Court ruling in favor of Obamacare benefits consumers and both political parties

On a decisive 6 to 3 vote, King v Burwell, the US Supreme Court ruled that the legislation implementing Obamacare was constitutional and that the legislative intent that federally administered  insurance could be subsidized.  What this means for consumers is that 6 million subscribers through the federal system will maintain their affordable health insurance and that for everyone else, the rates would not soar.  The subscribers most affected were those who lived in the 35 states that did not set up their own health insurance exchanges through which Obamacare could have been  administered on a state basis. 

Consumers everywhere in the US, regardless of which state, will continue to benefit.
Per healthcare.gov, On average, consumers enrolled in the Marketplace are receiving $3,260 per year in taxcredits, or $272 each month. About 8 in 10 consumers could find coverage for $100 orless with tax credits through the Marketplace.

 Kaiser Health had predicted that all insurance rates would have increased eventually more than predicted otherwise if the Court did not uphold the Obamacare law. The Congressional Budget Office also predicted a hit in the long term to the deficit if the law was overturned because indeed there were cost savings built into Obamacare  to the health care system that aided the flattening of the cost curve. Costs were held down by less charity care,  greater competition, and built in preventative care.  With fewer consumers unable to pay their bills and with more consumers getting preventative care and checkups without copays, the entire system would see lower costs than if the Obamacare system were not viable.

Colorado would not have been immediately affected since Colorado was one of the states that set up the state exchange. But in the future, the lack of participation of so many in health insurance in general would have set up conditions that might have made Obamacare financially unsustainable since the whole system depended upon a large number of healthy as well as sick making the pool of insurers large enough to attract even healthy payers.  Our own state health exchange has also come under fire for administrative and financial problems and there is talk of abandoning the state exchange and moving its customers to the federal exchange if the Court ruled in favor of Obamacare.  There is now a plan B, a fallback to the federal exchange, if the state exchange is put on ice by our state legislature.  I would hope the State exchange would survive because its administration is closer to home than Washington, and the State legislature has some control over it.

Politically both Democrats and the GOP can breathe a sigh of relief.  The Obama health care legacy is secure. The GOP would not have to face 6 million hardship stories of those who had to drop insurance and feel  pressure to find an alternative to replace Obamacare.  After years of trying, they have never come up with a comparable replacement.  One of their dumbest  proposals, to remove the individual mandate (already upheld by the Court) and mandates on employers, would have eventually destroyed the system since only the sick would have subscribed, the pool would have had less healthy paying for the sicker, and the cost would have spiraled into its eventual death. Their State legislatures are also off the hook for finding some state funds to keep the subsidies going.  Most of the states not having state run exchanges are red states, so the political uproar would have been more severe in a presidential election year.

For those in the GOP decrying the SCOTUS decision, they offer some very misleading reasons:
That Obamacare caused soaring premiums (in fact premium increases have been less than before Obamacare) and the costs are going to be outrageous (in fact, Obamacare will lower the deficit over time per the CBO).  For the sources and reasons, see the independent, non partisan factcheck.org
http://www.factcheck.org/2015/06/scotus-ruling-fallout/

A version of this blog appeared in the www.skyhidailynews.com July 3, 2015

How the ACA benefits all consumers who have health care insurance from any source:
A list from the White House: https://www.whitehouse.gov/sites/default/files/docs/health_reform_checklist.pdf

 http://www.coloradohealthinstitute.org/blog/detail/the-aca-lives-and-one-chi-report-dies

http://coloradostatesman.com/content/995830-us-supreme-court-ruling-deals-another-defeat-obamacare-foes

http://blogs.wsj.com/washwire/2015/06/19/facing-the-fallout-from-a-king-v-burwell-ruling/

http://acasignups.net/15/06/19/cbo-aca-repeal-federal-deficit-increase-353b-or-137b-over-next-decade-net-loss-24m-insured

 I constantly ask myself why there are those so many determined to deprive people of their health insurance?  For the 56^th time, the GOP dominated House voted to repeal the ACA (Obamacare) last week.  It was a futile exercise because President Obama still has the veto power. Do they just not care that insurance was unaffordable for millions before the ACA or are there other reasons? I can speculate on the answers.

Ideology plays a big role. I often hear expressed fear of federal government taking over. Small government is always better.  States’ rights should prevail.  Private enterprise should always do it instead. There are those who do not want any government to mandate them to do anything, much less help anyone else to be able to afford health insurance. 

The old status quo was tolerable, say some. Emergency rooms are good enough care; preventative care is not that important. So what if charity care and unpaid medical bills hike everyone else’s premiums. It is ok those stuck with unaffordable medical bills lose their homes or go bankrupt.

 Deficit hawks care more than anything that the ACA will run up the deficit in the next ten years. At least that is how Senate Republicans interpret a recent government report. Prior year reports showed it would reduce the deficit. Next year could show something different.   Legislative tweaks with payfor strategies and tackling entitlements are tougher to do.

However the reason for Obamacare in the first place was private sector insurers had already failed to cover so many and states other than Massachusetts were unwilling to provide a solution. So far the GOP has failed to agree among themselves on a comparably effective replacement.

And then there are partisan loyalists and Obama haters whose main motivation is to cripple President Obama. There is a lawsuit now before the Supreme Court which could rule that subsidies issued through the federal web site were illegal; only subsidies could only be provided through state exchanges. The chief plaintiff bringing the suit, David M. King, thinks the president is an “idiot” and has posted altered images of the first lady in Middle Eastern clothing.  A Court ruling against Obamacare would mean 80% of the 9 million beneficiaries of the ACA who receive those subsidies through the federal exchanges would be unable to afford their health insurance premiums.  That the thirty five states refusing to set up state exchanges would reverse themselves is slim since they have state houses controlled by Republicans hostile to Obamacare.

Obamacare is a failure? In spite of reparable computer glitches, the ACA is doing what it was designed to do even part of the way to full implementation.  By the end of 2016, 24 million fewer Americans will lack insurance, per the nonpartisan Congressional Budget Office.  Independent factcheck.org concluded premiums for employed and individuals have risen at a much lower rate than in the Bush years even accounting for the recession’s effect, nor will the ACA cost thousands  for everyone insured.  Fewer adults reported medical bill problems.  Destroying Obamacare would reverse those gains.

A version of this was published in the www.skyhidailynews.com

Sources tapped for the posting: 

http://www.politico.com/story/2015/02/face-of-supreme-court-case-hates-obamacare-and-obama-too-114953.html#ixzz3Qz2ZKi36

http://www.latimes.com/nation/politics/politicsnow/la-pn-obamacare-cost-20150126-story.html

http://www.factcheck.org/2015/02/slower-premium-growth-under-obama/

http://www.factcheck.org/2015/02/conflating-costs-of-the-aca

http://consumer.healthday.com/public-health-information-30/medicaid-news-421/survey-more-americans-getting-needed-health-care-695531.html
More:
http://www.politico.com/story/2015/03/supreme-court-obamacare-white-house-115631.html

Supreme Court's upholding Obamacare is a victory for consumers

There is an ad running in Colorado on behalf of Pres. Obama’s reelection that contains  a point  besides the one it intended.  The ad features an older woman with Parkinson’s like symptoms who said that when Bain capital (Mitt Romney’s firm) bought the profitable company  for which she had worked for many years and ran it into bankruptcy, she lost her health insurance  and pension..  The punch line: “Mitt Romney…….he made me sick”. The obvious  message of the ad is that Romney did not care about the damage his business practices caused to human beings. , but the ad also illustrates a nagging,  widespread  fear that loss of a job means loss  of health insurance. .    Had Obamacare been in effect, that  laid off worker  in poor health could have been able to get insurance  .    

 Supreme Court’s decision upholding  the constitutionality of  Obamacare   is more than just a political victory for the President.  It is a victory for  consumers..  The health system we have had has failed, both those who could not afford insurance and even the insured. .  Estimates are that 26,000 people die early because they did not have access to insurance. The number one cause of bankruptcy is inability to pay health care bills and many of those bankrupted  are insured with inadequate policies. Care providers pass their costs not covered by patients’ payments  on to the insured .

After the Supreme Court decision, I received calls from family members and close friends who were relieved .  One was self employed and could not afford health insurance for himself and his family. He will be able to afford it January 2014.  Another has college age children who will now be assured they can stay on their family’s insurance until they are 26. 

Another   was at work  and trying to pay off $20,000 worth of co-pays for cancer treatments not covered by her employer provided insurance.  She has been living in sheer fear of layoffs  and one incompletely covered major illness   would have driven her to bankruptcy or loss of her  home.  After COBRA would have run out,  she would be uninsurable due to her pre-existing conditions.  She has been very grateful for the part of Obamacare that is already in effect that requires coverage of necessary and frequent mammograms without a co-pay. 

We seniors are also relieved that the donut hole is covered.   Buried in the law is that the cost of the health system will be lowered due to some important cost savings measures,  Medicare just got at least 8  years tacked onto its life and my benefits are not reduced.   We are informed and aware  the so called “death panels” are prevented by the law from making any edicts that would have power over those end of life treatments.

We are also small business people and in spite of the GOP campaign of disinformation, we understand that we who have less than 50 employees do not have to provide health insurance, but if we do, we get generous tax credits. Our employees  can seek affordable insurance in the new market place exchange instead.

All of us understand that nothing in Obamacare will interfere with our relationships with our doctor. In fact, the uninsured will finally be able to afford to have a doctor with whom they can have a relationship.   Health care will  no longer be rationed by private insurers’ arbitrary denials and anyone’s ability to pay for care. 

These  benefits are what Mitt Romney and the GOP want  to take them away from consumers , though Romney is professing to keep some, but not all. He has offered no mechanism to fund them. He is in a difficult  situation, explaining why the policies of Romneycare for Massachusetts, the model for Obamacare, is wrong for the nation. 

A version of this also appears in the e and print editions of the Sky Hi Daily News (www.skyhidailynews.com) today.

There is no free lunch in health care or firefighting

The GOP’s attack on Obamacare has taken on a new tactic  since the Supreme Court ruled it constitutional.  They no longer could make the argument that the Affordable Care Act should be repealed on constitutional grounds. They now have a new one. “ It is a tax increase.  Yes, Obamacare in its entirety is a tax.  Taxes are evil. Therefore it should be overturned.”

Come on, GOP. Stop spinning.  Consumers have a choice: they can pay the penalty for not having health insurance or they can get health insurance, made affordable by Obamacare The sick-deniers  who believe in their own immortality and their ability to turn up at an emergency room if things get really bad are the only  ones who will pay the mandate tax if they persist in being irresponsible.. The tax is a penalty, but it is also a way to get slackers to pay for services.  It is those seeking  a free lunch that the GOP wants to protect.

   Yes, the GOP will now make the case that it is wrong to tax free riders and free loaders who cost us all money by going naked with insurance on some misplaced faith that they will never get sick, be in an accident, or die in a way that would put them in a hospital.  We are already paying for those slackers who refuse to take individual responsibility.  We are also paying for those who cannot afford to buy health insurance because they do not have enough income. The medical  costs of the free loaders and the near poor costs are passed onto insured families in higher premiums, higher copay and less coverage to the tune of $10000.   

The medical free loaders  are not the only free loaders in this country.  Look in your mirror; you may be one of those  who  want the services but do not want to pay for them in taxes or fees in the future. Colorado Springs cut their 2012 firefighting budget and  the deeply GOP El Paso County sends those to Congress who are sworn to a budget that would cut non discretionary spending that includes cutting federal money for  firefighting and disaster funding.  Post the Waldo Canyon  fire there, I wonder  what they do with their budget next year. I wonder, too, if their Congressman sees any connection.

George W Bush knew this.  That is why he launched two wars and gave seniors a welcome relief in drug care benefits, and  got a large reduction in taxes for the rich  without paying for it in taxes or any other measure.  That is why he busted a balanced budget and ran up the deficit.  He was under some assumptions that tax cuts would stimulate the economy enough to create tax revenue to offset this.  How wrong he was.  Even before the Great Recession of the last years of his administration, the assumption was faulty and the economy had not been stimulated and unemployed was already ticking up.  The crash of 2008 made recovery based on increased revenue to the treasury a laugh, and 40% of the current deficit is the result of the loss to tax revenue because of the recession that reduced taxpayers incomes and profits.

Polls show that overwhelmingly numbers of voters want their pre-existing conditions to be covered, to be able to afford insurance if their employer does not provide it, or  the insurance plan they are on cannot  kick you off if you are sick, or expenses surpass the lifetime limit,  or if they are laid off or even fired.  They do want their college age kids to be on their   insurance policies.  They just did not want the package plan of Obamacare that figured a way to get these benefits paid for with a some more  taxes on the rich,,  and making uninsured take responsibility for getting insurance and paying into the system as much as their income level would allow.  

So, GOP, now is the time to show your payfors for  the benefits consumers your own supporters want and need. You should know by now there is no such thing as a free lunch..

GOP is spreading fear and ignorance about "Obamacare"

Feigned ignorance and illiteracy is the GOP’s case against “Obamacare”.  They love to spread ignorance and then report polls that  claim small business is not spending because they will not hire because of the cost of Obamacare.  Their case is to throw out the health care reform law if the Supreme Court upholds its constitutionality because it just has too many words and is just too complex for the public to understand.  Even one of the Supreme Court  justices made some remark that “do you mean I have to read the whole thing?”

 On the other hand, the Obama administration has made sausage out of sausage, muddling their case and not bothering to counter the ignorance spread by the GOP trying either to scare the wits out of seniors with the bogus claims of death panels and a horrible burden on small business.  The death panel scare tactics have been somewhat diminished, but the ignorance they are spreading about  burden on small business is scaring the pants  off of them. No wonder small business opposes it, but ignorance is no excuse nor is illiteracy and the Obama administration should just not let these kinds of intentional  befuddlement go unchallenged.

Here is why. No matter how the Court rules, Obama loses.  If the court approves his health reform bill in toto, the 2/3 of American people who had hoped it would have been found unconstitutional and oppose the reform, will blame him for the monster bill they neither understand or they fear what they have been told by the GOP campaign of deceit  of the dire provisions that just might gore their oxen.  If it only strikes down the mandate, there will be repercussions which few understand and the GOP will continue to exploit  their ignorance. Romney will continue the debate with his swearing to repeal it in Congress if he is elected.  The war will not be over throughout the campaign..

 If the law is struck down by the Court , there will be egg all over the face of our constitutional law professor  President and frankly he will look incompetent.  He is going to have to sell Obamacare all over again as a good thing and then accuse Romney of wanting to cause our health system to be more expensive and sicker.  He could charge Romney with  wanting to deprive 30 million of the ability to afford health care, running up the cost of health care for those who already have it by having to pay for ER health for the uninsured in higher insurance premiums,  leaving  those laid off and losing employer’s insurance without any coverage after COBRA runs out, and making coverage of pre-existing conditions unaffordable for government or anyone else.

 Romney now  piously proclaims  says he  wants to cover pre-existing conditions.  Where’s the pay-for, Mitt? That is what the mandate is supposed to do…enlarge the pool, require healthy to pay into the system, which makes it economically feasible  for the private insurers  to  cover  the cost of covering pre-existing conditions. Without the mandate, how do you propose to pay for coverage of pre-exisitng conditions? You know  the problem. That is core to the Massachusetts system you set up and the rationale for the mandate.  Shame on promoting such ignorance when you know better..

The first chore for Pres. Obama to talk about the burden of supplying employee insurance now and how the burden will be taken off the shoulders of small business.  Has everyone forgotten that    small businesses are exempted from having to provide insurance for their employees?  That message has gotten lost in the Romney  campaign of fear and deception  and needs to be set  straight  by the Obama supporters ASAP. 

Obamacare will be political fodder no matter how the Court rules

My column in the Sky Hi Daily News today
The Supreme Court heard the arguments against Obamacare last week and it will be late June before they rule. The part of the law that received their most scrutiny was the mandate, the requirement that all must carry health insurance. The Court will decide whether they uphold the law, deny the one mandate clause and leave the rest standing, or whether they throw the health care law baby out with the bathwater.

Regardless of the Court ruling, health care reform will continue to be political fodder for the 2012 presidential campaign. If the court upholds the constitutionality of the law, the debate will continue about whether it is good policy. If the popular provisions, making health insurance affordable to all, removing life time limits, or covering pre-existing conditions, are thrown out with a ruling the entire law is constitutional, Democrats will point the blame finger at the GOP and a Supreme Court divided by party affiliation that gave us the legalized corruption of the election process by super PACs and sided with the election of a Republican president over Al Gore, as well.

If the court rules only the mandate is unconstitutional, it could be the Administration as plan B implements the remainder. If the court upholds the entire law or all but the mandate, GOP legislators sworn to kill Obamacare will not be able to repeal it. Because of the uncompromising turn to the right by the GOP, some moderate senators have quit, making the goal of GOP's getting sixty votes in the Senate to agree with the Tea Party dominated House of Representatives and vote for repeal is an impossible dream.

Assuming the GOP candidate is Mitt Romney, he will be no help to the GOP on the issue . He was the advocate and signer of a very similar law when he was governor of Massachusetts. He says with ringing rhetoric he says he will “kill Obamacare” and he calls the law “horrendous.” It is sound and fury that rings hollow, a clanging bell enclosing a puny clapper and a lot of air, crafted to bring applause from conservative audiences.

By calling the law horrendous, does he mean it is horrendous to make it possible for all to afford health insurance? Is it horrendous to forbid health insurers to deny coverage for pre-existing conditions? Is it horrendous to make it illegal for an insurer to drop coverage when you get sick? Is it horrendous to mandate all to carry health insurance? All of these provisions were in his own Massachusetts law.

What is left for Romney to oppose is the requirement that all states do it as part of a nationwide law. His position, that states rights in these matters are simply superior to a federal program, appeals to those who want a limited federal government, but has a worthless ring that provides neither a workable plan B or a plan C-Z.

Unless federal money from federal taxpayer's pockets is irresponsibly gifted to states without requiring standards and accountability, what state would be compelled or could afford to provide a similar alternative with the same benefits, including covering the uninsured and pre-existing conditions and removing life time limits? Not ours. Shoving Obama/Romneycare to the states would be dumping it in file 13 and Romney needs to come clean on that clunker.