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Four words that could deep-six Obamacare
The Supreme Court has agreed to hear a case called King v.Burwell, a case that could throw Obamacare for a loop should the SCOTUS rule against the administration. The case has to do with whether healthcare.gov, the federal site, can provide subsidies to low income Obamacare enrollees. The law as passed clearly says no, and we have the architect of the law on video saying that this was by design. The admin says 'yes.' The SCTOUS has agreed to decide, and the decision should be public sometime in June 2015.
If the court rules against the admin, we will have immediate chaos. Something like 5 million people, in the 34 states that lack exchanges, will be booted off of Obamacare.
The question is what the GOP strategy should be in all of this. The first option for the GOP is to do nothing. Obamacare was rammed through without a single Republican vote, and zero Republican input. This is the Democrat's baby. Live by the sword die by the sword. But as I say there would be chaos, and doubtless would be attempts to blame Republicans for this law written, passed, and signed by Democrats, on the basis that Republicans are standing in the way of a simple fix, namely deleting the language that limits subsidies to state exchanges.
Another option might be to try for a repeal of Obamacare if the court rules that the law means what it says. I doubt that a veto-proof (2/3rds) majority could be reached, so that is probably a lost cause.
A 3rd option would be for the GOP Congress to negotiate a fix to the language in exchange for concessions, and this is the option I like. The best time to do this would be prior to the ruling. Suppose that Boehner and McConnell agree to fix the faulty language in exchange for such things as:
• drop the individual mandate and fines for not having insurance. The admin has already really de facto done this with its 'hardship' rule. Only the low info people are going to be paying the fines.
•drop the medical device tax. This is unpopular, and the GOP might well be able to get a veto proof majority to agree to this anyway.
•change the 'Cadillac tax' so that the cap increases at the rate of health care inflation rather than CPI. This one that might just as well be left alone, because the initial victims of the Cadillac tax are public sector unions. But eventually everyone will be drawn in.
•require aggressive "wellness inspections" for Medicaid and subsidy recipients. If I'm going to subsidize your treatment for emphysema from pot or cigarette smoke, your liver transplant due to booze, or your gastric bypass due to overeating, then I damn well want some health Nazis watching over you.
•last but not least include a provision for health savings accounts (HSA's) in Obamacare. If you're like me, a marathon runner who does not smoke, use drugs, or engage in unprotected anal sex, and as a result rarely requires medical attention, you get a reward under HSA's. Because of all that health care you didn't use, you get a check.
Anyone see any other options out there? How should the GOP handle this opportunity?
NJ has created a State exchange twice and they will for a third time if the court rules against subsidies for the federal exchange. It will again go to the Governor. If he vetoes the bill I would not be surprised to see R's in the State legislature help over ride the veto.
I want to see what the R's in office at the State level will do if their residents become ineligible for the subsidies. I bet some will create State exchanges.
Your last bullet point is nonsense because none of those things make you immune from certain diseases that are genetic based or from accidents. You could be struck by either at any time.
My wife was a championship college athelete as fit as any person in America when she was struck by an immune system disease. I had a friend who had an anuerism. He was a runner in excellent shape.
NJ has created a State exchange twice and they will for a third time if the court rules against subsidies for the federal exchange. It will again go to the Governor. If he vetoes the bill I would not be surprised to see R's in the State legislature help over ride the veto.
I want to see what the R's in office at the State level will do if their residents become ineligible for the subsidies. I bet some will create State exchanges.
Some states might decide to create exchanges if the ruling goes against obamacare. After all there are only 14 states with exchanges, and 19 states with Democratic governors. I doubt that enough states would do it in order to avert chaos, but who knows?
Your last bullet point is nonsense because none of those things make you immune from certain diseases that are genetic based or from accidents. You could be struck by either at any time.
My wife was a championship college athelete as fit as any person in America when she was struck by an immune system disease. I had a friend who had an anuerism. He was a runner in excellent shape.
You might be to cocky for your own good.
I'm not cocky at all, I realize that there is a lot of luck involved, and I like everyone have not always taken the best care of my body. But according to the CDC, up to 75% of health care costs stem from behavior.
If health care costs are to be subsidized by the taxpayer, it makes sense that behavior must be monitored by the taxpayer's agent, the federal government. In fact it is arguably the inevitable result. There's an old saying: "live under my roof; live by my rules."
There will be some chaos in the beginning but over time the States with citizens not receiving the subsidies will create exchanges. It will not be a long time either. Those hard core R States have been at the government teat for a long time they are not getting off. This was nothing but a political ploy for them to rally the base.
I want the court to rule the subsidies do not apply so I can watch the R States fall over themselves figuring out they got screwed out of government money and the hypocritical arguments they make to get back on the gravy train.
25% of people getting sick by no fault of their own is a large number. The majority of any individuals health care cost comes the last few months of their life in most cases. That is what needs to be looked at.
As for that 75% figure out a way to penalize the behavior to recoup some of the cost- taxes on booze and cigarettes etc.
25% is 1 in 4, and 1 is a small number. If we could even come close to reducing health care spending to 25% of it's current level, that would be a revolutionary change. US annual health care spending is about $3.8 trillion. If we could reduce that to $950,000 billion (25 pct%), it would be a game changer. We could pay off our gargantuan national debt in less than 10 years with that.
You are making the false assumption that the 75% who get illnesses based on lifestyle will have no health care issues based on genetics, accidents etc.
I do agree with your proposition that we can make changes to make us healthier to cut costs.
It really depends because there are other challenges headed to the Supreme Court as well, for example, if ACA tax increases, which originated in the Senate, are constitutional.
if the Supreme Court agrees to take that case, then the GOP shouldnt do anything because that probably means ACA is thrown out completely.
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