I’m not a lawyer. I have a better understanding, however, of the Affordable Care Act after attending University of Southern Maine’s and the University of Maine School of Law’s public forum about legal challenges to the act, including its constitutionality and what it might mean if the law or part of it is overturned.
The forum provided an overview of the law and a discussion between panelists with constitutional law and health policy expertise. Speakers represented different perspectives which either supported or challenged the law. The civility of the speakers and standing-room-only audience was impressive. Everyone truly wanted more information about the legal debate to be heard by the U.S. Supreme Court at the end of March.
I was surprised about a recent Kaiser Family Foundation poll revealing nearly three-quarters of Americans mistakenly believe the ACA creates a government-run health insurance plan. It does not. It builds on our current system, allowing those who get health insurance from their employer to continue to do so and providing subsidies to people who can’t afford coverage.
It creates insurance exchanges where people can compare plans that cover essential benefits including mental health services. Members of Congress will be required to access coverage through exchanges.
It does away with denials based on preexisting conditions and places rules on insurance companies limiting administrative costs and profits. Children can remain on their parents’ policies until age 26. Preventive services, including cancer screenings for women, don’t require co-payments. Small businesses receive tax credits for providing coverage.
Too good to be true? Perhaps. The expectation that a major piece of legislation aimed at tackling one of our nation’s biggest, most expensive problems will be perfect, however, is absurd. The law does little to control rising health care costs. Funding subsidies over time will be difficult. The penalty for not purchasing coverage remains the most controversial aspect of the law; this is a good segue into its legal challenges.
There are four issues being considered by the court. The first is whether the Anti-Injunction Act prevents challenges to the ACA at this time. A lawsuit can’t be heard in any court if its purpose is to stop the collection of a tax. If failure to pay the ACA’s individual mandate is determined by the court as a tax penalty, the court will not be able to pursue the challenge until the law goes into effect and a penalty is actually collected. Circuit Court decisions on this issue have been mixed.
The constitutionality of individual mandate is also challenged, the argument being that requiring all people to obtain health insurance exceeds congressional powers to regulate interstate commerce under the Constitution. The court must decide if an individual’s failure to pay for health care expenses creates cost-shifting that impacts the U.S. health care market as a whole and if that market is unique. If so, such economic activity that impacts all U.S. citizens and commerce would give Congress the power to regulate.
The last two issues include whether a decision repealing the individual mandate would repeal just that section or the entire law and whether the Medicaid expansion is constitutional. The decision regarding whether only part or the entire law would be overturned is up to the court, since there is no “severability” clause in the law.
Some say the Medicaid expansion challenge is moot. No assumptions should be made, however, given the court has the opportunity to argue the issue. The case must be made that the federal government will be clear on the obligations of states accepting federal funds for the expansion and may not force states to comply by employing spending power in a coercive manner.
In other words, it must be clear the government will use financial incentives to encourage, not force, states to participate in the expansion.
I’ll leave the rest to the lawyers.
Ann Woloson is the executive director of Prescription Policy Choices. She lives in Belgrade Lakes.
“It builds on our current system, allowing those who get health insurance from their employer to continue to do so …”
The Congressional Budget Office (CBO) has just released a report that estimates that the new health care reform law may cost 3 to 5 million people to lose their employer health care coverage each year with a worst case scenario of 20 million employees losing their employer health insurance coverage.
Stay tuned for more unanticipated consequences resulting from the rushed passage of this sweeping legislation. “We have to pass the bill so you can see what’s in it.” – Nancy Pelosi 3/10/2010
‘What the CBO report actually says is that it expects deficits to be a bit smaller than Obama projects. Oh, and about spending: here’s the OMB projection of spending with and without Social Security and Medicare — both driven by demography — and interest costs:No binge here — but even GOP “experts” won’t admit it.’
This is from Paul Krugman, a nobel laureate in economics. You might want to visit his site to learn more factual information on health care costs.
Sorry on two points:
1. The CBO report does speak to the number of employees projected to lose coverage. Feel free to check the report and the facts.
2. I did not refer to CBO projections regarding deficits in my post. In any case, Paul Krugman , former Enron advisor, has forfeited his credibility by virtue of his transparently partisan columns in the NYT and as such has forfeited his credibility and any pretense of objectivity.
The CBO has recently doubled their estimated cost of ObamaCare over the next 10 years from around $900 billion when the Dems were trying to shove this down our throats to $1.74 Trillion. The estimate is expected to reach 2 Trillion soon.
I suggest you do a little research other that Fox News– I might suggest the following to start with and then it will also give you the CBO’s web site for the back up http://www.forbes.com/sites/rickungar/2012/03/15/anti-obamacare-forces-introduce-their-latest-effort-to-mislead-the-public/
I really hope people start thinking for themselves soon and do research on things they try to post about. If you heard it on Fox,CNN, MSNBC or anywhere check the facts. Fox seems to be the worse of the bunch but I have found many mistakes from the others also.
The only aspect I find problematic is that we’re being forced to purchase a product. I’d be more comfortable if there was the creation of a public option or required non-profit options.
If allowed to be enacted there will be no private insurance companies. They are for profit companies not welfare.
All those who think this is a good idea think about this. At what point do you want to control you life? How much are you truly willing to give up? When do we say enough is enough. If people do not have to ability to say no I do not want the gooberment involved in my medical options then it is not American. Do we want to be free to choose what we do or do not want or do you wish to simply hand your paycheck over and say thanks for nothing. The gooberment already controls the healthcare of our military ask a soldier how that is working for them. If they can not do it right for just the folks who put there life on the line for us what do you expect them to do with the rest of us? Really think about it.
If adults aged 26 are called children, we have problems.
It’s said that you can judge a man by the quality of his enemies. If the same principle applies to legislation, the Affordable Care Act — which was signed into law two years ago, but for the most part has yet to take effect — sits in a place of high honor.
Now, the act — known to its foes as Obamacare, and to the cognoscenti as ObamaRomneycare — isn’t easy to love, since it’s very much a compromise, dictated by the perceived political need to change existing coverage and challenge entrenched interests as little as possible. But the perfect is the enemy of the good; for all its imperfections, this reform would do an enormous amount of good. And one indicator of just how good it is comes from the apparent inability of its opponents to make an honest case against it.To understand the lies, you first have to understand the truth. How would ObamaRomneycare change American health care?For most people the answer is, not at all. In particular, those receiving good health benefits from employers would keep them. The act is aimed, instead, at Americans who fall through the cracks, either going without coverage or relying on the miserably malfunctioning individual, “non-group” insurance market.The fact is that individual health insurance, as currently constituted, just doesn’t work. If insurers are left free to deny coverage at will — as they are in, say, California — they offer cheap policies to the young and healthy (and try to yank coverage if you get sick) but refuse to cover anyone likely to need expensive care. Yet simply requiring that insurers cover people with pre-existing conditions, as in New York, doesn’t work either: premiums are sky-high because only the sick buy insurance.The solution — originally proposed, believe it or not, by analysts at the ultra-right-wing Heritage Foundation — is a three-legged stool of regulation and subsidies. As in New York, insurers are required to cover everyone; in return, everyone is required to buy insurance, so that healthy as well as sick people are in the risk pool. Finally, subsidies make those mandated insurance purchases affordable for lower-income families.Can such a system work? It’s already working! Massachusetts enacted a very similar reform six years ago — yes, while Mitt Romney was governor. Jonathan Gruber of the Massachusetts Institute of Technology, who played a key role in developing both the local and the national reforms (and has published an illustrated guide to reform) has surveyed the results — and finds that Romneycare is working pretty much as advertised. The number of people without insurance has dropped sharply, the quality of care hasn’t suffered, and the program’s cost has been very close to initial projections.Oh, and the budgetary cost per newly insured resident of Massachusetts was actually lower than the projected cost per American insured by the Affordable Care Act.Given this evidence, what’s a virulent opponent of reform to do? The answer is, make stuff up.We all know how the act’s proposal that Medicare evaluate medical procedures for effectiveness became, in the fevered imagination of the right, an evil plan to create death panels. And rest assured, this lie will be back in force once the general election campaign is in full swing.For now, however, most of the disinformation involves claims about costs. Each new report from the Congressional Budget Office is touted as proof that the true cost of Obamacare is exploding, even when — as was the case with the latest report — the document says on its very first page that projected costs have actually fallen slightly. Nor are we talking about random pundits making these false claims. We are, instead, talking about people like the chairman of the House Republican Policy Committee, who issued a completely fraudulent press release after the latest budget office report.Because the truth does not, sad to say, always prevail, there is a real chance that these lies will succeed in killing health reform before it really gets started. And that would be an immense tragedy for America, because this health reform is coming just in time.As I said, the reform is mainly aimed at Americans who fall through the cracks in our current system — an important goal in its own right. But what makes reform truly urgent is the fact that the cracks are rapidly getting wider, because fewer and fewer jobs come with health benefits; employment-based coverage actually declined even during the “Bush boom” of 2003 to 2007, and has plunged since.What this means is that the Affordable Care Act is the only thing protecting us from an imminent surge in the number of Americans who can’t afford essential care. So this reform had better survive — because if it doesn’t, many Americans who need health care won’t.
“known to its foes as Obamacare, and to the cognoscenti as
ObamaRomneycare — isn’t easy to love, since it’s very much a compromise”
A compromise? FORCING people to pay for something they do not support or want to provide welfare to those who refuse to work. Those who have already closed hospitals all over the southeast by receiving welfare at hospitals. Forcing PRIVATE companies to insure customers children until 26. This is the death nail to all private insurance and the start of government controled health care.
All one has to do is look to those countries that already have this system to see it does not work. Medical treatment is between the patient and the doctor the government should not be involved. When it does you get systems like the UK and Canada. Both systems are screwed. Wait times of 6 months plus to get a check up. Taxes that are incredible. Then the FACT that very few people want to go into medicine! Why go through 5 to 10 years of education for a job where you make less then other fields and do twice the work. The great minds who could have done so much all are entering other fields where they are free to do as they want.
Last it is simply un American. The founding fathers where clear that the government job was to provide the FREEDOM to choose. The government was to be BY the people not FOR the people. The government is there not to care for us but to allow us the opportunity to do for ourselves.
that’s why we need single-payer coverage.
WOW that what this IS!! I do not want it I am VERY happy with what I have. I do not want the government involved in my life much less my doctors visits.
As I said look to the countries who already have it. IT sucks just ask them. Why do you think so many people from the countries who get care in there countries without charge ( other the the super high tax rates they pay ) come here to the USA for health care? The FREE MARKET makes progress far faster.