interpret the legislation, which includes legilative intent as well as black and white language. Lot's of court cases are decided on legislative intent, particularly where the authority of the IRS to interpret is concerned. The cases rests upon interpretation of legislative language, not on intepretation of the US Constitution, so SCOTUS tends not to get involved unless there are conflicting Appeals Court decisions--which there may or my not be when the dust settles.
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