GOP Regularly Ignores Real Life Stories
(Public's Need Not a Major Concern)
GOP Alternative Plans Have this Same Coverage
Major Update on ACA
(Obama-care). The latest court ruling (from
CNBC):
KEY POINTS:
·
A
federal appeals court rules that the Affordable Care Act’s
individual mandate provision is unconstitutional but punts on deciding whether
the rest of the landmark health-care law should be tossed out.
·
The
court is ordering a lower court judge to reconsider whether
ACA, more commonly known as Obamacare, should remain intact.
Obamacare ruling lifts
health care sector: A federal appeals court ruled Wednesday that
the Affordable Care Act’s individual mandate provision is unconstitutional but
punted on deciding whether the rest of the landmark health-care law should be
tossed out.
The court (the 5th
U.S. Circuit Court of Appeals) in a 2 to 1 decision, is also ordering a lower
court judge to reconsider whether ACA, more commonly known as Obamacare, should
remain intact the majority said in part:
“The individual mandate is unconstitutional because it can no longer be
read as a tax, and there is no other constitutional provision that justifies
this exercise of congressional power. On the severability question, we remand
to the district court to provide additional analysis of the provisions of the
ACA as they currently exist. It may still be that none of the ACA is severable
from the individual mandate, even after this inquiry is concluded. It may be
that all of the ACA is severable from the individual mandate. It may also be
that some of the ACA is severable from the individual mandate, and some is not.”
Health policy analysts
expect the issue to go all the way to the Supreme Court, which upheld Obamacare
narrowly in 2012.
This appeals
court decision (passed back to a lower court) decreases the chances of a
Supreme Court decision before the 2020 elections.
Texas and other
Republican-led states brought the suit, which was defended by Democratic-led
states and the House of Representatives. The New Orleans-based court heard arguments in July. The suit alleged that the Affordable Care
Act’s individual mandate was unlawful under the federal government’s taxing
powers after Congress reduced the penalty for not having insurance to $0 in
2017. Texas argued that therefore the ACA must be scrapped.
Democrats said the
lawsuit was just the latest Republican legal assault on Americans’ health care.
Ending Obamacare has been a long-held goal of President Donald Trump and fellow
Republicans. Trump unsuccessfully rallied enough Republicans to repeal and
replace the health law in 2017.
CA Attorney General
Xavier Becerra said in a statement: “California will move swiftly to challenge
this decision because this could mean the difference between life and death for
so many Americans and their families.”
Democratic lawmakers
on Wednesday also blasted Trump and Republicans over the ruling.
Ways and Means
Committee Chairman Richard Neal said in a statement: “Today’s ruling is the result of the Trump Administration and
congressional Republicans attempting to make dangerous health policy using the
courts since they failed to succeed in Congress. This is a blow to our nation’s
health care system and the millions of Americans who have gained coverage and
protections under the Affordable Care Act. Democrats will continue to fight to
protect Americans’ access to quality, affordable care.”
Background up to this point:
·
March 2015: HHS reported a total of 16.4 million covered
due to the ACA between the Marketplace, Medicaid expansion, young adults
staying on their parents plan, and other coverage provisions. HHS has since updated that to 17.6 million (Sep
2015 data).
·
Before ACA in 2009: The Census Bureau reported
about 48.6 million Americans or some 15.7% of the population
was uninsured. A 2015 study by the CDC using Census data
showed the total uninsured rate at 9.2% and the uninsured rate for
the 18–64 year old group was 13%. That means that the uninsured rate has fallen
from 15.7% to 9.2% under Obama Care (Note:
the lowest uninsured rate in 50 years).
·
In May 2015: The RAND corporation study estimated
that 22.8 million Americans had coverage and 5.9 million lost plans for a
net total of 16.9 million newly insured. That translates into: (1) 9.6
million enrolled in employer-sponsored health plans, (2) 6.5 million in Medicaid,
(3) 4.1million in the individual marketplaces, (4) 1.2 million in non-marketplace
individual plans, and 1.5 million in other sources.
The
4.1 million and 7.1 million total is newly enrolled in the Marketplace or transitioned
to Marketplace coverage for the total of 11.2 million.
·
HHS estimates that 5.7 million
young adults (aged 19-25) stayed on a parent’s plan until age
26. That is 2.3 million who stayed on their parents plan from 2010 to
2013 with an estimated 3.4 million gaining coverage from 2013
to 2015.
·
10.8 million
more enrolled in Medicaid or CHIP since Oct 2013 (estimated at 11.7 million as of May 2015).
The uninsured rates dropped lower in
states that expanded
Medicaid.
·
The drop in uninsured is impressive versus a
2013 high of about 18%, but less impressive versus a pre-ACA low of about
14.5%. Consider that 1% equals about 3.2 million people (currently the US
population is about 320 million). Before the ACA up
to 47 million were
uninsured.
·
In 2014, 2.6 million young adults stayed on
their parents’ plan.
·
In 2015, more than 3 million did.
·
In 2014, about 8 million enrolled in Medicaid.
In 2015, about 11 million did.
·
Millions more, who would otherwise not be
insured, enrolled due to expanded coverage under the ACA and new requirements.
This includes those enrolled under expanded employer coverage, and those who
got covered outside of the Marketplace.
·
Consider that 4.5 million of 2015 enrollment
were auto-enrollments.
·
Consider that the HHS goal of 9.1 million for
2015 was meant to be a modest goal that accounted for fluctuations due to
special enrollment and people not paying their first month premium. On the
other hand, CBO projections of 13 million (revised
to 12 million in January 2015,
revised to 11 million in March 2015)
look at average totals for the whole year (including special enrollment and
plan drops), not just enrollments by the end of open enrollment.
·
COST: Less than $5,000 per enrollee (for enrollees
not getting subsidies but who use the Marketplace).
Many
of those who argue against socialized medicine in the United States fail to
note that large segments of health care have already been allocated to the
federal government through Medicare and
Medicaid, the military system for active duty and others (TRICARE), and the VA that serves over
30 million Veterans.
The
argument against those methods is weak. How weak you might ask? As Lincoln quipped in a Senate debate about
his opponent’s point: “As weak as soup
made by boiling the shadow of a pigeon that has starved to death.” That is
pretty darn weak. Those programs are effective and work just fine for millions.
Don’t believe me, then ask those who have that coverage. I am sure they will
answer with a resounding yes!!!
• Private health insurance plans. We’ll tell you whether you
qualify for lower costs based on your
household size and income. Plans cover essential health benefits, pre-existing conditions, and preventive care. If you don’t qualify
for lower costs, you can still use the Marketplace to buy insurance at the
standard price.
• Medicaid and the Children’s Health
Insurance Program (CHIP). These programs provide coverage
to millions of families with limited income. If it looks like you qualify,
we’ll share information with your state agency and they’ll contact you. Many
but not all states are expanding Medicaid in
2014 to cover more people.
No matter what state you
live in, you can use the Marketplace. Some states operate their own
Marketplace. In some states, the Marketplace is run by the Federal government. Find the Health Insurance
Marketplace in your state.
Most people must have
health coverage in 2014 or pay a fee. If you don’t have coverage in
2014, you’ll have to pay a penalty of $95 per adult, $47.50 per child, or 1% of
your income (whichever is higher). The fee increases every year. Some people
may qualify for an exemption to this fee. If you enroll by
March 31, 2014, you won’t have to pay the fee for any month before your
coverage began.
You’re considered covered if you have Medicare, Medicaid, CHIP, any job-based plan, any plan you bought yourself, COBRA, retiree coverage, TRICARE, VA health coverage, or some other kinds of
health coverage.
If you’re eligible for
job-based insurance, you can consider switching to a Marketplace plan. But you won’t qualify
for lower costs based on your income unless the job-based insurance is
unaffordable or doesn’t meet minimum requirements. You also may lose any
contribution your employer makes to your premiums.
If you have Medicare,
you’re considered covered and don’t have to make any changes. You can’t use the
Marketplace to buy a supplemental or dental plan. That coverage began January
1, 2014.
A Real Story: This is a key provision that the ACA is fixing that
individual and some group policies do not cover ... it’s the story of a
59 years old woman from Colorado who says on PBS the News Hour –
in her own words:
“I was diagnosed with cancer in 2008. I
would have died probably in February 2008 without treatment for it, which my
husband’s family policy covered from is job as the county attorney in Morgan County.
His job was eliminated. Since then, he has been doing contract work, which has
kept income coming in, but, for health insurance, all we have had is through
COBRA. That expires at the end of February.
If he doesn't have another job by the end of February, we would have to
apply for private insurance. But, right now we would get turned down because of
my preexisting condition. Even if they were going to cover me
because of the preexisting condition, it would be hugely expensive. The
affordable health care act (Obama-care) means now that I have a chance. I don't
have to stop treatment once the current insurance runs out.”
My 2 cents: For those opposed to the ACA (Obama-care) and to Mr. Obama
personally more than anything else, must ask this question: Imagine in the
above story were about your wife, your mother, your sister, your daughter, or
some other close relative in the exact same situation.
Kinda brings the issue into perspective up close and personal doesn’t
it?
The USSC must rule to keep this alive – will they? Time will tell. Stay
tuned.
Thanks for stopping by.
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