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.
The benefits of the reforms health care law. On the other side we have people who seem to think that this is the slow death march to socialism which is utterly incorrect.
But this is an outcome of trying to pass a huge law that reworks a sector of the economy that is a substantial fraction of annual GDP. And that human laws aren't perfect and that human legislation this highly imperfect in most cases.
So we see the logical outcome. It hints at the need for further reworking of a better health care law that addresses some of our significant deficiencies in the area. All too often people want a one time or one shot fix to the problem which isn't happening. This initially should've taken more time or more care to craft.
But people are too damn impatient and want to see a result now.
Here's to hoping we can find a workable solution for healthcare it will likely mean that people come both sides will be furious but it's going to be a pressing issue for the next few years.
whether you were for it or against it in the first place, what you've got right now is a mishmash of what passed, what survived legal challenge intact and what has been enacted by state governments as intended. And you've got concerns about the scope of presidential power to make this work in light of what has and hasn't happened without much of any support from the Congress.
The benefits of the reforms health care law. On the other side we have people who seem to think that this is the slow death march to socialism which is utterly incorrect.
But this is an outcome of trying to pass a huge law that reworks a sector of the economy that is a substantial fraction of annual GDP. And that human laws aren't perfect and that human legislation this highly imperfect in most cases.
So we see the logical outcome. It hints at the need for further reworking of a better health care law that addresses some of our significant deficiencies in the area. All too often people want a one time or one shot fix to the problem which isn't happening. This initially should've taken more time or more care to craft.
But people are too damn impatient and want to see a result now.
Here's to hoping we can find a workable solution for healthcare it will likely mean that people come both sides will be furious but it's going to be a pressing issue for the next few years.
[shrug]. Impatient? They've been ostensibly working on HC since the Clinton administration. I think the idea was to do something and then fix it. But, the act of doing something brought the government to a complete halt because the minority party decided to never let that happen again.
This is the kind of thing that could have been fixed in subsequent legislation, if legislation were something that was still possible.
As it is, it takes a pretty incredible interpretation of the law to support this legal argument
I think we both could agree that the revamping of the healthcare sector was necessary. Imperative, even.
But yes inpatient. Trying out a one-size-fits-all all law in one shot signals impatience. There are certainly political realities about this where if they had done minor changes they may not have been able to push through anything more.
But by doing minor changes people might have been able to see the added benefits of carefully crafted laws. This may have added further impetus for additional health care reform.
But beyond that impatience is apparent that they didn't address several significant flaws with the existing healthcare sector. Employer sponsored health insurance is but one example. It's not an unknown problem. That signals a rush to get through a major reworking of the healthcare sector instead of a smart reworking.
because I'm sure it's not long for this forum, but on the one hand you had a sense that this was some sort of "noble lie" and on the other an equally fictional commitment to an alternative reform package that didn't exist until after this was passed and even then was pretty trifling.
I think we both could agree that the revamping of the healthcare sector was necessary. Imperative, even.
But yes inpatient. Trying out a one-size-fits-all all law in one shot signals impatience. There are certainly political realities about this where if they had done minor changes they may not have been able to push through anything more.
But by doing minor changes people might have been able to see the added benefits of carefully crafted laws. This may have added further impetus for additional health care reform.
But beyond that impatience is apparent that they didn't address several significant flaws with the existing healthcare sector. Employer sponsored health insurance is but one example. It's not an unknown problem. That signals a rush to get through a major reworking of the healthcare sector instead of a smart reworking.
I guess minor changes might have worked. But what minor changes? And who will see the benefit? And the one thing that NO ONE but the crafters of this law have done is suggest anything that will expand access to health care for folks who aren't poor enough to have medicaid and can't afford it on their own. How long do they have to wait while we look for a perfect solution?
whether you were for it or against it in the first place, what you've got right now is a mishmash of what passed, what survived legal challenge intact and what has been enacted by state governments as intended. And you've got concerns about the scope of presidential power to make this work in light of what has and hasn't happened without much of any support from the Congress.
Agreed. Like you, I am an attorney. But whatever one thinks about the ACA, this ruling is correct. The law states that subsidies are available to people enrolled through an Exchange established by the State. Federal exchanges are not "established by the State."
Courts are required to apply the law as written. Some laws are badly drafted, so their meaning is subject to interpretation. Not this one. It is perfectly clear. That doesn't mean that the appeals court won't reverse this decision. But if they do, I'd be surprised if the Supremes didn't get involved, and reverse the appeals court. This is an extraordinarily clever and effective way of invalidating the ACA.
I think we both could agree that the revamping of the healthcare sector was necessary. Imperative, even.
But yes inpatient. Trying out a one-size-fits-all all law in one shot signals impatience. There are certainly political realities about this where if they had done minor changes they may not have been able to push through anything more.
But by doing minor changes people might have been able to see the added benefits of carefully crafted laws. This may have added further impetus for additional health care reform.
But beyond that impatience is apparent that they didn't address several significant flaws with the existing healthcare sector. Employer sponsored health insurance is but one example. It's not an unknown problem. That signals a rush to get through a major reworking of the healthcare sector instead of a smart reworking.
I guess minor changes might have worked. But what minor changes? And who will see the benefit? And the one thing that NO ONE but the crafters of this law have done is suggest anything that will expand access to health care for folks who aren't poor enough to have medicaid and can't afford it on their own. How long do they have to wait while we look for a perfect solution?
they don't have to wait, they just have to pay the fine.
All good points. But we've seen the crafting of this law and seeing the massive changes it has caused. The minor changes could have incorporated some sort of welfare additive with mandated coverage benefits and the destruction of the link between employment health insurance.
A counterpoint however is that this health care reform may have led to less impetus for further reform the next few years. Many people are skeptical about the long run implications of this law. Just like what the Fed is doing has long-run implications that we don't know, the same can be said about this health care law both good and bad.
I have always preferred local or state solutions to this problem. Coupled with top down mandates this might be a better future solution.
lawsuit to have been filed in the first place. So basically the letter of the law states that people who get insurance on the "state" exchanges will be eligible for subsidies - but a grievance was filed because they don't think people in states where they deferred the handling of their exchanges to the "federal" govt should be able to get the subsidies?
If this is upheld by an appellate court, who is this going to benefit? The rest of the law under Obamacare will still be intact and millions of people in those 34 states will be forced to pay more for private insurance - nobody wins.
depends on your feelings about federal subsidies I would guess
and the ability to simply wave a magic wand and make substantive changes to a law without sending it back through the legislature. If you're comfortable with the current occupant of the Oval Office doing so, ask if you'd be just as amenable to the next occupant doing the same thing.
kickerpa16 I am a big supporter of reform and the law
and you make very solid and fair points as you usually do. You are absolutely correct in that a law of this magnitude needs to be passed and that as the implementation begins, it should be constantly re-assessed/evaluated for changes and improvements. It's impossible to sit in the back halls of congress and accurately envision how a law of this magnitude will look once implementation begins. Unfortunately it may have been passed decades too late. In this political climate civil discourse and actual "legislating", which must include compromise is near impossible.
Listen in '81 Tip O'Neill and the Democratic House could easily have folded their arms and vowed to block every part of Reagan's agenda that they could. They didn't. They read the attitude of the country and did what they could do to work with Reagan on things, and hold firm to win a battle or 2 that they really wanted to win. I'm not saying I agreed with Reagan's policies or not. However when the country is struggling as it was then you need a govt. that is willing to move forward and work together on some level. This is simply not a part of the process any more. It's a shame because we are the ones that suffer.
Reagan wanted his tax policies and his military buildup, O'Neill wanted the bulk of his domestic/legislative prerogatives to remain unchanged or little changed. There is no comparable grand bargain to be made this time around.
All good points. But we've seen the crafting of this law and seeing the massive changes it has caused. The minor changes could have incorporated some sort of welfare additive with mandated coverage benefits and the destruction of the link between employment health insurance.
A counterpoint however is that this health care reform may have led to less impetus for further reform the next few years. Many people are skeptical about the long run implications of this law. Just like what the Fed is doing has long-run implications that we don't know, the same can be said about this health care law both good and bad.
I have always preferred local or state solutions to this problem. Coupled with top down mandates this might be a better future solution.
That's a fair point. Perhaps this holds together a fundamentally flawed system and puts off the real change we need, leading to a worse long term outcome.
I guess I look at it (like I look at everything) as an engineer. Get something in place, debug where necessary and refactor when appropriate. The odds that you could get the entire government to agree on one ideal approach is zero anyway.
Not really - the subsidies provided by the healthcare law
aren't like other federal subsidies where our income tax dollars directly or indirectly contribute to them. The funding of the insurance subsidies are self-contained within the law as it relates to insurance itself - the vast majority of people in the country aren't affected one way or another by the insurance discount someone else gets on the exchanges.
RE: kickerpa16 I am a big supporter of reform and the law
and you make very solid and fair points as you usually do. You are absolutely correct in that a law of this magnitude needs to be passed and that as the implementation begins, it should be constantly re-assessed/evaluated for changes and improvements. It's impossible to sit in the back halls of congress and accurately envision how a law of this magnitude will look once implementation begins. Unfortunately it may have been passed decades too late. In this political climate civil discourse and actual "legislating", which must include compromise is near impossible.
Listen in '81 Tip O'Neill and the Democratic House could easily have folded their arms and vowed to block every part of Reagan's agenda that they could. They didn't. They read the attitude of the country and did what they could do to work with Reagan on things, and hold firm to win a battle or 2 that they really wanted to win. I'm not saying I agreed with Reagan's policies or not. However when the country is struggling as it was then you need a govt. that is willing to move forward and work together on some level. This is simply not a part of the process any more. It's a shame because we are the ones that suffer.
Good post.
On a (hopefully) promising note, some of the lack of agreement between the parties is due to the cyclical nature of parties.
Over time, parties have folded as wings in that grouping fought for control and eventually splintered. The splinters grew larger and eventually started the process of compromise again.
I think we are seeing this splintering in process now and that, in a few decades, the grand bargains will again be a feature of the political landscape.
and the ability to simply wave a magic wand and make substantive changes to a law without sending it back through the legislature. If you're comfortable with the current occupant of the Oval Office doing so, ask if you'd be just as amenable to the next occupant doing the same thing.
Also agree. Presidents of both parties routinely use executive orders to try and get what they want, but Congress won't enact. "Signing statements" are another similar strategy presidents use to try and limit what part of a law they have to enforce. Neither are constitutional IMO. Both require a constitutional amendment. Good luck with that.
RE: On one side we have people mindlessly extolling
But this is an outcome of trying to pass a huge law that reworks a sector of the economy that is a substantial fraction of annual GDP. And that human laws aren't perfect and that human legislation this highly imperfect in most cases.
I think a comparison to the Tax Reform Act of 1986 might be enlightening. The process that led to the bill began more than 2 years before it was passed. Representatives and Senators from both parties had significant input into the legislation. And even them, a technical corrections
bill was needed to fix some minor glitches in the final bill. But compared to the ACA it was incredibly smooth process.
This was a rushed piece of legislation that was not properly vetted by either side. And this is the result.
because nobody wins this way. This cycle of whatever party is in charge even by the slimmest of margins slamming their agenda through always hurts at least 50% of the country.
All good points. But we've seen the crafting of this law and seeing the massive changes it has caused. The minor changes could have incorporated some sort of welfare additive with mandated coverage benefits and the destruction of the link between employment health insurance.
A counterpoint however is that this health care reform may have led to less impetus for further reform the next few years. Many people are skeptical about the long run implications of this law. Just like what the Fed is doing has long-run implications that we don't know, the same can be said about this health care law both good and bad.
I have always preferred local or state solutions to this problem. Coupled with top down mandates this might be a better future solution.
That's a fair point. Perhaps this holds together a fundamentally flawed system and puts off the real change we need, leading to a worse long term outcome.
I guess I look at it (like I look at everything) as an engineer. Get something in place, debug where necessary and refactor when appropriate. The odds that you could get the entire government to agree on one ideal approach is zero anyway.
The debugging analogy is a good one. But may I propose it one step further.
Politics is like stringing together a nuclear code for missiles. While bugs are inevitable, too many (or needing fixes to often because it was out together haphazardly) can lead to inadvertent nuclear war.
The unintended consequences of our actions can lead to decades of misery (hell, see stagflation and the Fed simply misinterpreting a data point). Change is necessary, but we've maintained the point where large scale planning (or attempts to do it) is futile and deadly.
because nobody wins this way. This cycle of whatever party is in charge even by the slimmest of margins slamming their agenda through always hurts at least 50% of the country.
Ha, I'd revise it to 90%.
Only those in power and a small fraction ever see good benefits from the changes recently.
RE: RE: On one side we have people mindlessly extolling
But this is an outcome of trying to pass a huge law that reworks a sector of the economy that is a substantial fraction of annual GDP. And that human laws aren't perfect and that human legislation this highly imperfect in most cases.
I think a comparison to the Tax Reform Act of 1986 might be enlightening. The process that led to the bill began more than 2 years before it was passed. Representatives and Senators from both parties had significant input into the legislation. And even them, a technical corrections
bill was needed to fix some minor glitches in the final bill. But compared to the ACA it was incredibly smooth process.
This was a rushed piece of legislation that was not properly vetted by either side. And this is the result.
Tax reform is a much smoother process and many of the longer term effects have been studied for decades.
there was room for compromise here. There always is.
Is there room for compromise? Sure. You would think economic crisis would be reason enough. But in the early 1980's there was a very obvious, overarching compromise to be made. Enact your tax reforms and build your defense budget but tread lightly on my domestic budget priorities, we'll finance the shortfall with debt. Here about the only thing anyone agrees upon - though not publicly of course - is the deficit spending.
"We, who champion the autonomy of states, are going to elect to forgo our own exchanges in favor of more Federal control. Then we're going to exploit one line of the law so that participants in the federal exchanges the we opted for can't benefit from them to their fullest effect."
It just all so perverse. You know one thing that 100% of these serial and obsessive objectors (be they in the media or the courtroom) have in common? They're all insured. It's nothing short of astounding the lengths to which these circles will go merely to deny Americans health insurance. I'm reminded of the scene in Titanic as the stuffy upper-class, safe on the life boats, watches from afar as the penurious flail in the water and drown. Except in this case they don't have watch.
I cannot for the life of me understand why they are still banned here. They really are some of the best, most informative discussions we have on the site. Is there anger/fighting now and then? sure. Has anyone seen the football/baskeball/baseball threads lately? They usually devolve into name calling/put-down wars that can last 30-40 comments long easy with plenty of obscenities thrown about.
In the case of Medicaid expansion, the option is there to directly expand coverage to millions more Americans. Governors and state legislatures have refused, thereby denying coverage to the people they represent. I get that they're poor/working poor people, but still...
You mean politicians don't always do what's best for the people who elected them? Shocking! :)
These are the two biggest issues with Health Care / ACA -
1. Health Insurance is a symptom, not the underlying problem. Insurance is a transfer of risk - the more risky you are, the higher the cost. If the population as a whole was less risky (i.e., healthier) then premiums would be lower and more people could afford it. We have a HEALTH problem in this country, not an insurance problem.
2. Tying health insurance to employment exaggerates every single healthcare issue in the country. Because it means that its no longer an individual risk/reward analysis.
This is the result of a law that was written politically and not practically. 71 times it's been changed from the law that Congress passed without Congress doing it. It's not even a law anymore, it's a decree.
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.
I've been touting the benefits of decoupling insurance from employment for years (on and off this website). It's not something that can be done overnight because it's been cemented as this country's MO for over half a century. O'care is a significant step to dissolving the cement and will progress as the exchanges grow and employers ditch covering their employees.
100% agreed. Obviously I think ACA is a clusterfuck, but if it's the catalyst for breaking the job/healthcare bond then I guess it has done a good job in the long run.
I'm in the benefits consulting arena. Some of my clients are VERY large household names. More than one is seriously considering saying "fuck it", paying the penalties and dropping coverage for active employees.
Once a major corporation takes that step, the dominos just might start to fall.
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.
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?
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
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.
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
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
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
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.
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.
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.
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 )
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.
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.
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.
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.
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.
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,
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!
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.
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
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.
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
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.
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.
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.
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.
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.
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.
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
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.
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.
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.
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.
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.
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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. Link - ( New Window )
But this is an outcome of trying to pass a huge law that reworks a sector of the economy that is a substantial fraction of annual GDP. And that human laws aren't perfect and that human legislation this highly imperfect in most cases.
So we see the logical outcome. It hints at the need for further reworking of a better health care law that addresses some of our significant deficiencies in the area. All too often people want a one time or one shot fix to the problem which isn't happening. This initially should've taken more time or more care to craft.
But people are too damn impatient and want to see a result now.
Here's to hoping we can find a workable solution for healthcare it will likely mean that people come both sides will be furious but it's going to be a pressing issue for the next few years.
But this is an outcome of trying to pass a huge law that reworks a sector of the economy that is a substantial fraction of annual GDP. And that human laws aren't perfect and that human legislation this highly imperfect in most cases.
So we see the logical outcome. It hints at the need for further reworking of a better health care law that addresses some of our significant deficiencies in the area. All too often people want a one time or one shot fix to the problem which isn't happening. This initially should've taken more time or more care to craft.
But people are too damn impatient and want to see a result now.
Here's to hoping we can find a workable solution for healthcare it will likely mean that people come both sides will be furious but it's going to be a pressing issue for the next few years.
[shrug]. Impatient? They've been ostensibly working on HC since the Clinton administration. I think the idea was to do something and then fix it. But, the act of doing something brought the government to a complete halt because the minority party decided to never let that happen again.
This is the kind of thing that could have been fixed in subsequent legislation, if legislation were something that was still possible.
As it is, it takes a pretty incredible interpretation of the law to support this legal argument
But yes inpatient. Trying out a one-size-fits-all all law in one shot signals impatience. There are certainly political realities about this where if they had done minor changes they may not have been able to push through anything more.
But by doing minor changes people might have been able to see the added benefits of carefully crafted laws. This may have added further impetus for additional health care reform.
But beyond that impatience is apparent that they didn't address several significant flaws with the existing healthcare sector. Employer sponsored health insurance is but one example. It's not an unknown problem. That signals a rush to get through a major reworking of the healthcare sector instead of a smart reworking.
Yup. It will go to full circuit which will overturn this decision. Just noise.
BREAKING: Obama administration says health care subsidies will keep flowing despite court decision.
But yes inpatient. Trying out a one-size-fits-all all law in one shot signals impatience. There are certainly political realities about this where if they had done minor changes they may not have been able to push through anything more.
But by doing minor changes people might have been able to see the added benefits of carefully crafted laws. This may have added further impetus for additional health care reform.
But beyond that impatience is apparent that they didn't address several significant flaws with the existing healthcare sector. Employer sponsored health insurance is but one example. It's not an unknown problem. That signals a rush to get through a major reworking of the healthcare sector instead of a smart reworking.
I guess minor changes might have worked. But what minor changes? And who will see the benefit? And the one thing that NO ONE but the crafters of this law have done is suggest anything that will expand access to health care for folks who aren't poor enough to have medicaid and can't afford it on their own. How long do they have to wait while we look for a perfect solution?
Agreed. Like you, I am an attorney. But whatever one thinks about the ACA, this ruling is correct. The law states that subsidies are available to people enrolled through an Exchange established by the State. Federal exchanges are not "established by the State."
Courts are required to apply the law as written. Some laws are badly drafted, so their meaning is subject to interpretation. Not this one. It is perfectly clear. That doesn't mean that the appeals court won't reverse this decision. But if they do, I'd be surprised if the Supremes didn't get involved, and reverse the appeals court. This is an extraordinarily clever and effective way of invalidating the ACA.
BREAKING: Obama administration says health care subsidies will keep flowing despite court decision.
Can they actually do that?
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I think we both could agree that the revamping of the healthcare sector was necessary. Imperative, even.
But yes inpatient. Trying out a one-size-fits-all all law in one shot signals impatience. There are certainly political realities about this where if they had done minor changes they may not have been able to push through anything more.
But by doing minor changes people might have been able to see the added benefits of carefully crafted laws. This may have added further impetus for additional health care reform.
But beyond that impatience is apparent that they didn't address several significant flaws with the existing healthcare sector. Employer sponsored health insurance is but one example. It's not an unknown problem. That signals a rush to get through a major reworking of the healthcare sector instead of a smart reworking.
I guess minor changes might have worked. But what minor changes? And who will see the benefit? And the one thing that NO ONE but the crafters of this law have done is suggest anything that will expand access to health care for folks who aren't poor enough to have medicaid and can't afford it on their own. How long do they have to wait while we look for a perfect solution?
they don't have to wait, they just have to pay the fine.
A counterpoint however is that this health care reform may have led to less impetus for further reform the next few years. Many people are skeptical about the long run implications of this law. Just like what the Fed is doing has long-run implications that we don't know, the same can be said about this health care law both good and bad.
I have always preferred local or state solutions to this problem. Coupled with top down mandates this might be a better future solution.
If this is upheld by an appellate court, who is this going to benefit? The rest of the law under Obamacare will still be intact and millions of people in those 34 states will be forced to pay more for private insurance - nobody wins.
Listen in '81 Tip O'Neill and the Democratic House could easily have folded their arms and vowed to block every part of Reagan's agenda that they could. They didn't. They read the attitude of the country and did what they could do to work with Reagan on things, and hold firm to win a battle or 2 that they really wanted to win. I'm not saying I agreed with Reagan's policies or not. However when the country is struggling as it was then you need a govt. that is willing to move forward and work together on some level. This is simply not a part of the process any more. It's a shame because we are the ones that suffer.
A counterpoint however is that this health care reform may have led to less impetus for further reform the next few years. Many people are skeptical about the long run implications of this law. Just like what the Fed is doing has long-run implications that we don't know, the same can be said about this health care law both good and bad.
I have always preferred local or state solutions to this problem. Coupled with top down mandates this might be a better future solution.
That's a fair point. Perhaps this holds together a fundamentally flawed system and puts off the real change we need, leading to a worse long term outcome.
I guess I look at it (like I look at everything) as an engineer. Get something in place, debug where necessary and refactor when appropriate. The odds that you could get the entire government to agree on one ideal approach is zero anyway.
Listen in '81 Tip O'Neill and the Democratic House could easily have folded their arms and vowed to block every part of Reagan's agenda that they could. They didn't. They read the attitude of the country and did what they could do to work with Reagan on things, and hold firm to win a battle or 2 that they really wanted to win. I'm not saying I agreed with Reagan's policies or not. However when the country is struggling as it was then you need a govt. that is willing to move forward and work together on some level. This is simply not a part of the process any more. It's a shame because we are the ones that suffer.
Good post.
On a (hopefully) promising note, some of the lack of agreement between the parties is due to the cyclical nature of parties.
Over time, parties have folded as wings in that grouping fought for control and eventually splintered. The splinters grew larger and eventually started the process of compromise again.
I think we are seeing this splintering in process now and that, in a few decades, the grand bargains will again be a feature of the political landscape.
Also agree. Presidents of both parties routinely use executive orders to try and get what they want, but Congress won't enact. "Signing statements" are another similar strategy presidents use to try and limit what part of a law they have to enforce. Neither are constitutional IMO. Both require a constitutional amendment. Good luck with that.
But this is an outcome of trying to pass a huge law that reworks a sector of the economy that is a substantial fraction of annual GDP. And that human laws aren't perfect and that human legislation this highly imperfect in most cases.
I think a comparison to the Tax Reform Act of 1986 might be enlightening. The process that led to the bill began more than 2 years before it was passed. Representatives and Senators from both parties had significant input into the legislation. And even them, a technical corrections
bill was needed to fix some minor glitches in the final bill. But compared to the ACA it was incredibly smooth process.
This was a rushed piece of legislation that was not properly vetted by either side. And this is the result.
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All good points. But we've seen the crafting of this law and seeing the massive changes it has caused. The minor changes could have incorporated some sort of welfare additive with mandated coverage benefits and the destruction of the link between employment health insurance.
A counterpoint however is that this health care reform may have led to less impetus for further reform the next few years. Many people are skeptical about the long run implications of this law. Just like what the Fed is doing has long-run implications that we don't know, the same can be said about this health care law both good and bad.
I have always preferred local or state solutions to this problem. Coupled with top down mandates this might be a better future solution.
That's a fair point. Perhaps this holds together a fundamentally flawed system and puts off the real change we need, leading to a worse long term outcome.
I guess I look at it (like I look at everything) as an engineer. Get something in place, debug where necessary and refactor when appropriate. The odds that you could get the entire government to agree on one ideal approach is zero anyway.
The debugging analogy is a good one. But may I propose it one step further.
Politics is like stringing together a nuclear code for missiles. While bugs are inevitable, too many (or needing fixes to often because it was out together haphazardly) can lead to inadvertent nuclear war.
The unintended consequences of our actions can lead to decades of misery (hell, see stagflation and the Fed simply misinterpreting a data point). Change is necessary, but we've maintained the point where large scale planning (or attempts to do it) is futile and deadly.
Always enjoy your posts.
Ha, I'd revise it to 90%.
Only those in power and a small fraction ever see good benefits from the changes recently.
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But this is an outcome of trying to pass a huge law that reworks a sector of the economy that is a substantial fraction of annual GDP. And that human laws aren't perfect and that human legislation this highly imperfect in most cases.
I think a comparison to the Tax Reform Act of 1986 might be enlightening. The process that led to the bill began more than 2 years before it was passed. Representatives and Senators from both parties had significant input into the legislation. And even them, a technical corrections
bill was needed to fix some minor glitches in the final bill. But compared to the ACA it was incredibly smooth process.
This was a rushed piece of legislation that was not properly vetted by either side. And this is the result.
Tax reform is a much smoother process and many of the longer term effects have been studied for decades.
That and the fact that they affect different actors in different ways, making comparisons problematic.
Is there room for compromise? Sure. You would think economic crisis would be reason enough. But in the early 1980's there was a very obvious, overarching compromise to be made. Enact your tax reforms and build your defense budget but tread lightly on my domestic budget priorities, we'll finance the shortfall with debt. Here about the only thing anyone agrees upon - though not publicly of course - is the deficit spending.
It just all so perverse. You know one thing that 100% of these serial and obsessive objectors (be they in the media or the courtroom) have in common? They're all insured. It's nothing short of astounding the lengths to which these circles will go merely to deny Americans health insurance. I'm reminded of the scene in Titanic as the stuffy upper-class, safe on the life boats, watches from afar as the penurious flail in the water and drown. Except in this case they don't have watch.
The ACA attempts (poorly) to help the later. You're complaining about the former, which doesn't exist anyway.
IMO this bill was much too complex, especially for the first step.
It's wonderfully complex, but not so complex we have the legislation we currently have (in terms of length).
These are the two biggest issues with Health Care / ACA -
1. Health Insurance is a symptom, not the underlying problem. Insurance is a transfer of risk - the more risky you are, the higher the cost. If the population as a whole was less risky (i.e., healthier) then premiums would be lower and more people could afford it. We have a HEALTH problem in this country, not an insurance problem.
2. Tying health insurance to employment exaggerates every single healthcare issue in the country. Because it means that its no longer an individual risk/reward analysis.
What employer mandate?
This is the result of a law that was written politically and not practically. 71 times it's been changed from the law that Congress passed without Congress doing it. It's not even a law anymore, it's a decree.
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Either to the full circuit court or the USSC. This is just one step on the way.
Yup. It will go to full circuit which will overturn this decision. Just noise.
And then the SCOTUS.
I'm in the benefits consulting arena. Some of my clients are VERY large household names. More than one is seriously considering saying "fuck it", paying the penalties and dropping coverage for active employees.
Once a major corporation takes that step, the dominos just might start to fall.
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.
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?
Update: An appeals court rules in favor of Obamacare subsidies, on same day other court ruled against them. http://cnn.it/1wVAQAj
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.
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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.
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.
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.
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.
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In comment 11776239 BeerFridge said:
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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 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.
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.
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.
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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.
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 )
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.
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.
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.
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.
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.
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.
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!
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.
(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.
And it's here to stay despite the haters.
Oh sorry, was Welfare reform not "major legislation"? That's one possible way you could back out of your bullshit claim.
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.
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.
These can be mitigated by future re-examinations of parts of the act.
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.
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.
Exactly. Once it this ruling is overturned by the full panel the SC will not take it.
You couldn't be more wrong. Your argument of "intent" is semantics. The suit is based on the actual wording.
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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