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PPACA (Obamacare) ruled unconstitutional

atara

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https://www.bloomberg.com/news/arti...re-provisions-ruled-unconstitutional-by-judge

"Obamacare was struck down by a Texas federal judge in a ruling that casts uncertainty on insurance coverage for millions of U.S. residents."

"The decision Friday finding the Affordable Care Act unconstitutional comes just before the end of a six-week open enrollment period for the program in 2019 and underscores a divide between Republicans who have long sought to invalidate the law and Democrats who fought to keep it in place."

"U.S. District Judge Reed O?Connor in Fort Worth agreed with a coalition of Republican states led by Texas that he had to eviscerate the Affordable Care Act, the signature health-care overhaul by President Barack Obama, after Congress last year zeroed out a key provision -- the tax penalty for not complying with the requirement to buy insurance. The decision is almost certain to be appealed all the way to the Supreme Court."

"?Today?s ruling is an assault on 133 million Americans with preexisting conditions, on the 20 million Americans who rely on the ACA?s consumer protections for health care, and on America?s faithful progress toward affordable health care for all Americans,? California Attorney General Xavier Becerra said in a statement. A spokeswoman for Becerra said an appeal will be filed before Jan. 1."

"Texas and an alliance of 19 states argued to the judge that they?ve been harmed by an increase in the number of people on state-supported insurance rolls. They claimed that when Congress repealed the tax penalty last year, it eliminated the U.S. Supreme Court?s rationale for finding the ACA constitutional in 2012."

"The Texas judge agreed."

"?The remainder of the ACA is non-severable from the individual mandate, meaning that the Act must be invalidated in whole,? O?Connor wrote."

"California and Democratic officials in 14 states, along with the District of Columbia, won permission to defend ACA in the Fort Worth case when the Trump administration sided with the states seeking to dismantle it. They contended that overturning the law would throw millions off health insurance rolls by reversing Medicaid expansion, ending tax credits that help people and empowering insurers to once again deny coverage based on pre-existing conditions."

"Justice Department lawyers urged the judge to strike down the individual mandate and provisions requiring insurance companies to cover individuals with preexisting health conditions and charge them the same premiums as healthy individuals. They argued the judge should spare the rest of the law, which includes Medicaid expansion, the employer mandate, health exchanges, premium subsidies and federal health-care reimbursement rates for hospitals."

"Maryland Attorney General Brian Frosh launched a counterattack Sept. 13 to save Obamacare, seeking a judgment that the Affordable Care Act is constitutional and a court order barring the U.S. from taking any action inconsistent with that conclusion. Frosh sued then-U.S. Attorney General Jeff Sessions and the federal departments of Justice and Health and Human Services."

"The Texas case is Texas v. U.S., 4:18-cv-00167-0, U.S. District Court, Northern District of Texas (Fort Worth). Frosh?s case is State of Maryland v. United States, 1:18-cv-02849, U.S. District Court, District of Maryland (Greenbelt)."

Well... that happened.
 
What the fuck? What does that mean for people who don't live in Texas? Anything? I don't need it but my girlfriend has it and almost all of my friends and it's the only way they can afford health insurance. :|
 
Federal court rules Obamacare unconstitutional — but the law stands for now

A federal judge in Texas has ruled the Affordable Care Act unconstitutional, finding that the law cannot stand now that Congress has rolled back the mandate that everyone carry health insurance or pay a fine.

The new ruling poses a significant threat to the Affordable Care Act’s most popular and most sweeping health insurance reforms. If affirmed at higher courts, it could roll back Obamacare’s ban on preexisting conditions. Insurers would once again be able to charge sick patients higher premiums.

The Trump administration had partially supported this lawsuit, filing a brief asking the court to overturn Obamacare’s ban on preexisting conditions.

“The Court finds the Individual Mandate ‘is essential to’ and inserverable from ‘the other provisions’ of the ACA,” judge Reed O’Connor wrote in a late Friday ruling.

O’Connor’s decision will almost certainly be appealed up to the Fifth Circuit Court of Appeals, which could ultimately send the case to the Supreme Court. It is not entirely clear yet what the ruling will mean for current Obamacare enrollees — or those currently signing up, as the program’s open enrollment period ends at midnight on Saturday.

Legal experts on the left and the right believe the arguments being made by Republican-led states are, on their face, uncompelling and unlikely to succeed in overturning the Affordable Care Act.

At the same time, there is a history of lawsuits that most legal experts thought were unpersuasive nonetheless putting ACA in mortal danger — first the lawsuit against the individual mandate and then the challenge to insurance subsidies.

With this first victory, it becomes a more real possibility that this lawsuit could end up in that category.

Texas v. United States, the lawsuit that threatens to take down Obamacare, explained

Twenty state attorneys general filed this lawsuit against Obamacare in early 2018. They essentially make a two-part argument for why Obamacare is unconstitutional in the wake of Congress’s decision to end the law’s mandate to carry health insurance.

The first part of their argument is over the individual mandate itself. Remember, the 2017 tax bill got rid of the financial penalties for remaining uninsured. But it didn’t totally kill off this part of Obamacare. The mandate to carry health insurance actually still stands as federal law — there just isn’t any fine for those who decide not to comply.

The Supreme Court specifically upheld the individual mandate as a tax. If there the mandate doesn’t have a penalty, the attorneys general argue, then it’s no longer a tax — and thus unconstitutional.

On its own, a court decision that declares the individual mandate unconstitutional wouldn’t be a big deal for Obamacare. The financial penalty is, after all, already gone.

But the state attorneys general take their case a step further. They argue that, if the individual mandate is declared unconstitutional, than the rest of the law needs to fall along with it. Or, as the lawsuit itself puts it: “Once the heart of the ACA—the individual mandate—is declared unconstitutional, the remainder of the ACA must also fall.”

Essentially, the state attorneys general are arguing that the individual mandate isn’t severable from the rest of the law. If the court finds the mandate unconstitutional, then the rest of the law — everything from protections for preexisting conditions to the Medicaid expansion required calorie labeling on menus — has to go down with it.

Usually, a presidential administration defends current law, but the Trump administration took a different approach in this case. It agreed with the conservative states that the mandate and, with it, the law’s rules that prohibits insurers from denying people health insurance or charging them higher rates, should be found unconstitutional.

However, the Justice Department lawyers didn’t go quite as far as the state attorneys general. They told the court that the rest of the law could stand, including the law’s massive expansion of Medicaid to millions of the nation’s poorest citizens.

If the Trump administration’s argument were to prevail, insurers could once again be able to flat-out deny Americans insurance based on their health status. No amount of federal subsidies would protect them. Medicaid expansion would remain, but the private insurance market would no longer guarantee coverage to every American.

Because the Trump administration is not defending the Affordable Care Act in this case, a group of pro-Obamacare attorneys general from 16 states and the District of Columbia swooped in to take over the case.

They argue that Congress clearly understood what it was doing when it reduced the individual mandate penalty to zero dollars. Their intent was to get rid of the penalty but leave the rest of the law standing, and that the courts ought to respect that.

Most legal experts, it’s worth noting, are skeptical of the arguments made in this case — even those that have worked on other legal challenges to the Affordable Care Act. They say that it willfully ignores the intent of the 2017 Congress, which zeroed out the individual mandate penalty without touching the rest of the Affordable Care Act.

”They are asking the court to evaluate the current law on the basis of what the law used to be,” Jonathan Adler, a law professor at Case Western University who supported previous Obamacare challenges, has told Vox. “That whole analysis just doesn’t apply or work anymore.”

Let's see how conservative the Supreme Court is, I say. Or not. :\

Trump is unbelievable. :X
 
From what I've read Trump has said he would like Congress to seek a solution that protects people from being refused for pre-existing conditions. How true he is to his word is a different story.

As much as I dislike Trump, Obama care does no good for me whatsoever, it actually puts me in a disadvantage. I do not make enough to qualify for cheaper/subsidised Obamacare. But I don't make enough to afford private insurance either. That's how it is for most of my unmarried friends as well.

Work offers insurance, but it's terrible. Premiums are insane as well as deductable, AND you can only use it with ONE certain hospital/Dr affiliates. It's ridiculous.

So, I do believe SOMETHING needs to be done. I don't believe the true root is insurance though, but the medical/pharmaceutical companies themselves.
 
I work basically under independent contractor conditions for a standardized testing nonprofit (although I am paid on a W-2 and am considered an employee). We voted down employer health insurance because if your employer offers health insurance you don't qualify for a subsidized ACA policy. I have a great ACA policy that I pay $130 a month for, and I didn't want to risk putting my coverage in jeopardy if the employer offered shitty insurance. My copays to see the GP is $10, to see the psychiatrist is $35 and my most expensive copay for prescriptions is 60 10mg Adderall IRs is $18. My out of pocket max for the year is $2,500. There's a lot of misinformation floating around out there. If you earn between $12,140 and $48,560, you qualify for a subsidy. While I agree with Medicaid expansion in theory, in Florida, it wouldn't make a whole hell of a lot of difference because single, able-bodied people without dependent children wouldn't qualify anyway. Something is going to have to be done long-term about the mandate penalty, though. New York State tried an Obamacare lite approach and it tanked because it didn't have a mandate and only the old and sick were getting insurance. You don't need an advanced degree in actuarial science to understand the concept that risk diminishes when spread across a larger pool. Case in point, Florida has had a little over 2 million people buy ACA policies in the last two open enrollments and premiums from Florida Blue Cross Blue Shield rose only .5 percent.
 
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People hated Obamacare because the premiums were too high. It wasn't just the mandate. The fact is, administrative overhead is out of control:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4283267/

"A simplified financing system in the U.S. could result in cost savings exceeding $350 billion annually, nearly 15% of health care spending."

http://citeseerx.ist.psu.edu/viewdoc/download?doi=10.1.1.562.5280&rep=rep1&type=pdf

"Administrative costs are much higher for small employer groups—often in the range of 20% to 30% of premiums—than for larger ones, for several reasons. First, marketing costs are higher. While larger groups commonly deal directly with the insurer, small groups are enrolled by agents and brokers who are paid on commission.
Second, because expenses for small groups are difficult to predict, insurers often demand higher risk reserves. Third, small group carriers in most states still engage in underwriting, with its attendant costs, to set each group’s premium rate. For all these reasons, costs in the nongroup market may be even higher, although there are no reliable data. "


If the US is not going to have single-payer, what it does need is a way of organizing group insurance coverage which is not dependent on employers. Personally, I think the best option is to have universities offer group coverage to their alumni, and maybe pair this with some kind of national community college program.

No group coverage strategy is likely to enroll all Americans in a suitable group of insured, but if we can reduce the number who are in small groups or who buy individual insurance, we should be able to free up more money to subsidize those who really need it. The most significant moves to expand group coverage have come from Sen. Rand Paul:

https://reason.com/blog/2018/06/19/rand-paul-endorsed-association-health-pl

Single-payer is still a decent option, but it's got a political mountain to climb.
 
My Obamacare is 50$/month and that gets me doctor visits for like $5, scripts of Sub for $3, and it's generally a great deal. I heard the Dems will block this shit, so we have nothing to fear but a rebel democrat or two voting to abolish the ACA, right?
 
What the fuck? What does that mean for people who don't live in Texas? Anything? I don't need it but my girlfriend has it and almost all of my friends and it's the only way they can afford health insurance. :|

it applies to everyone in the US. it was ruled unconstitutional per the US constitution not the texas state constitution. the original SCOTUS ruling was that it was a tax, because of the tax penalty if you didnt have insurance. now that there's no tax penalty for being uninsured, the original ruling isnt valid anymore

People hated Obamacare because the premiums were too high.

and now they're going to be even higher. hopefully we can get medicare for all out of this
 
Guys you need to take a breath. The ACA has kept a lot of Americans not only insured but also employed. Wait for the stories to run about the job losses. Stock market will continue to tank.

Don’t fret. There will be replacement legislation. ACA gets to stay in place until replacement legislation happens.
 
From article in post # 3

Because the Trump administration is not defending the Affordable Care Act in this case, a group of pro-Obamacare attorneys general from 16 states and the District of Columbia swooped in to take over the case.

They argue that Congress clearly understood what it was doing when it reduced the individual mandate penalty to zero dollars. Their intent was to get rid of the penalty but leave the rest of the law standing, and that the courts ought to respect that.

Most legal experts, it’s worth noting, are skeptical of the arguments made in this case — even those that have worked on other legal challenges to the Affordable Care Act. They say that it willfully ignores the intent of the 2017 Congress, which zeroed out the individual mandate penalty without touching the rest of the Affordable Care Act.

The ACA still stands. The case is headed towards the Fifth Circuit Court of Appeals and possibly the Supreme Court. Until then, ACA is still in effect.

However, I don't mean to minimize the risk to Obamacare.
 
People hated Obamacare because the premiums were too high. It wasn't just the mandate. The fact is, administrative overhead is out of control
Your information is out of date. Obamacare's 80/20 rule that kicked in AFTER the data presented in the linked article is that no more than 20 percent of premium costs can be spent on overhead. Please spend more quality time informing yourself of timely information.
 
Your information is out of date. Obamacare's 80/20 rule that kicked in AFTER the data presented in the linked article is that no more than 20 percent of premium costs can be spent on overhead. Please spend more quality time informing yourself of timely information.
It doesn't work:

https://www.nber.org/papers/w23353

"we find claims costs rose nearly one-for-one with distance below the regulatory threshold: 7% in the individual market, and 2% in the group market. Premiums were unaffected. "

Price controls never work. You need to make systemic modifications that actually reduce overhead; you can't just ban overhead and expect it to go away. If getting bitten by mosquitoes was illegal, would there be no more mosquitoes?
 
My girlfriend pays like $30/month for Obamacare. All my friends that have it are happy with their premiums. I don't have it because I have health insurance through my employer but from what I see it works well.
 
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atara said:
Price controls never work. You need to make systemic modifications that actually reduce overhead; you can't just ban overhead and expect it to go away. If getting bitten by mosquitoes was illegal, would there be no more mosquitoes?
I finally made it all the way through that behemoth paper and my takeaway is that you cherry-picked one particular line. Although it has been a challenge to find more timely data than 2013, the net effect when the 80/20 medical loss ratio took effect in 2011 was that premiums either stayed static or actually decreased so as to not have to pay a rebate to policyholders.

Next time you post an esoteric paper that's not exactly easy to understand, keep in mind I used to sit on thesis and dissertation committees and I've read a lot of boring shit in my time. I won't be deterred from calling out obfuscation when I see it.
 
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