Obamacare upheld

[Julie Fern]

no, court specifically ruled that statute exceed conressional power under commerce clause.  that separate from whether allowed under tax clause.  more than taxes, strictly speaking, allowed under tax clause.

[Cher1300]

Wow...

[HolmesBoy]

I think I'm cool with the opinion, except I don't really understand what this means:

The Act, however, bars the IRS from using several of its normal enforcement tools, such as criminal prosecutions and levies.  §5000A(g)(2). And some individuals who are subject to the mandate are nonetheless exempt from the penalty—for example, those with income below a certain threshold and members of Indian tribes.  §5000A(e). Nat'l Fed'n of Indep. Bus. v. Sebelius,  No. 11–393, at *8 (2012).

This just says the government can't put a lien on someone's property or put them in jail for not having insurance.  They will just be required to pay the penalty.

Does that not basically kill the "super creditor" status of the IRS? Other than withholding tax refunds, it seems like there's not much that the IRS can do to enforce the penalty. I'm probably completely wrong, though. There are probably other methods the government can use to entice people to pay the penalty (or buy insurance!).

[Cher1300]

I think I'm cool with the opinion, except I don't really understand what this means:

The Act, however, bars the IRS from using several of its normal enforcement tools, such as criminal prosecutions and levies.  §5000A(g)(2). And some individuals who are subject to the mandate are nonetheless exempt from the penalty—for example, those with income below a certain threshold and members of Indian tribes.  §5000A(e). Nat'l Fed'n of Indep. Bus. v. Sebelius,  No. 11–393, at *8 (2012).

This just says the government can't put a lien on someone's property or put them in jail for not having insurance.  They will just be required to pay the penalty.

Does that not basically kill the "super creditor" status of the IRS? Other than withholding tax refunds, it seems like there's not much that the IRS can do to enforce the penalty. I'm probably completely wrong, though. There are probably other methods the government can use to entice people to pay the penalty (or buy insurance!).

You are correct - there really isn't much the IRS can do other than penalize you on your tax returns.  The way it works in Massachusetts, (my parents still live there), is you have to show proof of insurance on your tax return or you pay the penalty.  This is why the plan hasn't really worked as far as decreasing insurance rates.  Since 2006, the health care costs have not declined much in Massachusetts.  The rates actually increased for the first two years.  Although most of the state is insured, many small businesses are struggling because insurance companies are hiking their rates for them knowing they have to provide insurance to their employees.  It has helped the medicare costs a bit because younger people that have to get insurance are helping to cover the costs for the oler sicker residents.   But for people who still can't afford the insurance, it is cheaper for them to just pay the penalty and go without insurance. 

[Julie Fern]

penalty get bigger over time.  why pay penaslty and get no health care when could just buy health care for close same amount?

[FalconJimmy]

penalty get bigger over time.  why pay penaslty and get no health care when could just buy health care for close same amount?

the penalty will be less than $2,000 per year. 

Insurance for a family will cost you at least $500 a month (or it did back when I bought insurance for my family), but that's before all the pre-existing condition folks were added.

Odds are, this will just make tax scofflaws out of people  Or they'll just claim they are christian scientists.

[Julie Fern]

but incentive buy insuance clearly there.  why pay $2k for nothing rather than buy insurance?  even after $2k, there going be medical bills, especially if children.

some not buy insurance, to be sure.  but many will, and that whole idea.

[FalconJimmy]

but incentive buy insuance clearly there.  why pay $2k for nothing rather than buy insurance?  even after $2k, there going be medical bills, especially if children.

some not buy insurance, to be sure.  but many will, and that whole idea.

Perhaps.  We'll have to see how this goes.  A lot of folks who won't buy insurance were getting pretty big checks for refundable tax credits, anyway.  The two will probably offset. 

The main problem I have is that for most people, they COULD buy insurance today, but don't because it's too expensive.  Yes, this will make things much less expensive for high-risk folks, but will make things much more expensive for healthy folks.  I was without insurance for a few years in my 20s.  The cost of it far outweighed the potential downside.  Lots of people make that calculation.  Some percent of them gamble and lose. 

Trouble is, now, everybody is compelled to buy the insurance or pay the fine.  If we couldn't afford it before, and it'll actually get MORE expensive if you're healthy, this is a huge step backwards for a lot of folks.

It's not that I don't support health reform.  I think it's one of the most important things in the country right now.  However, we have to address cost and Obamacare really doesn't do that in any meaningful way.  It just tries to share the costs across a broader pool.  But let's face it, the folks with money pretty much already had health insurance.  The uninsured either won't have to pay for their insurance, or can't afford it. 

Until we have single payer and are not paying 100% more for the same drugs that England buys, we won't have a solution to this problem.  I think everybody realizes that.  Where I differ is that I am not entirely sure this is a meaningful first step.

[Cher1300]

but incentive buy insuance clearly there.  why pay $2k for nothing rather than buy insurance?  even after $2k, there going be medical bills, especially if children.

some not buy insurance, to be sure.  but many will, and that whole idea.

Perhaps.  We'll have to see how this goes.  A lot of folks who won't buy insurance were getting pretty big checks for refundable tax credits, anyway.  The two will probably offset. 

The main problem I have is that for most people, they COULD buy insurance today, but don't because it's too expensive.  Yes, this will make things much less expensive for high-risk folks, but will make things much more expensive for healthy folks.  I was without insurance for a few years in my 20s.  The cost of it far outweighed the potential downside.  Lots of people make that calculation.  Some percent of them gamble and lose. 

Trouble is, now, everybody is compelled to buy the insurance or pay the fine.  If we couldn't afford it before, and it'll actually get MORE expensive if you're healthy, this is a huge step backwards for a lot of folks.

It's not that I don't support health reform.  I think it's one of the most important things in the country right now.  However, we have to address cost and Obamacare really doesn't do that in any meaningful way.  It just tries to share the costs across a broader pool.  But let's face it, the folks with money pretty much already had health insurance.  The uninsured either won't have to pay for their insurance, or can't afford it. 

Until we have single payer and are not paying 100% more for the same drugs that England buys, we won't have a solution to this problem.  I think everybody realizes that.  Where I differ is that I am not entirely sure this is a meaningful first step.

You are correct in that it is probably not a meaningful first step.  So many people are under the impression that this plan gives healthcare to "everyone."  It does not.  The costs of insurance hasn't gone down for healthy people or small business owners in Massachusetts.  That is why they'd rather pay the penalty.  Since it is taken out of your tax return, it doesn't feel as bad as making the monthly payment. 

I didn't have insurance for 9 years from about 25 to 34.  I would just pay for office visits as needed.   I was young and healthy, so I didn't run up any medical bills.  Scary not to have insurance?  Probably, but I don't think this is the solution.  It would be great if we could get socialized medicine or if Congress could regulate the insurance companies or pharmaceudical costs like you said, but there's just too much money in it.   

I'll keep my fingers crossed, but based on how the plan has operated in Mass, I don't think it will be very successful.   The rich already have insurance.  Most poor people are covered through state medicaid, and the elderly have medicare.  The burden will be, as usual, on working lower-middle class people struggling to keep their homes or to get by.  My boyfriend, for instance is self-employed.  He lost his job a few years ago and has been getting by with jobs that last a few months here and there.  Sometimes he works as a carpenter on a TV show that is non-union for a few weeks or months, or he works on people's homes.  Because he owns a house, he will not qualify for free healthcare, but will be required to buy health insurance.  These are the people that will not buy the insurance, and there are soooo many people out there like him.  Their unemployment has run out and they are doing everything they can to get buy, but can't afford health insurance because they don't know how much income they'll bring in from month to month.   When you are healthy, have a mortgage to pay or utility bills that are consistently rising, that will take priority over health insurance.

So while I believe something needs to be done, the majority of healthy folks that can't afford insurance now, still won't be able to afford it unless the job market improves.  It hardly seems fair to make healthy - not wealthy - people carry the burden of regulating health insurance If nothing else, the timing is bad. 

[Maintain FL 350]

I'm increasingly convinced that a single payer system may be the only way to go. I just don't see how else we can get costs down. Fareed Zakaria mentioned last week that doctors in Taiwan get paid about $14 per office visit. My doctor charges $350. Seriously, $350. Admittedly, my insurance probably negotiates that down by half, but still. Doctors here argue that you'll get less time with the patient, crappy care, etc. Well, for $350 my doctor only spends about five minutes with us anyway then moves on.

In Germany doctors make between $90-$130,000 almost without exception. Still a good living, but not the Porsche-driving, golf-playing, trophy wife-divorcing lifestyle that every doctor here I've ever met believes that they "deserve".