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Friday, 29 June 2012

Supreme Court Upholds ACA

category_bug_politics.gif The health care law stands. As you undoubtedly know by now, the Supreme Court of the United States in a five-to-four decision yesterday, upheld President Barack Obama's Affordable Care Act.

Although it is a giant victory for President Obama and the people of the United States, there are complications. Expansion of Medicaid was rejected and that was a more nuanced decision than I'm prepared to discuss today.

There are many dozens of places online where you can read details, explanations and commentary of the decision, and the full, 193-page decision is posted at the Supreme Court website [pdf].

Most importantly, the individual mandate was upheld but there are questions. It was not under the Commerce Clause that it remains Constitutional, but under Congress's power to tax.

So apparently, if people do not purchase coverage, there is a consequence – a significant tax to be paid. However, there is no penalty for not paying the tax. Or maybe there is. News reports I saw and heard on that point conflict with one another and I haven't had time to follow up yet.

For elders, all our gains from the health care act continue: free, annual, wellness examinations and free or low-cost health screenings such as mammograms, bone-density measurements, diabetes, HIV and obesity screenings among others.

The doughnut hole in the prescription drug plan (Part D) will continue to gradually close and Medicare Advantage plans cannot charge more for chemotherapy, dialysis and some other procedures than allowed under Medicare Parts A and B.

According to the National Committee to Preserve Social Security and Medicare (NCPSSM), the solvency of Medicare has been extended eight years thanks to this legislation.

One provision I like a lot in today's awful economy is that parents can continue to carry their children under age 26 - more than three million of them - on their health insurance policies. That, of course, continues too.

The Affordable Care Act is nowhere near perfect. I believe a better way to go is single payer, Medicare for All or something similar and I do believe it will be necessary in the future to move in that direction. But now, with this Court decision, that will not happen while I still walk the Earth and this is best we've got. It's better than what the Republicans prefer.

Because I was out of the house most of Thursday with meetings and other obligations, I haven't yet had much opportunity to think about the Court's decision and write anything useful or informative. So I am leaving that in your capable hands today.

What was your reaction to the decision? What did you learn or take away from any of the reporting and commentary? What about the Republican threat to repeal the ACA - is that just defeat bluster or will they try to do it?

What's your take on Justice John Roberts' left-leaning decision and does it signal a change in his future deliberations? How will this decision change healthcare in the U.S. overall? What kind of effect will it have on the presidential election campaign?

Oh, and you might want to comment too on yesterday's nasty bit of business in the House of Representatives instigated by Representative Darrell Issa (R-CA) voting to hold Attorney General Eric Holder in contempt over - well, nothing. I was mildly cheered to read that a whole bunch of Democrats walked out rather than dignify the proceeding with their votes.

I'm curious and eager to hear from you all and to read your back-and-forth on this.


At The Elder Storytelling Place today, Terry Hamburg: Passing Through Puberty


Posted by Ronni Bennett at 05:30 AM | Permalink | Email this post

Comments

Nuances aside, it is a significant victory for elder women, and all women I think. Note that ALL the female Justices voted for this. Ah, just think if women ruled the world....my two daughters can now have birth control covered as well. It was a good day!

It is the essential first step on the way to a health care system that makes sense and protects our citizens.

Frankly, I'm hoping that so much profit gets squeezed out of health insurance that the industry dries up and we go to single payer by default.

As I've commented elsewhere, "At least one pundit thinks that Justice Roberts made a concession on this vote to give him firmer standing for votes on issues that are before the court but not yet decided. I would like to think that he ruled on merits." (Wish I remembered who was being interviewed on the radio.)
The Supreme Court has taken a drubbing from the public, lately, and quite rightly so. I think that the pundit might be right in believing that Justice Roberts was looking at the long term and wanting to have a bit of stature before ruling on other issues.

I haven't read the 193 report -- and probably most other commenters haven't either -- but the ACA seems like a step in the right direction and I'm glad the Court upheld it. My bet: the Reps. will get nowhere with repeal.

I am surprised and delighted by the Court's ruling. But it hardly means the ACA is out of the woods. Because of the way the ACA has been presented in the media--not to mention many Americans' short attention span when asked to deal with complex issues--the ACA has become increasingly UN-popular (at least if the polls are to be believed). Hopefully, this is a trend that can be reversed, so that misinformed voters don't "vote Romney" in November as "the only way left to stop this catastrophic law from destroying America." Obviously, I am concerned that this will be used as yet another argument to vote against Obama, and that too many of the people who will actually benefit from the ACA will be persuaded to buy into the rhetoric against it.

I like Marty's hope about the insurance companies...but until that happens, I'm crossing my fingers the voters shake the cobwebs out of their heads and realize deadlock isn't doing good for anyone, is directly related to our country's economic doldrums, and re-elect Obama and a Democratic House.

What has happened in this country? Are we truly so divided that keeping the other guy down, or in the case of health care, letting the other guy die, is more important than progress?

Romney said in his response that "20 million people" would lose their employer -paid health insurance due to the ACA. PolitiFact explains: the CBO's highest estimate of employees who may CHOOSE a different plan than the ones offered by their employers is 20 million. The number is most likely way too high- there were several lower estimates- and these folks are not "losing their insurance" but choosing something different! And he didn't include the number of people who would become insured...

I would like to hear ideas on how to educate Americans on what to expect from the ACA. Maybe a segment on South Park or the Simpsons?

I've written some reactions at my site. Mostly, I feel enormous frustration that this effort (the ACA) to tackle a real, non-symbolic problem, has been made a political football by nearly all the elites who've made decisions that will help or harm millions of people who have almost no voice in what is done to them. We call this a democracy?

This country is in trouble.

I've read that Roberts is concerned about the court being seen as a partisan, political body and made his decision with the court's integrity and his own legacy in mind. I'm glad to see someone being willing to look beyond partisanship.

I think the Republicans will indeed try to repeal the law, and failing that, will try to weaken it through a thousand tiny cuts, just as they have done with abortion rights.

The best thing that can happen now is if Obama goes on the campaign trail and SELLS this law to benighted Americans who don't understand what it's about and have been saying they oppose it. If he can do that, he gets re-elected and maybe takes some Democrats to the Senate and House in the process.

One thing stands out for me in this morass of issues. Yes, I am over the moon that the court upheld this plan and I don't care why Roberts broke the tie. He did it! And that one thing? Sick kids can get the care they need and not have their fate decided on by anybody's bottom line. I think of sick kids!

First, I have never liked the idea of all us being forced to give even more money to big greedy insurance companies. I think whoever came up with that idea should be fired.

It has been a time bomb waiting to go off. And it is STILL a time bomb waiting to go off. The court has simply put it on hold until the election passes.

Then the Republican Congress will take steps to force the issue again, this time in a form that the court CAN find unconstitutional.

The decked is stacked, folks.

I posted on this subject yesterday. I think this is a victory, even though it is a small one. If the ACA is not repealed it will be improved on once the public realize it's a good law.

I think Obama and the Democrats have done an abysmal job of explaining the way this will affect everyone's pocketbook. On reading comments on the syndicated blogs I find that the common thread among the opponents of ACA is that it is going to cost the individual more for his/her policy and some even think they will be going to jail if they don't buy insurance.

The misinformation is repeated so often that it has become a fact in the minds of those opposed. The Democrats need to explain repeatedly how this will save the individual money (with tax rebates, etc.) and start refuting the negative lies.

Yes, the Republicans will certainly ramp up the lies in preparation of Romney's repeal. They are already screaming loud and clear.

Unfortunately, the meat of the act won't kick in until 2014 (Why is it taking so darned long to implement?) so the public won't fully understand the benefits. Once they do the act will be safe so the Republicans will fight tooth and nail to repeal it before that happens.

I fear that many states won't accept the expanded Medicare provision since they will not be penalized under SCOTUS ruling. Certainly, those with Republican governors won't do so. This will weaken the intent of the law and Congress will have to correct that. If any part of Congress remains in Republican hands it will not be changed (except to repeal the entire law).

So it remains to be seen whether this will be a giant stepping stone to Universal coverage or another wasted battle that ends in the law being repealed.

"So apparently, if people do not purchase coverage, there is a consequence – a significant tax to be paid. However, there is no penalty for not paying the tax. Or maybe there is. News reports I saw and heard on that point conflict with one another and I haven't had time to follow up yet."

Actually, FactCheck.org has laid out who pays and who is exempt and what penalties/taxes will be levied here.

At the bottom of this page it also points out a recent CBO analysis showing the actual number expected to pay this "tax" if they choose not to purchase health care insurance - 6 million. Now, this is no small number and I don't want to belittle any who may fall victim to this, but it is only slightly above 1% of the total U.S. population. More people than this would suffer if this law was revoked by the high court, even if the Medicare expansion doesn't go through in some states.

Correction on my recent remarks. The 6 million people who the CBO thinks will wound up paying this tax is not 1% of the population but slightly above 2%. Still a low figure compared to those who would suffer had this law been negated by the SOTUS.

I forgot to tell you that almost before the ink was dry on the SCOTUS ruling I received a robo-call starting with the sentence that "Obama care would cost (?billions of dollars) and would bankrupt the country". At that point I hung up. But the forces of evil were ready and prepared to start fighting for repeal.

From wher I sit . . .

1. People who opt-out will get health care - everyone else will pay for it. Not a problem because, that is the way it has always been done. (Now considered an extra burden? Hardly!)

2. Those who pay $700 - $900 a month now, can get dropped out or cancel on their own for almost any reason, will now pay less than $100 a month. A Tax? A penalty? I'll take it. In fact if there are tax incentives to do so - it's a windfall!

3. Take out the political implications and you have one group of people who can afford unprecedented healthcare, regardless. They don't need insurance. (Some I know have fortunes and rely on 'free' public healthcare!) They can afford to buy the best. Do a means test and eliminate them from the equation.

The remaining two groups: actually working class and the unemployed and impoverished. They are the ones who benefit. These are the ones that need healthcare. These are the ones who work for every dollar they earn. These are ones who get sick and affect all of us; financially as well as physically. We should all encourage the safe passage and support the implementation of the ACA.

4. The federal Legislature crafted the law. Supreme Court said it was constitutional. The Executive is to enforce it. Those are their jobs; respectfully. If the opposition party (GOP) takes White House occupancy then it is up to them to enforce the law - OR REPEAL IT!

So, take names now and remember to VOTE appropriately! Your future healthcare depends on your vote this fall.

No the ACA isn't perfect but, as many have noted, it's a start. I agree that a single-payer system is the only way we will ever break free of the for-(obscene)-profit health insurance industry.

As the election approaches, I think Progressives need to keep emphasizing that (1) Romney is, once again, flip-flopping like a fish out of water; after all, the prototype for the ACA was enacted on his watch in Massachusetts; and (2) it's actually working there and has not bankrupted the state.

Although President Obama is an immensely gifted speaker, that hasn't always been apparent in his explanation and defense of Progressive programs including the ACA. In the cause of bipartisanship he has sometimes been outshouted by the Hard Right. These are folks who will be satisfied with nothing less than his failure, which is what they've wanted since Day 1. I think he has come to realize that you can't negotiate in good faith with people whose one goal in life is to see you gone!

During the campaign he will need to focus all his intelligence and skill on "pocketbook" issues--primarily job creation--but also how the ACA will benefit almost all Americans over time.

I have a few points to make:
* I have spent about an hour on FaceBook, deleting Republican ads to repeal ACA. They keep popping up all along the right side of the page. I finally had to label them "offensive" to get rid of them.
* My husband picked up our prescriptions this morning and, because I am over 60 they suddenly gave me a $30 refund -- which they have never done before and which I'm not sure is right. My healthcare insurance does not cover prescriptions and I'm not yet elegible for Medicare, but I didn't think that ACA meant that I was to get a 10% refund on my prescriptions. Hope the pharmacy doesn't realize they made a mistake and I have to give them back the money?!?
* I am also amazed at how many people do not realize what is in ACA -- even smart people.
* Evidently Karl Rove threatened to move to Canada if Scotus approved ACA, so I signed a petition this morning telling him to start packing!

I'm a dual citizen. USA and Canada, and proud of both.- and deeply hope the universal health care I have experienced living in Canada for 40 years is available to Americans, and soon.

So Karl Rove is threatening to move to Canada if National Health Care is approved.

Doesn't he know that Canada is mostly KNOWN for its National Health Program?

MORON!

Posted about it yesterday. Elated, of course. Most important focus for all of us: get active in Obama 2012 efforts.

Wow I am surprised at how biased these comments are....I sure hope that others who see the enormous cost of such a plan that over 60 % of the American people did not want and when polled still do not want. Its a matter of our rights being eroded that has me concerned. I am not for anything that forces a person to pay for anything.....

At this point, Kathy, you are forced to pay for the uninsured. You pay with higher bills when YOU go to the doctor or hospital.

Kathy, I believe that a large percentage of Americans believed the misinformation that was being put out about the PPACA.

When Americans were polled about the individual provisions of the ACA, they were in favor of them. For example, they were in favor of children being covered until age 26, coverage for pre-exisitng conditions, closing the "donut hole" for seniors' prescription payments, requiring small companies to provide insurance, etc.

Many poll respondents didn't even realize that the individual items they were being asked about were in the PPACA.

Total Public Outstanding Debt as of today:

15,780,999,920,520.17

What kind of people are we that we leave our children this staggering debt to pay.

This debt figure is horrendous, but thank heavens we're beginning to rectify the grossly lacking provisions for providing health care to our citizens.

There are a multitude of areas in which we can whack away at this debt but we mustn't be mislead by those who attempt to distract by blaming healthcare gains, then suggesting we must do so on the back of Medicare and
Soc. Sec. for the well-being of ourselves, our children and future generations. But this is a topic for another column.

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