Tuesday, July 22, 2014
Fed appeals court panel says most Obamacare subsidies illegal
In a potentially crippling blow to Obamacare, a top federal appeals court Tuesday said that billions of dollars worth of government subsidies that helped nearly 5 million people buy insurance on HealthCare.gov are illegal.
A judicial panel in a 2-1 ruling said such subsidies can be granted only to those people who bought insurance in an Obamacare exchange run by an individual state or the District of Columbia — not on the federally run exchange HealthCare.gov.
"Section 36B plainly makes subsidies available in the Exchanges established by states," wrote Senior Circuit Judge Raymond Randolph in his majority opinion, where he was joined by Judge Thomas Griffith "We reach this conclusion, frankly, with reluctance. At least until states that wish to can set up their own Exchanges, our ruling will likely have significant consequences both for millions of individuals receiving tax credits through federal Exchanges and for health insurance markets more broadly."
In his dissent,
Indeed, the decision threatens to unleash a cascade of effects that could seriously compromise Obamacare's goals of compelling people to get health insurance, and helping them afford it.
In a report issued Thursday, the consultancy Avalere Health said that if those subsidies were removed this year from the 4.7 million people who received them in HealthCare.gov states, their premiums would have been an average of 76 percent higher in price than what they are paying now.
Before the decision, a leading Obamacare expert who was firmly opposed to the plantiffs' arguments said a ruling in their favor could have major consequences for the health-care reform law.
"If the courts were to decide that the Halbig plaintiffs were right, it would be a huge threat to the ACA," said that expert,Timothy Jost, a professor at the Washington and Lee University School of Law.
Michael Cannon, director of health policy studies at the libertarian Cato Institute, said more than 250,000 firms in those states—which have about 57 million workers—would not be subject to the employer mandate being phased in starting next year.
http://www.cnbc.com/id/101819065
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How do you say "failed presidency?"
ReplyDeleteWilliam, the law remains unchanged and the subsidized policies are unaffected until the legal case plays out.
ReplyDeleteHowever, the potential long-term impact is huge.
If the final result backs the appeals decision, the result would wipe out subsidies for millions and undermine a key component of Obamacare's requirement that all Americans obtain health coverage.
The easiest fix -- changing the law to specify that it allows subsidies for coverage purchased through the federal government as well as state exchanges -- would mean reopening the debate over the 2010 Affordable Care Act that passed with zero Republican support.
I know this topic polarizes just about everyone, but objectively, I think it's a sign of pure dysfunction when the only way something useful for America can get done is when one party controls all three houses and passes it with no support from the other party. It is a fact that our system, as it was, delivered worse outcomes despite spending the most money and left millions uninsured with no choice but to clog ER's and consume enormous resources.
DeleteArguably, the majority of Republicans, minus the Teas, are essentially owned by the insurance and banking lobbyists who also own the Democrats. This bill, like Bush's drug boondoggle, was written to benefit insurance companies rather than the people of the country. The only good thing this bill accomplished is that it forced the issue and a lot of people who previously couldn't afford coverage are getting it. The more that people fight this to the death in court, the more likely I think it is that meaningful fixes get put in place.
Oops! Another court ruled today that he subsidies are legal, so the whole thing will probably go the Supreme Court. Also, if the subsidies are not legal then there goes paid insurance for Congress. That wasn't mentioned in either story I saw.
ReplyDeletehttp://www.chicagotribune.com/news/chi-irs-obamacare-court-ruling-20140722,0,3395290.story
The Internal Revenue Service adopted a regulation in 2012 that said those who buy coverage on a government-run exchange are eligible to receive a tax credit, if qualified by income, “regardless of whether the exchange is established and operated by a state.”
DeleteBut in the D.C. ruling, Judge Thomas Griffith said the law “unambiguously restricts the (authorized) subsidy to insurance purchased on exchanges ‘established by the state.’” The health law, he wrote, “plainly makes subsidies available only on exchanges established by states.”
So we have a case that pits what the law actually says verses regulation that the IRS promulgated.
We'll see if Justice Roberts caves in again. We will see if we have temporary situational law governed by politics.
In 2010 the Democrats held the House and Senate. No longer the case. No chance this or a post 2014 congress changes the law.
This will be interesting for sure. As I mentioned, some members of Congress may be affected adversely if this provision is overthrown.
ReplyDeleteSection 1312(d)(3)(D) of the Patient Protection and Affordable Care Act (ACA; P.L. 111-148, as amended) generally specifies that the only health plans that the federal government may make available to Members and certain congressional staff (with respect to their service as Members or staff) are either created under ACA or offered through an exchange. A final rule issued by the Office of Personnel Management (OPM) amends FEHBP eligibility regulations to comply with
Section 1312(d)(3)(D) of ACA. Under the final rule, beginning January 1, 2014, Members and designated congressional staff are no longer able to purchase FEHBP plans as active employees; however, if they enroll in a health plan offered through a small business health options program (SHOP) exchange, they remain eligible for an employer contribution toward coverage. Additionally, the final rule allows Members and designated congressional staff who are eligible for retirement to enroll in a FEHBP plan upon retirement.
How do you say the repubs have fucked the people again. Let's look at the states that did not set up exchanges.
ReplyDeleteMaine Paul LePage R
New Jersey Chris Christie R
Pennsylvania Tom Corbett R
Ohio John Kasich R
Indiana Mike Pence R
Wisconsin Scott Walker R
Virginia Bob O Donnell R
North Carolina Pat McCrory R
South Carolina Nikki Haley R
Georgia Nathan Deal R
Florida Rick Scott R
Alabama Robert Bentley R
Mississippi Phil Bryant R
Louisiana Bobby Jindal R
Texas Rick Perry R
Oklahoma Mary Fallin R
Kansas Sam Brownback R
Missouri Jay Nixon D Legislature is heavily Repub
Nebraska Dave Heinemann R
South Dakota Dennis Daugaard R
North Dakota Jack Dalrymple R
Montana Steve Bullock D legislature is heavily repub
Wyoming Matt Mead R
Utah Gary Herbert R
Arizona Jan Brewer R
Tennessee Bill Haslam R
All these people denied their constituency the ability to buy affordable healthcare under the ACA. These states comprise 59% of the poorest people in America.
Hail Hail William here is your list of heroes. please feel free to cut it out and frame it to hang on your wall.
But......... are these people in limbo? 7 states have a hybrid system combining an instate setup with the government exchange.
New Hampshire
Delaware
West Virginia
Illinois
Arkansas
Iowa
Michigan. What becomes of them? do they receive a subsidy or not?
And the 14 States and D.C. did the right thing and created a state exchange to enroll their citizens to affordable healthcare.
Vermont Pete Shumlin D
New York Andrew Cuomo D
Massachusetts Deval Patrick D
Rhode Island Lincoln Chafee D
Connecticut Dannel Malloy D
Kentucky Steve Beshear D
Minnesota Mark Dayton DFL
Colorado John Hickenlooper D
New Mexico Susana Martinez R Dem legislature overrode veto
California Jerry Brown D
Nevada Brian Sandoval R Dem Legislature
Idaho C L Otter R
Oregon john Kitzhaber D
Washington Jay Inslee D
These represent states wher a great deal of the population doesn't need the subsidies.
So 59 percent of Americans who need affordable Health coverage are denied by one party to score political points with their radical base. Nice.
So now what becomes of the 59%. Well they turn back to Medicaid so we continue to support them anyway. They continue to go into our medical facilities without insurance and the premiums and costs continue to rise for all of us. They now get to pay a tax penalty for not having insurance, something they can ill afford. But hey the Republicans scored a few worthless political points so now the base will be out to vote. Yeah!
ReplyDeleteIt appears that States representing the 59%, if your figure is correct, do not agree with Obamacare.
DeleteBut this party's not over. Not when the supreme's can mould political decisions made from whole cloth.
Something the spender in chief can ponder whilst on his two week vacation in the Vin yads.
Delete"But this party's not over. Not when the supreme's can mould political decisions made from whole cloth."
DeleteSomeday, William, the conservatives in this country may regret having stacked the court to lean so far to the right. I can fully understand the inclination to say, "I don't give a fuck about compromise". But heavy handedness tends to eventually bite you in the ass. While a teensy weensy slice of America likely applauds the SCOTUS for things like the hobby lobby decision, decisions like that may be just the thing that pisses enough people off to demand a legitimate fix. Or, that decision may be the thing that forces the issue of taking away corporate personhood.
Yesterday in Australia the head honcho of the Medical association made a significant statement at the National Press Club in Canberra. This bloke went to great lengths to warn all Australians, particularly the politicians, to be very wary of going down the American path in medical insurance. He claimed that your system is controlled by Insurance companies and even went to the extremes of claiming some American insurance companies are dictating to the doctors they insure; This is madness if true, a man with a serious illness can be denied particular investigations at the behest of some bean counter in an insurance office. I say again, IF TRUE this is a state of affairs not to be tolerated by a people who kicked up such a fuss over a few chests of tea some 200 years ago. I have previously shown you a successful system; why not stop treating the health of your nation as a football and get together to INSTRUCT THE GOVERNMENT WHAT TO DO IN ORDER TO FIX THE MESS.
DeleteCheers from a frustrated Australian.
While I am frustrated, let me mention that 30 something Australians were lost in the Malaysian Airline brought down over the Ukraine last weekend. I felt this personally as it was the same airline and the same route over which I flew in a visit to UK a year or so ago. No comment on this site as yet, perhaps there were no Americans involved. Friends, we bleed in the same way that you do, the Dutch seem to have been hit the hardest and these are perhaps the nation deserving tragedy less than many others.
King,
DeleteThere was one American killed in that war crime, but the only real discussion that I have seen occur in this country is primarily the usual banter that is meant to make a political point. This was a war crime. Period. But, for convenient reasons, no head of state will call it that because that would require action. Even the supreme war mongers like McCain openly admit we are not going to commit American troops to an armed conflict against Russian armed thugs and so far, Obama has resisted contributing arms in order to fight a proxy war with Russia. This is a horrible situation with few options that Americans will support, especially if it means they need to commit lives of money. that's extremely crass, but it seems to be the reality. When you are the size of America or Russia, you seldom pay for the damage you cause let alone acknowledge responsibility for it.
To your point about health care here, I think your "honcho" hit the nail on the head. our plan is a disaster and is a pure give away to insurance companies. here are a couple links
http://www.kaiserhealthnews.org/stories/2013/october/01/preexisting-condition-consumers-insurance-obamacare-marketplaces.aspx
http://mediamatters.org/research/2013/09/27/because-fox-asked-here-are-examples-of-people-w/196139
You've had a lot of discussions with folks here and I think that despite frustration, you probably understand some of this. Your outlook on social equity would at best make you a liberal conservative in this country and in today's hyper conservative movement, you wouldn't even register as right of center. We have comparably bad outcomes for equal dollars spent compared to other countries, but we have very advanced equipment and procedures and we can provide quite a few options for those who have money. Rather than seeing health care be a system that creates health and helps contribute to a stable society, we see it as just another commodity to consume. What we spend on health care here is about 20% of our GDP (http://blogs.wsj.com/economics/2013/07/23/u-s-health-spending-one-of-these-things-not-like-others/). think about how much money is available to to sellers of health care services and devices and it's not hard to see why we have the system that we do.
King the Dutch prime minister has liken this to our 911. It is their 911. Are they going to act against these terrorists who downed the plane and killed so many of their own? I don't know but the fact that they are a NATO member means that if they see this as an attack on their country as we did in 911, and decide to go we all go. They backed us in Afghanistan we back them in Ukraine.
Delete"He claimed that your system is controlled by Insurance companies and even went to the extremes of claiming some American insurance companies are dictating to the doctors they insure;"
DeleteKing that is a true statement. I have a sister in law who is high up in the insurance business with one of America's biggest insurance companies. She acts as a liaison between the doctors and the company. She decides what is going to be covered and what isn't. She dictates what is needed and what isn't and receives bonus on the money she saves the insurance company. Needless to say she is a very wealthy woman.
This is what gets me when people like William talk of death panels which are just people who are searching for the best practices to treat different ailments to eliminate so many un-necessary tests and procedures that are done to run up the bill. What William doesn't realize is that the death panels are already out there and they earn their living by saving the insurance companies money by denying services not a panel, but a single individual with a monetary stake.
How do the states that accepted new medicaid people pay for the 10% cost added to they budgets in 3 years?
DeleteAs to Hickenlooper, you are completely out of touch, Bill Ritter agreed to the exchange and adding the people to medicaid without a thought of how to pay for it. The best part, Hickenlooper doesn't care either. in 2010 he proposed 1 billion in tax increases to the states taxpayers. He was soundly defeated as he should be.