There is a lawsuit trying to kill the subsidies on the federal exchanges that Obamacare put in. It all hinges on the wording of the law. It says "the State" will provide subsidies. The judges have to determine if Congress meant the Federal government or if they meant each individual state.
As a matter of legislative history, Congress intended these exchange subsidies to be available regardless of the entity administering the exchanges. I followed the legislative and policy debate closely. Everyone on all sides understood the law’s intent perfectly well. To cite one obvious example, Republican and Democratic legislators routinely cite Congressional Budget Office cost estimates which presume that exchange subsidies would be available in all fifty states.
Lamontagne quoted favorably from the court's 5-4 majority opinion, written by Justice Samuel Alito: “The owners of the businesses have religious objections to abortion, and according to their religious beliefs the four contraceptive methods at issue are abortifacients. If the owners comply with the [Obama administration’s contraception] mandate, they believe they will be facilitating abortions..."
The problem here is that their religious belief is not a scientific truth. Just because the Greens believe that emergency contraception and intrauterine devices induce abortion does not make it so.
In fact, medical experts say quite the opposite.
The American College of Obstetricians and Gynecologists filed a friend-of-the-court brief supporting the contraceptive mandate. On its website, here is how ACOG replies to a question about whether emergency contraception like Plan B and Ella, the “morning-after” pills to which Hobby Lobby so strenuously objects, can cause an abortion:
"Emergency contraception will not disrupt an established pregnancy..."
On Tuesday, the idea that insurers would flee Obamacare joined the long procession of Obamacare disasters that simply didn't happen. Health and Human Services Secretary Sylvia Matthews Burwell announced that in the 44 states where numbers were available, the number of companies offering plans in 2015 would increase by 25 percent. So, far from fleeing the exchanges, insurers are rushing into them. Competition is increasing.
This is the problem in the debate about Obamacare. The two sides live in different informational universes. A few days ago, the New Republic's Danny Vinik tweeted a picture of the headlines he was receiving from the conservative YG Network:
That top headline, "More bad news for Obamacare exchange customers," quotes a New York Times report that "in many places premiums are going up by double-digit percentages within many of the most popular plans." It omits the next two sentences: "But other plans, hoping to attract customers, are increasing their prices substantially less. In some markets, plans are even cutting prices." (The point of the piece is that to get the best price you need to shop around.)
So to recap the judicial challenges to this...In July, two Republicans on a panel of 3 ruled that one badly worded sentence in the bill invalidated the entire Federal Health Care Exchange concept, even though in all other parts of the bill it was worded correctly. In September, an appeals court vacated that opinion. Now it is going to D.C. Appellate court - one step below the Supreme Court. They are expected to announce a decision on December 17. They are expected to uphold the vacating of the July decision, because there are more Democratic appointed judges than Republican ones on that court.
But to reiterate - a challenge got 1 step from the Supreme Court all because of a single poorly worded sentence in a document that contains 11.5 million words, and in theory it could possibly still see the Supreme Court. They could decide to review it if they feel like it. This article compares it to the Bubble Boy episode of Seinfeld: Moops.
Well, I guess that old story popped up because the Supreme Court DID decide to take this case. The decision will be out in June 2015.
All this decision could potentially do is throw out the federal exchanges. It won't repeal the whole law. The states that created their own exchanges would be unaffected. The 36 states who did not create their own and used the federal ones will have to decide whether to create their own or not. I bet a lot of them will but the reddest ones won't of course, which will screw some of the poorest areas in the country.
Kalanick told reporters that Obamacare had been a crucial element in his firm’s success. “It’s huge," he said, according to BuzzFeed. “The democratization of those types of benefits allow people to have more flexible ways to make a living. They don’t have to be working for The Man.”
What makes Kalanick’s comments not just cutting but a knife thrust to the Republican heart is that Uber is the very model of the sort of firm the party covets. Republicans actually circulated a pro-Uber petition and sought to brand itself in general as the party of Uber. Uber sits in the tiny overlapping Venn diagram center of the party’s reputational needs. It represents their idealized self-image as advocates of dynamism rather than existing privilege, new technology rather than financial manipulation or resource extraction, and its is urban rather than rural.
It is not merely bad luck, though, that has brought the GOP’s Uber strategy into fatal conflict with Uber itself. The underlying problem is that the Uber strategy bears no relationship to the party’s actual agenda.
Related: Satanists are also pushing to have an 8 foot tall statue of Satan on the grounds of the Oklahoma State Capitol, after Oklahoma politicians put a monument of the 10 Commandments on the statehouse lawn.
Last fall, Mark Warshawsky and Andrew Biggs made a striking observation: From 1999 to 2013, the cost to employers of an average family health policy increased from $4,200 to $12,000 per year. In an alternative universe in which employer premiums had remained flat, salaries would have been $7,800 higher, a life-changing difference for most low- and middle-income families. To protect these families, many people want the government to pick up a bigger share of our hospital bills. But this just shifts the burden from employers to taxpayers. The Congressional Budget Office expects federal health spending to almost double as a share of GDP between now and 2039. With the exception of interest on the debt, all other federal spending will shrink. What this means in practice is that high medical prices charged by hospitals will gobble up taxpayer dollars that might otherwise have gone to giving poor people more cash assistance, welfare-to-work programs, and Pell grants; fixing potholes; sending missions to Mars; and who knows what else.
When you survey the health systems of other rich countries, you’ll find some that rely a bit more on private insurance markets than ours (like Switzerland) and others that rely a bit more on centralized bureaucracies (like Britain), but what you won’t find is a country where hospitals dare to charge such obscenely high prices. Avik Roy, a senior fellow at the Manhattan Institute and a conservative health reform guru, has observed that although the average hospital stay in the world’s rich countries is $6,222, it costs $18,142 in the U.S. Guess what? Spending three times as much doesn’t appear to yield three times the benefit.
To me it is pretty clear that whether we go to single-payer or not, some kind of big action by the government is going to be necessary. Basically, single-payer is a way to crack down on hospitals and insurers and negotiate a better deal for everyone. You might get a similar result if you just broke up all these various monopolies in the health care industry and changed how we treat them.
Last fall, Mark Warshawsky and Andrew Biggs made a striking observation: From 1999 to 2013, the cost to employers of an average family health policy increased from $4,200 to $12,000 per year. In an alternative universe in which employer premiums had remained flat, salaries would have been $7,800 higher, a life-changing difference for most low- and middle-income families. To protect these families, many people want the government to pick up a bigger share of our hospital bills. But this just shifts the burden from employers to taxpayers. The Congressional Budget Office expects federal health spending to almost double as a share of GDP between now and 2039. With the exception of interest on the debt, all other federal spending will shrink. What this means in practice is that high medical prices charged by hospitals will gobble up taxpayer dollars that might otherwise have gone to giving poor people more cash assistance, welfare-to-work programs, and Pell grants; fixing potholes; sending missions to Mars; and who knows what else.
When you survey the health systems of other rich countries, you’ll find some that rely a bit more on private insurance markets than ours (like Switzerland) and others that rely a bit more on centralized bureaucracies (like Britain), but what you won’t find is a country where hospitals dare to charge such obscenely high prices. Avik Roy, a senior fellow at the Manhattan Institute and a conservative health reform guru, has observed that although the average hospital stay in the world’s rich countries is $6,222, it costs $18,142 in the U.S. Guess what? Spending three times as much doesn’t appear to yield three times the benefit.
To me it is pretty clear that whether we go to single-payer or not, some kind of big action by the government is going to be necessary. Basically, single-payer is a way to crack down on hospitals and insurers and negotiate a better deal for everyone. You might get a similar result if you just broke up all these various monopolies in the health care industry and changed how we treat them.
+++++
I've been saying for years that it's not the insurance companies that are gouging us (well, they are, but they're not the worst culprits). It's the medical industry.
The ACA mandates transparency for the insurance industry, but nobody is reeling in the health industry at all.
