Healthcare Content (Protest Instructions) >>>>>

[VDB]

And the bigger irony is that the individual mandate was proposed by Republicans and even implemented by one.

[runawayjimbo]

Hobby Lobby may have been the hot button case, but it's impact on the ACA is negligible. But a lesser known case that could come out from the DC Circuit Court today (or Friday), Halbig v. Sebelius, is a more serious threat to the overall fate of the law.

[VA $l!m]

Tennessee state senator compares signing up for Obamacare to Nazi 'train rides for Jews'

Tennessee state Senator Stacey Campfield is coming under bipartisan fire for his "Thought of the Day" post on his blog.

"Democrats bragging about the number of mandatory sign ups for Obamacare is like Germans bragging about the number of manditory [sic] sign ups for 'train rides' for Jews in the 40s," he wrote today.

Tennessee Democratic Party Chairman Roy Herron responded in a statement that "Senator Campfield's blog post this morning is just the latest example of Tea Party Republican extremism. To compare attempts to save American lives through access to healthcare with Nazis killing European Jews is outrageous, pathetic, and hateful."

"Sen. Campfield and other Tea Party Republicans," he continued, "ought to look at the 5,000 Tennesseans who will die within the next 3 years because Tea Party Republicans refused to take the 100% federal funding to expand Medicaid and have denied working Tennesseans access to healthcare."

Campfield's fellow Republicans were no more supportive. In a statement, GOP Chairman Chris Devaney wrote that "[w]hile Stacey Campfield routinely makes remarks that are over the top, today's comments are ignorant and repugnant."

"No political or policy disagreement should ever be compared to the suffering endured by an entire generation of people. Those comments have no place in our public discourse. He should offer an apology to members of the Jewish faith immediately."

At this time, Campfield has yet to issue an apology, but he did speak to WKRN, saying that he "is not minimizing loss of life" in Nazi Germany," but that "it is not an accurate portrayal for the administration to brag and signups for Obamacare when it's mandatory."

"When you control people's health, you control their lives and if they live or die," he added.

in bold-- same issue i face in Nebraska.
Trust me,  the only people worthy of a Nazi comparison are the lying Republicans that have signed my death warrant by denying the Federal money we pay for in taxes already.

[runawayjimbo]

Hobby Lobby may have been the hot button case, but it's impact on the ACA is negligible. But a lesser known case that could come out from the DC Circuit Court today (or Friday), Halbig v. Sebelius, is a more serious threat to the overall fate of the law.

@ReutersUS  #BREAKING: U.S. Appeals Court throws out IRS regulation that implements key Obamacare health insurance subsidies

This will obviously head to Supreme Court, but this is a big deal.

[runawayjimbo]

Supreme Court grants cert in King v. Burwell challenging the legality of subsidies in states where federal gov't operates exchanges, which many are saying is a more serious threat to the law than even the challenge to the individual mandate.

http://www.nytimes.com/2014/11/08/us/politics/supreme-court-to-hear-new-challenge-to-health-law.html

Supreme Court Accepts New Challenge to Health Law

WASHINGTON — The Supreme Court on Friday agreed to hear a new challenge to the Affordable Care Act, potentially imperiling President Obama's signature legislative achievement two years after it survived a different challenge in the court by a single vote.

The case, King v. Burwell, No. 14-114, concerns tax subsidies that are central to the operation of the health care law. According to the challengers, those subsidies are improperly being given in states that have decided not to run the marketplaces for insurance coverage known as exchanges. Under the law, the federal government has stepped in to run exchanges in those states.

If the challengers are right, millions of people receiving subsidies would become ineligible for them, destabilizing and perhaps dooming the law.

The central question in the case is what to make of a provision in the law limiting subsidies to "an exchange established by the state."

The challengers say the provision means that only people in states with their own exchanges can get subsidies. Congress made the distinction, they say, to encourage states to participate.

But the Internal Revenue Service has issued a regulation saying subsidies are allowed whether the exchange is run by a state or by the federal government. The challengers say that regulation is at odds with the law.

In response, Solicitor General Donald B. Verrilli Jr. told the justices that the I.R.S. interpretation was correct. The one offered by the challengers, he said, is "contrary to the act's text and structure and would render the act unrecognizable to the Congress that passed it."

The case the Supreme Court agreed to hear is from Virginia. It was brought by four people who said they did not want to be subject to the law's requirement that they buy insurance or pay a penalty. But for the subsidies, they said, they would have been eligible for a hardship exemption.

In July, the United States Court of Appeals for the Fourth Circuit, in Richmond, Va., ruled against the challengers. Judge Roger L. Gregory, writing for a three-judge panel of the court, said the contested phrase was "ambiguous and subject to multiple interpretations." That meant, he said, that the I.R.S.'s interpretation was entitled to deference.

That same day, the United States Court of Appeals for the District of Columbia Circuit ruled the other way, agreeing with the challengers that only people in states that run their own exchanges are eligible for subsidies.

The Supreme Court often steps in when federal appeals courts have disagreed. But the split between the two courts was wiped out in September when the full District of Columbia Circuit vacated the July ruling and set the case for argument in December.

It takes only four votes to add a case to the Supreme Court's docket. They may have come from the four members of the court who were ready in 2012 to strike down the Affordable Care Act: Justices Antonin Scalia, Anthony M. Kennedy, Clarence Thomas and Samuel A. Alito Jr. Once again, it seems, the fate of the law may rest with Chief Justice John G. Roberts Jr.

[runawayjimbo]

Vermont gives up (for now) on becoming first state to implement single-payer. Turns out free healthcare is a lot more expensive than initially thought.

http://www.politico.com/story/2014/12/vermont-peter-shumlin-single-payer-health-care-113653.html

Vermont bails on single-payer health care

Vermont Gov. Peter Shumlin on Wednesday dropped his plan to enact a single-payer health care system in his state — a plan that had won praise from liberals but never really got much past the framework stage.

"This is not the right time" for enacting single payer, Shumlin said in a statement, citing the big tax increases that would be required to pay for it.

Shumlin faced deep skepticism that lawmakers could agree on a way to pay for his ambitious goal and that the feds would agree to everything he needed to create the first state-based single-payer system in 2017.

And that was all before Shumlin, a Democrat, almost lost reelection last month in one of the country's most liberal states. And it was before MIT economist Jonathan Gruber, the now notorious Obamacare consultant who also advised Vermont until his $400,000 contract was killed amid the controversy, became political poison.

Shumlin had missed two earlier financing deadlines but finally released his proposal. But he immediately cast it as "detrimental to Vermonters." The model called for businesses to take on a double-digit payroll tax, while individuals would face up to a 9.5 percent premium assessment. Big businesses, in particular, didn't want to pay for Shumlin's plan while maintaining their own employee health plans.

"These are simply not tax rates that I can responsibly support or urge the Legislature to pass," the governor said. "In my judgment, the potential economic disruption and risks would be too great to small businesses, working families and the state's economy."

And that was for a plan that would not be truly single payer. Large companies with self-insured plans regulated by ERISA would have been exempt. And Medicare also would have operated separately, unless the state got a waiver, which was a long shot.

Shumlin added that federal funds available for the transition were $150 million less than expected.

He also has a lot less political capital than before November. Shumlin, chairman of the Democratic Governors Association, still hasn't even officially won his own reelection bid: The Legislature will settle the outcome of the November race in January because Shumlin failed to win more than 50 percent of the vote. He's leading his Republican challenger by just a few thousand ballots.

And the substance of the plan isn't its only politically problematic aspect. Gruber, now infamous for his blunt assessments of the Affordable Care Act and his remarks about "stupid" voters, was until recently a state consultant. Days after the election, video emerged of him dismissing criticism of Vermont's plan in 2011 by asking, "Was this written by my adolescent children, by any chance?" State officials said they would cut off his contract.

Advocates of a single-payer plan said Shumlin should not be able to cast aside Act 48, the 2011 law that called for the creation of Green Mountain Care, without repealing it. A group planned to hold a rally in front of the statehouse on Thursday to protest his decision.

"The governor's misguided decision was a completely unnecessary result of a failed policy calculation that he pursued without Democratic input," the group Healthcare Is a Human Right Campaign said in a statement.

[rowjimmy]

The pool was too small.

[sunrisevt]

The pool was too small.

None of us have any real faith in Shumlin, anyways. "The pool is too small" might as well refer to the talent pool of small-state politics.

[rowjimmy]

The pool was too small.

None of us have any real faith in Shumlin, anyways. "The pool is too small" might as well refer to the talent pool of small-state politics.

I was deliberately vague.

[runawayjimbo]

The pool was too small.

It's single payer; there is no pool.

The issue is simply one of health care costs and the required amount of taxes to fund the them. Thankfully (for Vermonters), the governor realized that the financing mechanism was an exorbitant increase in taxes which would put a severe burden on the state's residents and businesses (mostly of the smaller variety since the largest employers would continue to self-fund their plans). I mean, I know the costs don't matter to single-payer proponents, but it is something that practitioners have to reconcile. Reality just caught up with the VT experiment in the end.

[runawayjimbo]

Preliminary 2016 rate proposals for exchanges are starting to roll in and the results are not good. This makes the decision in King v. Burwell (which is coming down in a couple of weeks) all the more significant.

Full CMS list to see what your state looks like here

http://money.cnn.com/2015/06/02/news/economy/obamacare-rates

Obamacare sticker shock: Big rate hikes proposed for 2016
Hold onto your wallets ... many insurers want to substantially hike rates on Obamacare policies for 2016.

Many are proposing double-digit premium increases for individual policies, with some companies looking to boost rates more than 60%, according to a list posted Monday by the federal Centers for Medicare & Medicaid Services.

In Florida, for instance, United Healthcare (UNH) wants to raise the rates of plans sold on the Obamacare exchange by an average of 18%. Individual policies available outside the exchange through United Healthcare or through a broker would go up by 31%, on average, with hikes as high as 60% for certain plans in certain locations.

In Texas, insurer Scott & White is looking for a 32% increase for exchange-based plans, while Humana (HUM) is asking for an average 30% boost for its exclusive provider organization policies, which generally cover only in-network services.

Insurers say they want to hike rates because enrollees are going to the doctor, getting lab work and filling prescriptions more than they had originally anticipated.

"We've seen a great pent-up demand for services," said Aaron Billger, spokesman for Highmark, a Blue Cross Blue Shield licensee offering plans in Pennsylvania, Delaware and West Virginia. Enrollees in Obamacare exchange plans use more healthcare than those in job-based policies, he noted.

Insurers submitted their proposed rate hikes for individual policies sold both on and off Obamacare exchanges for review by state officials. The government's list includes insurers that requested increases of 10% or more. Insurers can opt to offer plans on the exchanges, directly or via both methods, but policies with similar coverage must be priced the same.

Rates for Obamacare plans have been closely watched -- and their affordability hotly debated -- since the exchanges first opened in 2014. Insurers had a tough time setting rates in the first two years because they didn't have a lot of data on how much customers would visit the doctor. Now they can base their prices on actual usage, said David Axene, fellow at the Society of Actuaries, an industry group. Some insurers may have underestimated and set their prices too low in 2014 and 2015.

Blue Cross and Blue Shield of North Carolina cited hospital in-patient care, particularly cancer and heart conditions, emergency room visits and specialty drugs as major contributors to its proposed 26% hike.

Insurers, however, probably won't be granted all that they seek. Insurance commissioners in 36 states have the power to deny the rate requests, though they usually negotiate smaller hikes with insurers.

Also, the requested rate changes for 2016 can vary widely based on the specific plan. United Healthcare, for instance, noted it's only asking for a 1.2% increase on some of its plans. This reinforces the need for consumers to shop around when open enrollment begins in November and not just renew their existing plan.

While the proposed rate hikes seem steep, they won't hit Obamacare enrollees as hard since most receive federal subsidies. But even subsidized enrollees will have to pay more depending on the plan they select. Those signing up for individual coverage outside an exchange will pay full freight since they aren't eligible for subsidies.

Rates will be finalized in coming weeks, but consumers may not learn the final prices until just before enrollment opens.

[runawayjimbo]

Court rules subsidies available in states with federal exchanges, to which the GOP candidates say "Thank freaking Jeebus."

http://www.bloomberg.com/news/articles/2015-06-25/obamacare-tax-subsidies-upheld-by-u-s-supreme-court-ibc9o863

Obamacare Tax Subsidies Upheld by Divided U.S. Supreme Court

The U.S. Supreme Court upheld the nationwide tax subsidies that are a core component of President Barack Obama's health-care law, rejecting a challenge that had threatened to gut the measure and undercut his legacy.

The 6-3 ruling is the high court's second in three years to preserve Obamacare in the face of Republican-backed legal attacks. It averts a collapse in state insurance markets and lets millions of Americans keep using federal tax credits designed to make policies affordable.

Chief Justice John Roberts and Justice Anthony Kennedy joined the court's four Democratic appointees in the majority. They said the 2010 Affordable Care Act allows tax credits in all 50 states, not just the 16 that have authorized their own online insurance exchanges.

"Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them," Roberts wrote.

The decision eliminates what was probably the most potent legal challenge to the landmark health-care law that was designed to expand coverage to at least 30 million uninsured Americans. Republican opponents now must look to winning the White House in the 2016 election if they hope to roll back the law.

A ruling against the administration might have forced more than 6 million people to drop Obamacare policies because of tripling and even quadrupling premiums.

[rowjimmy]

Ruling the other way would have been disastrous for so many people, including a handful of politicians on either side of the spectrum.

[pcr3]

Yay, almost 2 years of my own personal work not flushed down the toilet...yet.

[sls.stormyrider]

The Donald, in his address to the Governor's Association

"I have to tell you, it's an unbelievably complex subject. Nobody knew that health care could be so complicated."