Obamacare passes muster

[FScouter]

"I really do not know why people insist on calling the Affordable Healthcare Act, 'ObamaCare'."

 

Obviously, it's a not-so-subtle way to snub the man that took the bull by the horns to actually DO something to improve the country's broken health care "system". Little digs such as "Obamacare" speak volumes about one's character.

 

It's sad really that the executive branch of government has to step in and take action because the legislative branch is too lily-livered to do their jobs. They're great at obstructionist politics, but it seems most of Congress sees their "job" as blocking and emasculating the efforts of others.

 

 

It's no wonder that the vast majority of Americans simply tune out, don't vote, and shake their heads in disgust.

[SR540Beaver]

Let's apply the court ruling to something other than healthcare and see if it passes muster with everyone here. Gun ownership. Just as everyone is "in the market" with healthcare and it's a life or death proposition, so is personal and home security. Does anyone here not have locks on the doors and windows of their homes? When you go to bed at night, do you make sure your home and family is secure behind those locks? How about a universal personal security law that requires all Americans to purchase a gun and training? For those who chose not to, we can penalize them thru the IRS when they file their annual return. Sure, requiring everyone to purchase a gun to protect themselves from crime wouldn't be found constitutional, but a tax to penalize those who don't so it is fine and dandy. So, who is with me on passing gun ownership legislation? Let's end crime in our time! Universal security for all.

 

The point is folks, do we really want to allow the government to have control over every aspect of our lives? Whether it is thru passing a mandate or thru penalties? Is their role to protect us from ourselves? Isn't one of the purposes of the constitution to LIMIT the government or not? Whatever happened to free enterprise, capitalism and personal responsibility. Do we really want to give up freedom for security? Does no one realize what a slippery slope we just set foot on?

 

What's next?

[SR540Beaver]

"I really do not know why people insist on calling the Affordable Healthcare Act, 'ObamaCare'."

 

Ever hear of the "Bush Tax Cuts" or "Bush's wars"? Same thing. What's good for the goose......

 

If the administration is going to refer to the Affordable Healthcare Act as Obama's signature policy acievement, it kind of follows that it will be nicknamed "Obamacare". Just the way it works.

[Brewmeister]

As to that survey, I am aware of those numbers, but that survey was taken almost immediately after the Act passed. As we get closer to 2014, those numbers have dropped, and when you go to benefit conferences, people are not talking about dropping their coverage. People are more worried about being able to attract talent to difficult to fill positions, and guess what, the employers that keep their health insurance benefit will be better able to attract that talent (isn't that the free market)?

 

The nations 100 largest employers will pay $111 billion in fines if they drop health insurance when Obamacare...er...ACA provisions are fully implemented in 2014, but it will cost them over $450 billion to provide ACA-compliant coverage.

 

The free market will indeed move this decision, and employer provided health plans will become as rare as defined-benefit pensions in the private sector.

[FScouter]

How about a universal personal security law that requires all Americans to purchase a gun and training? For those who chose not to, we can penalize them thru the IRS when they file their annual return.

 

That might make sense if those folks that dont lock their doors get their possessions stolen and expect those that do lock their doors to pay the cost of replacing their stuff. Imagine that you get burglarized, head on down to the local home center, pick out what you need to replace, and tell the cashier I dont have insurance or locks on my doors, so I dont have to pay for replacements. How far would that fly??

 

Yet, its OK to go without health insurance and head to the emergency room for health care and not pay for it. I dont want to pay for somebody elses health care costs. Yes, either mandate insurance, or allow hospitals and doctors to charge up front before treatment cash on the barrelhead.

[Papadaddy]

"Thing is this is not the first thing government (Federal, State and City) has regulated us to do. It will not be the last thing.."

 

That kind of thinking is what scares me about the future of Liberty in this country. I thank God that our founding fathers did not feel that way when King George III was "regulating" the Colonies. Otherwise, we'd all be speaking English, have National Health Care and have our tax dollars going to support lavish royals who feel entitled to luxury.

 

No wait...never mind. Bad analogy.

 

[NJCubScouter]

scoutingagain says:

 

The irony of having Mitt Romney, who signed into law Romneycare in Mass. with basically the same mandate and who had argued for the need and legality of it in interviews and in editorials now campaign on repealing the law is too rich. How is he supposed to maintain a shred of crediblity on any issue?

 

Good question. I have been wondering the same thing. Yesterday Romney said this decision is one of the reasons why he should be elected, so he can (try to) repeal the health care law. Of course he did not mentions his health care law in Mass., which while not identical in all the details, was very similar and included a mandate. (Which does not create a constitutional issue because state governments have much broader powers in many areas than the federal government does, including the power to legislate for the "general welfare" without worrying about whether it affects "commerce" or anything like that.) I do not see how he is going to get away from it during the campaign. Every mention of "Obamacare" is going to be met with a reply of "Romneycare." It will be the proverbial albatross around his neck. If Romney is smart he will not talk about health care at all and just stick to the economy, the one issue he can actually win on. (Whether he should, or will, is another story -- but he could.)

[SR540Beaver]

Fscouter,

 

Ever hear of the Emergency Medical Treatment and Active Labor Act?

 

"The Emergency Medical Treatment and Active Labor Act (EMTALA) is a U.S. Act of Congress passed in 1986 as part of the Consolidated Omnibus Budget Reconciliation Act (COBRA). It requires hospitals to provide care to anyone needing emergency healthcare treatment regardless of citizenship, legal status or ability to pay. There are no reimbursement provisions. Participating hospitals may only transfer or discharge patients needing emergency treatment under their own informed consent, after stabilization, or when their condition requires transfer to a hospital better equipped to administer the treatment."

 

That is why you are paying for other people's health care. Now imagine if Congress decided that home improvement stores had to provide you with the items that were stolen from your home. The home improvement stores would raise prices to spread the cost to the paying customers. But if everyone had the means to protect themselves and their belongings, the crime and burgulary rates would drop and the home improvement stores would reduce prices for goods. It's a win-win for everyone! How do we get everyone to protect themselves from burglary? We require them to buy a gun and get trained.

 

Is it the same? No. Is it an analogy? Yes. Could it happen? Why not. Who would have ever imagined that the government could overstep their contitutional bounds and require people to buy health insurance whether they want it or not........even if it is a smart thing to do? Give them an inch and they have always taken a mile. This is just another (big) step in a journey of becoming a cradle to grave nanny state that erodes our individual liberties.

 

What's next?

[SR540Beaver]

"The irony of having Mitt Romney, who signed into law Romneycare in Mass. with basically the same mandate and who had argued for the need and legality of it in interviews and in editorials now campaign on repealing the law is too rich. How is he supposed to maintain a shred of crediblity on any issue?"

 

The difference is one size does not fit all. There are 50 individual states with different economies and needs. The powers not enumerated to the federal government in the constitution is left to the states. While Obamacase and Romneycare may both be fruit, one is apples and one is oranges. Plus, if I don't like the laws, taxes or penalties in my city, county or state, I can move. I suppose I could leave the US too, but that's a tad more complicated situation.

[fred8033]

I'm really confused on this whole thing. And generally, I believe Obamacare just means many more changes will need to be legislated.

 

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I don't mind calling it Obamacare. That's not necessarily negative. He did push for it. The abbreviation ACA is entirely forgettable. If Obamacare succeeds, it will be a crowning compliment. Heck, I've already seen posters reading "Obamacares".

 

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More audits??? .... 26 year old children on parents helath insurance .... I'm already audited yearly to see if my spouse is eligible under another employeer and to get proof that my kids are my kids. NOW, will my health insurance company want proof that my son is not working for a company offering health insurance or eligible under another channel? Not sure if they will even have that right. But apparently they have the right to ask about my spouse.

 

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8% income limit .... I look forward to learning more about this. With a $50,000 income, the premiums need to be lower than $333 per month. If above that, you won't get a tax penalty. $333 is not much. If your single and healthy, you can find plans cheaper than $333. But if you have a family or special conditions, try to find a cheaper plan. Or find a plan with reasonable deductibles. So....

 

---- Does the law refer to gross or AGI income? Big difference!

 

---- What type of insurance qualifies as insurance? Insurance with a $15k deductible can push many families into bankruptcy.

 

---- Is deductible factored into the insurance cost? Large deductible means I effectively a higher monthly insurance premium.

 

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At time of tax filing or continually thru the year? ... So I could get insurance for one month and then cancel? I'd be legit avoiding the tax penalty? ... JUST FOUND ANSWER ... Looks like you can have a small gap ... three months ... with other restrictions and allowances.

 

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So exactly who will be penalized if they don't change their ways? ... I'm betting most will either be waived by the 8% limit or already have health insurance. So who is really affected by the mandate?

 

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I work as an independent software contractor. Over the last five years, the cheapest I've paid for insurance is $1200 per month. The most is around $1800. I would have to make $180k to be subject to the 8% penalty ... unless I buy cheaper insurance that doesn't cover much or has a huge deductible. Considering that I've got family members with special conditions, I can't afford a $10k deductible in addition to the $1200 premium.

 

SO ... Depending on what happens, a family of four earning $100k would not be penalized if they did not purchase insurance.

 

Does it mean that a family of four earning $100k could sign up under medicaid?

 

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Medicaid - One thing Obamacare does do is move the goal posts for evaluating the solvency and future of Medicaid. It won't be the same system as before and I can easily see now arguing for tax increase or other to support Medicaid. But I'm not that familiar with all the intricate Medicaid funding issues.

 

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non-citizens - What's interesting is that this is a tax penalty? So this hits US citizens the most. I'd like to understand more about the foreign workers both legal and illegal. I'd prefer it to be a withholding that's then refunded. That way your not trying to collect something after the fact whether you can even find the person.

 

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tax withholdings - By 2016, the penalty is $695 per adult up to larger of 2.5% of family income or $2085. That's a huge amount. One reason our tax system works is that employeers withhold the funds. People continually get in trouble if they have to pay the tax in after-the-fact. That's one reason so many small business people get in trouble. Will the penalty be with-held or after-the-fact? ... Will we need to show employeers health insurance status so they know what withholding rate to use?

 

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I'm mostly happy the law was left in place. I see good in the child age increase and pre-existing condition changes. But the only thing the law guarantees is that more change is coming. This is not an end state. I don't believe the system will work smoothly and I think it's only a next step in a transition in how this country does health care.

 

 

[johnponz]

Romney as said time and again that the nations plan should be modeled on MA, and there is tape and editorials to prove it.

 

The mandate is actually based on Republican ideas presented when the Clintons were trying to reform healthcare.

 

 

[scoutingagain]

"The difference is one size does not fit all."

 

Ya, that's the Republican refrain now. Prior to Obama's implementation of Romneycare, the individual mandate was THE conservative approach to expanding health care coverage. The Democratic approach was the single payer system. Romney himself has made the conservative arguement in favor of the individual mandate several times. Face it, if Romney had won the Republican nomination in 2008, he'd have campaigned on the Masssachusetts healthcare law as one of his signature accomplishments and Republicans would be praising the individual mandate as the essence of personal responsiblity. When Obama and the Democrats actually passed it, Romney and other Republicans that supported the mandate now find it politically expedient to villify it.

 

The additional irony for Romney is that he's claimed he balance the Massachusetts budget without raising taxes. Sure he increased fees on everything from driver's licenses to state parks, but he claims he didn't increase taxes. Well apparently, according to the Supreme Court, primarily from Bush appointee Roberts, he actually passed one of the most significant new broad based taxes in state history.

 

This is one area where Rick Santorum had it right. Mitt Romney is possibly the Republican with the least credibility in making an effective case against Obama/Romney care. His best hope is the economy tanks and voters are ready to give just about anybody else a try.

 

SA

 

 

 

 

[Engineer61]

I already have three doctors who have said that if completely implemented, they will become cash-only practices.

 

They've said what they would be paid under the plan does not offset the costs of providing the care and the cost of dealing with the new red tape.

 

Two are my primary care doctors (mine and the kids).

 

The other is my retinal surgeon.

[Horizon]

Engineer61 - to my knowledge they have not published any reimbursement rates. How would they know what they will make?

 

Now - if every service was paid at the Medicaid rate - that WOULD hit a lot of doctor's offices. Tricare usually pays the best, followed by Medicare, then Medicaid. Medicaid patients rarely pay for themselves in a traditional practice.

[CalicoPenn]

I see we're back to silly arguments again. Beavah has a good analysis of one section - most of the other stuff is just plain silly, like saying that Medicare will pay for a consult between patient and doctor to discuss end of life care is "death panels". The suggestion that now the government could require everyone to buy guns? About as silly as Scalia's Brocolli argument (I almost wonder if Roberts voted to uphold so people wouldn't think he fell for that stupid bit of nonsense), except that there are some local governments that have done just that. Doctors are going to go to cash only basis? Nonsense - the vast majority of patients pay with some form of insurance already, and both the insurance companies and Medicare have used tables to determine how much they'll pay doctors for services - and have contracts with the doctors that the doctoras will accept that funding - the affordable health care act doesn't change that equation at all - Medicare and the private insurance companies will continue to do what they've done all along, and doctors that drop out better be so good that they can offer healthcare to millionaires only or they will go broke, fast.

 

The silliest argument of all? "The nations 100 largest employers will pay $111 billion in fines if they drop health insurance when Obamacare...er...ACA provisions are fully implemented in 2014, but it will cost them over $450 billion to provide ACA-compliant coverage." The nation's 100 largest employers already pay over $450 billion per year to offer their employees health care benefits, and they do it without the threat of any fines because they want to attract top talent and want to make sure their employees are healthy and, if they do get sick, can be brought back to wellness quickly. It's not very likely that they will decide to drop their health care plans to employees and just pay the fine (and that is what this argument suggests - if they can pay just $111 billion instead of $450 billion, they'll do it). They aren't going to stop offering health care benefits because their competitors aren't going to stop health care benefits and they want to remain competitive and can only do that by continuing to offer up health care benefits. The exceptions - the Walmarts and McDonalds and the like, who are heavily reliant on part time workers, are the ones most likely to be affected by these provisions - and if they decide to pay the fines instead of beefing up their benefits, we shouldn't be surprised, since they haven't felt the need to pay decent benefits now.