SCOTUS Upholds Affordable Care Act!

"Everyone" was a stretch, but most.  Amongst government services, it was near the top, above National Parks.  Given the alternative of finding private health insurance > 65 years,  I'm sure it is very welcomed by most. 

When you pay the gov't anything it's a tax. Social security tax, Medicare tax, federal tax, state tax, etc. So, that is why the "penalty" is a tax. Because it will impact so many people in the middle class, I expect the GOP to go wild with "Obama just instituted the largest middle class tax increase in history" stuff. We will be sick of hearing it come November. I live in the northeast which is overwhelmingly liberal and generally fine with social programs no matter the cost. Other areas are as well. But there is a huge part of the country that is crazy conservative and they hate taxes. So, if nothing else, this election cycle will be interesting.

They say only 1% of the population will pay the penalty for not getting health insurance.  I say penalize....it's all about personal responsibility. (It's a penalty that results in a higher income tax...just like the old marriage penalty.)   A good many will welcome being able to buy health insurance, but the biggest majority of the currently uninsured will now qualify for health insurance via Medicaid Expansion.

Here is the irony, while the mandate was ruled Constitutional, the Medicaid Expansion was not, allowing States to opt out. It's possible that states that reject the 100% funding for Medicaid, for whatever political reasons, could result in less people insured than we have now.  So far, Florida and South Carolina are definitely opting out, leaving those in poverty, and those that would get Medicaid under the Expansion, without any medical coverage.  Hard to believe a Governor would actually do that?!

Really, the only solution is to federalize Medicaid. 

Oh, no, not politics...  We're supposed to keep our stress levels low.    Just kidding.

In all seriousness, count me as one of the people not happy about this ruling.

The vast majority of Americans are insured.  For people who cannot afford insurance, there's Medicaid - or Medicare for people over 65.  Plus, there are all sorts of other government programs, privately-funded charities, etc., already in existence to help people.

There is just a small percentage of people who either cannot or will not buy insurance and do not qualify for assistance.  At one point, when I was younger and before BC, I was one of those people for a short time.  I had a pre-existing condition that my insurance policy wouldn't cover, and I could not qualify for gov't assistance, either.  Having had that experience, there are other reforms I would've liked to have seen established - more market-friendly reforms, for example - to help other people in the same position.

Reforms are needed.  But, what they will be doing is forcing people to buy insurance if they don't have it.  Some people might be perfectly healthy for years without ever needing high-cost medical care; many can pay for their doctor's visits out-of-pocket.  Why should they be forced to buy insurance through Uncle Sam if they don't need it?  Not sure where this plan is going, but it worries me.

Also, any type of assistance program really should be run at the state level, not the federal level.  Because if the Feds get something wrong, they get it wrong for the whole country.  If you don't like what a state is doing, you can move to another state.

Just wanted to add something about the "tax":  I read that not even Congress referred to this penalty as a "tax" in the bill.  Also, here's a point I heard someone else make:  This is the first time we would pay a tax for not doing something.  Taxes always have been based on what you do - how much you earn, how much you spend, etc.  In this case, we would be "taxed" for not buying something (insurance).

All of the above is said with love, by the way.  I have a friend who lost her house after BC.  If Uncle Sam offers to help pay your bills, go for it.  I just worry about how this whole system will play out in the long run.

Yup. This topic is one that brings out people's passion.

Life....I don't know the percentages but the ACA allows 30 million more people to get health insurance - that's significant to me and to the 30 million.



I am not a huge fan of the ACA for several reasons - primary among those is that it takes a system that's inefficient to begin with (I.e.,insurance companies as the middle men AND an unnecessary cost layer) and expands it.



For those who hate the ACA, please hate it for fact-based reasons. The ACA is NOT a government takeover of health care; it IS additional regulation over insurance companies. It does not and will not result in care rationing. It does not include death panels. It does not fund abortions, nor does it provide coverage for illegal immigrants. It does NOT require physicians to get government approval prior to treatment nor does it dictate care.



There are a lot of resources on the Internet explaining the ACA's provisions and limitations. You could also read the ACA if you're so inclined.

Lifeiswonderful

      Let's go through some of the benefits of ACA:

     1. Kids up to the age of 26.  I don't know if you've noticed, but a lot of the jobs that young people are getting these days do not offer health insurance.  It's all well and good to say that they can take the risk because they're young and healthy, but most would prefer not to.  My daughter, 25, perfectly healthy, fell - and now she's facing possible knee surgery.  Had the ACA not been in effect, she would have had no insurance.

     2. People with pre-existing conditions that's us here.  If your company went under, if you got laid off, if you were self-employed, you would never have been able to buy insurance under the previous state of affairs.

      3.  No life-time cap.  Insurance companies would put a life-time cap of a million on a policy, and when you reach it, nothing more is covered.   That's why people with serious long-term illnesses, even with insurance, wind up bankrupt, losing their homes.

       4.  Insurance companies cannot cancel your policy when you get sick.  I don't know how many cases I read where an individual policy holder became ill with a serious disease like, oh, breast cancer and insurance companies suddenly "found" a pre-existing condition and cancelled the policy.

      4.  The poor and uninsured.  You think that people who are poor are getting Medicaid.  Think again.  WE have 30 million people in our country without insurance.  Unfortunately, because the Republican governors of states with the most uninsured care more about politics than people and the Supremes made it optional, the Medicaid expansion won't help as many as originally intended.

     Requiring people to buy insurance is a small part of this plan and it is the way the plan is financed.

      As for the Republican plan, it seems to be to allow people to buy insurance across state borders.   They have no plan on how to deal with pre-exisiting conditions, the young people, and the uninsured. 

I think there are elements in this plan we can all agree on.  As it has taken 60 years to get here, I say we give it a try.  We all just saw the battle to get here--it's not going to happen again, soon and something needed to be done.

Why start being consistent now?  Seriously, who cares what it is called?  Penalty that causes more tax or a tax.  Regardless, it only affects 1%of the population and frankly, I'm tired of paying for their trips to the Emergency Room, or hiding income and getting Medicaid (a whole nother problem, I realize, but I've seen this right before my eyes).  This whole hangup on "taxes" is a Grover Norquist invention. IMHO, and anyone who supported the Iraq war in Congress has no right to complain about taxes...that war was not paid for and is a major cause for our current debt...the first time we didn't raise taxes during war time.  OK - I knew I shouldn't join in on this thread...I just feel too strongly about this subject and I'm even a federal employee that gets the "gold standard" (NOT) health insurance.  I have no worries about health care at all (except for the $5000 out-of-pocket).

Wow...I think we should all take a vacation!

Kayb, When I said "move to another state," I put it in a whole context that said:  If the Feds get something wrong, they get it wrong for the whole country.  If a state gets it wrong, at least you can move to another state.  FTR, I'm not suggesting it's easy to pick up and move.  (If it were, I would be moving right now.   )  I'm merely suggesting that at least moving would be an option - certainly an option I would want.

All, I read that Congress has been calling it a "penalty" and that the "tax" angle was only used in court.  I don't know how accurate those early stories were, though.

Agreed that the reason this plan is so hated by Republicans is that it came from Obama.  this whole idea of a mandate and keeping insurance companies came from the Heritage Foundation and was sponsored by Republicans as an alternative to a single payer system - until, of course, Obama took it up - then it became socialism.

I found it interesting when Mitch McConnel was asked repeatedly on Fox news what he would do about 30 million uninsured Americas if the ACA were repealed and his reponse was, "That's not the issue."  I also remember the crowd at a GOP debate cheering the idea that a man who was uninsured and couldn't pay for his care should just die.  And that sums up the Republican plan.

I favor Medicare for all, but until the country sees that the world as we know it will not end because of expanded health insurance, I don't see it happening.  So I support the ACA as in intermediate step.

Ok...I can't help but respond to "don't believe everything I read."  What does one believe then, someone's gut feeling?  Their informal survey of personal friends?  The actual figure is 98.1% of Mass state residents are insured and it's increasing every year.  Easy to google Governor Deval Patrick's report.

Healthcare costs are a fortune now! How does one solve that problem?  You bring down admin costs eating up our premiums.  You develop Electronic Medical Record Systems which cuts the paperwork and redundancy.  You crack down on Medicare fraud.  These are just some of the things in Obamacare.

Can you enumerate how this "will cost us a fortune?"  I don't mind statements like this, but back it up please. Per CBO scoring, it is paid for in the cost cutting measures.....including those mentioned above, but not limited to.  If you assume that all are getting healthcare now (wouldn't that be your assumption for doing nothing, afterall?) and you created efficiencies, redistribute some of the premium cost responsibilities to those that can afford to be insured but choose to be a burden to the rest of us, from those of us who are responsible or privledged enough to get insurance, then it is a zero sum game.

I'm not bothered..frustrated maybe, as I continue to look for some facts to refute mine, and others. 

We came do,something or nothing. We choose:



From National Nurses United website:





U.S. Healthcare in a Glance



•    The percentage of adults with no health insurance is the highest on record, 17.3 percent of adults as of the third quarter of 2011. Three years ago, in the third quarter of 2008, only 14.4 percent of adults lacked health insurance. (Gallup, Politico, Nov. 11, 2011). By January, 2012, the percentage of unemployed was up to 17.7 percent.

(http://fdlaction.firedoglake.com/2012/01/24/number-of-uninsured-americans-steadily-increasing/)



•    Factoring out those 65 and over, eligible for Medicare, and young adults up to 26, now eligible to remain on their parent’s coverage as a result of the Affordable Care Act, the numbers are even higher. 19.9 percent of 26-64 year olds are uninsured, up from 18.1 percent in mid-2010.Further, the number getting health coverage from their employer continues to fall, now down to 44.5 percent in the third quarter of 2011 (Gallup, Politico, Nov. 11, 2011).



•    Total number of uninsured Americans- 49.9 million in 2010, up from 49 million in 2009 (U.S. Census Bureau, CNN/Money, Sept. 13, 2011). An additional 29 million Americans were underinsured in 2009, up from 16 million in 2003, an increase of 80 percent (Health Affairs, September, 2011)  



•    About half of unemployed and underemployed U.S. residents do not have health insurance and 56% are delaying necessary care because of concerns about cost.  Among those who said that they or another family member have delayed medical care because they could not afford it: 63% skipped dental care or checkups;  46% skipped a recommended test of treatment; 40% did not fill a prescription; and 18% reported problems receiving mental health services. (NPR/Kaiser Family Foundation survey, Dec. 12, 2011)



•    Between 2003 and 2010, premiums for employer-sponsored health insurance increased by a nationwide average of 50%.--  62 percent of Americans now live in a state in which health insurance premiums equal 20 percent or more of median earnings for adults younger than 65. In 2003, 13 states had annual premiums that comprised less than 14 percent of the median income. In 2010, there were none. Average annual premiums for family coverage were $13,871, with the average annual employee share at $3,721 in 2010, up from $2,283 in 2003. (Commonwealth Fund, Washington Post, Nov. 16, 2011; San Francisco Chronicle, Nov. 17, 2011)



•    Under a study of high income countries, sicker adults in the U.S. stood out for having cost and access problems. More than one of four (27%) were unable to pay or encountered serious problems paying medical bills in the past year, compared with between 1 percent and 14 percent of adults in the other countries. In the U.S., 42 percent reported not visiting a doctor, not filling a prescription, or not getting recommended care. This is twice the rate for every other country but Australia, New Zealand, and Germany. (Commonwealth Fund, Nov. 9, 2011)



•    On life expectancy, between 2000 and 2007, more than 80% of U.S. counties fell in standing against the average of the 10 nations with the best life expectancies in the world. Some US counties are more than 50 calendar years behind – meaning they have a life expectancy today that nations with the best health outcomes had in 1957. Five counties in Mississippi have the lowest life expectancies for women, all below 74.5 years, putting them behind Honduras, El Salvador, and Peru. Four of those counties have the lowest life expectancies for men, all below 67 years, behind Brazil, Latvia, and the Philippines. Nationwide, women fare more poorly than men. Women in 1,373 counties – about 40% of US counties – fell more than five years behind the nations with the best life expectancies. Men in about half as many counties – 661 total – fell that far.  Black men and women have lower life expectancies than white men and women in all counties. (Institute for Health Metrics and Evaluation (IHME) at the University of Washington, June 15, 2011)



•    In a global survey of inequality in healthcare for children, the US ranked just 22nd in material well being for children, behind even economically struggling Greece. (Unicef study, December, 2010)



•    Between 2003 and 2007, the average maternal mortality rate – defined by deaths that occur within 42 days of childbirth – rose to 13 deaths per 100,000 live births, approximately double the low of 6.6 deaths per 100,000 live births recorded in 1987. Today, the United States ranks 41st in the world for maternal mortality, one of the worst records among developed countries. "Near misses", complications so severe that a woman nearly dies, increased between 1998 and 2005 to become common – at one woman every 15 minutes. African American women are three to four times more likely to die of pregnancy-related death than white women. States in which poverty rates exceeded 18% had a 77% higher rate of maternal mortality than states with lower rates of poverty. Over the last seven years, federal spending for maternal and child health programs has been reduced by 10%. (Guardian, UK, July 5, 2011)



•    More than one in four U.S. emergency departments were closed in the past two decades, forcing the nation’s poor and elderly to seek care in fewer, more crowded facilities. The number of emergency rooms in metropolitan and suburban areas fell 27 percent to 1,779 in 2009 from 2,446 in 1990. (Bloomberg News, May 17, 2011)



•    Illness and medical bills are linked to 62 percent of all U.S. personal bankruptcies. The proportion of bankruptcies attributed to medical bills rose by nearly 50 percent between 2001 and 2007 (Physicians for a National Health Program, 2009).



•    In California, the only state that makes such data public, the seven largest private insurers rejected 26% of claims in 2010. Typically, the rejections came from payment disputes between the insurers and providers, such as doctors and hospitals, but often that resulted in patients and families getting stuck with massive bills in a system that does little to control costs. Outright care denials are all too common from insurers, which have developed a laundry list of lingo to justify denial of care, such as transplants, even when recommended by the patient's physician.



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California Nurses Association/Institute for Health and Socio Economic Policy, Jan. 28, 2011



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