ACA..aka Obamacare is the law....for now.

Discussion in 'Politics, Religion & War Issues' started by bigvalboy, Jun 25, 2015.

  1. bigvalboy

    bigvalboy Regent

    Sacalia dissents, and the Republicans wind up on the wrong side of history...again.

    http://abcnews.go.com/Politics/supreme-court-upholds-obama-health-car



    Supreme Court Upholds Obamacare Subsidies, President Says ACA 'Is Here to Stay'

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    The U.S. Supreme Court sided today with the Obama administration over its major healthcare overhaul, upholding federal subsidies across the country.


    In a 6-3 ruling, the nation’s highest court ruled that critics’ reading of Obamacare might make sense in isolation, but not when viewed in a larger context and in light of the intention of the law.
    "After multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay," President Obama said.

    Flanked by Vice President Joe Biden, Obama added that had the Supreme Court struck down the use of subsidies on the federal exchange, “America would have gone backwards. That’s not what we do."

    Supreme Court Upholds Obamacare Individual Mandate as a Tax



    It’s the second time the Supreme Court -- and its conservative chief justice, John Roberts -- has backed controversial portions of Obamacare. The first ruling was in 2012.
    Justice Antonin Scalia wrote an angry dissent, saying the Supreme Court’s pair of decisions over Obamacare will “surely be remembered through the years” as evidence the court does “whatever [it] takes to uphold and assist its favorites.”


    The chairman of the Senate Homeland Security Committee, Sen. Ron Johnson, R-Wisconsin, called the ruling “incredibly disappointing.”


    “Obamacare has never been accepted by the American people,” Johnson said. “The harm that the law inflicts shows that the people were right. Congress must move America past this unaffordable, destructive law.”

    The decision has a major impact on the millions of Americans who are receiving financial assistance from the federal government to buy health insurance.


    Obamacare -- technically titled The Affordable Care Act -- gave states the option to build their own healthcare marketplaces or simply use one operated by the federal government.




    Joe Raedle/Getty Images
    PHOTO: A Florida woman looks to purchase an insurance policy under the Affordable Care Act at the store setup in the Westland Mall in Hialeah, Fla., Nov. 14, 2013.

    In all, 34 states decided to rely on the federal “exchange.” And more than 6 million low- to moderate-income Americans are now receiving subsidies of on average $260 a month through the federal exchange, according to Health and Human Services Secretary Sylvia Burwell.

    But in a lawsuit challenging the law, critics insisted the federal government is not allowed to subsidize insurance in states that rejected their own exchange for the federal system. Those critics based their argument on a single phrase in Obamacare that refers only to participants enrolled “through an Exchange established by the State.”


    “If subsidies are authorized for all Exchanges, why does [the law] specify an Exchange ‘established by the State’?” petitioner David King and others wrote in their brief to the Supreme Court.


    The White House has maintained, though, that in drafting and passing Obamacare, Congress clearly intended to offer insurance subsidies to those participating in both the federal and state exchanges.



    Jacquelyn Martin/AP Photo
    PHOTO: Security guards the Supreme Court in Washington, June 25, 2015.

    Last week, Burwell said the administration was “in a very strong position in the case,” based on the wording of the law and “the intention of the law.”

    She warned an adverse ruling would likely mean millions of Americans would lose subsidies and be unable to afford health insurance coverage.

    With only the sickest people in the insurance marketplace then, costs for coverage “drive up,” she added.


    In all, at least 10.2 million Americans have signed up for health coverage through Obamacare, according to Burwell’s department.


    She indicated an adverse ruling would mean governors in states without exchanges would have to decide whether to create them, and Congress would face a decision over whether to intervene through legislation.


    ABC News’ Nancy Gabriner contributed to this report


     
    Last edited: Jun 25, 2015
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  2. bigvalboy

    bigvalboy Regent

    http://www.newyorker.com/humor/boro...y-for-education-environment?intcid=mod-latest

    Republicans Fear Victory for Health Care Could Pave Way for Education, Environment
    By Andy Borowitz

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    WASHINGTON (The Borowitz Report)—The Supreme Court’s decision to preserve Obamacare subsidies has drawn sharp rebukes from Republican Presidential hopefuls, who warn that the victory for health care might eventually pave the way for similar advances in education and the environment.

    “The Supreme Court has decided, apparently, that every American should have access to quality health care,” said Senator Ted Cruz (R-Texas). “What if it decided to say the same thing about education? I don’t mean to be an alarmist but, after today, I believe that anything is possible.”

    Senator Rand Paul (R-Kentucky) also blasted the Court, telling reporters that “a government that protects health care is one small, dangerous step away from protecting the environment.”

    “The nightmare that I have long feared is now suddenly upon us,” Paul said. “Mark my words, we are on a slippery slope toward clean air and water.”

    On the campaign trail in Iowa, the former Arkansas governor Mike Huckabee raised another doomsday scenario, telling his audience, “If the Court thinks people should be allowed to see a doctor when they want, they probably also think that people should be able to marry anyone they want. My friends, that is not what God intended when He created America.”

    Speaking from New York, candidate Donald Trump offered his own scathing critique of the Supreme Court. “You look at them in their robes, and you say, ‘Those robes look freaking cheap,’ ” he said. “When I’m President, we’re getting more expensive robes.”

    :D
     
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  3. dutchmuch

    dutchmuch Count

    On the campaign trail in Iowa, the former Arkansas governor Mike Huckabee raised another doomsday scenario, telling his audience, “If the Court thinks people should be allowed to see a doctor when they want, they probably also think that people should be able to marry anyone they want. My friends, that is not what God intended when He created America.”

    He's gonna have a stroke tomorrow.
     
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  4. bigjoey

    bigjoey Marquess

    What no one talks about is that the subsidies are for the purchase of "health insurance" and that is not the same thing as "health care."

    While it will take a while for the results to become clear, many of those who have policies under the ACA still do not have health care. Some of those covered have huge deductibles, co-pays they can not meet or the provider network is so small that a local service provider can not be found. Many of the problems will surface for the next president to handle like the states that expanded Medicaid having to start paying part of the bill; some states like Illinois have absolutely no money and are deeply in the red paying expanding pension and retired worker health care benefits.

    What is needed is a single payer system that is funded directly with something like a VAT and not what we got.
     
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  5. sync

    sync Viscount

    Hopefully, what we have now is a solid step toward a single payer system.
     
    Lookin likes this.
  6. sync

    sync Viscount

    I would love to have seen his face this morning when the marriage equality decision was made public.
     
    bigvalboy likes this.
  7. dutchmuch

    dutchmuch Count

    Huckster is gonna stew over this all weekend.
     
    bigvalboy likes this.
  8. Oaktown

    Oaktown Baron

    So the Repubs have had 7 years to defeat ACA, and work on its replacement.

    Perhaps they don't want a lot of folks to have healthcare.
     
    bigvalboy and MiamiLooker like this.
  9. deej

    deej Administrator

    Republicans can't come up with a replacement is because ACA *IS* the republican healthcare plan.
     
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  10. BSR

    BSR Viscount

    The state insurance exchanges are collapsing left, right & center; the "if you like your doctor, you can keep your doctor" line was a steaming pile of cowplop; and premiums are increasing to the point of unaffordability while coverage is decreasing. This is what Obamacare hath wrought? It sounds like Democrats are the ones who don't want folks to have health care.
     
  11. purplekow

    purplekow Regent

    20 million people have insurance that did not. i see them every day. They are very grateful that they have had the opportunity to have access to care they would not otherwise have received. The Republicans have been very adept, as usual, at painting with a tar brush all of the many positive outcomes for real people with real medical problems. Medical care is expensive because it hard to give all that care and keep the Insurance Company executives in their private jets and because Super Bowl commercials just do not make themselves. There was a time when 90% of insurance premiums when to actual health care, if that were still the case, medical care would be much more affordable. Thanks to special interest lobbying, changes in the ACA, at the time it was being negotiated, had to be made. This might not have been the case if any Republicans had broken ranks and supported it. The great red wall of inaction made the ACA less than is could be, but better than the previous situation.
    So now, tearing down is easy, lets see what get built in its place. So far, lots of hot air and nothing concrete.
     
    Last edited: Jan 10, 2017
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  12. MiamiLooker

    MiamiLooker Count

    What key points in a healthcare plan would you support and would be acceptable to you?
     
  13. BSR

    BSR Viscount

    20 million? That number of Americans insured thanks to Obamacare comes straight out of the White House talking points. The Obama White House got that number from Gallup surveys and then did a lot of rounding to make Obamacare look good. A more reliable source would be the Census Bureau, which puts the number of newly insured thanks to Obamacare at 12.8 million. Even if that's a lot less than 20 million, it's still good news, right? Well, hold on a sec. Most of that 12.8 million, an estimated 88%, comes from people newly covered by expansions in Medicaid. purplekow, if you're seeing Medicaid patients, I applaud you, but 55% of your peers refuse to do so because of lowered reimbursements. And the number of doctors refusing Medicaid patients will only increase as reimbursements continue to fall. In other words, congratulations, you're covered! But sorry, you can't see a doctor. Only liberals would call millions more enrolled in a government program rife with doctor shortages, cost overruns, fraud, and abuse a "success story."

    Another significant factor in the increase in the number of newly insured is simply that more people are working. When Obamacare passed in 2009, we were mired in a recession so severe that it was arguably a depression. Since 2009, the economy has recovered (not as strongly as it should have, but that's another debate), which means millions are working and therefore got insured through their job. You might argue that having a job was no guarantee of health insurance prior to Obamacare, true enough, but plenty of employers used provide that benefit regardless of a government mandate. There is a dark side, however, to employer-provided health insurance plans: their unaffordability. In stark contrast to average $2,500 in savings that Obamacare promised to provide (funny how you NEVER hear that number any more), premiums have been rising so much that working Americans can no longer afford insurance. Either that, or the state insurance exchanges are collapsing as more companies are pulling out of the marketplace. From CNN: "The law already forced termination of health insurance for millions of Americans, estimated at 4.7 million by the Associated Press -- insurance they personally had chosen to buy. The Congressional Budget Office now projects that a stunning 10 million Americans will be forced off their chosen employer-based health insurance by 2021 -- a tenfold increase in the number that was initially projected back in 2011, at the onset of the law." Even if you're lucky enough to be able to find and afford health insurance, your options are more and more limited. 68% of Obamacare insurance options provide narrow or very narrow coverage networks. And it has only gotten worse because Obamacare exchanges across the country are restricting access to top doctors and facilities in a desperate attempt to hold down soaring premiums.

    So Republicans are somehow at fault for the failures of Obamacare for not allowing the program (that was passed because we had to pass it in order to find out what's in it) to be all that it can be? That's outrageous. When faced with a failure of government, the consistent liberal response is: "we need more government!" May I remind you of Einstein's definition of insanity? All major social welfare programs in the past were passed with significant bipartisan support: Social Security, Medicare, the War on Poverty. Obama, Pelosi, and Reid - in all their infinite arrogance - created a vast government program with zero Republicans on board. And when the Democrats even lost Ted Kennedy's old seat in deep-blue Massachusetts (did any Democrat stop & think of just how unpopular Obamacare was at this point?), they passed the final parts of Obamacare through the trick of reconciliation. Arrogant Democrats established a deeply flawed government program because they've been obsessed with the government takeover of the health care system since FDR. They thought it was more important to pass a bill, even if it was a bad one that would need fixing later. Well, it clearly does need fixing. My post is already too long, almost Kessleresque in length, yet I haven't even scratched the surface of all that's wrong with Obamacare. Unfortunately, Americans are paying the price for the Democrats' arrogance.

    PS: I totally botched some of the URLs in this post. My apologies, but I can't figure out how to go back and fix them through the edit feature.
     
    Last edited: Jan 10, 2017
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  14. purplekow

    purplekow Regent

    Fact is i am seeing Medicaid patients. Every day. Sometimes 15 to 20 a day. I know full well about the difficulties of finding colleagues to see these patients. There are a limited number of people choosing to see these patient but for someone like me, who used to see these people without insurance and had no option but to tell them there was no option that was not going to bankrupt them, this meager insurance was a godsend. I have dozens of patient's who had preexisting conditions who had been refused insurance. Middle class working people whose jobs did not cover them and who could not afford or could not find affordable insurance. There were lots of young adults, just out of college who were basically healthy but who had an injury that would have been otherwise catastrophic financially.
    I cannot help what other physicians do, but for those of us on the front lines, this is was a plan which was terrible for me financial but great for many of my patients. One father of 5 who is a mason and works very hard to support his children but could not afford a family plan. He went without insurance. When I diagnosed him with a lymphoma, I sought out physicians who would see him at discounted rates or on a payment plan. This man wanted to pay as best he could. I called friends and called in favors. A surgeon volunteered his services. Others worked with him, but chemotherapy was exorbitantly expensive. Fortunately, timing was everything and he was able to get insurance through the ACA and he is alive and doing well after a bone marrow transplant. Afterwards, he built a nice stone wall at my house and he is working, paying taxes (unlike mr trump who now will be getting a great medical plan with his new job) and raising his children. One man. One family. One American. One American family. There are millions of other stories. And maybe the program has been expensive for other Americans. Fact is their insurance premiums were rising every year before this. I know as an employer before ACA,medical costs for my employees and I, through my business rose every year from my opening the practice in 1992 until 2010. Every year it was juggle the price and cut the benefits. Perhaps that was not true for you, but that was true for a large percentage of Americans who were insured.

    As to the Republican responsibility, cooperation to supply medical care to American families should have been a bipartisan effort. It was not. The previous try in the 1990s was a one sided affair which managed some progress in child medical care. It also faced nothing but opposition from the Republican side of the aisle. Where was the great Republican leadership wich would offer the help shoulder the load? Constructive ideas to build a plan of which would could be proud. No one stepped out the shadows to say, the people of my state, or my districts or my country need to have reasonable access to excellent health care. No one stepped up to build it. Not one. How is that even statistically possible? A system was instituted, but as rickety a bridge as it may have been, it was still a bridge and not a wall. It was a helping hand not a slap in the face.

    Now it will be torn down. Will those that need it have a way across the chasm of access to medical insurance and medical care? I hope something credible and workable replaces it. I hope for the next father of 5 with lymphoma that there is something there to give him the chance my patient got, just barely in the nick of time.

    And I must congratulate you. an Obama critic who admits that there are more people working than in the past. . Are you sure?
     
    Last edited: Jan 11, 2017
  15. BSR

    BSR Viscount

    You want Obamacare horror stories? I got Obamacare horror stories! Larry Basich underwent open-heart surgery in early January. The UnitedHealthCare plan he signed up for on Nevada’s exchange claims they have no record of him and will not cover his surgery. Xerox, a contractor for the Nevada exchange, says Basich signed up with a different insurer. Right now Baisch is liable for $407,000 in costs for his treatment. That's just one. I can post hundreds of other Obamacare horror stories if you want to play this game.

    "Cooperation to supply American families should have been a bipartisan effort." Absolutely! I agree 100%! But what the Democrats were doing was not providing medical care so much as nationalizing health care. Margaret Thatcher often lamented that Reagan was able to do so much more to undo the harm of liberalism in America because she often had her hands tied because of nationalized health care. Dems have been obsessed with national health care since FDR because they knew if they could control health care, they could control everything. Dems weren't looking to help Americans to find medical care; they sought greater government power and control, damn the consequences!! The Dems were obsessed with getting their way, and they did, but look at the consequences. You liberals lost the White House, and a "deplorable" Republican is now President-elect. You lost a filibuster-proof majority in the Senate; the GOP now has 52 seats and will almost certainly increase their majority in 2018. You lost a strong majority in the House, and thanks to gerrymandering the GOP is almost sure to be a House majority until at least 2022. You lost the majority of governorships, and the GOP now has 34 of 50 governors. You lost the state legislatures, and now the GOP has majorities in 68 of 99 state legislative chambers. There are many reasons for the catastrophic Democrat losses, but if I had to pick the number one reason, I'd say it's Obamacare. Be careful what you wish for.

    Yes, I am absolutely sure that the economy has recovered and that there has been a net gain of jobs created since 2009, but that's damning with faint praise because the economy couldn't get much worse than it was in 2009. Whether the recovery is anywhere near what it should have been is a very different issue. And whether the $trillion stimulus accomplished anything other than helping out government cronies and digging us deeper into debt is another issue still. But I barely have the energy to deal with the vast issue of Obamacare. If you want to discuss the other topics, please start another thread.
     
  16. purplekow

    purplekow Regent

    Post another one. One that you know personally and not from the bash Obamacare handbook. By the way,where in that story is there responsibility for the patient's right to access medical insurance? Errors were made in the use perhaps but there is nothing in that story which is intrinsic to the ACA. That story is unfortunate, if true but it is still money, which can be remedied. He thought he had insurance and perhaps he did not. He is alive to tell it. He had his surgery. His issue is not with his access to insurance.
     
    Last edited: Jan 11, 2017
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  17. deej

    deej Administrator

    The story actually rings bogus to me. I can't imagine a hospital admitting someone and only checking their insurance after the procedure. Even at a doctor's office I usually have to present the insurance card right up front.
     
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  18. purplekow

    purplekow Regent

    I could see it happening but I agree that all sorts of missteps need to hae been made for that to happen and none of those have anything to do with access to insurance for health care.
     
  19. BSR

    BSR Viscount

    I'm not getting into a pissing contest with you over Obamacare sob stories because whether for or against, individual sob stories prove nothing.

    But I will discuss Obamacare's failures as a government program.

    First, even Obama's own Department of Health & Human Services admits that premiums have shot up 25%. The White House tried to play down the devastating increases by insisting that a lot of people won't have to pay the increase because subsidies will also increase. Apparently, the Obama White House must think that these subsidies will come from leprechauns' pots of gold or something, as opposed to anyone with a lick of common sense who knows that these subsidies come straight out of the paychecks of hard-working Americans. And since premiums are spiraling out of control while state exchanges are collapsing (15 so far), fewer and fewer people will qualify for these subsidies. Remember when Obama promised a savings of $2500 for a family of four? Quite the opposite, premiums have gone up an average of ~$3000, with more increases expected.
     
    Last edited: Jan 13, 2017
  20. BSR

    BSR Viscount

    Second, deductibles are also increasing. Obamacare's deductibles are set to increase by an average of 17% for all silver plans and an average of 6% for bronze plans. For the latter, the increase is slated to be a whopping 21 percent for those who don't qualify for the subsidies. Something like 40% of Americans are afraid of getting sick or injured because they can't afford the deductible, which is as high as $10,000 for some plans.