In 2017 Congress approve and Trump signed a measure that would eliminate the penalty for not buying health insurance. That measure will start in 2019.
The Supreme court ruled 5-4 in 2012 that Obamacare was legal. One of the reasons the court cited was the penalty was a tax. Now that the tax is gone, U.S. District Judge Reed O’Connor, an appointee of President George W. Bush, ruled that the entire Obama-era health law is invalid.
The ruling sides with 20 Republican states that brought a lawsuit seeking to strike down the ACA.
Trump Chimes In
Unconstitutional Disaster
Five Alarm Fire
The Wall Street Journal reports Federal Judge Rules Affordable Care Act Is Unconstitutional Without Insurance-Coverage Penalty
“This is a five alarm fire—Republicans just blew up our health care system,” Sen. Chris Murphy (D., Conn.) said in a statement. “The anti-health care zealots in the Republican Party are intentionally ripping health care away from the working poor, increasing costs on seniors, and making insurance harder to afford for people with preexisting conditions.”
The ruling, while invalidating the law, didn’t immediately block enforcement of the ACA, a situation that could trigger widespread uncertainty in the near term. Some states could stop enforcing or administering the law, including Medicaid expansion, starting Jan. 1, when the elimination of the penalty takes effect.
Democratic states that had intervened in the lawsuit said they would quickly seek an appeal to the Fifth U.S. Circuit Court of Appeals. Ultimately, the case could reach the Supreme Court. The decision Friday thrust the future of the 2010 law on unstable terrain just before the busiest final days for sign-ups during the ACA’s open-enrollment period.
“It will destabilize health-insurance coverage by rolling back federal policy to 2009,” said Barbara McAneny, president of the American Medical Association.
A deeply divided Supreme Court upheld the ACA in 2012, treating the insurance penalty as a tax and ruling that such a tax was within Congress’s power.
With the tax no longer in place starting in 2019, the insurance mandate can no longer be upheld on that basis and is now unconstitutional, Judge O’Connor said Friday. And because the mandate is so central to how the entire ACA operates, the whole law must fall, the judge said.
Gaming the Outcome
Also consider What ACA Ruling May Mean for Millions of Americans’ Health Coverage.
These things are difficult to predict, but the confirmation of Justice Brett Kavanaugh in October won’t necessarily determine the outcome of this case if it reaches the high court. The man Justice Kavanaugh replaced, Justice Anthony Kennedy, was the swing vote in so many high court cases, but not those on the ACA. He was a dissenter who wanted to strike down the health-law in 2012 but was with the 6-3 majority in upholding the ACA insurance subsidies in 2015.
A key factor is that Chief Justice John Roberts, a conservative, wrote both opinions upholding the ACA. He would almost surely remain the central figure if this case reached the Supreme Court. If the chief justice believed the Texas ruling was incorrect, the court would likely have the votes to again uphold the health law, even if Justice Kavanaugh were to conclude that the ACA should be invalidated.
My Guess
I suspect Obamacare would survive a supreme court challenge by a 5-4 margin if the case gets there, which itself may be a tossup.
If the Appeals Court rejects the Texas District decision, I believe the Supreme Court will not hear the case, ending the matter … sort of.
Elimination of the mandate forcing people to buy insurance will eventually make Obamacare so unwieldy that Congress will have to opt for a complete overhaul.
So, even if the case gets to the Supreme Court, the Court may well decide on the premise “You broke it, you fix it” even if they are highly unlikely to phrase it precisely that way.
Yet, Democrats will be in control of the House making the entire setup extremely contentious.
Mike “Mish” Shedlock
The ‘problem’ with that stance in what do you do with those that do not have the necessary resources to pay for care . . . unless you let these persons ‘die in the street’ other people will have to pay for their care . . . and making that payment dependent on voluntary charity makes it so the only photogenic with a good story will be able to raise the money . . .
Obama Care is already disintegrating. My son is an insurance specialist. He is directing families with no preexisting conditions insured through Obama Care to become a member of an association supporting individual insureds at half the premium. Already the Obama Care site in Connecticut has had another 50% increase in premiums
One can plan to have 2 out of 3 (Cheap, Pronto & Best) but NOT all the THREE!
American public should approach this pragmatically but not with dreamy expectations!
Moses didn’t come down from Sinai with complete description for neither cheap, pronto nor best wrt health care. All three are always evolving.
Instead, like with all else, the fundamental difference is how efficient care is rendered across a wide horizon of cost and delay tolerances, as well has how quickly that horizon itself improves.
Just as is the case for all products and services in a world of limited resources but unlimited demand, there never can be a better way to solve that puzzle, than letting anyone who thinks he has a better idea, pursue it; as well as letting anyone make his own priorities amongst current offerings. The further you get away from that, the closer you get to the Soviet Union and Venezuela.
This plan to sabotage the ACA might have worked, if not for the dumpster fire in the Whitehouse. People are mad enough at the depravity the republicans are enabling that the democrats will have full control of the government in 2020, and the ACA will be Scrapped in favor of single payer. Trump may be playing 4d chess, but he’s getting beat badly. Pelosi will continue to spank him in public, if he has the courage to show himself anywhere but one of his staged rallies.
It curious that countries with universal healthcare spend about half per capita as the US with much better health outcomes. We spend about 19% of GDP while Canada spends about 9-10%. We have the worst health outcomes; rank dead last. We are behind former soviet block countries and even Ecuador. WTF.
Seems like the more we let government take over the American health care market – the worse it gets.
Maybe there is a lesson in there somewhere.
Medicare, the current universal govt healthcare system for seniors has about 5% admin costs versus 30% for private insurance companies. Which one is more productive.? I hate the govt as much as anyone but the private insurance companies are greedy fucks who’s only function is to screw doctors by withholding payments on claims and maximizing their own profits.
…as is government. The head of a government department doesn’t magically care more about the government’s customers, than the CEO of Goldman Sachs cares about his. To the extent there is any difference, the latter can at least conceptually be held accountable by customers leaving. Assuming a realistic freedom to do so, which is less and less the case, the closer government and big companies huddle up in bed to “save the system,” of course.
The US has some of the worst health outcomes because Americans make such bad personal decisions.
“It curious that countries with universal healthcare spend about half per capita as the US with much better health outcomes.”
How is it a better outcome to sit on a waiting list for six months or more, while a condition deteriorates?
Denninger makes a point that if USC15 was enforced, costs would drop up by as much as 80%.
Universal isn’t about better medical care, it is about government control.
The French are now protesting their high taxes. The Economist says they should be raised even more.
Denninger makes a point that if USC15 was enforced, costs would drop by as much as 80%.
Never remind Denninger that if he gets his wish and Medical Costs drop 80%, there will be an instant collapse in employment in all things medical. Reminding him of that gets you banned.
All roads lead to a deflationary collapse. The entire world has been putting their lifestyles on the MasterCard and the bill’s about to come due.
Denninger is right—never been a better time to make sure to stay healthy.
I speak to a lot of Canadians, the wait time for elective procedures and non urgent problems can be longer in underserved areas. Medical conditions that are serious and require urgent care get prompt attention. What you are stating is a myth. If you have to wait6-12 months for a hip replacement not a big deal in my book.
The Canadians voted the politician who brought them national health care as the most popular politician in Canadian history. I always ask Canadians, and I know many, they are predominately happy with the system. Ditto for Germany. The rest I can’s speak for.
Concur the same with mu interactions with my family and friends in Canada (Toronto & Vancouver)
Waiting 1 minute for a cup of coffee, is a big deal for the guy who wants the coffee. While someone else waiting a few centuries to be freed from cotton picking slavery, isn’t that big a deal for those unaffected.
In free societies, people can wait as long as they fancy. Not as long as someone else fancies.
Universal doesn’t mean just ‘govt control’ but ‘equal access and affordability’ to quality care! One can afford to have 2 out of 3 (cheap, pronto and best) b
You like your doctor…you can keep your doctor.
You premiums will go down by average of $2500.
We have to pass obamcare to see what is in it.
A “lack of transparency” and the “stupidity of the American voter” – we Grubered some folks
Corruption at it finest – all to buy the votes of the free sh*t army.
Very well stated.
If it’s Required to cover Pre Existing Conditions it’s not insurance it’s Welfare..
You can’t buy car insurance for existing dents and damage.
You can’t buy house insurance for a house that’s on fire….
The Only Problem with Health Care in our Country is to much government, and BTW, all federal meddling in health care is Un Constitutional…
Agree, that’s the truth.
Wonder, how the other advanced OECD Countries can afford to serve their citizens with the tax dollars, while their mortality and morbidity rate are equal or better than those of USA! It is a question of priority of BREAD over GUNS or vice versa!
Lower salaries for doctors and nurses, enabled by lower salaries for professions that are realistic alternatives to the above is a big one.
Also, totalitarianism, like all else, is more efficient if applied directly. Rather than in an obfuscated manner requiring huge payments to banksters, lawyers and other irrelevants whose only role is to serve as a cover-up aimed at suckering the less than astute into believing the abomination that is the USA still retains some tenets of a free society.
It doesn’t. Hasn’t for a long time. The Euros have already fessed up to that fact wrt their own hellholes, hence can spend all their money on running the camps. Instead of diverting half of it to sham tribunals and other pointless facades.
Those doctors need to service their 250.000+ debt racked up to become doctors (although I agree that at least some seem to make exorbitant salaries) . . . part of the reason other OECD countries have seemingly less health care expenditures is because they heavily subsidize their medical education (through free or low cost medical school) so doctors do not need such large salaries as they- comparatively – have no educational debt. These expenditures do not show up as health care but as education . . .
They sure do. But on top of that, they also need to make enough so that a medical education is not some sort of ticket to the Ghetto.
Most doctors don’t get into the field to straight up maximize salary potential. But at the same time, they do expect to afford a reasonable standard of living. As in, living in neighborhoods without metal detectors at their children’s schools.
In Europe, Japan et al, a “decent neighborhood” is generally cheaper than in many places in the US. Courtesy of, at least pre ECB going mad, less wealth and income stratification. While in the US, doctors have to compete with an army of useless, zero-to-negative-value-add nothings in the financial, legal, insurance, realty etc… rackets, who receive ever higher welfare checks from the Fed and government. Putting a floor under how low their wages can go here.
Things are increasingly going the same way for other productive people. It’s just not worth bothering doing anything productive, when chasing ambulances and living off Fed and government welfare is so much more remunerative.
You want to go to medical school in the USA. Cost is about $500,000, I’d guess. After residency you have to pay the loans.
You apply for a job with a “heath system.” Competing for that job is a girl who went to Hyderabad U, total cost: $5K, no loans. The “health system” is going to base it’s pay package on WHO?
The USA is suiciding right before our eyes.
Exactly.
“…the confirmation of Justice Brett Kavanaugh in October won’t necessarily determine the outcome of this case…”
What about Trump’s other SCOTUS appointee, Neil Gorsuch? Anyone know where his humble opinion might lie?
The rule requiring coverage of pre-existing conditions was always the Achilles heel of ACA. Eliminating penalties for non-participation (as a proxy for requiring all to participate) makes ACA eventually unsustainable. It’s a dead duck without significant modification.