Friday, June 26, 2015

SCOTUS and the Affordable Care Act

As Yogi Berra said, "It ain't over until it's all over"

Any baseball fan can quote this fundamental Yogi Berra-ism. Berra was a famous catcher for the New York Yankees in the 1950s and 60s. I was a diehard Yankee fan during an era when they won  7 straight world  series, a feat yet to be duplicated in the 'modern era'.

it will be along time before ObamaCare and it's influence can be duplicated, nor produce a more disruptive, controversial law.

SCOTUS'  decision is far from ending the dispute about the Affordable Care Act.  Out of desperation the  GOP has focused it's effort to negate the entire law.  This is a fundamental flaw in the game to unravel the law.

Today there are many opinions from health reform pundits and politicians about what the SCOTUS ruling means.

Avik Roy
Forbes, 6/26/15

 “In a statement after the decision, President Obama declared that his signature health law is “here to stay.” But in his remarks, the President knowingly ignored the key concept in the case: that if the challengers had won, not one word of the law called the “Affordable Care Act” would have been changed. On the other hand, if voters elect a Republican President and a Republican Congress in 2016, quite a bit will change.”

Most Americans aren’t signing up for Obamacare
For the people that Obamacare claims to help—those who shop for coverage on their own—an analysis by the Manhattan Institute found that the law increased individual-market premiums by 49 percent in the average county, in its first year alone. Since, then many states are facing additional double-digit rate hikes.

It shows that as a percentage of those eligible for Obamacare’s subsidies, only those near poverty—with incomes between 100 and 150 percent of the Federal Poverty Level—are signing up in large proportion. That’s because for them, taxpayers are subsidizing nearly all of the cost of their coverage. As you go up the income scale, Obamacare’s subsidies aren’t large enough to make up for the law’s steep premium hikes. This is exactly what I and my Manhattan Institute colleagues were concerned about when we first started writing about Obamacare’s “rate shock” problem.

Indeed, the vast bulk of Obamacare’s increase in health insurance “coverage” comes from its expansion of Medicaid. Medicaid is so dysfunctional that it has been shown to have “no significant effect” on health outcomes, relative to having no insurance at all.

Insurers will continue to announce premium hikes, and states will continue to struggle to fund roads and schools, as Medicaid eats up more and more of their budgets. Obamacare will remain unpopular.
And if voters elect a Republican President in 16 months, it will be elected officials—not the Supreme Court—who will be rewriting the law.

Bill Would Force Supreme Court to Enroll in Obamacare

A House Republican on Thursday proposed forcing the Supreme Court justices and their staff to enroll in ObamaCare. ....

(John Lynn) from EMR & HIPAA

In case you’re living under a hole (in the healthcare world we call that in the middle of an EHR implementation), the Supreme Court ruled on King v Burwell today. You can read the 47 page document here if you’re interested in the details of the decision. If you’ve ever read a Scalia decision or dissent, then you’ll know what to expect in his dissenting comments.

The Anti-Constitutional Consequences of King v. Burwell

Roberts gets it wrong -- Again from National Review Online

The Affordable Care Act was drafted with extraordinary carelessness given its importance, and conservatives who say that the Obama administration has implemented it contrary to its plain meaning have strong arguments. So opined six justices of the Supreme Court, including its most liberal members, in King v. Burwell. 

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