And no matter what the Supreme Court decides, the approximately 26 million Americans who need help getting healthcare the most still won't have it - a point driven home by Lawrence O'Donnell last night in his "Rewrite" segment.

Originally Posted by Deb C

People are going bankrupt everyday in this country but the CEOs are doing just fine. Actually, more than fine. Any doubts why our healthcare costs are through the roof?

Health Care CEOs See Biggest Paycheck Bumps

The healthcare industry saw the largest increases in executive pay out of all sectors, according to a Wall Street Journal and Hay Group CEO compensation survey, released yesterday.

Although healthcare CEOs saw the smallest pay increases out of all industries in 2010, the tides shifted last year, as healthcare executive compensation jumped 7.8 percent in 2011. Healthcare companies’ net income rose 1.1 percent, while the industry saw a 9.8 percent one-year total shareholder return.
In general, industries across sectors pay their chief executives based on the companies’ financial results and share prices with a strong emphasis on pay for performance, The Wall Street Journal reported.

“Our study showed that companies proceeded very carefully on both pay levels and pay design in 2011. Directors are taking proactive steps to ensure that their executive pay plans are aligned with shareholders’ desired outcomes,” Irv Becker, Hay Group national practice leader for executive compensation, said in a statement yesterday.

Healthcare execs also are seeing fatter checks, as healthcare becomes increasingly complex, the Coloradoan reported. The CEO of Community Health Systems in Tennessee, for example, has a total compensation package of $21.58 million, far above salaries in Northern Colorado.

However, shareholders of the acute care hospital operator yesterday voted against the pay plan. CEO Wayne T. Smith’s pay rose 6 percent last year, while net income fell 28 percent and the company’s shares lost more than half their value, according to the WSJ.

http://www.healthcare-now.org/health...paycheck-bumps

What can one expect from a privileged class devoid of virtues yet all-powerful? Restraint is the essence of credibility with economic power.

Here's where you will hear the decision first -

http://www.scotusblog.com/cover-it-live/

- this is where even the White House will get the news first.

Should be between 10:15 and 10:45 am.

My bet is that the mandate goes down 5-4

With that, one or two of the more liberal judges will see the futility and join the majority so that the whole bill goes down 6-3 or 7-2.


Any others want to hazard a last-minute prediction?

PW, not sure what the SC will do. It does look as if the House Progressives are willing to push Single Payer Health Care if it's voted out.

Single-Payer Health Care Favored By House Progressives If Court Strikes Down Obamacare

WASHINGTON -- The last thing House progressives want is for the Supreme Court to strike down President Barack Obama's health care law. But if the high court rules Thursday that some or all of the law is unconstitutional, progressives are ready to renew their push for the model of health care they wanted all along: the single-payer option.

"It's easy to see it's a good idea," Rep. Keith Ellison (D-Minn.), co-chairman of the Congressional Progressive Caucus, told The Huffington Post. "It's the cheapest way to cover everybody."

http://www.huffingtonpost.com/2012/0...n_1630777.html

The Right will choose "freedom of contract" -- basically the idea that economic power can exploit any personal hardship to enforce a contract. Such is the dream of our Ruling Class -- with the ultimate abolition of collective bargaining, minimum wages, and prohibitions of child labor. Such is the essence of liberty as our elites understood them back in the Gilded Age, and what current elites want a return to.

Single-payer is a better idea, and such requires a return to the drawing board.

HOLY SHIRT

If I'm reading this right, the mandate survived!

Not sure yet; I'll be back

Looks like it did with Roberts joining the progressives

Tom: The bottom line: the entire ACA is upheld, with the exception that the federal government's power to terminate states' Medicaid funds is narrowly read.

Romney's done.

It was Roberts that swung it. Incredible.

Kennedy went with the minority - douchbag.


Making the mandate as a tax - that actually puts more teeth in it. The Act itself had a provision that the mandate would not be actively enforced; the SCOTUS may have changed that.

I am really shocked how this came out.

those Red States that held off on implementing the ACA schedule are totally F'd

That pleases me.

Originally Posted by Ghost Echo

This decision puts people like me (under 130% pl) into a unique squeeze. The government dictates that everyone has to buy insurance, but doesn't provide for those like me who can't afford it.

Now that the states no longer have a mandate to cover those who can't afford it or state exchange, I predict either return of a public option, a federal exchange, a a type of federal medicaid or single payer option.

Or I'll have to start figuring on paying 700 a year for not being able to afford insurance.

It's been awhile since I've looked into this. Could you explain more clearly your circumstance?

You make too much money to get a govt subsidy to pay for your insurance, but $700 a year is a big hit?

Originally Posted by playwrite

It's been awhile since I've looked into this. Could you explain more clearly your circumstance?

You make too much money to get a govt subsidy to pay for your insurance, but $700 a year is a big hit?

How I understand it is that he makes under 130 percent of poverty, but because States aren't required to expand Medicaid, he'll be out in the cold. However, I understand with the state exchanges, there will be very heavy subsidies for people with low incomes (low defined as under 300 percent of poverty), with the subsidy getting larger the lower the income is. I'm not an expert on the ACA, however, and given that I have employer health care, I don't have a personal horse in this race, as the saying goes.

Here's something from Ezra that brings some prespective -

The individual mandate, by bringing healthy people into the insurance market and lowering premiums, means health insurance for between 12.5 million and 24 million more Americans than if the mandate was struck down. And as Kennedy said in his dissent that the conservatives on the Court believed the entire law should have been invalidated, it means health insurance for 33 million more Americans than if Kennedy and the conservatives had their way.

Those are big numbers, But behind them are real people. People like Eric Richter.

Richter, a 39-year-old resident of Ohio, works at a stone drilling company. He and his wife made $36,000 a year. That’s too much to qualify for Medicaid, but too little to easily afford insurance. So Richter didn’t purchase insurance. “It’s hard to pay for the unknown, when you’re struggling to cover the known,” he told Sabrina Tavernise of the New York Times. “I know it sounds irresponsible, but that’s just the way it was. It’s a game of roulette you hope you’re going to win.”

Then Richter discovered a tumor growing up his leg. He first tried home remedies, cutting out sugar and eating beets, having read somewhere that it might help. But it kept growing. His wife sewed him new pants to accommodate the “melon-sized” lump. He stood in church, because it was too painful to sit down. He was turned away from a needed scan because he lacked insurance. In April, doctors in the emergency room told Richter his tumor was malignant. His wife desperately tried to find an insurer would would cover them. No one would. The tumor was, of course, a preexisting condition.


Perhaps nothing in Richter’s story speaks to the cruel reality of the American health-care system better than this: Richter’s wife, Dani, was recently let go from her job at an electronic records firm. For most families, this would be a tragedy. For the Richters, it might be a lifesaver. The loss of income pushed them well beneath the poverty line, and that might mean they qualify for Medicaid. “We’re back to crossing our fingers,” Mrs. Richter told Tavernise.

Richter has had some good luck, too. A doctor eventually took an interest in his case and helped him get surgery. The family, however, still has no idea how they will pay the bill for the surgery, or for his needed follow-up care.

The passage of the Affordable Care Act means that, come 2014, people like the Richters get guaranteed health care coverage. If their income is less than 133 percent of the poverty line, they receive Medicaid. If their income is between 133 percent and 400 percent, they receive some level of subsidies. At $36,000, the Richters would be paying less than $200 a month, and no insurer can turn them away. If they are now below the poverty line, they get Medicaid, no questions asked.

There is uncertainty between here and 2014. In particular, Mitt Romney could win the election and repeal the law entirely, meaning none of the 30 million Americans expected to gain coverage under the law get it.

But the particular roulette wheel that began spinning when Republicans took to the courts to invalidate the Affordable Care Act has come to a stop. And the Richters have won. They can finally uncross their fingers.

Originally Posted by playwrite

It was Roberts that swung it. Incredible.

Kennedy went with the minority - douchbag.


Making the mandate as a tax - that actually puts more teeth in it. The Act itself had a provision that the mandate would not be actively enforced; the SCOTUS may have changed that.

I am really shocked how this came out.

I'm not, unfortunately. I've seen the argument many times that there wouldn't be the outcry about this had it been named a tax from the beginning (at least, on Volokh and some of the more legal oriented blogs), but since it was construed as a penalty for not acting (under the Commerce Clause) that it is seen as compelling action, rather than regulating it. I am glad to see that concept struck down.

Construing the Commerce Clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority.

I am not surprised, however, that the court might rule on substance of a law more than name. (See the gross construction of bad english law names so they have a "cute acronym", USA Patriot for example?)

Because “every reasonable construction must be resorted to, in order to save a statute from unconstitutionality,” Hooper v. California, 155
U. S. 648, 657, the question is whether it is “fairly possible” to interpret the mandate as imposing such a tax.

I'm not overly sure that it adds any more teeth, as you claim. The original law provides for this "tax" collection through the IRS, and specifies which enforcement methods the IRS may or may not use. Since the mandate was read as a tax in substance, if not in name, and the law upheld, I don't see why those restrictions would be removed.

All 198 pages of opinion, concurring opinion, and dissent here: http://www.supremecourt.gov/opinions...11-393c3a2.pdf

Originally Posted by The Wonkette

How I understand it is that he makes under 130 percent of poverty, but because States aren't required to expand Medicaid, he'll be out in the cold. However, I understand with the state exchanges, there will be very heavy subsidies for people with low incomes (low defined as under 300 percent of poverty), with the subsidy getting larger the lower the income is. I'm not an expert on the ACA, however, and given that I have employer health care, I don't have a personal horse in this race, as the saying goes.

Here's the current incomes based on the poverty level that gets one a subsidy -

http://ccf.georgetown.edu/index/cms-...guidelines.pdf

You get a subsidy up to 400% of the poverty line. For an individual that is about $45K per year. For a family of three that is $76K per year.

If you have a kid and refuse to have health insurance even with a govt subsidy, I have no pity for you if you're paying the penalty.

If your healthy single in your 20s making over $45K, I can see where you might not appreicate the $700 (about $58 a month - might have to forgo your data plan on your iPhone) penalty. But overall, I'm still happy that folks like Eric Richter can get their tumors removed without having his family sleeping in a tent city. Don't get me wrong, I would prefer single payer or even a national public option (I expect a lot of state-level public options will be comng), but given that we're a hair's width away from serfdom nation, I'll take this outcome.

Originally Posted by Joral

I'm not, unfortunately. I've seen the argument many times that there wouldn't be the outcry about this had it been named a tax from the beginning (at least, on Volokh and some of the more legal oriented blogs), but since it was construed as a penalty for not acting (under the Commerce Clause) that it is seen as compelling action, rather than regulating it. I am glad to see that concept struck down.



I am not surprised, however, that the court might rule on substance of a law more than name. (See the gross construction of bad english law names so they have a "cute acronym", USA Patriot for example?)



I'm not overly sure that it adds any more teeth, as you claim. The original law provides for this "tax" collection through the IRS, and specifies which enforcement methods the IRS may or may not use. Since the mandate was read as a tax in substance, if not in name, and the law upheld, I don't see why those restrictions would be removed.

All 198 pages of opinion, concurring opinion, and dissent here: http://www.supremecourt.gov/opinions...11-393c3a2.pdf

Good insights. Thanks!

I wasn't claiming that they put more teeth in; just wondering if that was the end results. Thanks for clarifying.

I went back to the govt's presented case and he did present the constitutionality under the tax clause. He did such a poor job with the commerce clause that everyone focused on that and forgot about the other. Putting aside the idelogical differences, these judges are really really smart people (well, except for maybe Thomas).

Something that is noticed. Roberts, Republican appointed, sided with the Dems. Why? It's a tax and he gets to decide you writes the opinions and it was him. This is a political set-up for the election.

Roberts sided with the 4 liberals? I'm shocked!

Originally Posted by Ghost Echo

Where are you finding this subsidy? When you make 3-4k a year, 58 dollars a month tax/penalty simply for not having insurance because you can't afford it is a lot.

I can't imagine this standing as it is. I predict that the feds will be pressured to step in for the states and implement a solution. (again a nation health exchange, subsidy, single payer, federal medicaid, etc.) Either that or we're screwed.

At this current stage, I just received a new tax for being low income.

Wait... You make 3-4k per year? And that is above the poverty line? I'm having a bit of trouble squaring these two. Are there other circumstances which are changing things?

And that's why Roberts sided the other way and got to write the oppinion: make it a tax issue and Obama wants to raise middle and low income people's taxes.

The acorn do noth fall too far from the oak

Just because a couple people on the Supreme Court declare something to be ‘constitutional’ does not make it so. The whole thing remains unconstitutional. While the court may have erroneously come to the conclusion that the law is allowable, it certainly does nothing to make this mandate or government takeover of our health care right. - Rand Paul, 6/28/12

Originally Posted by disgruntledxer

And that's why Roberts sided the other way and got to write the oppinion: make it a tax issue and Obama wants to raise middle and low income people's taxes.

You do know that Federal taxes have done nothing but gone down since Obama came into office?

Am I missing your point?

EDIT
__________________________________________________ ____________
Never mind. I got it. I think it's a stretch to go from subsidized health insurance for all low income and many middle income to them paying more taxes by way of the penalty. But, give some of the stupidity now comng out from the t-baggers, I wouldn't be surprised by such desperate grasping.

Here's a run down from Health Care NOW:

The ACA:

- Will not achieve universal coverage--at least 26 million people will remain uninsured.

- Will not control healthcare costs, leaving Americans vulnerable to bankruptcy.

- Embeds private, for-profit insurance in the system's core, allowing them to continue to profit and game the system at our health's expense.


While a national single-payer system, such as the one proposed in Representative Conyers' (D-MI) National Health Care Act (HR676), would:

- Cover all necessary medical care for everyone living in the US from birth to death.

- Reduce healthcare spending by a minimum of $400 billion a year by significantly reducing administrative costs.

- Remove for-profit insurers from the system along with their excessive profits and CEO salaries.

The bottom line: Medicare: improve it and expand it to everyone! Now *that's* a common good message.

- and treasonous as well -

“I urge every governor to stop implementing the health care exchanges that would help implement the harmful effects of this misguided law. Americans have loudly rejected this federal takeover of health care, and governors should join with the people and reject its implementation.” - Jim DeMint 6/28/12

I guess South Carolina is going to kick that whole succession thingee off again.

I know this is a long way from final resolution; with a Romney win, they won’t be able to kill it outright but they could starve it to death in budget reconciliation. But even with that, let me just savor this moment with –

F U TEABAGGERS!


Okay, sorry, just had to get that out of my system.