The Day after Tomorrow

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a "marketplace" which totally prices out the working class, who in america are widely considered to be mere disposable lumpenproles, to be kicked to the curb when they break down and replaced with an endless supply of replacement drones.

which is just fine for the powers-that-be, a most profitable situation for the 1%, and the other 99% be damned [whether they get the picture or not]

1.) Apples and Oranges. I may get an incentive for winterizing my house, but I don't pay a penalty if I don't. Same with the mortgage. I don't pay a special "renter's tax" or penalty.

2.) I don't think you understood what I meant. Did you know Medicare sets the prices of a lot of medical services and prices?

1) Exact same real world effect. Man A has more money in his pocket than Man B after the government picks a winner. They could just tax you up front with a health tax and then give your neighbor a break for having insurance. That's the issue. The government can tax you, tell you what to do to get some of the money back, and reward your neighbor in the tax code for doing it. Then take your tax money and subsidize coverage for a third person. All legit.

2) I read your paragraph. It didnt mention Medicare.

The government can neither force you to buy health insurance under this plan for force you to pay a penalty under this plan if you don't choose to buy health insurance.

In it's current form while it's called a mandate, it doesn't have any legal teeth as far as a requirement to pay a penalty. There is no criminal liability for not paying the penalty. As the law is written the IRS can deduct the penalty from a tax refund at the end of the year, if one does not voluntarily pay the penalty, but can impose no criminal liability, levies, or liens. Tax refunds at the end of the year are easy to avoid, if one selects the correct number of IRS deductions, for with-holding taxes.

In addition, there are a number of clauses in the law, specified in the quote and link below that exclude individuals from having to purchase insurance.

It's not likely that if the mandate is overturned, that these same loopholes will be available, with whatever congress eventually comes up with to replace it. The clock is already ticking, insurance companies have already taken on additional costs by the mandatory requirement to insure minors, and those living with their parents to age 26. It's only a matter of time, before they are going to either receive additional compensation for their services or drop the additional coverage that exists now. Only a few of the largest companies have made their intentions known to continue the coverage if the law is struck down.

Unless one makes four times the poverty level they are going to be subsidized by the government to purchase insurance and if one makes below 133 percent of the poverty level, they are not going to pay a thing, through expanded medicaid coverage, as the law is currently written.

Considering anyone through a small amount of effort could avoid the mandate or paying a penalty, as the law is currently written, it was a win-win situation for those individuals with conscientious objection to the law. Moreover, once the reality of how cheap the insurance is for those, through government subsidies is, it was a win-win situation for those that might change their mind when they saw the reality of the numbers, particularly if their health did not look as rosy as it does today.

https://www.bcbsri.com/BCBSRIWeb/pdf/Individual_Mandate_Fact_Sheet.pdf

Not really I know more uninsured non working people then I do self-employed people.

That's really the crux of the issue, it isn't technically a mandate and barely rises to the definition of a tax because of the limited enforcement that the IRS is empowered with in enforcing the mandate/tax.

However, it would have been impossible to pass the bill if the word extra tax was inserted anywhere in it, because of political aversion to that word, in the election cycle.

Everyone seems to still be on the "all or nothing" bandwagon. But the presumption in law is toward severability--unless a document expressly declares that it is not severable, it is presumed to be severable.

Which means that even if the individual mandate falls (and that's not guaranteed), there is nothing to say that Supreme Court won't lob this particular grenade right back at Congress by leaving the rest of the legislation in place.

Insurance companies will then be in a disastrous position. They will have won their Pyrrhic victory by kicking back at the commerce clause--but they will left with a series of legislative fences that will compel them to come to Congress, cap in hand, with a plea for relief. The guaranteed insurability and the invalidation of pre-existing condition exemptions will be a fearsome combination for an industry faced with the potential of tens of millions of freeloaders.

American health care isn't all that *great* either. When rich people have certain life threatening medical conditions, they travel abroad to countries like Sweden(in particular)whose medical technology is the most advanced in the world. Swedish healthcare is free for swedes by costs a fortune for foreigners. But its sheer sophistication helps pay for it by attracting rich foreigners.

Not when they can get it here our healthcare system is great if you have the money to afford it.

Well buddy, some things cannot be gotten here. Like embryonic stem cell treatments for neurological injuries. Those can be gotten at the Lund Institute in Sweden. Also, if you need an an organ to live, are on a waiting list and time is running short, you can also buy them in various countries in the world OTHER than the USofA.

I don't give a sh*t how much you love america and its healthcare system. It's not the best, and that's just the plain ol' truth. A big problem is that doctors, nurses, and hospital staff are overworked to the point of exhaustion and this jeopardizes the lives of patients undergoing surgery and with life threatening emergencies. I could go on......

Never said I liked it but I would rather have it done here seening how I have health insurance and all. It's a lot better then what people think though at least it is to me.

http://www.forbes.com/sites/rickungar/2012/06/25/busted-health-insurers-secretly-spent-huge-to-defeat-health-care-reform-while-pretending-to-support-obamacare/

My understanding is that insurance companies publicly supported healthcare reform, but at the same time covertly have been working to defeat it, per the link above, as they are not too happy about the potential of refunds that will be required of customer money. I feel like their initial cooperative effort was mostly to "insure", that there was no public option to compete with.

The odds are set high that the mandate will be ruled unconstitutional, but the Supreme Court is not necessarily predictable.

I don't think there is any good third party predictions at this point as to whether or not the Supreme Court will toss out the entire act. However, they don't appear to have the expertise to go through the rest of the act and determine which parts are not dependent on the mandate and which are, in determining which provisions to keep, if the mandate is ruled unconstitutional. It would only seem reasonable to allow the legislative process to sort that out, in lobbying the severed grenade back to congress.

What seems unfortunate though is a group of 21 law scholars reviewed the case and 19 out of 21 found the mandate constitutional. However, only 8 of 21 predicted that the Supreme court would uphold it. If there were 5 liberals and 4 conservatives, it appears unlikely that the mandate would be ruled unconstitutional per that analysis.


A reasonably stated argument on that issue is linked here, per the severability clause, that reflect your points.

http://www.nytimes.com/2012/03/23/opinion/the-severability-doctrine.html

Not much doubt in my mind though that insurance companies, will raise rates quickly, if the rest of the bill is left in tact, and there are no reasonable quick solutions provided by congress to replace a mandate. I think it is likely that insurance companies understood the odds of the entire act being overruled from the get go, and have their contingencies well thought out and planned, for any potential scenario.

I think congress is going to be the ones left with a headache at least the size of the initial attempt to pass healthcare reform, as insurance rates will likely continue to skyrocket, and both parties are going to be held responsible for gridlock on this issue for some time to come.

I don't see a reasonable Supreme Court precedent to overturn the entire act, and would expect the most negative result will be that the mandate is ruled unconstitutional, and as you say this particular grenade is lobbed back at congress.

I suspect I may be paying $10,000 a year for my government subsidized employment plan before all is said and done, and a replacement for the mandate is found some years from now, but if it keeps those whom don't have the same advantages that I have covered, it's my contribution to their health, as well as others whom will contribute as well that already have insurance, whether they like it or not, if they want to keep their insurance, because the mandate was struck down.

There really is the potential that people are going to pay thousands more in coverage a year, because of tomorrows decision. Not likely that many of those people that feel that economic pinch, are going to be too happy with either party, eventually, per the results of tomorrow. And likely some believe that the republicans are going to magically solve that problem before they feel that pinch. Not likely, if the past few years, provide any forecast for political gridlock.

I've been pretty happy with my insurance and health care as well. But the story is quite different for those that can't afford it or have preexisting conditions that cannot be covered under private insurance plans, if they are over 19. Are you covered under your parents policy, or through an employer, if you don't mind me asking.

Many individuals don't even realize they are at potential risk of losing their insurance benefits after tomorrow, and there are likely parents that aren't fully aware of that risk either. There could be some involved in this conversation in that position, and not realize there is that potential, after tomorrow, in what I see as a fairly unlikely scenario if the entire act is overruled. Particularly if they are in their early twenties, covered under their parents insurance policy.

who in the 99% can afford $10k+ a year in premiums? what will happen, is that the system will collapse in upon itself due to too many insurance bills chasing too few available dollars. the american health care industry is eating itself alive by its refusal to take half a loaf rather than none.

Per latest statistics the average overall premium for single coverage in the US is $5423 and the average overall family coverage is $13,940.

For those enrolled in company plans the average cost is $1,225 for single coverage and $4,465 for family coverage.

http://www.statisticbrain.com/health-insurance-cost-statistics/

Also, I checked my insurance site, and I was off in the estimation of how much the total cost of the policy with government contributions is. It is close to $23,000 a year, for a couple, and close to $26,000 for a family. Current premiums for my wife and I, are about $6,000 and about 7,000 for family coverage.

The full rates are incredible. The government is picking up a larger percentage of the tab than they have historically picked at close to 75% of the cost of insurance whereas they use to only pick up about 2/3 of the cost.

Amazing I would have never thought it possible that my health insurance rates would eventually exceed the mortgage on my home, 20 years ago when I bought my home, as at that point in time I was paying about $600 a year for coverage for my wife and I. It's actually gone up from about $3600 five years ago to $6,000 now.

The federal, state, and local governments are one of the last strong holds on any potential group insurance policy into retirement. It's not hard to understand why most corporations can no longer do that for their employees, considering total costs for these insurance policies.

That's the reality of now.

This is the reality of what could have been, in 2014, if the mandate had been ruled constitutional.

http://healthreform.kff.org/SubsidyCalculator.aspx

Here is a subsidy calculator that shows that a family of 4, policy holder age 40, making close to the median income of about $47K in the US would pay less than $3000 dollars a year, for private insurance. The government picks up more than $9,000 dollars of the tab.

A single person 21,making $15,300 pays nothing for medicaid insurance, and a couple, policy holder age 21 with two kids making $31,000 a year pays nothing for medicaid insurance.

There are many young people working in service industries that have no opportunity for health insurance, this would have provided that opportunity for those that need the advantage the most, particularly if they have children.

Some people will stay mired in welfare benefits, food stamps, and subsidized housing, to keep their medicaid coverage for their children. This would have provided an opportunity for some to move out of that situation.

This may not have been the best of all possible plans but it would have been an incredible improvement for what many Americans face in their health care coverage realities today.

The most disgusting scenario, would be to have to go back to point zero, with no reform, if the entire plans is overturned and potentially have to wait until 2020+, if another plan was ever passed, when average premium rates for families might easily exceed $20 thousand dollars a year, considering they are already pushing 14K.

At some point it is going to become a national emergency, the government will have to step in, and likely move to a single payer system. Not likely though that something like that would happen for another decade, while meanwhile, increasing numbers of individuals take the only option available, no coverage at all.

It's really sad that people the age of my wife and I, close to the income in today's dollars per current inflationary dollars 20 years ago, could have actually paid lower rates than what we did 20 years ago, if this bill had become fully effective, even if they were not fortunate like I was to have a company sponsored plan.

And by the way, a recent report released showed that an additional 3.1 million individuals have been insured between the ages of 19 to 25, mostly males, as part of their parents policy, due to the benefits already instituted by health care reform.

My understanding is that close to 50 percent of college graduates are unemployed under the age of 25, a recent down turn for the employment prospects of young college graduates. This is one of the few safety nets provided for young adult males in US society, at a point in time where health is often good, but life is overall more dangerous, per statistical risks of accidents. A catastrophic event for a young unemployed uninsured adult could easily bankrupt their families life savings at this point in life, without insurance coverage.

Problem is though, that only likely impacts less than 10 million people's direct interests at this point in time, but the other benefits fully instituted, that most have no understanding of, could benefit up to half the population.

Apparently it is the majority of the other half, and many of the half that could benefit, that have no concern for the potential health and welfare of half of the population, or are just oblivious to the details of the benefits, listening to quick snippets of urban legends regarding the plan.

I suspect what will happen is the mandate will be ruled unconstitutional, The 19 to 25, 3.1 million will keep their insurance along with potential millions not reported yet of children under the age of 19 gaining private insurance with preexisting conditions, with the rest of the bill left intact. And, the rest of the population will see that 20K average rate per year much sooner than 2020. My potential 10K will still be cheap compared to 20K.

Meanwhile congress will likely stay in gridlock, until the country yells uncle, and they are ready for real effective single payer change that will bring their rates down, tremendously, per the expansion of medicare, an already proven commodity of excellent healthcare coverage that most are pleased with.

Of course there will be those sweating bullets thinking the country is turning into a socialist one. But at some point the US, must arrive into the 21st century, with the rest of the western developed world, if the country is not going to continue to move into developing world status.

At least some progress appears to be certain, eventually, as the result of the miraculous effort so far, to get anything passed at all regarding health care reform. Otherwise the result might have eventually been developing country status.

To that regard, Nancy Pelosi. as a 70 year old grandmother, was standing with the country on her shoulders, several years back. Fitting that a country moving in an egalitarian direction, might look to a 70 year old grandmother, as a saving force for that egalitarian direction. She definitely changed the world, in a way most people will never have the potential to effect.