Posts tagged Patient Protection And Affordable Care Act

Threading the Needle

500
11 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…)

Unpacking the Court

2
1 year ago
by Monotreme in

Stop right there. I wanna know right now, before we go any fur­ther. Do you love me? Will you love me forever?

The coun­try is in cri­sis. Faced by the worst eco­nomic dis­as­ter in two gen­er­a­tions, a new Pres­i­dent with a clear man­date for change rams through a set of con­tro­ver­sial eco­nomic reforms.

Many Amer­i­cans oppose the changes. Fear­ful of change, call­ing the Pres­i­dent a Social­ist or Com­mu­nist or worse, they sue. The first of the eco­nomic reform bills make their way to a Supreme Court that is much more con­ser­v­a­tive than the Pres­i­dent. Just months after a tri­umphant inau­gu­ra­tion, still in his first term, the President’s plans are in dis­ar­ray, thanks to a series of adverse Supreme Court rulings.

The Pres­i­dent lashes out, tak­ing what mea­sures he feels are nec­es­sary to save his key­stone eco­nomic pro­grams. He openly crit­i­cizes the Court, and the imme­di­ate push­back ignites a polit­i­cal firestorm. A polit­i­cal observer, Jeff Shesol, notes: “He didn’t think there was any­thing in the Con­sti­tu­tion that pre­vented him from doing what he needed to do. The prob­lem as he saw it was not the Con­sti­tu­tion; it was the con­ser­v­a­tives on that par­tic­u­lar Supreme Court.”

As George San­tayana, much beloved of con­ser­v­a­tives, famously said, “Those who can­not remem­ber the past are con­demned to repeat it.” The above events are not cur­rent — and yet they are. (more…)

Supreme Court Watch: PPACA on Trial

33
1 year ago
by Michael Weiss in
President Barack Obama's signature on the heal...

Pres­i­dent Barack Obama’s sig­na­ture on the health insur­ance reform bill at the White House, March 23, 2010.

Today marks the first two hours of six hours of Supreme Court tes­ti­mony, over three days, on U.S. Depart­ment of Health and Human Ser­vices v. Florida, which serves to adju­di­cate the con­sti­tu­tion­al­ity of the Patient Pro­tec­tion and Afford­able Care Act (PPACA, ACA, or Oba­macare). It’s now three days since the sec­ond anniver­sary of Pres­i­dent Obama sign­ing the ACA into law.

Today and tomor­row, the argu­ments are focused on the ques­tion of the con­sti­tu­tion­al­ity of the indi­vid­ual man­date. Wednes­day, argu­ments shift to answer two ques­tions. First, does Con­gress have the author­ity to require states to com­ply with the new Medicare pro­vi­sions in order to receive fed­eral fund­ing for their Med­ic­aid pro­grams? Sec­ond, if the indi­vid­ual man­date is uncon­sti­tu­tional, does that inval­i­date the ACA in its entirety, or is that pro­vi­sion sev­er­able? (more…)

Of Medical Loss Ratios and Men

30
1 year ago
by Monotreme in

Agit­prop caduceus.

My Face­book feed has been filled with gloat­ing about a Rick Ungar col­umn in Forbes: The Bomb Buried in Oba­macare Explodes Today [12/​2] — Hallelujah!

In his col­umn, Ungar argues that new med­ical loss ratios estab­lished in the Patient Pro­tec­tion and Afford­able Care Act (PPACA, “Oba­macare”) will force pri­vate insur­ance com­pa­nies out of busi­ness, leav­ing the mar­ket open for a single-​​payer plan that Ungar and oth­ers have wanted all along (there­fore, his “hallelujah!”).

What is the med­ical loss ratio, is it really that crit­i­cal, and what are the chances it will put insur­ance com­pa­nies out of business?

The numer­a­tor of the MLR equals the insurer’s incurred claims and expen­di­tures for activ­i­ties that improve health care qual­ity, and the denom­i­na­tor equals the insurer’s pre­mium rev­enue minus fed­eral and state taxes and licens­ing and reg­u­la­tory fees. — Proskauer

That is, if an insur­ance com­pany takes in 100 dol­lars in pre­mi­ums, and spends 85 dol­lars of that money on health care, then it has a med­ical loss ratio of 85 per­cent. The PPACA sets the med­ical loss ratio at a min­i­mum of 80 per­cent for small car­ri­ers and 85 per­cent for large car­ri­ers. If the med­ical loss ratio is below that thresh­old, then the insur­ance com­pany is required to issue a rebate check to con­sumers to bring the ratio to the thresh­old. (more…)

Right Will Talking

17
1 year ago
by dcpetterson in

George Will

I recently wrote about some of the dis­hon­est and manip­u­la­tive tech­niques used by colum­nist and radio talk show host James Lewis. Today’s it’s George Will’s turn. He syn­di­cated a col­umn yes­ter­day about the upcom­ing SCOTUS case related to the Patient Pro­tec­tion and Afford­able Care Act (PPACA). It’s an instruc­tive les­son on how to write a polit­i­cal col­umn that sounds ratio­nal, but is based on noth­ing. (more…)

Go to Top