Entire ACA upheld by Supreme Court

[Clip-Clop]

Originally Posted by Danzig

how in the hell can it be deficit neutral?? how can doubling medicaid rolls not cause an increase in spending? how can subsidizing premiums not cost money?
in what fuci<ing thomas more utopian fantasy land does this **** work? is believable? it's not logical!! if you have x amount on medicaid now...you double that-what does that do to the cost of providing that care alone? well, i would think one could safely extrapolate that if you double the membership of a group, that would also double the cost of covering that group. that's just medicaid. what about the subsidies? who will pay that? and if your stop loss is a certain amount, who is funding that? with what? monopoly money??
adding people with pre-existing conditions-who will pay for those? high risk coverages, who will pay? all the' free' add ons, where will that money come from?

oh, wait...let me guess, because hospitals are going to magically cut their costs, right? LMAO. yeah, sure they will. sure they will. and that'll make up aaaallll the difference.

dear god. and people think that'll happen. HA!

They will, because they will only be paid what the gov't thinks is fair.

[Danzig]

Originally Posted by Clip-Clop

They will, because they will only be paid what the gov't thinks is fair.

lol
yeah, sure. that's why people are throwing money at health providers stock right now, because we all know how profitable things are when there are price controls.

well, at least it'll be interesting to watch how it all turns out.

[Riot]

"Obamacare a big tax hike on middle class America? No."
by Joan McCarter

Chief Justice John Roberts (who might want to think about increasing his security detail) is today's number one traitor for the Right. Roberts did conservatives a solid in one thing, however—he gave them their talking point by declaring that the individual mandate isn't really a mandate, but a tax. With some help from Rush Limbaugh, that's the new narrative from Republicans.

Speaker John Boehner calls it a tax hike. Ditto Rep. Joe Walsh (R-FormerlyADeadbeatDad), calling it a "new tax on middle class America." Sarah Palin, of course, piled on.

So did Mitt Romney, putting himself in some dubious company by declaring the same thing: "Obamacare raises taxes."

Well, not really, as Chris Hayes explains:

There is a difference between something being a tax and being permissible under congress' taxing authority.
— @chrislhayes via web

The Supreme Court ruling gives the federal government taxing authority, which is by no means the same as the imposition of a broad new tax.

No, this is not a massive tax increase on the American people. It's a penalty paid by people who choose not to purchase insurance. The Congressional Budget Office estimates that it will hit about 4 million Americans, about 1 percent of the population.

Now, it's refreshing that Republicans care about a different 1 percent for a change, but that still doesn't make this a tax hike.

And what's (way, way) more, most of the federal spending for the ACA is in tax credits for middle class people to help them afford insurance. Which is actually more like a tax cut.

Facts aside, since you know Republicans won't be swayed by them, here's the other part that Republicans, particularly Romney, have to tread carefully around. It's exactly how Mitt Romney expanded health insurance coverage in Massachusetts. If you don't buy health insurance in Massachusetts, guess what?

You pay a tax, as Mr. Romney explains at that link.

You pay a tax and take personal responsibility. (Remember that phrase, Mr. Romney? It's a real favorite in your set. Or was.)

The individual mandate isn't the route most of us on the left would have taken toward universal health coverage. But it's the route settled on by pragmatic, moderate political leaders like Barack Obama. And Mitt Romney.

[Danzig]

got home from work and spanish class. figured i'd start looking in my usual spots for more being said on obamacare, and here's something interesting already. and it goes more into what i said earlier-that if states can't be forced (and today's ruling takes away the one big stick to force them) into participating by expanding medicaid, what would that do to ppuca:

http://www.slate.com/articles/health...the_poor_.html

Don’t Celebrate Yet
The Supreme Court’s decision will make it much harder to extend health insurance to America’s poor.
By Darshak Sanghavi|Posted Thursday, June 28, 2012, at 7:45 PM ET

and here's the teeth of it:

"When one understands that the ACA’s real impact will derive from its expansion of Medicaid, the Supreme Court’s decision seems more worrisome. By limiting the federal government’s power to expand Medicaid in many states, the Supreme Court has seriously damaged the liberal dream of universal health coverage. As I wrote last fall, almost half of all people who qualify for free health insurance never sign up, especially in the Southern states where the highest number of uninsured people live. That’s not because inhabitants are lazy; it’s because those states create all kinds of barriers to Medicaid enrollment, since they have to assume some of the costs. The Supreme Court’s decision leaves the federal government without a big stick to beat ornery states like Texas, Florida, and Mississippi into expanding Medicaid, which means it has been left powerless to make sure that poor people get their coverage.

State reluctance to expand Medicaid gets at the core problem in health care today—it’s just too damn expensive and the ACA does very little about that. Currently, the average person consumes $5,000 per year in health care. By simple math, newly insuring 60 million people will cost taxpayers $300 billion annually, a far higher number than many policymakers admit. (For example, health care costs now consume 54 percent of Massachusetts’s budget, with the lion’s share going to the expanded Medicaid, despite massive federal subsidies.) And the dream that newly insured people will take advantage of more preventive services, often touted as a means to cut costs, hasn’t panned out, according to a meticulous new study from Oregon."

...i know the focus was on the IM, because that was felt to be the constitutional bugaboo. but there's far more to the whole thing. by ruling that they can't cut current state medicaid funding, there is NO earthly reason for a state to decide to expand their program, especially with many already suffering budget-wise with their current medicaid outlays vs funding.
then there's the fact, since i've read more on the ruling, that they've slashed the fine amounts-you've just removed a real reason for people to go after coverage. it should cost MORE, not less, to not buy it, if the intent is to get young, healthy, non-insurance buying people to decide to buy it.

so, they didn't remove the heart, but it's still possible it's a mortal blow.

[pointman]

Originally Posted by Danzig

got home from work and spanish class. figured i'd start looking in my usual spots for more being said on obamacare, and here's something interesting already. and it goes more into what i said earlier-that if states can't be forced (and today's ruling takes away the one big stick to force them) into participating by expanding medicaid, what would that do to ppuca:

http://www.slate.com/articles/health...the_poor_.html

Don’t Celebrate Yet
The Supreme Court’s decision will make it much harder to extend health insurance to America’s poor.
By Darshak Sanghavi|Posted Thursday, June 28, 2012, at 7:45 PM ET

and here's the teeth of it:

"When one understands that the ACA’s real impact will derive from its expansion of Medicaid, the Supreme Court’s decision seems more worrisome. By limiting the federal government’s power to expand Medicaid in many states, the Supreme Court has seriously damaged the liberal dream of universal health coverage. As I wrote last fall, almost half of all people who qualify for free health insurance never sign up, especially in the Southern states where the highest number of uninsured people live. That’s not because inhabitants are lazy; it’s because those states create all kinds of barriers to Medicaid enrollment, since they have to assume some of the costs. The Supreme Court’s decision leaves the federal government without a big stick to beat ornery states like Texas, Florida, and Mississippi into expanding Medicaid, which means it has been left powerless to make sure that poor people get their coverage.

State reluctance to expand Medicaid gets at the core problem in health care today—it’s just too damn expensive and the ACA does very little about that. Currently, the average person consumes $5,000 per year in health care. By simple math, newly insuring 60 million people will cost taxpayers $300 billion annually, a far higher number than many policymakers admit. (For example, health care costs now consume 54 percent of Massachusetts’s budget, with the lion’s share going to the expanded Medicaid, despite massive federal subsidies.) And the dream that newly insured people will take advantage of more preventive services, often touted as a means to cut costs, hasn’t panned out, according to a meticulous new study from Oregon."

...i know the focus was on the IM, because that was felt to be the constitutional bugaboo. but there's far more to the whole thing. by ruling that they can't cut current state medicaid funding, there is NO earthly reason for a state to decide to expand their program, especially with many already suffering budget-wise with their current medicaid outlays vs funding.
then there's the fact, since i've read more on the ruling, that they've slashed the fine amounts-you've just removed a real reason for people to go after coverage. it should cost MORE, not less, to not buy it, if the intent is to get young, healthy, non-insurance buying people to decide to buy it.

so, they didn't remove the heart, but it's still possible it's a mortal blow.

You mean that insuring another 60 million people won't pay for itself? I thought that Obamacare won't add to the deficit and Riot assured us it wouldn't, how could this be? She even gave us a pie chart.

[Riot]

Originally Posted by pointman

You mean that insuring another 60 million people won't pay for itself? I thought that Obamacare won't add to the deficit and Riot assured us it wouldn't, how could this be? She even gave us a pie chart.

^^^ often confuses on-line persona with bitchy 14-year-old mean girl

The Supremes did remove the ability to withhold all Medicaid funds from states that just want to take the money, not actually spend it on their poor people via Medicaid, and run. Feds can still withhold some Medicaid money.

So if states want to step up, take Medicare money, then announce they are not going to spend it on the poor who are on Medicaid ... well, good luck the next election, Gov.

[Danzig]

Originally Posted by pointman

You mean that insuring another 60 million people won't pay for itself? I thought that Obamacare won't add to the deficit and Riot assured us it wouldn't, how could this be? She even gave us a pie chart.

yeah, a pie in the sky chart, viewed thru rose colored glasses.

[Danzig]

Originally Posted by pointman

You mean that insuring another 60 million people won't pay for itself? I thought that Obamacare won't add to the deficit and Riot assured us it wouldn't, how could this be? She even gave us a pie chart.

perry came out today and said (no surprise) no expansion of medicaid, no exchanges. he joins fla, south car, louisiana....
26 states sued fighting obamacare. what will happen with that legislation if over half the country doesn't opt in?

[Riot]

Originally Posted by Danzig

perry came out today and said (no surprise) no expansion of medicaid, no exchanges. he joins fla, south car, louisiana....
26 states sued fighting obamacare. what will happen with that legislation if over half the country doesn't opt in?

Notice that it is the poorest, most uninsured, least healthy red states doing this: they choose to simply be killing their poor and lower middle-class citizens by denying them the health care access afforded them legally by the #ACA Medicaid expansion.

Those losers need to be kicked out of office.

What happens? Those states still get to take the money, but don't have to use it for it's intended purpose. Their citizens suffer by remaining out of the health care system.

As far as refusing to set up the exchanges, the federal government comes in and does it for the state, if the state refuses. So the state loses any "states rights" to tailor the exchanges specifically to the needs of that state. They get the generic federal plan.

That will affect you, Danzig, as your governor is refusing to follow the benefits the law gives you. Too bad for you.

Ezra Klein's WonkBlog explains it easily and well

If governors opt their states out of the health law’s Medicaid expansion — as many are now threatening to do — it’s the poorest Americans who would find themselves getting the rawest deal.

This set of charts from our graphics department helps explain why: People who earn less than 100 percent of the Federal Poverty Line (about $11,170 for an individual) are ineligible for tax credits to purchase health insurance. In a state like Arkansas, for example, that could be a big deal: