The Supreme Gamble
In the past few days, I’ve talked about two different political gambles. Today I’ll talk about a third.
This week, the Obama administration opted not to appeal last month’s 11th Circuit PPACA ruling, which concluded that the individual mandate is unconstitutional. Given that Obama’s position is, obviously, that the mandate is constitutional, why not appeal the decision?
Simply put, because this forces the Supreme Court’s hand.
The PPACA is written to apply to all Americans, and therefore needs a national legal consensus on its applicability and constitutionality. But right now, we have a difference between regions. The 6th Circuit, in a 2–1 decision, upheld the mandate, while the 11th, also in a 2–1 decision, struck it down. This means that, as it stands, the mandate is legal within the states of Michigan, Ohio, Kentucky, and Tennessee, but illegal in Alabama, Georgia, and Florida.
This situation, naturally, cannot remain. The law is either constitutional in all states, or unconstitutional in all states. By leaving this contradiction in place, the Obama administration is forcing the Supreme Court to do something, and do something now. This means a decision to be issued (most likely) in the spring of 2012.

The Deciders
Why does Obama want this issue decided next spring, just as the election campaigns will be ramping up in force? Because this will take the issue off the table. If the Supreme Court finds the law constitutional, no longer will he have to defend the constitutionality of the law.
And even if the Supremes do not, it will almost certainly be a decision along party lines, giving Obama reason to point to the partisan nature of the Supreme Court. That may not be as strong a position, but it removes a lot of slipperiness that he is forced to deal with today in discussing the law. And it’s not as weak an argument as you might think. Witness how the public responded to the Citizens United decision. It’s not necessarily a win-lose proposition.
The Supreme Court has an out, for now. The Justices can conclude that the plaintiffs lack standing, given that the individual mandate has not yet taken effect. Congress has the opportunity to repeal that portion of the law without it ever affecting a single American, which may render that portion of the law moot.
But even if the Supremes opt for dodging the bullet, Obama can come out out ahead. If the Supreme Court says the law is no big deal, why should the rest of us freak out about it?
So it looks like the Obama administration is betting that the possible outcomes range from neutral to positive. They may be right.
This entry was posted by Michael Weiss on October 1, 2011 at 3:00 am, and is filed under Uncategorized. Follow any responses to this post through RSS 2.0.You can leave a response or trackback from your own site.
-
#2 written by GROG 1 year ago
This is a losing issue for Obama no matter what the Supreme Court decides to do.
RCP has a 13% spread opposing the law and a 10% spread favoring appeal. With his 39% approval/52% disapproval at Gallup and 55% viewing his party negatively, his best bet politically is to dump Obamacare all together.
Hell, even John Kasich of Ohio has a better approval rating than Obama.
http://www.quinnipiac.edu/x1322.xml?ReleaseID=1651
-
This is a winning issue for President Obama no matter what the Supremes decide.
A majority of the public opposes repeal of PPACA. Huge majorities love that they can’t be dropped by insurance companies when they get sick, that they can’t be denied coverage for prexisting conditions, that children can stay on parents’ insurance until age 26, that the Medicare doughnut hole is being closed, that there are no more annual or lifetime maximums for benefits.
If the Supremes decide against the law, President Obama can run on fixing it (getting rid of the mandate, instituting the hugely popular public option or single-payer instead). If the Supremes uphold it, the President will campaign on preventing the Republicans from repealing this necessary (and proven Constitutional!) law.
Besides being a win for the President, supporting and defending this law — and improving on it over the coming years — is simply the right thing to do for America.
-
-
#5 written by rgbact 1 year ago
-
#6 written by shortchain 1 year ago
rgbact,
I don’t recollect that Kaiser claimed that the increase was “partly due to PPACA”. Is that an editorial assertion on your part, or can you link to a Kaiser report that makes it?
Here’s a report that indicates that premiums have gone up (and cites Kaiser) — but doesn’t give any indication as to why.
-
#7 written by Armchair Warlord 1 year ago
Mike,
What is it with liberals and getting all butthurt when their elected figures can’t follow through on all their election promises (not just the ones they said, too — the ones that were entirely in your head also count) immediately by dictatorial decree?
Republicans have been screwing conservatives over for decades in this country without a peep from their electoral base. Refresh my memory — how exactly did the Brady Bill die? Oh, yeah, it quietly reached its 10-year sunset in 2004 after 10 years of Republican congresses took no action to kill it. And these people support your 2nd Amendment rights?
-
premiums have gone up (and cites Kaiser) — but doesn’t give any indication as to why.
The reason is that the rates charged by healthcare suppliers (doctors, hospital, drug companies, etc.) have gone up. This has nothing to do with PPACA. Suppliers didn’t rates their rates very quickly over the last two years, because of the recession — people were already putting off medical procedures because they couldn’t afford them. Now that we’re moving away from recession, the suppliers are “catching up” on the rate increases they didn’t do over the previous two years.
That the rates are going up is an unfortunate side-effect of the improving economy. Only someone who isn’t paying attention (or who watches FOX) can claim it has anything whatever to do with PPACA,
-
AW,
What is it with liberals and getting all butthurt when their elected figures can’t follow through on all their election promises (not just the ones they said, too — the ones that were entirely in your head also count) immediately by dictatorial decree?
I’m not Michael, but I’m equally confused over this. That President Obama has had to face an obstructionist Republican monolith isn’t the fault of the President. The solution, clearly, is to get rid of Congressional Republicans.
-
#10 written by rgbact 1 year ago
Is that an editorial assertion on your part, or can you link to a Kaiser report that makes it?
Its a reference from an article written about the survey. I assume its right. The actual report is 250 pages long, so I’m not scouring it for the exact quote. Kaiser is a lefty outfit anyway, so I’m shocked they even mentioned anything negative about PPACA.
-
#11 written by GROG 1 year ago
-
#12 written by Max aka Birdpilot 1 year ago
Michelle Bachmann asserts mental retardation caused by Gardasil.
Nikki Haley states half of nuclear job applicants fail drug test.
rgbact claims ACA cause of HC insurance premium increases.
What?? Nothing to support claims?
I assume its right.
I’m not scouring it for the exact quote.
Kaiser is a lefty outfit anyway…
Well played, rgb,well played!
-
rgbact,
Kaiser just reported HC costs rose 9%, most in 6 years, partly due to PPACA.
What you left out (accidentally, I’m sure), is that this year’s rise came because it’s the last year that they can raise their premiums without the approval necessary under PPACA. So they’re getting it in while they can.
-
-
#16 written by shortchain 1 year ago
rgbact,
I see. We’re to accept that you read something, somewhere in a 250 page report (which you don’t give a link to) that you interpreted as meaning that some of the increase (how much? Echo answereth not) is due to the PPACA, but, apparently, doesn’t explain why. Is it due to upgrading cheap plans so that they actually, you know, cover medical care? (I had one of those through a company. It amounted to “sure, go ahead, and we’ll make the medical provider submit it three times, then underpay them and pretend that it was paid”.)
Fine. I’m totally convinced.
-
-
#19 written by rgbact 1 year ago
-
#20 written by GROG 1 year ago
-
rgbact pathetically edits #19:
Do I need to provide all links, or can I be allowed to make a bold uncited statement such as this and assume people can Google?
Most everything rgbact posts is unsubstantiated/uncited propaganda, so no, don’t change your laughable debating technique now … unless one wants to be taken seriously.
Re: providing any verifiable proof, laziness seems to be a pattern w/conservatives ~ go figure!
Next time a winger gives a dubious opinion w/out proof, they can just add use the Google if you disagree w/anything.
That’s the ticket!
-
#23 written by Max aka Birdpilot 1 year ago
rgb,
You absolutely MAY make bold uncited statements. But don’t come crying when you get hammered!! You brought it on yourself! Particularly, if someone DOES Google and find you to again be in error. Don’t do your homework, don’t show your work and you don’t even get partial credit. But ultimately, as it is impossible to prove a negative, an patently false assertion can be made that may not be able to be either confirmed or found false. Thus the burden of proof, once challenged, in on the person making the assertion. True in all debates, true in the courtroom, true here.
Citations protect YOU.
-
Grog,
Start reading here. Then read this. And then over here.
People do not want to de-fund PPACA.
When people do oppose it, mostly they don’t like that it didn’t have a public option or a single-payer plan — or else what they oppose are things like “death panels” that aren’t part of the bill (but were part of the false propaganda put out by the Republicans). They love the things that are actually in the bill.
With the exception of the individual mandate, which was a Republican idea. That’s really the only part of the bill that Americans don’t like.
But we should really be discussing what’s good for America. I note that conservatives tend to cite polls when they don’t have an actual argument.
-
Grog,
Since you like polls, and you asked for one, you can also read about a recent CNN poll on de-funding PPACA here.
Personally, I find conversations about warring polls to be pretty boring. I’d rather discuss the merits of the bill, and the possible legal and constitutional arguments.
-
#26 written by Jean 1 year ago
-
rgbact,
Everything I’ve ever read off their website or heard from them in media.
Sounds like a situation ripe for confirmation bias.
Do I need to provide all links, or can I be allowed to make a bold uncited statement such as this and assume people can Google?
A handful of links would be useful, since I suspect from your past comments that your definition of “liberal” would include such people as Ronald Reagan.
-
#29 written by Armchair Warlord 1 year ago
Mike,
Well, how else do you explain the daily squawks of outrage from the hard left over Obama’s polices?
dc,
This is both confusing and very worrying — had Democrats maintained some semblance of party unity after Obama was elected and genuinely worked together to bring about Change in America instead of instantly descending into chaotic infighting and, later, demoralized retreat before the tea-fueled GOP, the 2010 elections would have been a different story. It’s a testament to Obama’s political genius that he’s managed to get what he has given his own party’s lack of unity.
Righties,
Nobody cares to stick up for the Republican Congress’s handling of the Brady Bill, a key culture-war wedge-issue that helped get them elected in 1994? Pro-gun owners my… well, you fill in the rest.
-
AW,
… had Democrats maintained some semblance of party unity after Obama was elected and genuinely worked together to bring about Change in America instead of instantly descending into chaotic infighting and, later, demoralized retreat before the tea-fueled GOP, the 2010 elections would have been a different story.
I disagree. Midterms are never nearly as well attended as the Presidentials. The 2010 elections turned out as they did because the right-wing noise machine spent two years generating terror and rage in the minds of the Teaper crazies.
It is true that a bit more unity might have helped the narrative — but Democrats are almost never unified. it just doesn’t happen. Unlike Republicans, we actually value hearing voices other than our own.
I don’t believe Democrats are “demoralized.” They’re just not enraged like the Republicans are (fear and hate are powerful motivators).
It’s a testament to Obama’s political genius that he’s managed to get what he has given his own party’s lack of unity.
Now, this is true. The 111th Congress was one of the most productive in a half century, despite unstinting and unthinking Republican obstructionism. And you’re right to call President Obama a “political genus.” We’ll all see that over the next year as the President begins actively campaigning.
-
#31 written by Armchair Warlord 1 year ago
dc,
I tend to see the proof as being in the pudding, so to speak.
Did Democrats do anything effective to counter the right-wing propaganda machine?
Did Democrats do anything at all to bring the Blue Dogs to heel?
Did Democrats do anything to maintain their energy from 2006 and 2008 to counter right-wing rage and hatred?
The reason conservatives are so good at seizing power in this country is because they have come to see politics as a war on the left. If liberals thought the same way, I assure you, the left would have no trouble at all achieving its goals. All of them.
It’s a mindset thing.
-
AW,
Did Democrats do anything effective to counter the right-wing propaganda machine?
Not enough, certainly.
Did Democrats do anything at all to bring the Blue Dogs to heel?
Some. We were able to get a LOT of legislation enacted.
Did Democrats do anything to maintain their energy from 2006 and 2008 to counter right-wing rage and hatred?
I think most of the problem with this is that Democrats actually want to put energy into governing, not just campaigning, which is all the Republicans are interested in. Campaigns can raise more public energy than the boring reality of governing. I think that’s a big part of the problem.
The reason conservatives are so good at seizing power in this country is because they have come to see politics as a war on the left. If liberals thought the same way, I assure you, the left would have no trouble at all achieving its goals. All of them.
You may be right, and I won’t try to prove you wrong. However, Democrats are seriously and sincerely interested in changing the tone in Washington, and creating a more civil environment. That’s why they didn’t engage in the strong-arm, scorched-earth, take-no-prisoners, win-at-any-cost methods of Republicans. We don’t actually want to engage in Republicans-style totalitarianism. Those us-vs-them attitudes are destructive to the fabric of our nation.
However, after years of this, it is to be hoped that Democratic lawmakers — and the President — have learned that Republicans will not compromise, on anything — because they have no interest in actually government. In fact, they want to cripple and dismantle government.
I don’t know what the right strategy is. I didn’t want to elect a leftist version of Cowboy George Bush, and I’m glad we didn’t get one. But I think the President has lost his patience with Republican obstructionism, after having given them all the rope they needed to prove they’re not interested in the health of the nation. I expect his way of handling the Republicans will be different for the next year, and different in the second term, than it has been so far.
-
#33 written by GROG 1 year ago
DC,
GROG,
Since you like polls…
You made the statement “A majority of the public opposes repeal of PPACA.” I merely assumed you were referring to polling data.
According to RCP, nowhere near a majority “opposes repeal of PPACA”.
When you say I like polls, I assume you’re also referring to my comment to Michael regarding the Gallup’s polling on Obama’s approval by ideology.
You seem to be forgetting that the bulk of growth in Obama’s disapproval rating has come from the left, not the center.
Again, I assumed Michael was referring to polling data. It’s not that I “like polls”. I was simply responding to your and Michael’s comments about polling. That’s why I linked to the Gallup poll showing his support remaining high among liberals and Democrats.
-
Grog,
The problem with those polls is that they don’t tell us anything useful. They don’t tell us anything that can help govern the nation.
How many people oppose PPACA because they are afraid of “death panels?” If that’s the reason they oppose it, then they don’t actually oppose PPACA, because there are no “death panels.”
How many people oppose PPACA because they are afraid it will increase the deficit, or require higher taxes? If that’s the reason they oppose it, then they don’t actually oppose PPACA, because it does neither of those things.
How many people want to repeal PPACA because they want a single payer plan? How many of those people would vote against the President?
How many people claim to oppose PPACA, but don’t want insurance companies to be able to drop them when they make a claim, or to refuse them for “pre-existing conditions,” or to put caps on annual benefits, or to raise rates without some independent review? Because if they want these things, then they do support PPACA because that’s what’s in the law.
How many people don’t like the idea of an individual mandate — but do like everything else in the law — and actually already have insurance themselves, which means the requirement for an individual to purchase insurance isn’t going to affect them anyway?
These polls tell us nothing about what people are actually thinking, about how they’re likely to vote., or about what they do or don’t like about the law.
-
#35 written by Mainer 1 year ago
And that DC is exactly what I was saying on here a short while back. We have polls but they are not telling us any thing. In fact often what they are telling us is so vague that it is worse than no information at all. I think this is hurting both sides. How can a political party respond to changing conditions constituant desires if the pol data that should indicate that is so poorly done it misleads or can be taken in a number of ways leaving the party to wonder just what the American people do want?
-
#36 written by rgbact 1 year ago
Sounds like a situation ripe for confirmation bias.
You mean like liberals thinking FOX is biased to conservatives? Is it too hard to admit that many think tanks are biased, some liberal? Why deny this? Not much unbiased information out there. I’m not discrediting Kaiser’s data, just admitting they have a bias.
How many people oppose PPACA because they are afraid it will increase the deficit, or require higher taxes?
Of course PPACA requires higher taxes. And only extreme partisans think it won’t increase the deficit.
-
rgbact suggested,
only extreme partisans think it won’t increase the deficit.
The CBO is an “extreme partisan?” Who knew?
Oh wait, what you meant to say was ‘only extreme partisans think it will increase the deficit.” There, I fixed it for you.
Of course PPACA requires higher taxes.
Really? Which of my taxes is going to be increased to pay for PPACA, and by how much?
You mean like liberals thinking FOX is biased to conservatives?
Are you honestly saying it isn’t? Really?
-
#38 written by shortchain 1 year ago
rgbact,
You just called the CBO “extreme partisans”. Only someone who can’t see their own confirmation bias could possibly believe that. Biased slightly, or even moderately, one way or the other is believable. Not “extremely”, sorry.
As for Fox being biased towards the conservative side, that’s not an example of “confirmation bias”. Thanks to some leaked messages from Roger Ailes, we now know it’s not only true, but not accidental. There have also been studies done which use metrics to demonstrate this. We may call into question whether the studies actually show much left-wing bias in the news — but Fox is to the right (and not as in the meaning “correct”) in these studies.
-
#39 written by GROG 1 year ago
DC,
The problem with those polls is that they don’t tell us anything useful.
When you said, “A majority of the public opposes repeal of PPACA.”, where you not referring to a poll? That’s my point. You referred to some poll (which I still haven’t seen) and I responded to it.
Same with Michael when he said, “You seem to be forgetting that the bulk of growth in Obama’s disapproval rating has come from the left, not the center”. There must have been some poll he was referring to (which I still haven’t seen) and I responded to it.
And you’re criticizing me for liking polls.
-
#40 written by rgbact 1 year ago
We may call into question whether the studies actually show much left-wing bias in the news — but Fox is to the right (and not as in the meaning “correct”) in these studies.
I’m not questioning FOX’s bias…just that people would need a college study to confirm it. Most bias should be easily observable, at least the extreme cases, like FOX and Kaiser.
I suspect even the “non-partisan” CBO has alot of bias. The current head is from Brooking Institute, a liberal think tank. The last one was Peter Orzag, who then went to work for Obama. I’m not discrediting all their work, but it likely has a bias.
-
#41 written by GROG 1 year ago
-
Grog,
And you’re criticizing me for liking polls.
I’m not “criticizing” you for it. I merely acknowledge it, and point out that the polls don’t show anything useful. Further, I presented polls which indicate that the public doesn’t want to de-fund PPACA, and I note you haven’t acknowledge the existence of those polls. Further, we have thus demonstrated that anyone can prove nearly anything, by chosing which polls to ignore. What use, then, is it to quote issue polls?
How many people favor PPACA because they think it will create 2 million jobs?
Me, among other reasons. But again, I note you didn’t disagree with any point that I listed, showing that people do actually support what’s in the bill, and what they oppose (other than the mandate) are things that aren’t in the bill.
rgbact
I’m not questioning FOX’s bias…just that people would need a college study to confirm it.
Actually, all one needs is a television. Oh, and a mind. It’s painfully obvious.
-
#43 written by GROG 1 year ago
DC,
Further, I presented polls which indicate that the public doesn’t want to de-fund PPACA, and I note you haven’t acknowledge the existence of those polls.
I haven’t acknowledged it because it doesn’t says anything about your claim that a majority of Americans oppose reapealing PPACA. I don’t want to de-fund PPACA either. I want to repeal it.
-
-
#45 written by GROG 1 year ago
DC,
GROG: How many people favor PPACA because they think it will create 2 million jobs?
DC: Me, among other reasons.
Then one of the reasons you favor PPACA is based on misinformation. There’s misinformation on both side, so those who favor repeal based on misinformation probably balance out those who oppose repeal based on misinformation.
-
This is the poll Michael was referring to.
We discussed it here, but it must’ve been in the comments thread, because I couldn’t find a main article citing it.
-
-
Bottom line rgbact, “we” know you’re biased, so if you give your biased opinion, you “may” want to give verifiable/certifiable citations/links to back up said opinion …
Or not!
Do I need to provide all links, or can I be allowed to make a bold uncited statement such as this and assume people can Google?
-
#49 written by shortchain 1 year ago
rgbact,
I’m not questioning FOX’s bias…just that people would need a college study to confirm it. Most bias should be easily observable, at least the extreme cases, like FOX and Kaiser.
No, the “college study” merely confirms that Fox is biased to the right. Anybody who watches a variety of news sources can tell that Fox is biased. (Anybody who watches only Fox would not only not be in a position to tell, but would be blithely unaware that they’re being fed a steady diet of “processed news” — AKA “propaganda”.)
I have no doubt you can detect “bias” from the right-wing viewpoint. All that requires is that you identify anything you disagree with. Problem solved.
I suspect even the “non-partisan” CBO has alot of bias. The current head is from Brooking Institute, a liberal think tank. The last one was Peter Orzag, who then went to work for Obama. I’m not discrediting all their work, but it likely has a bias
You can “suspect” whatever you like, whether you have any evidence or not. If, as in the earlier case, your criterion is whether you disagree with them, this proves nothing. Reality doesn’t care what you think about it.
-
rgbact,
You mean like liberals thinking FOX is biased to conservatives?
This one’s been studied by independent organizations, and clearly confirmed.
Is it too hard to admit that many think tanks are biased, some liberal?
Not at all. But Kaiser isn’t among them. You should probably look into the history of that organization before you make such claims.
Of course PPACA requires higher taxes. And only extreme partisans think it won’t increase the deficit.
There are too many competing factors and unknowns for anyone to know how it will play out. And only extreme partisans think they know what the outcome will be.
-
#51 written by GROG 1 year ago
DC,
And what are your reasons for wanting to repeal PPACA?
I don’t think the government should dictate that I have to buy health insurance and fine me if I don’t.
I don’t think the government should require any business with 51 or more employees to supply those employees with health insurance or pay a fine.
I don’t think the government should tell health insurance companies that they must sell “insurance” to sick people. It’s not even honest to call it “insurance” at that point.
I don’t think we should create dozens of new government agencies which will employ thousands of new government bureacrats to oversee the multi thousand page of PPACA.
I don’t think the government should mandate how much profit a private health insurance company can make.
The law does little to address the rapidly increasing rise in health care costs.
I don’t like the HIT (health insurance tax) which will be a devastating blow to small businesses and the self employed.
In my opinion, the private health insurance companies will realize that with all the burdensome new government regulations and restrictions on their business practices, that it won’t be profitable to stay in the health insurance business anymore. Small businesses will just stop offering coverage and pay the fines. At that point it will all be left to the government, which after all, is the ultimate goal anyway. Right?
-
Grog,
Thanks for responding. The first several objections amounted to a theory of the proper extent of government regulation. I can understand this basic difference of viewpoint on what government is for. We probably can’t come to agreement there.
But I hasten to add that the insurance industry has proven itself incapable of serving the public’s interest (or perhaps merely unwilling to do so), or even the interest of its customers. The health care system is broken, and the insurance industry is a big part of the reason why. So we need an alternative. If you can come up with some other way to fix the enormous problems in the healthcare system, that does not involve public regulation, please suggest it.
I agree that PPACA does little to address health care costs, so much as it addresses the abuse that is endemic within the health insurance industry. I see no reason to object to addressing the latter problem, and then coming back around and using this new structure to address the former. PPACA is far from a final and perfect solution, but rather than allow the perfect to be be the enemy of the good, it seems reasonable to take this first giant stop in the right direction.
The tax / fee you mention is unlikely to be as burdensome as you fear. For one thing, the availability of health care will improve the health of workers, and that alone will save money for small businesses (less absenteeism, better customer service, a host of other ways, too). And the fee isn’t that large anyway.
I do agree that it would be better to have a public system, and to scrap the employee-benefit system. A public system means you carry your insurance from one employer to another, even from one state to another, even when you’re not employed at all. This would make American businesses more competitive, because foreign companies don’t have to pay for employee healthcare (it’s usually handled through some form of public program or public-private insurance partnership). But it is, again, certainly an incremental step in the right direction, and it leverages the system we already have.
Finally, our objection to the individual mandate — that was proposed in an effort to get Republican votes, since it was a Republican idea. I’d prefer a universal single-payer public system myself. Either way, it’s necessary to get more people paying in, if we are to cover more people. It seems odd to me — you object to that “47% who don’t pay Federal income taxes,” yet here is a system, that’s going to require everyone to pay in, and you still object. Seems inconsistent to me.
If what you object to is the requirement to buy private insurance, would you be happier if the requirement was to pay into a public system? Why or why not?
Thanks again, Grog. I enjoy the conversation.
-
#53 written by Jean 1 year ago
Here’s the facts that rgbact intentionally omitted.
Drew Altman, president and CEO of Kaiser, said that the ObamaCare law probably accounted for 1 to 2 percentage points of the 9 percent increase. He further explained, “In a world where some blame almost everything on what they call ObamaCare — I certainly blame the collapse of my Red Sox on Obamacare — one thing we can say about the premium increase this year is that it is not because of the Affordable Care Act,” Altman told reporters in a conference call on TuesdayHowever, he continued, “Our analysis is that the Affordable Care Act [ObamaCare] could have been responsible for about one-and-a-half percentage points – we say 1 to 2 percentage points – of the increase that we’re documenting this year,” he said. “And that reflects the costs of providing prevention benefits without cost-sharing,” he said. “It reflects the costs of covering young adults up to 26 years of age under their parents’ policies. Those are also very popular benefits, according to our tracking polls.”
When later asked on the conference call to clarify about how ObamaCare could have been responsible for “1 to 2 percentage points – of the increase” in premiums, Kaiser Foundation Vice President Gary Claxton said: “Yes, that would be 1 to 2 percentage points of the 9 percentage points – 1⁄9 to 2/9, yes.”
The Kaiser Employer Health Benefits 2011 Annual Survey rgbact mentioned but would not link is located here:
http://ehbs.kff.org/
And the Methodology for Estimating the Effect of the Affordable Care Act on the Average Premium for a Family of Four in 2011 is available at http://www.kff.org/pullingittogether/upload/Methodology-for-Estimating-the-Effect-of-the-Affordable-Care-Act-on-the-Average-Premium-for-a-Family-of-Four-in-2011.pdf
The CEO of Kaiser also had other interesting insights: The “Supercommittee” created by the recent debt reduction legislation will be looking for more ways to save money in government health programs, but the focus in Washington is almost entirely on cutting government spending, not curbing rising health costs overall. Employers will be left to their own devices to try to keep health care costs down. They have never been very successful at this, nor have private health insurance companies. While the conventional wisdom is that private insurance does a better job of controlling costs, the opposite is true. The Centers for Medicare and Medicaid Services (CMS) says that Medicare spending per enrollee grew at a much lower rate than private insurance between 1999 and 2009 (4.9% vs. 7.2% for comparable benefits). Some say Medicare outperforms private insurance by using its purchasing power to drive a harder bargain, others, mainly providers, say it simply underpays.
In the short term, employers have few new tools to control premium increases. Employees will continue to see more high-deductible health plans, with and without tax-preferred savings accounts, and deductibles will get even larger. These plans have lower premiums because the big upfront deductible that people must pay before their insurance kicks in causes them to use fewer health services. The trend here is very clear, especially in firms with fewer than 200 employees where the percentage of workers in a plan with a deductible of $1,000 or more for single coverage has grown from 16% in 2006 to 50% today. Conservatives rail about Obamacare, but they may be winning more than they are losing; it is their vision of insurance with more “skin in the game” that is gradually taking over the marketplace because employers have no other way to control costs.
Health care groups are maneuvering with defense lobbyists and health provider groups are jockeying with beneficiary advocates about who will take the brunt of the hit from the Supercommittee. But one thing that should be clear is that reducing federal health spending is not the same thing as controlling health care costs; just ask the 150 million Americans and their employers who will be paying $15,000 when they buy a family policy this year.Premiums for employer-provided health insurance, where 150 million Americans get their coverage, jumped 9% in 2011 while workers’ wages grew just 2%, according to our annual employer survey. The average family policy now costs more than $15,000 per year, more than the cost of a Chevy Aveo or a Ford Fiesta. Since we began doing this survey thirteen years ago, worker contributions to premiums have increased 168%, wages 50%, and inflation 38%.
-
GROG,
I don’t think the government should dictate that I have to buy health insurance and fine me if I don’t.
Do you think the government should tax you to cover the health expenses of those who don’t buy health insurance, then?
I don’t think the government should require any business with 51 or more employees to supply those employees with health insurance or pay a fine.
Me either. I don’t think businesses should be providing health insurance at all. It’s an antiquated affectation left over from the Great Depression.
I don’t think the government should tell health insurance companies that they must sell “insurance” to sick people. It’s not even honest to call it “insurance” at that point.
It has never really been insurance in the first place. We covered this last November, if I remember right.
I don’t think we should create dozens of new government agencies which will employ thousands of new government bureacrats to oversee the multi thousand page of PPACA.
OK, I get that you oppose government employees on principle. This would hardly constitute a divergence from your previously-stated principles.
I don’t think the government should mandate how much profit a private health insurance company can make.
They’re not. At least not de jure. Health insurance companies can make as much profit as they wish, de jure. You’re merely presuming the ultimate de facto result. I’m not yet convinced that your expectations would come to pass.
The law does little to address the rapidly increasing rise in health care costs.
This is true. What would you propose to do about the rapid rise?
I don’t like the HIT (health insurance tax) which will be a devastating blow to small businesses and the self employed.
In what way would it be a devastating blow?
In my opinion, the private health insurance companies will realize that with all the burdensome new government regulations and restrictions on their business practices, that it won’t be profitable to stay in the health insurance business anymore.
I realize that this is your opinion. But on what do you base this? Many insurance companies were already in compliance with the new law.
Small businesses will just stop offering coverage and pay the fines.
Very likely. The fines are much smaller than the cost of health insurance premiums, so that would be the less expensive option.
-
#56 written by rgbact 1 year ago
Here’s the facts that rgbact intentionally omitted.
Nah, I said I was too lazy to do it, so thanks for posting. But 1 to 2 % was what the article I saw quoted, so you got the correct reference.
Btw, the last paragraph points to a big reason that wages have stagnated over the last few years, I think. Hard to see big raises with those numbers,especially for low wage folks.
-
-
#58 written by rgbact 1 year ago
So…what would you do to reduce healthcare costs?
Many things. The Kaiser piece points to one of the legacies of the Bush years, which is the emergence of high deductible plans. That is a promising solution that alot of private firms are going with. So, as Kaiser implies, we’ll see a battle over which ideas save cost best. Is it private firms and high deductible plans, or Medicare with its provider squeezing or union/government plans with their do nothing approach.
-
How do high-deductible insurance plans reduce health care costs?
I know, the *magic* of the “free market,” right? Force consumers to buy their own medical care (instead of having the insurance companies pay for it), and fairy dust will make the medical suppliers charge less because consumers will suddenly become more discerning about who they go to.
Nonsense.
People will forgo necessary treatment and preventive care (which is actually pretty cheap) and instead wait until they require incredibly expensive emergency services — which they’ll buy on the spot because they have to, and not be too picky about which ambulance takes them to which hospital. And the hospitals will charge whatever they want to, because the consumer is already there with IV’s in his arm. Sort of a captive audience.
And the people who decide not to buy those high-deductible plans, let alone actually pay those high deductibles, will be in the emergency room with no insurance. the rest of us pay for their emergency care.
All you’ve done is to raise the cost to the consumer, and increase the profits of the insurance companies, without restricting what the suppliers charge. High deductible policies are a way of shifting more of the cost and the burden onto the consumer, allowing the insurance companies to pocket a larger percentage of the insurance premiums, and without doing anything whatever to control costs.
High-deductible plans are shams and scams.
-
DC,
High-deductible plans are shams and scams.
Not necessarily. They can work well for people who are especially well informed with respect to the long-term value proposition, and are thus able to make the correct determination of beneficial preventative medicine versus wasteful minor medical treatments. I can’t imagine that there are very many people who fall into this category, though in the Lake Wobegon sense I’m sure that there are plenty who erroneously believe that they do.
-
rgbact,
The Kaiser piece points to one of the legacies of the Bush years, which is the emergence of high deductible plans. That is a promising solution that alot of private firms are going with.
While I agree that high deductible plans reduce premium costs (how could they not), what do they do to reduce health care costs?
-
#62 written by shortchain 1 year ago
Mr. High deductible plan holder here. However, I got a plan which covered preventive and diagnostic services (the first several hundred worth). It was cheaper than the other plan. But then I have insurance with the best organization, and it costs more.
But, unlike every other company I’ve dealt with, these guys pay up without complaint or re-submission — and they’ve negotiated the lowest costs (excepting Medicare) with all the providers. That means, even though I pay up front for anything, I get the best deal possible.
Any insurance can reduce costs if it is offered through as large a company as possible with as aggressive a negotiating stance as possible. (You don’t get that, oddly, when you are dealing with an HMO, where the payer is the same as the organization offering the services…)
Which is one reason letting out-of-state companies do business in your state may raise your costs — they likely won’t be as aggressive in negotiating, nor pay as readily, which will encourage providers to insist on more money for the same services.
-
#63 written by Mainer 1 year ago
You know shorts I agree with the out of state company thing to a point and that is where it might involve an out of state commercial entity. I have an out of state provider and it works very well and apparently does pretty well with negotiating better costs. TriCare works, it is that simple. While providers might not be in love with the payment amounts I have never had a problem with it being accepted. Guess there is some value to knowing one is going to be paid now as opposed to maybe some day. As long as the biller plays by the rules and submits stuff correctly the turn around is apparently really good. BC/BS used to be pretty good but what I have heard of late doesn’t seem to inspire much confidence.
-
#64 written by shortchain 1 year ago
Mainer,
It’s pretty clear that the answer “depends”. My provider is BC/BS of Minnesota. They love to see me coming at my family practice clinic, because they know they’ll get paid promptly or be able to bill me — and get paid promptly.
My significant other has spent the last several years being shuttled from one plan to another, with varying degrees of comfort and coverage.
-
You must be logged in to post a comment. - Comment Feed for this Post
- Happier, Not Healthier
- Congress, not Progress
- Lara Croft, Cancer Raider
- Supreme Court Watch: FOIA Edition
- Supreme Court Watch: University of Texas Southwestern Medical Center v. Nassar
- Cruzin’ for a Bruzin’
- Supreme Court Watch: Association for Molecular Pathology v. Myriad Genetics, Inc.
- The Hatter Resolution
- Supreme Court Watch: McQuiggin v. Perkins
- Supreme Court Watch: Butt v. Utah
About Michael Weiss (326 posts)
Michael is a jack of many trades, and master of a few. His varied background includes government and private businesses, both large and small. His experience in the financial services and computer industries has led him to computer security.





I can just see Scalia and Thomas sending their clerks scurrying for the depths in order to find legal justification against the APPA.