- make it a certainty that the latest challenge to the ACA will go back to the SCOTUS -

http://talkingpointsmemo.com/dc/4th-...bsidies-halbig

Federal Appeals Courts Clash Over Obamacare Subsidies

Apparently 2 t-baggin Bush holdover judges on the DC Appeals want to override Congressional intent and legislate from the bench (much like 5 males SCOTUS judges decided in the Hobby Lobby to put corporations ahead of women as human beings).

However, minutes later, the three judges on the 4th District unanimously decided the exact opposite.

While both decisions will now go to their respective full court for a final decision and likely overturn the 2 t-baggin judges, it does set this as a certainty to go to the SCOTUS.

If the SCOTUS decides to go the t-bagger way (like they did on Hobby Lobby), it would be a huge set back for the ACA in those states that did not set up their own exchanges - it would be much like those states that did not choose to expand Medicaid.

The big political difference is that this would not be poor disenfranchised folks on Medicaid, this would be working class people that are much more likely to vote.

Here's an early analysis on what states would be hit the hardest if the federal subsidies are removed -



The political impact of several million people having their premiums skyrocket directly as a result of t-baggin a-holes (e.g. Ted Cruz has already come out cheering the baggers' decision) could be immense in tipping elections at the state and national levels. It could also further focus the 2016 Presidential race on the most important issue - who gets to nominate the next few SCOTUS Justices.

It is also estimated that the states without exchanges will lose a total of $20 billion a year in free federal monies flowing into their state.

Then there's the mass dropping of insurance by people in the states without exchanges and subsidies - studies show lack of insurance leads to higher health and death risks. A way to de-populate Red states?

Not sure where that map came from but Idaho has its own exchange. I think New Mexico does, as well.

I have to think that it's not going to be good news for the ACA if SCOTUS hears this. The Roberts Court has a habit of deciding an issue on a narrow basis and using it as precedent for a more sweeping ruling later. See NAMUNDO leading to Shelby County as a prime example. Roberts would strike me as more likely to issue that sweeping ruling here than in NFIB because he could take the statutory-over-constitutional argument and write something along the lines of "all it takes is a simple act of Congress to fix this!" while conveniently ignoring the dysfunction that's in Congress.

Originally Posted by Bronco80

Not sure where that map came from but Idaho has its own exchange. I think New Mexico does, as well.

I have to think that it's not going to be good news for the ACA if SCOTUS hears this. The Roberts Court has a habit of deciding an issue on a narrow basis and using it as precedent for a more sweeping ruling later. See NAMUNDO leading to Shelby County as a prime example. Roberts would strike me as more likely to issue that sweeping ruling here than in NFIB because he could take the statutory-over-constitutional argument and write something along the lines of "all it takes is a simple act of Congress to fix this!" while conveniently ignoring the dysfunction that's in Congress.

I'm pretty much in agreement. This time, however, the dysfunction being pointed out results in millions losing insurance, paying much higher prices, and states losing billions in economic activity. That could result in some much needed blowback to the SCOTUS by way of another 10 years of a Democrat in the WH nominated 2 or 3 of their replacements. One step back, two steps forward.

Originally Posted by playwrite

I'm pretty much in agreement. This time, however, the dysfunction being pointed out results in millions losing insurance, paying much higher prices, and states losing billions in economic activity. That could result in some much needed blowback to the SCOTUS by way of another 10 years of a Democrat in the WH nominated 2 or 3 of their replacements. One step back, two steps forward.

Well, if the dissenters had their way in NFIB all of the ACA would have been struck down due to their claim of inseverability. This would only gut a(n albeit important) piece, and perhaps it could still be feasible that states running their own exchange won't be impacted that much. I guess you could make an argument that taking away something that was already given is crueler than having never given it at all. And while I clearly hope that in such a bad scenario that the political backlash against SCOTUS would result in longer-lasting Democratic control of the White House, who knows what the future will hold. Health insurance is a tricky good in that people may not feel really strong about having it until they really need it. Those that have already really needed it thanks to the ACA are likely to vote Democratic anyway.

Originally Posted by Bronco80

... Those that have already really needed it thanks to the ACA are likely to vote Democratic anyway.

I'm not sure why that would be the situation. Remember, we are talking about the private insurance provided through the health exchanges. Premiums are subsidized on a sliding scale up to 400% of the federal poverty level (FPL). For a family of 4 that is around $92,000 and a family of 5 that is around $111,000 - both far above the average household incomes in the US and in every state - and likely far far above incomes in rural area Republican strongholds. Go to your next t-baggin get together and take a hard look at the baggers around you.

Also we know this -

http://www.commonwealthfund.org/publ...age-Access-ACA

The survey, from the Commonwealth Fund, a research group, a research group, came to similar conclusions as other surveys about the expansion of health insurance. It found that about 15 percent of adults younger than 65 now lack health insurance, down from 20 percent before the Affordable Care Act rolled out in January.

What was more surprising is that people who got the new coverage were generally happy with the product. Overall, 73 percent of people who bought health plans and 87 percent of those who signed up for Medicaid said they were somewhat or very satisfied with their new health insurance. Seventy-four percent of newly insured Republicans liked their plans. Even 77 percent of people who had insurance before – including members of the much-publicized group whose plans got canceled last year – were happy with their new coverage.

Also, it's not just that taking away something that people already have is worse (and it gets worse as it ages) than never giving it to them in the first place. The way this will happen is by increasing each person's federal taxes; and we all know how much everyone loves it when their taxes go up.

If a building was so obviously unsound structurally, would you knowingly let people live and/or work in it?

No. More likely you'd tear the damn thing down and put up a structurally sound building in its place, right?

That's what needs to be done with ObamaCare. It needs to be torn down, and replaced with a national charity-care program funded by a tax on legalized marijuana sales.

And this cannot possibly be assailed as "wealth redistribution," since such a tax would be inherently regressive - and massively so (I kind of doubt that the Waltons of Walmart fame or infame, depending on one's POV, or the Koch brothers, etc., smoke a great deal of pot).

Captain obvious -

http://www.modernhealthcare.com/arti...t-on-governors

Obamacare subsidy rulings put heat on governors

Eliot Cutler, independent candidate for Maine governor, called a news conference last week to decry the ruling by a federal appellate court that could lead to the elimination of premium subsidies for Obamacare enrollees in Maine and 35 other states relying on the federal insurance exchange.

“Had there been a state exchange designed specifically for Maine … families across the state of Maine would not be wondering when they go to sleep tonight if and when they will lose their health insurance,” Cutler said.

So far Cutler, who trails Republican Gov. Paul LePage, a hard-line Obamacare foe, and Democratic nominee U.S. Rep. Mike Michaud in the polls, is one of the first political candidates across the country to use the court decision to fire up support among voters who benefit from the healthcare reform law's subsidies. But some experts say other political candidates may follow as they and voters have time to assess the ruling.

The ramifications of last week's 2-1 ruling by the U.S. Circuit Court of Appeals for the District of Columbia in Halbig v. Burwell, which disallowed premium subsidies in states using the federal exchange, are potentially immense. If that opinion is ultimately upheld by the U.S. Supreme Court and enrollees in those states are denied subsidies, more than 7 million Americans would lose some $36 billion in premium assistance in 2016, according to the Urban Institute. It's expected that many if not most would drop their coverage. Those people would be disproportionately in Republican-led states, some of which saw big enrollment on the federal exchange.

“It becomes health reform for blue states,” said John Holahan, an author of the Urban Institute report. “In the rest of the country you don't have health reform.”

Republicans could face a backlash if their constituents realize they could lose benefits due to a lawsuit broadly backed by GOP politicians. That could be problematic for Republican governors facing tough re-election contests in states such as Florida, Georgia, Maine, Pennsylvania and Wisconsin. Those governors already are under pressure from hospitals and other business groups to expand Medicaid to lower-income adults as allowed under the Patient Protection and Affordable Care Act.

“If the end result is if you live in New York you get (subsidies) and if you live in Georgia you don't, I don't think that's politically palatable,” said Kevin Wagner, a political science associate professor at Florida Atlantic University. “You start hitting middle-class people, and they vote.”

In Florida, Democratic gubernatorial candidate and former Gov. Charlie Crist quickly used the Halbig ruling to attack Republican Gov. Rick Scott. Florida had among the highest rates of exchange enrollment in the country, with roughly 1 million sign-ups by mid-April. More than 90% of Florida exchange enrollees qualified for premium subsidies that on average covered 80% of their monthly premiums. “Rick Scott's refusal to bring Republicans and Democrats together on affordable healthcare now means that 1 million middle-class Floridians may find their affordable health insurance far more expensive,” the Wall Street Journal quoted a Crist campaign spokesman saying last week.

In Pennsylvania—where Republican Gov. Tom Corbett, a strong Obamacare opponent—is behind in the polls, healthcare has been pushed to the background behind education funding and the economy as the top two issues, said Terry Madonna, a pollster and political science professor at Franklin & Marshall College, Lancaster, Pa.

But there is the potential for Democratic candidate Tom Wolf—who has promised to take aggressive action to expand access to healthcare—to exploit the legal threat to the subsidies. It could be a potent issue given that 318,000 Pennsylvanians signed up for coverage through the federal exchange and about 81% receive premium subsidies.

Democratic governors in states that did not establish a state-run exchange—such as Illinois Gov. Pat Quinn, who is facing a tough re-election contest—also could face pressure to take action. Democratic state Rep. Robyn Gabel said she may push a bill to establish a state-run exchange when the Illinois Legislature reconvenes in November. “Having the subsidies only be available to people who enroll in a state exchange is a very compelling reason to pass this bill,” Gabel said.

Some analysts argue that governors, if they want to, could find an easy legal workaround to establish a state-run exchange that would comply with the Halbig ruling. Nicholas Bagley, an assistant professor of law at the University of Michigan, wrote that a state could “establish an exchange and appoint a state-incorporated entity to oversee and manage it. That state-incorporated entity could then contract with HealthCare.gov to operate the exchange.”

Attorney Mark Rust, chair of Barnes & Thornburg's healthcare practice in Chicago, said the seven states such as Illinois with so-called partnership exchanges—which rely on HealthCare.gov for enrollments but fulfill other duties such as plan management—already may meet the standard for having a state-based exchange. Other states could fairly easily convert to this hybrid model, he added.

Wagner said the political dynamics of healthcare reform have changed since 2010, when Republicans wrested control of 11 governorships from Democrats. “It's not an abstraction anymore. There are millions of people signed up,” he said. “Historically we don't take (benefits) away, and (politicians) who try to tend to be finding another job.”

Originally Posted by '58 Flat

...I kind of doubt that the Waltons of Walmart fame or infame, depending on one's POV, or the Koch brothers, etc., smoke a great deal of pot...

Ah, put what of the Teleprompter-in-Chief?

If Halbig does prevail at SCOTUS and (if so, it would likely be Jone 2015), there could be a double whammy on political backlash thanks to the individual mandate, which has always been the one part of the ACA that I'm struggled with. If people can't afford to buy insurance on the exchange without subsidies, they're still liable to get docked on their income tax returns instead. That could lead to some ticked off people come April 2016, right when the presidential race is gaining steam. And this is only the beginning if the dreaded death spiral comes to fruition.

- I give you Paul Krugman and California -

http://krugman.blogs.nytimes.com/201...-single-payer/

Stealth Single Payer

The Kaiser Family Foundation has a new survey (pdf) on Obamacare in California, and it’s full of remarkably good news. For those who haven’t been following this, CA — with its now-dominant Democratic Party — is where Obamacare was implemented the way it was supposed to be implemented: the website worked pretty well from the beginning, Medicaid expansion was implemented, and the state worked hard on outreach. It was also a place that really needed reform: the uninsured were a high percentage of the population, and an individual market without community rating meant that the mere hint of a preexisting condition was enough to prevent coverage.

So it now appears that most of California’s uninsured — 58 percent of the total, or well over 60 percent of those eligible (because undocumented immigrants aren’t covered) have gained insurance in the first year. Considering the complexity of the scheme, that’s really impressive, and it strongly suggests that next year, once those who missed out have had a chance to learn via word of mouth, California will have gotten much of the way toward universal coverage for legal residents.

But there’s something else the Kaiser report drives home: most of those gaining coverage are doing so not via the exchanges (although those are important too) but via Medicaid. And that’s important as an answer to critics of Obamacare from the left.

There have always been critics complaining that what we really should have is single-payer, and angry that subsidies were being funneled through the insurance companies. And in principle they’re right; the trouble was that cutting the insurers out of the loop would have made the plan politically impossible, both because of the industry’s power and because of the unwillingness of people with good coverage to take a leap into a completely new system. So we got this awkward public-private hybrid, which I supported because it was what we could get and despite its impurity it dramatically improves many people’s lives.

But it turns out that many of the newly insured are in fact being covered under a single-payer system — Medicaid. And as I’ve pointed out before,

Medicaid is actually the piece of the US system that looks most like European health systems, which cost far less than ours while delivering comparable results.

All in all, liberals really should be celebrating. California shows how Obamacare can and should work, and it’s looking pretty good.

Krugman gets it.

And at some point, the bagger high tide will recede enough and the ACA infrastructure of not only Medicaid and subsidies, but the MLR and policy standardization requirements on insurers, is going to increasingly move us toward single payer - something politically unimaginable before Obama. Only a matter of time now.

So "stealth single payer" means a sort of two tier system?

Originally Posted by TimWalker

So "stealth single payer" means a sort of two tier system?

Yep, one for states with modern intelligent people and another for backward Neanderthals.

But eventually, well, we all know what happens to the Neanderthals.

Originally Posted by playwrite

Yep, one for states with modern intelligent people and another for backward Neanderthals.

But eventually, well, we all know what happens to the Neanderthals.

If you have European or Asian ancestry, chances are, you've got a bit of Neanderthal in you. I plead guilty.

Well, I guess we can expect maybe 2% of Neanderthal politics to remain in our system after "eventually" comes. I guess we can deal with that. Maybe it will protect us from being too thin-skinned (too compassionate, or something).

Originally Posted by The Wonkette

If you have European or Asian ancestry, chances are, you've got a bit of Neanderthal in you. I plead guilty.

I lean more toward nurture than to nature as cause. But even if its the latter, that other 97% seems to have made you a very nice person. And well, maybe that 3% can come in handy - you never know when you might need to stare down a Mammoth or a Sabre Tooth - particularly in NM!

A 3% representation in our political arena would also not only be okay by me but could be a source of some harmless entertainment. Hmm, maybe that's why these guys are always driving around in clown cars.

Originally Posted by The Wonkette

Originally Posted by playwrite

Yep, one for states with modern intelligent people and another for backward Neanderthals.

But eventually, well, we all know what happens to the Neanderthals.

If you have European or Asian ancestry, chances are, you've got a bit of Neanderthal in you. I plead guilty.

Most of my DNA is northern European, and the Swedish half awarded me with a big jaw and a noticeable brow ridge. Yeah, I have some too.

Krugman states the obvious =

http://krugman.blogs.nytimes.com/201...yond-the-lies/

Beyond the Lies

August 19, 2014 2:48 pmAugust 19, 2014 2:48 pm

Greg Sargent notes that the midterm election, which was supposed to be a referendum on Obamacare, isn’t looking at all like that in practice; Republican ads denouncing health reform have been dwindling month by month.

The reason is fairly obvious, although it’s not considered nice to state it bluntly: the attack on Obamacare depended almost entirely on lies, and those lies are becoming unsustainable now that the law is actually working. No, there aren’t any death panels; no, huge numbers of Americans aren’t losing coverage or finding their health costs soaring; no, jobs aren’t being killed in vast numbers. A few relatively affluent, healthy people are paying more for coverage; a few high-income taxpayers are paying more in taxes; a much larger number of Americans are getting coverage that was previously unavailable and/or unaffordable; and most people are seeing no difference at all, except that they no longer have to fear what happens if they lose their current coverage.

In other words, reform is working more or less the way it was supposed to (except for the Medicaid expansion in non-cooperating states).

Many of us argued all along that the right’s chance to kill reform would vanish once the program was actually in place; the horror stories only worked as long as the truth wasn’t visible. And that’s what seems to be happening.

This is how hard-working Progressives get 'er done -

http://www.washingtonpost.com/blogs/...ands-medicaid/

Pennsylvania’s Republican governor expands Medicaid

- that's another 1/2 million people who now have insurance as a result of Obamacare!

Some folks are noticing -

http://talkingpointsmemo.com/dc/gop-...ections-no-mas

The GOP's All-Out War On Obamacare Is In A Death Spiral

http://www.washingtonpost.com/blogs/...om-the-courts/

Obamacare supporters just got some good news from the courts

The Obama administration and supporters of the president's health-care law are probably breathing a little easier this morning after some pretty big news from the U.S. Court of Appeals for the District of Columbia Circuit.

A few months after a three-member panel of the court ruled the federal government can't provide insurance subsidies through federal-run exchanges in 36 states, the court on Thursday granted the Obama administration's request for the entire panel to re-hear the case. The en banc hearing, as it's known, wasn't entirely unexpected — and with a heavy makeup of Democratic-appointed judges on the panel, it seems likely the administration will get a more favorable ruling when the entire court reconsiders the case.

In July, the D.C. appellate court decided 2-1 that Congress only intended to provide subsidies in states that set up their own health insurance marketplaces under the Affordable Care Act. If the ruling survived, it could invalidate federal help to about 5 million people who purchased insurance through federal-run exchanges last year.

However, a federal appellate court in Virginia in a similar case sided with the administration, ruling that although the text of the Affordable Care Act is unclear, the IRS acted appropriately to provide subsidies in all exchanges.

The challengers in the Virginia case have asked the Supreme Court to take their challenge as soon as possible, but the Supreme Court may want to delay consideration until after the appeals court in D.C. finishes its review of its subsidies case, Halbig v. Burwell. Oral arguments for the entire D.C. circuit court are scheduled for Dec. 17, a month after the next Obamacare open enrollment period starts.

The entire D.C. circuit is expected to uphold subsidies through the federal-run exchanges, which would eliminate conflicting decisions in the appellate courts. That makes it less likely that the Supreme Court will eventually take the subsidy challenges, though it still can decide to do so.

With the target of another 5 million to be signed up on the exchanges this coming Fall, the Obamacare haters will be aimng to take away health insurance from a total of 10 million people by the time of this larger DC ruling.

I would suggest to those looking for issues where today's conservatives are not bat shit crazy to perhaps shy away from this area.

I won't be satisfied about the Halbig decision unless SCOTUS denies cert on it. There's still a ways to go on that case...

Originally Posted by Bronco80

I won't be satisfied about the Halbig decision unless SCOTUS denies cert on it. There's still a ways to go on that case...

Yea, but this is a very very good development in two ways -

- First, the deadenders were doing everything they could to move the denial of subsidies as fast as possible knowing that the 5 million who would loss health coverage would likely double to 10 million with the new enrollment period. With the now en banc review scheduled to start in mid - December that nightmare of putting 10 million people at risk is now a certainty (see bat shit crazy).

- Second, the SCOTUS gets between 8-9,000 petitions to hear cases each year and they only do a small fraction of that. High on their list are highly controversial issues where lower courts (particularly federal district courts!) have reached completely different judgements - that is exactly where we were until just a couple days ago. On the other hand, they hardly ever take up a case where there is unanimity by the lower courts (particularly federal district courts!); to do otherwise will look extremely for political motivations particularly on THIS issue where the Court is having to infer what Congress meant. With the exception of obvious wins for his corporate masters, Chief Justice Roberts bends over backwards to protect his legacy as not being partisan.

I think if the en blanc review overturns the 2 GOP judges' decision, either along political lines or not, Roberts isn't going to let Scalia/Alito/Thomas anywhere near this political WMD; AND, importantly, he will have every excuse not to if the en blanc review goes that way.

yea, not done yet; but very very good news.

With the victory laps on the ACA keep adding up, Krugman suggests a victory spiral -

http://krugman.blogs.nytimes.com/201...ype=blogs&_r=0

Obamacare Life Spiral

Ezra Klein directs us to the latest from the Kaiser Family Foundation, which asks what the average Obamacare 2015 premium increase will be for those places for which we have full information — and finds that premiums will actually decline slightly. Ezra tries to get us to appreciate just how good the Obamacare news has been with a thought experiment:

Imagine taking a time machine back to 2010 and telling Republicans in Congress, who were arguing that the CBO was wildly underestimating Obamacare’s cost, that the law would be cheaper than predicted and, at least in the states that accepted its Medicaid dollars, cover more people than the Congressional Budget Office thought. After the laughing and mocking and the calling of security, let’s say you offered this prediction in the form a of a bet. What odds do you think Obamacare’s critics would have offered? 2:1? 5:1? 10:1?

But you don’t have to go back to 2010. Look at John Cochrane in late 2013, taking it for granted that Obamacare would implode in a death spiral within a few months. Look at The Hill just four months ago, telling us that double-digit premium hikes were coming.

One question we might ask here is, why is the news so good? The answer, I’d suggest — although I hope the real experts will weigh in — is that we’re actually seeing the opposite of a death spiral; call it a life spiral. For one thing, the huge surge in enrollments late in the day meant that the risk pool this year is better than insurers expected, and they now expect 2015 to be better still. Also, importantly, big enrollments mean that more insurers are entering the market, increasing competition. And, of course, the better the deal the more people will sign up: success feeds success.

Another question we might ask: Is our conservatives learning? Are those who bought into the death spiral stories, who seized on every hint of bad news, asking themselves how they got it so wrong? Are they, maybe, considering the possibility that they’re listening to the wrong people, that maybe Jon Gruber knows what he’s talking about and John Goodman is a hack?

Hahahaha.

Has anyone else notice that all the ACA deadenders, from the Left as well as the Right, have completely disappeared from this thread? Sort of reflects how GOP candidates have shut up about the ACA as well.

I guess bat shit crazy only goes so far!

Like Krugman said -

Hahahaha.

Originally Posted by playwrite

Yea, but this is a very very good development in two ways -

- First, the deadenders were doing everything they could to move the denial of subsidies as fast as possible knowing that the 5 million who would loss health coverage would likely double to 10 million with the new enrollment period. With the now en banc review scheduled to start in mid - December that nightmare of putting 10 million people at risk is now a certainty (see bat shit crazy).

- Second, the SCOTUS gets between 8-9,000 petitions to hear cases each year and they only do a small fraction of that. High on their list are highly controversial issues where lower courts (particularly federal district courts!) have reached completely different judgements - that is exactly where we were until just a couple days ago. On the other hand, they hardly ever take up a case where there is unanimity by the lower courts (particularly federal district courts!); to do otherwise will look extremely for political motivations particularly on THIS issue where the Court is having to infer what Congress meant. With the exception of obvious wins for his corporate masters, Chief Justice Roberts bends over backwards to protect his legacy as not being partisan.

I think if the en blanc review overturns the 2 GOP judges' decision, either along political lines or not, Roberts isn't going to let Scalia/Alito/Thomas anywhere near this political WMD; AND, importantly, he will have every excuse not to if the en blanc review goes that way.

yea, not done yet; but very very good news.

I've noticed that quite a few on the left are saying what you said about Roberts: that he wouldn't dare rip away millions from their health insurance. I just can't exude that same confidence. Roberts can say all he wants about transcending partisanship but the results of his court tell the opposite tale. You are correct that the usual SCOTUS modus operandi is to only grant cert when there is a circuit split, but they are not bound by that, and if enough justices see a precedent that they feel is mistaken, they'll jump on it. The Roberts Court has proved that, with Citizens United and its ilk being one blatant example.

I hope you're right, of course, but I'll only believe that SCOTUS won't screw things up once I see that cert denial from a presumably correct en banc DC circuit on the orders sheet.

Originally Posted by Bronco80

I've noticed that quite a few on the left are saying what you said about Roberts: that he wouldn't dare rip away millions from their health insurance. I just can't exude that same confidence. Roberts can say all he wants about transcending partisanship but the results of his court tell the opposite tale. You are correct that the usual SCOTUS modus operandi is to only grant cert when there is a circuit split, but they are not bound by that, and if enough justices see a precedent that they feel is mistaken, they'll jump on it. The Roberts Court has proved that, with Citizens United and its ilk being one blatant example.

I hope you're right, of course, but I'll only believe that SCOTUS won't screw things up once I see that cert denial from a presumably correct en banc DC circuit on the orders sheet.

Look at it from the Roberts' corporatist eyes. This is about subsidized insurance policies. So you have the insurers, pharm, hospitals, doctors on the keep-the-subsidies side and on the other side we have exactly whom? Remember, we're talking Roberts beloved corporations here, not the morons that show up at t-parties demanding the evil socialist govt keep its hands off their Medicare.

Still, we got to get the en blanc decision first.

And...SCOTUS just granted cert in King v. Burwell, the case that the circuit court interpreted correctly. Time to get more worried...