Posts tagged Patient Protection And Affordable Care Act

The Coercive Writing on the Wall

8
10 months ago
by Monotreme in

Greg Louga­nis has nothin’ on John Roberts.

Last month’s Supreme Court rul­ing on the con­sti­tu­tion­al­ity of the Patient Pro­tec­tion and Afford­able Care Act (PPACA, Oba­macare) pro­duced two large surprises.

One was the needle-​​threading by Chief Jus­tice John Roberts, as he did a reverse 2 ½ som­er­saults with 2 ½ twists in pike (degree of dif­fi­culty 3.8) in order to jus­tify the con­sti­tu­tion­al­ity of the so-​​called indi­vid­ual man­date (now called the “indi­vid­ual tax except when it’s imposed at the state level” by Republicans).

The sec­ond was the rul­ing that Con­gress could not force states to expand Med­ic­aid by with­draw­ing exist­ing Med­ic­aid fund­ing, but could only threaten to with­draw the pro­jected increase in fund­ing that would come with an expan­sion of the pro­gram. That makes it much more likely that states will opt out of Med­ic­aid expansion.

Why would states opt out, and what would be the result if they do? (more…)

A Radical Proposal

22
10 months ago
by dcpetterson in

Employ­ment hasn’t been recov­er­ing at a high enough rate sat­isfy any­one. Return to full employ­ment will likely take more than a few years. Many have been com­plain­ing about this, so here are a few rad­i­cal ideas to cre­ate jobs. I don’t think there’s any ques­tion they’d work for that pur­pose. But I can antic­i­pate a lot of opposition.

  1. Require that busi­nesses shorten their aver­age work week by a min­i­mum of five hours, set­ting the Amer­i­can “stan­dard” work week to 35 hours. Pro­vide tax incen­tives for going beyond that, by as much as an addi­tional five hours, low­er­ing the work week to 30 hours.
  2. Remove the age require­ment for Medicare, to allow all Amer­i­cans to get on a single-​​payer health care sys­tem, and allow employ­ers to drop all insur­ance coverage.
  3. Lower the retire­ment age for Social Secu­rity to 60. Encour­age Amer­i­cans to retire earlier.

It may not be obvi­ous how these mea­sures could cre­ate jobs. They could lead to full employ­ment, vir­tu­ally overnight, give a jolt to the econ­omy such as Amer­ica has never seen, make us all health­ier, and give us a lot more free time. Let me explain. (more…)

Healthcare Cost Curveball

14
10 months ago
by Michael Weiss in

We have our answer regard­ing the Patient Pro­tec­tion and Afford­able Care Act (PPACA, or Oba­macare). The indi­vid­ual man­date stands. But, as I have often pointed out, Oba­macare doesn’t appear to have done much regard­ing “Afford­able”. And yet, afford­abil­ity is one of the key desires of Amer­i­cans, and with good rea­son. We spend twice as much per-​​capita on health­care as the next most spendy nation, yet we are not get­ting results that are twice as good. Clearly, we are get­ting less bang for the buck than are other countries.

But does that mean that the only path to afford­abil­ity is single-​​payer? Or, if there are many paths, is that the best one? Some of my own recent expe­ri­ences sug­gest that a move to single-​​payer may not lead to afford­abil­ity at all, but Oba­macare (plus a pre­ceed­ing bill) may get us there — albeit not overnight — even if no new leg­is­la­tion is passed. (more…)

The Fourth Branch

29
10 months ago
by Monotreme in

Patient Pro­tec­tion or Law Protection?

The Patient Pro­tec­tion and Afford­able Care Act (PPACA, “Oba­macare”) has been sub­ject to a great deal of polling.

A poll of the Sen­ate on Decem­ber 24, 2009 resulted in a 60–39 mar­gin in favor.

A poll of the House of Rep­re­sen­ta­tives on March 21, 2010 favored the mea­sure by a much nar­rower mar­gin, 219–212.

The Exec­u­tive Branch was unan­i­mous in its praise for PPACA.

The most recent polling is from the Supreme Court, which voted 5–4 sup­port­ing the con­sti­tu­tion­al­ity, if not nec­es­sar­ily the con­cept, of PPACA.

Now that all three branches of gov­ern­ment have had a crack at it, where do the peo­ple stand? (more…)

Threading the Needle

500
10 months ago
by Michael Weiss in ,

Ever since the Supreme Court heard oral argu­ments on the con­sti­tu­tion­al­ity of the Patient Pro­tec­tion and Afford­able Care Act (PPACA, “Oba­macare”) indi­vid­ual man­date, pun­dits have been pre­dict­ing that the man­date is dead. The remain­ing ques­tion would then be: will the Supreme Court find the law sev­er­able, that is, can the man­date be ruled uncon­sti­tu­tional but the rest of the law stands? Or does the whole thing go down because of an unac­cept­able mandate?

The Supreme Court finally answered today. By a five-​​to-​​four vote (Jus­tices Breyer, Gins­burg, Kagan, and Sotomayor dis­sent­ing), the indi­vid­ual man­date was tech­ni­cally struck down as a vio­la­tion of the Com­merce Clause, but by a dif­fer­ent five-​​to-​​four vote (Jus­tices Alito, Kennedy, Scalia, and Thomas dis­sent­ing) the fine for being unin­sured was not. In that regard, the Court threaded the nee­dle, object­ing to the “ille­gal­ity” of being unin­sured, while leav­ing the rel­e­vant penalty in the Act unchanged.

This deci­sion is cer­tainly a huge win for the Obama admin­is­tra­tion at first blush. But it may prove to be less of a win for Obama himself.

(more…)

The “Unprecedented” Individual Mandate

18
1 year ago
by Michael Weiss in

Sen­a­tor Orrin Hatch (R-​​UT) called the indi­vid­ual man­date “unprecedented”.

The Supreme Court is cur­rently delib­er­at­ing on the con­sti­tu­tion­al­ity of the Patient Pro­tec­tion and Afford­able Care Act’s “indi­vid­ual man­date”, which requires all Amer­i­cans to pur­chase med­ical insurance.

It has been pointed out by oppo­nents that the indi­vid­ual man­date is an unprece­dented require­ment to engage in com­merce. The Con­gres­sional Research Ser­vice, for exam­ple, observed that “it is a novel issue whether Con­gress may use the clause to require an indi­vid­ual to pur­chase a good or a service.”

The Cato Insti­tute came to a sim­i­lar con­clu­sion, that “[f]inding the man­date con­sti­tu­tional would be the first inter­pre­ta­tion of the Com­merce Clause to per­mit the reg­u­la­tion of inac­tiv­ity — in effect requir­ing an indi­vid­ual to engage in an eco­nomic transaction.”

Yet it seems that, from an exam­i­na­tion of his­tory, they are incor­rect. (more…)

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