Breaking: SCOTUS to consider ACA subsidies

[King]

What do you mean no circuit split?

http://www.npr.org/blogs/thetwo-way/2014/11/07/362305465/supreme-court-will-hear-case-challenging-obamacare-subsidies

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Ernest explains above.  The other ruling against subsidies was not an official court decision.

[Sbane]

Do Republicans want national health insurance as opposed to private plans? Because that is precisely what they will get if Obamacare is struck down. Look at the public polling on healthcare or even look at the exit polls from Tuesday. Even the conservative electorate that turned out on Tuesday trusts the Democrats more on health care. The people may hate the individual mandate, but they sure do love the underpinnings of this bill. If Republicans think nothing will happen if Obamacare gets struck down, then they don't understand the electorate.

[🐒Gods of Prosperity🔱🐲💸]

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Read more: http://www.politico.com/magazine/story/2014/07/jonathan-gruber-the-flip-flopping-architect-of-the-aca-109466.html#ixzz3IQAZ7C6M

This statement of the meaning of the law by one of the authors of the bill might be easily dispensed with had members of Congress read the bill and come up with a different interpretation - but how many of them did that? "We'll find out what's in the bill when we pass it."  This is what's in the bill.

Perhpas Roberts et al will find some creative way around this.  On the other hand perhaps Roberts will be deferential to states here. The option exists for the states to fix this themselves - and I see no reason contracting it out to the Federal Government's exchange wouldn't be an option. The point is the law requires state action.   If the state decides not to open an exchange, according to the plantiffs, the state also has exemption from regulations that depend in the law upon the existence of the exchange such as the employer and individual mandates.

The question here is not whether the ACA law will be overturned. It is whether the law is being implemented as written.

[Beet]

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Read more: http://www.politico.com/magazine/story/2014/07/jonathan-gruber-the-flip-flopping-architect-of-the-aca-109466.html#ixzz3IQAZ7C6M

This statement of the meaning of the law by one of the authors of the bill might be easily dispensed with had members of Congress read the bill and come up with a different interpretation - but how many of them did that? "We'll find out what's in the bill when we pass it."  This is what's in the bill.

Perhpas Roberts et al will find some creative way around this.  On the other hand perhaps Roberts will be deferential to states here. The option exists for the states to fix this themselves - and I see no reason contracting it out to the Federal Government's exchange wouldn't be an option. The point is the law requires state action.   If the state decides not to open an exchange, according to the plantiffs, the state also has exemption from regulations that depend in the law upon the existence of the exchange such as the employer and individual mandates.

The question here is not whether the ACA law will be overturned. It is whether the law is being implemented as written.

The disagreement here is precisely what "as written" means, and if we accept your interpretation, it would effectively overturn the law- because, as the plaintiffs say, people like them would then qualify for a hardship exemption and not be required to buy insurance or face the tax penalty. And given that there are 5 million people who are receiving subsidies, there are a lot of people like him. Without as many people as possible with insurance, health insurance costs would rise and start a death spiral in the marketplace. In fact, that is why this case is receiving so much attention to begin with. The text of the law has been public since it was voted on by Congress. That's well over four years.

What's creative is this challenge, not the responses to it. The law's political opponents tried to elect McCain; they failed. They tried to block it in the House and Senate; they failed. They failed with the filibuster. They tried to challenge the mandate already once in SCOTUS. They failed. They tried to defeat the president whose name is popularly attached to it. They failed. I know you guys claim you're just going by the text of the law- but language is ambiguous. If all of the above contests cannot create verdicts in the American political system, it undermines the reason for having them to begin with.

As for the Gruber quote, it's a fascinating quote, but by introducing it, aren't you agreeing that contextual factors - such as how people who voted on the law, debated the law, and experts on the law, behaved, are relevant? Gruber points out that "his projections of the law's impact have always assumed that all eligible people would get subsides, even though, he said, he did not assume all states would choose to run their own marketplaces." If you only look at Gruber's words and actions, I agree that they're contradictory, but if you take the whole picture of the law's drafters' actions before this issue came up, it's clear that people were meant to receive subsidies on state exchanges.

[Starbucks Union Thug HokeyPuck]

Do Republicans want national health insurance as opposed to private plans? Because that is precisely what they will get if Obamacare is struck down. Look at the public polling on healthcare or even look at the exit polls from Tuesday. Even the conservative electorate that turned out on Tuesday trusts the Democrats more on health care. The people may hate the individual mandate, but they sure do love the underpinnings of this bill. If Republicans think nothing will happen if Obamacare gets struck down, then they don't understand the electorate.

Liberals will get fired up as all hell, but as far as the moderates and independents that decide these things... The ruling classes and 1% don't care if poors don't have healthcare.  It's beneficial for them when poor people die.  They are evil and greedy, so they will tell the GOP to market this as good.  The GOP will then try to convince Americans that the old broken system of free market chaos is good.  Will they convince enough of them?  That's to be seen. 

And as far as trusting Democrats more on healthcare?  Of course, they are the only party that even provides a solution when talking about it! 

[Lief 🗽]

It'll be pretty hilarious (in a very dark way) when a right-wing activist judge is responsible for the largest tax hike in American history.

[🐒Gods of Prosperity🔱🐲💸]

As for the Gruber quote, it's a fascinating quote, but by introducing it, aren't you agreeing that contextual factors - such as how people who voted on the law, debated the law, and experts on the law, behaved, are relevant? Gruber points out that "his projections of the law's impact have always assumed that all eligible people would get subsides, even though, he said, he did not assume all states would choose to run their own marketplaces." If you only look at Gruber's words and actions, I agree that they're contradictory, but if you take the whole picture of the law's drafters' actions before this issue came up, it's clear that people were meant to receive subsidies on state exchanges.

I guess you meant to say subsidies were supposed to exist even when there is not a state exchange. The key phrase here is " through an Exchange established by the State under 1311."  Even if the Federal exchange qualifies as an Exchange under 1311, as the Government argues, it can't be said to be an Exchange established by the State absent any state action.  That is what is written. The government's best defense is that it was a drafting error, a thoughtless omission, and they didn't write the law the way the meant to.  I don't know that people acting a certain way in response to a law defines the meaning of that law against the plain meaning of the text. If members of Congress explicitly stated during debate that people would get subsidies even if they did not have an exchange set up by the state where they reside, and this was not challenged by other members, then it might show different intent and could be significant. Then again perhaps it is possible for Congress to pass a bill its members do not fully understand - I think in fact this is often assumed to be the case both by the Courts and by the Executive.

[True Federalist (진정한 연방 주의자)]

It'll be pretty hilarious (in a very dark way) when a right-wing activist judge is responsible for the largest tax hike in American history.

Not really.  Without the subsidies, the health plans will be expensive enough that for most people there won't exist for them an option cheap enough to trigger the tax penalty for non-coverage if they don't have it.  It might get some of those in the 300-400% FPL level, but few if any wage earners would face the tax for not having coverage., and those at the 300%+ level weren't getting that much in the way of subsidy in the first place.

[7,052,770]

I've mentioned my mother-in-law a couple of times here. She wasn't able to purchase insurance until 2014 due to her pre-existing condition (she's a cancer survivor). It was either unavailable to her or way too expensive.

But thanks to Obamacare, a f***ing godsend to her, she was finally able to purchase insurance on the Mississippi Exchange at around $60 per month, a price she can afford. Now you're telling me that Republicans want to take that subsidy away from her (which is worth around $6,000 per year) and the millions like her? That's just plain evil.

So what, would she have to pay that $6,000 back if the Supreme Court rules against her? Where's she supposed to come up with that money? The government promised her that subsidy and now the Republicans are going to go back on their word? Sure, some of the saner Republicans might vote to "forgive" the 2014 subsidies since they're already out there (although we all know the saner ones don't run the party, so I doubt it), but what's she supposed to do in 2015? Just go back to being uninsured?

F*** every single person who supports this. It's not her fault that Mississippi had it's own state-based Exchange website up and running, only to have our governor (who claims to literally converse with Jesus), after previously supporting the state Exchange until that point, pull the plug on it just to stick it to Obama.

[Beet]

As for the Gruber quote, it's a fascinating quote, but by introducing it, aren't you agreeing that contextual factors - such as how people who voted on the law, debated the law, and experts on the law, behaved, are relevant? Gruber points out that "his projections of the law's impact have always assumed that all eligible people would get subsides, even though, he said, he did not assume all states would choose to run their own marketplaces." If you only look at Gruber's words and actions, I agree that they're contradictory, but if you take the whole picture of the law's drafters' actions before this issue came up, it's clear that people were meant to receive subsidies on state exchanges.

I guess you meant to say subsidies were supposed to exist even when there is not a state exchange. The key phrase here is " through an Exchange established by the State under 1311."  Even if the Federal exchange qualifies as an Exchange under 1311, as the Government argues, it can't be said to be an Exchange established by the State absent any state action.  That is what is written. The government's best defense is that it was a drafting error, a thoughtless omission, and they didn't write the law the way the meant to.  I don't know that people acting a certain way in response to a law defines the meaning of that law against the plain meaning of the text. If members of Congress explicitly stated during debate that people would get subsidies even if they did not have an exchange set up by the state where they reside, and this was not challenged by other members, then it might show different intent and could be significant. Then again perhaps it is possible for Congress to pass a bill its members do not fully understand - I think in fact this is often assumed to be the case both by the Courts and by the Executive.

The Reconciliation bill passed by the House and Senate states that the IRS should report "The aggregate amount of any advance payment of such credit or reductions" under section 1311 or 1312, the latter which established the federal exchange. It makes no sense they would tell the IRS to report credits under section 1312 if there weren't meant to be any.

[Sbane]

Do Republicans want national health insurance as opposed to private plans? Because that is precisely what they will get if Obamacare is struck down. Look at the public polling on healthcare or even look at the exit polls from Tuesday. Even the conservative electorate that turned out on Tuesday trusts the Democrats more on health care. The people may hate the individual mandate, but they sure do love the underpinnings of this bill. If Republicans think nothing will happen if Obamacare gets struck down, then they don't understand the electorate.

Liberals will get fired up as all hell, but as far as the moderates and independents that decide these things... The ruling classes and 1% don't care if poors don't have healthcare.  It's beneficial for them when poor people die.  They are evil and greedy, so they will tell the GOP to market this as good.  The GOP will then try to convince Americans that the old broken system of free market chaos is good.  Will they convince enough of them?  That's to be seen. 

And as far as trusting Democrats more on healthcare?  Of course, they are the only party that even provides a solution when talking about it! 

The moderates and true independents who decide things are very supportive of most of Obamacare. They may hate the label but they love what's inside it. Democrats just have to package it correctly. Don't mention anything about Obamacare. Just rightly point out that the reason why your mother with a pre-existing condition doesn't have coverage anymore. Also, they need to grow some balls and actually come out in favor of it and defend it. As you saw in 2014, the Democrat's real problem is turnout. There are more than enough out there who favor the Democrats and it is becoming truer by the day as more people turn 18 and more olds die.

[Deus Naturae]

Do Republicans want national health insurance as opposed to private plans? Because that is precisely what they will get if Obamacare is struck down. Look at the public polling on healthcare or even look at the exit polls from Tuesday. Even the conservative electorate that turned out on Tuesday trusts the Democrats more on health care. The people may hate the individual mandate, but they sure do love the underpinnings of this bill. If Republicans think nothing will happen if Obamacare gets struck down, then they don't understand the electorate.

Liberals will get fired up as all hell, but as far as the moderates and independents that decide these things... The ruling classes and 1% don't care if poors don't have healthcare.  It's beneficial for them when poor people die.  They are evil and greedy, so they will tell the GOP to market this as good.  The GOP will then try to convince Americans that the old broken system of free market chaos is good.  Will they convince enough of them?  That's to be seen. 

And as far as trusting Democrats more on healthcare?  Of course, they are the only party that even provides a solution when talking about it! 

LOL...calling the pre-ACA health care system "free market" is just as silly as people who call Obamacare socialist. Actually, scratch that, it's 100X more ridiculous. I mean, really, what person in their right mind looks at a system where most hospitals are owned or subsidized by the government and new hospitals can be prevented from coming into existence by licensing boards representing incumbent hospitals (who totally don't have an incentive to prevent competitors from entering the market), where life-saving medicines can be delayed for years or banned outright by unaccountable bureaucrats, where the AMA (the doctors' union) gets to decide how many physicians are allowed to practice medicine (yeah, they totally don't have an incentive to artificially restrict the supply of doctors to inflate their members' salaries) and specific physician interest groups limit entry into their fields via occupational licensure, where countless insurance regulations force people to pay more for procedures they will never need and create a system in which everything is payed for by insurers and nobody knows how much hospitals are actually charging them, and then says, "WAY too much freedom! This is CHAOS...moar regulation!!"

[Snowstalker Mk. II]

National health service or nothing.

[bedstuy]

Do Republicans want national health insurance as opposed to private plans? Because that is precisely what they will get if Obamacare is struck down. Look at the public polling on healthcare or even look at the exit polls from Tuesday. Even the conservative electorate that turned out on Tuesday trusts the Democrats more on health care. The people may hate the individual mandate, but they sure do love the underpinnings of this bill. If Republicans think nothing will happen if Obamacare gets struck down, then they don't understand the electorate.

Liberals will get fired up as all hell, but as far as the moderates and independents that decide these things... The ruling classes and 1% don't care if poors don't have healthcare.  It's beneficial for them when poor people die.  They are evil and greedy, so they will tell the GOP to market this as good.  The GOP will then try to convince Americans that the old broken system of free market chaos is good.  Will they convince enough of them?  That's to be seen. 

And as far as trusting Democrats more on healthcare?  Of course, they are the only party that even provides a solution when talking about it! 

LOL...calling the pre-ACA health care system "free market" is just as silly as people who call Obamacare socialist. Actually, scratch that, it's 100X more ridiculous. I mean, really, what person in their right mind looks at a system where most hospitals are owned or subsidized by the government and new hospitals can be prevented from coming into existence by licensing boards representing incumbent hospitals (who totally don't have an incentive to prevent competitors from entering the market), where life-saving medicines can be delayed for years or banned outright by unaccountable bureaucrats, where the AMA (the doctors' union) gets to decide how many physicians are allowed to practice medicine (yeah, they totally don't have an incentive to artificially restrict the supply of doctors to inflate their members' salaries) and specific physician interest groups limit entry into their fields via occupational licensure, where countless insurance regulations force people to pay more for procedures they will never need and create a system in which everything is payed for by insurers and nobody knows how much hospitals are actually charging them, and then says, "WAY too much freedom! This is CHAOS...moar regulation!!"

That's true to an extent, but it's sort of a false choice.  The problem is BOTH government over-regulating and the abuse of regulation by special interests.  It's the Republicans carrying water for doctors, pharmaceutical companies, medical device companies, insurance companies and health systems.  It's Democrats doing those same things, but also looking out for nurses and healthcare workers.  Both parties are at least partially owned by these health industry parasites that make money off of our broken system. 

The difference though is that Democrats actually are trying to fix healthcare in this county and care about the moral imperative of providing healthcare.  Republicans aren't proposing any free-market ideas to improve healthcare because it's the third rail of politics.  Republicans would rather just see America waste trillions of dollars and see our healthcare system ruin the economy, than try to make the hard choices and take on the special interests.

[Deus Naturae]

That's true to an extent, but it's sort of a false choice.  The problem is BOTH government over-regulating and the abuse of regulation by special interests.  It's the Republicans carrying water for doctors, pharmaceutical companies, medical device companies, insurance companies and health systems.  It's Democrats doing those same things, but also looking out for nurses and healthcare workers.  Both parties are at least partially owned by these health industry parasites that make money off of our broken system.

The difference though is that Democrats actually are trying to fix healthcare in this county and care about the moral imperative of providing healthcare.  Republicans aren't proposing any free-market ideas to improve healthcare because it's the third rail of politics.  Republicans would rather just see America waste trillions of dollars and see our healthcare system ruin the economy, than try to make the hard choices and take on the special interests.

I 100% agree with your points about the GOP having no solutions and being beholden to special interests instead of free-market policy. Have to disagree with your view of the Dems though. What special interests are challenged by the ACA?

[bedstuy]

That's true to an extent, but it's sort of a false choice.  The problem is BOTH government over-regulating and the abuse of regulation by special interests.  It's the Republicans carrying water for doctors, pharmaceutical companies, medical device companies, insurance companies and health systems.  It's Democrats doing those same things, but also looking out for nurses and healthcare workers.  Both parties are at least partially owned by these health industry parasites that make money off of our broken system.

The difference though is that Democrats actually are trying to fix healthcare in this county and care about the moral imperative of providing healthcare.  Republicans aren't proposing any free-market ideas to improve healthcare because it's the third rail of politics.  Republicans would rather just see America waste trillions of dollars and see our healthcare system ruin the economy, than try to make the hard choices and take on the special interests.

I 100% agree with your points about the GOP having no solutions and being beholden to special interests instead of free-market policy. Have to disagree with your view of the Dems though. What special interests are challenged by the ACA?

Insurance companies, through the competition on exchanges, capping spending on administrative costs, taxes on high priced plans and this  pressure on insurance companies filters throughout the system.  There are also the cost control measures for medicare that put pressure on providers. 

On top of all of that, Obamacare advances a basic principle that will inevitably butt heads with special interests, that we're all part of this one big healthcare market.  Obamacare makes everyone a stakeholder in everyone else's healthcare.

[© tweed]

So what, would she have to pay that $6,000 back if the Supreme Court rules against her? Where's she supposed to come up with that money?

interesting question.  though I doubt the court will take a position on this question, and it's hard to imagine the Obama DoJ going after the past subsidies, and who else could claim standing to sue?  these were federal subsidies.  would a Republican DoJ?  hard to say.

that said there may already be a way this is handled somewhere in the US code.  Ernest might somehow know the answer to this question.

[True Federalist (진정한 연방 주의자)]

The coverage that I've read indicates that if the subsidies were struck, they'd likely simply end with no further subsidies on the federal exchange but no requirement to pay back any subsidies already paid out.  As already pointed out, it's inconceivable that the Obama administration would seek to claw back existing subsidies, and I can't imagine even a future Republican administration being so tone deaf as to try that.

[Person Man]

Of course allowing interstate purchases would allow someone from Wyoming to buy insurance on a Colorado exchange...A chance to fix Obamacare or kill the GOP alternative or have both?

[AggregateDemand]

I 100% agree with your points about the GOP having no solutions and being beholden to special interests instead of free-market policy. Have to disagree with your view of the Dems though. What special interests are challenged by the ACA?

Republicans have a solution called refundable tax credits. Unfortunately, refundable tax credits are powerful policy instruments, and responsible implementation could be more precarious than ACA. But make no mistake, refundable tax credits could cut costs so effectively that the healthcare industry is brought to its knees.

[AggregateDemand]

Do Republicans want national health insurance as opposed to private plans? Because that is precisely what they will get if Obamacare is struck down. Look at the public polling on healthcare or even look at the exit polls from Tuesday. Even the conservative electorate that turned out on Tuesday trusts the Democrats more on health care. The people may hate the individual mandate, but they sure do love the underpinnings of this bill. If Republicans think nothing will happen if Obamacare gets struck down, then they don't understand the electorate.

The Treasury doesn't have enough funds to implement what American liberals believe is universal single-payer or nationalized healthcare. They'd have to double taxes or eliminate all other programs, including Social Security.

Our version of single-payer is restricted to a relatively tiny segment of the population for a reason--it can't be expanded in its current form.

[DemPGH]

I guess I have a hard time understanding why they would rule it constitutional, but then rule it can't be subsidized (unless Roberts wants to do this over again). That would fit how this court reasons, though, especially when Kennedy is at the helm, but it just doesn't make sense.

At this point I wouldn't mind keeping some basic provisions of the ACA, like ending pre-existing conditions and some of the caps that applied, but the bulk of it no one was willing or able to work up a reasonable way to fund, so if it gets tossed I guess worse things could happen. We need something of a universal option, but we're not going to get it anytime soon. My outlook on this issue is pretty pessimistic.

[Starbucks Union Thug HokeyPuck]

Do Republicans want national health insurance as opposed to private plans? Because that is precisely what they will get if Obamacare is struck down. Look at the public polling on healthcare or even look at the exit polls from Tuesday. Even the conservative electorate that turned out on Tuesday trusts the Democrats more on health care. The people may hate the individual mandate, but they sure do love the underpinnings of this bill. If Republicans think nothing will happen if Obamacare gets struck down, then they don't understand the electorate.

Liberals will get fired up as all hell, but as far as the moderates and independents that decide these things... The ruling classes and 1% don't care if poors don't have healthcare.  It's beneficial for them when poor people die.  They are evil and greedy, so they will tell the GOP to market this as good.  The GOP will then try to convince Americans that the old broken system of free market chaos is good.  Will they convince enough of them?  That's to be seen. 

And as far as trusting Democrats more on healthcare?  Of course, they are the only party that even provides a solution when talking about it! 

LOL...calling the pre-ACA health care system "free market" is just as silly as people who call Obamacare socialist. Actually, scratch that, it's 100X more ridiculous. I mean, really, what person in their right mind looks at a system where most hospitals are owned or subsidized by the government and new hospitals can be prevented from coming into existence by licensing boards representing incumbent hospitals (who totally don't have an incentive to prevent competitors from entering the market), where life-saving medicines can be delayed for years or banned outright by unaccountable bureaucrats, where the AMA (the doctors' union) gets to decide how many physicians are allowed to practice medicine (yeah, they totally don't have an incentive to artificially restrict the supply of doctors to inflate their members' salaries) and specific physician interest groups limit entry into their fields via occupational licensure, where countless insurance regulations force people to pay more for procedures they will never need and create a system in which everything is payed for by insurers and nobody knows how much hospitals are actually charging them, and then says, "WAY too much freedom! This is CHAOS...moar regulation!!"

Free market chaos refers to the situation an unemployed is placed in when they had previously lost their job or benefits.  Getting sick then means "find the cheapest" doctor, and an emergency means "hospital bill for several thousand".  I'm not saying there was no bureaucratic garbage upon arrival to the place of medical care, but there was no reliable system in place for a lot of people receive coverage in desperate times... just go to the ER and see what happens.  This is the chaos I referred to.

[angus]

I don't know.  I voted yes.  The SC is so obtuse at times.  They have had multiple legitimate opportunities to review this beast of a law, and each time they ruled that it passed constitutional muster.  Some of the previous challenges seemed to have merit, whereas this one is silly.  If they didn't strike down the law under legitimate complaints, I don't see why they would strike it down for the silly reason presented in this case.  I no longer hold out much hope that it'll go away.

[AggregateDemand]

Free market chaos refers to the situation an unemployed is placed in when they had previously lost their job or benefits.  Getting sick then means "find the cheapest" doctor, and an emergency means "hospital bill for several thousand".  I'm not saying there was no bureaucratic garbage upon arrival to the place of medical care, but there was no reliable system in place for a lot of people receive coverage in desperate times... just go to the ER and see what happens.  This is the chaos I referred to.

If you don't know the history of healthcare or health insurance, you can't just make up a political narrative. It's true that the libertarian healthcare system was not nearly as comprehensive as our current system......because modern healthcare had only just been invented when the government inadvertently jumped into the healthcare industry with both feet.

During WWII, Congress limited executive compensation, but the labor board ruled that the regulations could be skirted if companies provided non-cash benefits like healthcare or health insurance. Naturally, the rest of the workforce wanted a healthcare exclusion, though they had no cap on their pay, and they got the exclusion in 1954.

As the modern healthcare industry was in its adolescence, the federal government started pouring billions of dollars of demand subsidies into the industry. Demand subsidies almost always cause rampant inflation, which is only preferable if you're dealing with some sort of market failure. We weren't dealing with market failure. We were trying to make inherently unfair regulations fair for everyone.

If workers have health insurance provided by the employers and it's excluded from gross income (tax exempt), what do unemployed poors and retried olds want? Medicaid and Medicare. In 1965, they got it.

We've allowed an ill-conceived executive-compensation-cap spiral out of control, and now our healthcare system costs 200% of healthcare elsewhere in the developed world. If you do the math, you'll find that the succession of poor regulations cost us about $1.4T every year.