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The Pronk Pops Show 931, July 19, 2017, Story 1: “Obamacare Failed” Says President Trump — Wants Obamacare Completely  Repealed and Replaced Sooner or Later — Obama Lied To American People — Does President Trump Understand The Relationship Between Pre-existing Conditions, Guaranteed Issue, Community Rating and Adverse Selection — Many Doubt Trump Really Understands The Relationship That Is The Real Reason Obamacare Was Designed To Fail From The Beginning So It Could Be Replaced By Single Payer Government Health Care — Videos

Posted on July 20, 2017. Filed under: Abortion, Addiction, American History, Barack H. Obama, Biology, Blogroll, Breaking News, Bribery, Budgetary Policy, Business, Cartoons, Chemistry, Communications, Congress, Constitutional Law, Corruption, Countries, Crime, Culture, Diet, Diets, Disasters, Donald J. Trump, Donald J. Trump, Donald Trump, Donald Trump, Drugs, Economics, Education, Elections, Empires, Employment, Energy, Eugenics, Exercise, Fiscal Policy, Food, Food, Former President Barack Obama, Freedom of Speech, Government, Government Dependency, Government Spending, Health, Health Care, Health Care Insurance, Hillary Clinton, Hillary Clinton, Hillary Clinton, History, House of Representatives, Human, Human Behavior, Illegal Drugs, Immigration, Independence, Insurance, Investments, Labor Economics, Language, Law, Legal Drugs, Life, Lying, Media, Medical, Medicare, Medicine, Monetary Policy, National Interest, Networking, News, Obama, People, Philosophy, Photos, Politics, Polls, President Trump, Pro Abortion, Pro Life, Progressives, Radio, Rand Paul, Raymond Thomas Pronk, Regulation, Religion, Resources, Rule of Law, Scandals, Science, Security, Senate, Social Science, Social Security, Success, Tax Policy, Taxation, Taxes, Ted Cruz, United States Constitution, United States of America, Videos, Violence, Wealth, Welfare Spending, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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The Pronk Pops Show Podcasts

Pronk Pops Show 931,  July 19, 2017

Pronk Pops Show 930,  July 18, 2017

Pronk Pops Show 929,  July 17, 2017

Pronk Pops Show 928,  July 13, 2017

Pronk Pops Show 927,  July 12, 2017

Pronk Pops Show 926,  July 11, 2017

Pronk Pops Show 925,  July 10, 2017

Pronk Pops Show 924,  July 6, 2017

Pronk Pops Show 923,  July 5, 2017

Pronk Pops Show 922,  July 3, 2017 

Pronk Pops Show 921,  June 29, 2017

Pronk Pops Show 920,  June 28, 2017

Pronk Pops Show 919,  June 27, 2017

Pronk Pops Show 918,  June 26, 2017 

Pronk Pops Show 917,  June 22, 2017

Pronk Pops Show 916,  June 21, 2017

Pronk Pops Show 915,  June 20, 2017

Pronk Pops Show 914,  June 19, 2017

Pronk Pops Show 913,  June 16, 2017

Pronk Pops Show 912,  June 15, 2017

Pronk Pops Show 911,  June 14, 2017

Pronk Pops Show 910,  June 13, 2017

Pronk Pops Show 909,  June 12, 2017

Pronk Pops Show 908,  June 9, 2017

Pronk Pops Show 907,  June 8, 2017

Pronk Pops Show 906,  June 7, 2017

Pronk Pops Show 905,  June 6, 2017

Pronk Pops Show 904,  June 5, 2017

Pronk Pops Show 903,  June 1, 2017

Pronk Pops Show 902,  May 31, 2017

Pronk Pops Show 901,  May 30, 2017

Pronk Pops Show 900,  May 25, 2017

Pronk Pops Show 899,  May 24, 2017

Pronk Pops Show 898,  May 23, 2017

Pronk Pops Show 897,  May 22, 2017

Pronk Pops Show 896,  May 18, 2017

Pronk Pops Show 895,  May 17, 2017

Pronk Pops Show 894,  May 16, 2017

Pronk Pops Show 893,  May 15, 2017

Pronk Pops Show 892,  May 12, 2017

Pronk Pops Show 891,  May 11, 2017

Pronk Pops Show 890,  May 10, 2017

Pronk Pops Show 889,  May 9, 2017

Pronk Pops Show 888,  May 8, 2017

Pronk Pops Show 887,  May 5, 2017

Pronk Pops Show 886,  May 4, 2017

Pronk Pops Show 885,  May 3, 2017

Pronk Pops Show 884,  May 1, 2017

Pronk Pops Show 883 April 28, 2017

Pronk Pops Show 882: April 27, 2017

Pronk Pops Show 881: April 26, 2017

Pronk Pops Show 880: April 25, 2017

Pronk Pops Show 879: April 24, 2017

Pronk Pops Show 878: April 21, 2017

Pronk Pops Show 877: April 20, 2017

Pronk Pops Show 876: April 19, 2017

Pronk Pops Show 875: April 18, 2017

Pronk Pops Show 874: April 17, 2017

Pronk Pops Show 873: April 13, 2017

Pronk Pops Show 872: April 12, 2017

Pronk Pops Show 871: April 11, 2017

Pronk Pops Show 870: April 10, 2017

Pronk Pops Show 869: April 7, 2017

Pronk Pops Show 868: April 6, 2017

Pronk Pops Show 867: April 5, 2017

Pronk Pops Show 866: April 3, 2017

Image result for cartoons trump on obamacare failure

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Story 1: “Obamacare Failed” Says President Trump — Wants Obamacare Completely  Repealed and Replaced Sooner or Later — Obama Lied To American People — Does President Trump Understand The Relationship Between Pre-existing Conditions, Guaranteed Issue, Community Rating and Adverse Selection — Many Doubt Trump Really Understands The Relationship That Is The Real Reason Obamacare Was Designed To Fail From The Beginning So It Could Be Replaced By Single Payer Government Health Care — Videos

Trump Warns GOP Senators; 7-19-2017

MUST WATCH: President Trump Reacts to GOP Healthcare Bill Collapse – “Let ObamaCare Fail” (FNN)

LIMBAUGH: If We REPEAL Obamacare, “It’s The WILD WEST”

Rand Paul on Failed Healthcare Bill | Repealing Obamacare

Sen. Rand Paul Still Wants a Clean Repeal of Obamacare

Senator Mike Lee: Trump is right. repeal Obamacare now, replace later

Richard Epstein: Obamacare’s Collapse, the 2016 Election, & More

Richard Epstein – Obama Explained

Health Care 2: Can Congress Force Individuals to Buy Insurance?

Richard Epstein on Health Care Reform

The Truth Behind the Affordable Care Act – Learn Liberty

Is Obamacare Working? The Affordable Care Act Five Years Later

Why Is Healthcare So Expensive?

Why Is U.S. Health Care So Expensive?

Milton Friedman on universal health care

Milton Friedman on Medical Care (Full Lecture)

Professor Richard Epstein tribute to Milton Friedman

Does Trump Even Know What A Pre-Existing Conditions Is??

Here’s Why the Epic Health Care Reform Disaster Occurred

Here’s Why the Epic Health Care Reform Disaster Occurred

Will I pay more for insurance if I have a pre-existing condition under Obamacare?

Hume: Trump’s scenario for ObamaCare ‘politically nuts’

Obama’s Health Plan In 4 Minutes

How ObamaCare has been a financial failure

We Now Have Proof Obamacare Was Designed to Fail… and Here’s Why

The Pronk Pops Show Podcasts Portfolio

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The Pronk Pops Show 925, Story 1: Republicans Rush To Pass Repeal and Replace Obamacare Before August Recess with Pence, Cruz and McConnell Leading The Way — Videos — Story 2: Total Repeal of Obamacare Requires Total Repeal of All Obamacare Regulations Including Requiring Guaranteed Issue In Individual Health Insurance Market For Those With Preexisting Conditions, Community Rating Premiums and 10 Essential Health Care Benefits as Well As Repeal of The Individual and Employer Mandates and All Obamacare-Related Taxes– Address Individuals With Preexisting Conditions by State Special Risk Pools Insurance Coverage With State Subsidies Only and No Federal Subsidies — Otherwise Guaranteed Failure Just Like Obamacare Due To Adverse Selection — Leading To Single Government Payer Health Care System — Total Repeal of Obamacare Now Or Replace Your Representative and Senators Both Democrat and Republican Next November — It’s Now Or Never (O Sole Mio) — Videos

Posted on July 10, 2017. Filed under: American History, Biology, Blogroll, Breaking News, Communications, Computer, Congress, Countries, Donald J. Trump, Donald J. Trump, Donald J. Trump, Donald Trump, Donald Trump, Education, Elections, Employment, Freedom of Speech, Government, Government Spending, Health Care, Health Care Insurance, History, House of Representatives, Human, Insurance, Investments, Language, Law, Life, Media, Medical, Medicine, Mike Pence, National Interest, News, People, Philosophy, Photos, Politics, Polls, President Barack Obama, President Trump, Progressives, Rand Paul, Rand Paul, Raymond Thomas Pronk, Rule of Law, Science, Security, Senate, Success, Taxation, Taxes, Ted Cruz, Ted Cruz, United States of America, Videos, Wealth, Wisdom | Tags: , , , , , , , , , , , |

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The Pronk Pops Show Podcasts

Pronk Pops Show 925,  July 10, 2017

Pronk Pops Show 924,  July 6, 2017

Pronk Pops Show 923,  July 5, 2017

Pronk Pops Show 922,  July 3, 2017 

Pronk Pops Show 921,  June 29, 2017

Pronk Pops Show 920,  June 28, 2017

Pronk Pops Show 919,  June 27, 2017

Pronk Pops Show 918,  June 26, 2017 

Pronk Pops Show 917,  June 22, 2017

Pronk Pops Show 916,  June 21, 2017

Pronk Pops Show 915,  June 20, 2017

Pronk Pops Show 914,  June 19, 2017

Pronk Pops Show 913,  June 16, 2017

Pronk Pops Show 912,  June 15, 2017

Pronk Pops Show 911,  June 14, 2017

Pronk Pops Show 910,  June 13, 2017

Pronk Pops Show 909,  June 12, 2017

Pronk Pops Show 908,  June 9, 2017

Pronk Pops Show 907,  June 8, 2017

Pronk Pops Show 906,  June 7, 2017

Pronk Pops Show 905,  June 6, 2017

Pronk Pops Show 904,  June 5, 2017

Pronk Pops Show 903,  June 1, 2017

Pronk Pops Show 902,  May 31, 2017

Pronk Pops Show 901,  May 30, 2017

Pronk Pops Show 900,  May 25, 2017

Pronk Pops Show 899,  May 24, 2017

Pronk Pops Show 898,  May 23, 2017

Pronk Pops Show 897,  May 22, 2017

Pronk Pops Show 896,  May 18, 2017

Pronk Pops Show 895,  May 17, 2017

Pronk Pops Show 894,  May 16, 2017

Pronk Pops Show 893,  May 15, 2017

Pronk Pops Show 892,  May 12, 2017

Pronk Pops Show 891,  May 11, 2017

Pronk Pops Show 890,  May 10, 2017

Pronk Pops Show 889,  May 9, 2017

Pronk Pops Show 888,  May 8, 2017

Pronk Pops Show 887,  May 5, 2017

Pronk Pops Show 886,  May 4, 2017

Pronk Pops Show 885,  May 3, 2017

Pronk Pops Show 884,  May 1, 2017

Pronk Pops Show 883 April 28, 2017

Pronk Pops Show 882: April 27, 2017

Pronk Pops Show 881: April 26, 2017

Pronk Pops Show 880: April 25, 2017

Pronk Pops Show 879: April 24, 2017

Pronk Pops Show 878: April 21, 2017

Pronk Pops Show 877: April 20, 2017

Pronk Pops Show 876: April 19, 2017

Pronk Pops Show 875: April 18, 2017

Pronk Pops Show 874: April 17, 2017

Pronk Pops Show 873: April 13, 2017

Pronk Pops Show 872: April 12, 2017

Pronk Pops Show 871: April 11, 2017

Pronk Pops Show 870: April 10, 2017

Pronk Pops Show 869: April 7, 2017

Pronk Pops Show 868: April 6, 2017

Pronk Pops Show 867: April 5, 2017

Pronk Pops Show 866: April 3, 2017

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Story 1: Republicans Rush To Pass Repeal and Replace Obamacare Before August Recess with Pence, Cruz and McConnell Leading The Way — Videos —

Ronald Reagan speaks out on Socialized Medicine – Audio

Is the GOP plan to replace ObamaCare dead?

Vice President Pence ‘s Obamacare Listening Session with Ohio Small Business Owners

Trump’s push to replace Obamacare in trouble as Congress returns from recess

Sen. Cruz on ‘Face the Nation’ – July 9, 2017

Sen Mike Lee on the push to repeal ObamaCare

Lawmakers respond to Senate health care proposal

Sen. Rand Paul: Senate health care bill needs more Obamacare ‘repeal’

Sen. Rand Paul: We shouldn’t try to fix government intervention with more intervention. – 6/22/17

I won’t vote to keep ObamaCare: Rand Paul

Coolidge: The Best President You Don’t Know

Amity Shlaes on Coolidge’s life, ideas, and success in bringing about low taxes and small government

Uncommon Knowledge: The Great Depression with Amity Shlaes

Amity Shlaes: Calvin Coolidge, Better Than Reagan?

Archie Bunker on Democrats

 

Trump prods Congress to pass stalled healthcare overhaul

By Susan Cornwell and Ian Simpson | WASHINGTON

President Donald Trump on Monday prodded the Republican-led U.S. Congress to pass major healthcare legislation but huge obstacles remained, with a senior lawmaker saying the Senate was unlikely to take up the stalled bill until next week.

The House of Representatives approved its healthcare bill in May but the Senate’s version appeared to be in growing trouble as lawmakers returned to Washington from a week-long recess.

“I cannot imagine that Congress would dare to leave Washington without a beautiful new HealthCare bill fully approved and ready to go!” Trump wrote on Twitter, referring to the seven-year Republican quest to dismantle Democratic former President Barack Obama’s signature legislative achievement.

Lawmakers are set to take another recess from the end of July until Sept. 5.

Repealing and replacing the Affordable Care Act, dubbed Obamacare, was a central campaign pledge for the Republican president. But Senate Republican leaders have faced a revolt within their ranks, with moderate senators uneasy about the millions of Americans forecast to lose their medical insurance under the legislation and hard-line conservatives saying it leaves too much of Obamacare intact.

They were struggling to find a compromise that could attract the 50 votes needed for passage in a chamber Republicans control by a 52-48 margin, with Vice President Mike Pence casting a potential tie-breaking vote in the face of unified Democratic opposition.

No. 2 Senate Republican John Cornyn said Republicans could release an updated draft of their bill by the end of the week and told Fox News that senators could vote as early as Tuesday or Wednesday of next week.

 
U.S. President Donald Trump waves as walks on the South Lawn of the White House upon his return to Washington, U.S., from the G20 Summit in Hamburg, July 8, 2017. REUTERS/Yuri Gripas
“We’re going to continue to talk and listen and exchange ideas on how we can continue to make improvements,” Cornyn said on the Senate floor.

Also speaking on the Senate floor, Majority Leader Mitch McConnell gave no timetable for the bill. McConnell signaled his determination to keep working and said mere legislative “band-aids” would not suffice.

Senate Democratic leader Chuck Schumer said he had written to McConnell urging a bipartisan effort to stabilize the health insurance market, noting that McConnell had been quoted recently as saying Congress would need to shore up that market if lawmakers fail to repeal Obamacare.

The U.S. Centers for Medicare and Medicaid Services issued data on Monday showing a 38 percent decrease in applications by insurers to sell health plans in the Obamacare individual market in 2018 compared to this year. The agency said insurers continue to flee the exchanges, the online marketplace for health insurance set up under Obamacare.

MORE AMERICANS UNINSURED

With uncertainty hanging over the healthcare system, the percentage of U.S. adults without health insurance grew in the April-May-June period to 11.7 percent, up from 11.3 percent in the first quarter of 2017, according to Gallup-Sharecare Well-Being Index figures released on Monday. That translates into nearly 2 million more Americans who have become uninsured.

Scores of protesters voiced opposition to the legislation outside the Republican National Committee headquarters and at the offices of some Republican lawmakers including House of Representatives Speaker Paul Ryan, chanting slogans including “Trumpcare kills” and “Healthcare is a human right.”

U.S. Capitol Police said in a statement 80 people were arrested at 13 locations in House and Senate office buildings after they refused “to cease and desist with their unlawful demonstration activities.”

Republicans criticize Obamacare as a costly government intrusion into the healthcare system. Democrats call the Republican legislation a giveaway to the rich that would hurt millions of the most vulnerable Americans.

The Senate legislation would phase out the Obamacare expansion of the Medicaid health insurance program for the poor and disabled, sharply cut federal Medicaid spending beginning in 2025, repeal most of Obamacare’s taxes, end a penalty on Americans who do not obtain insurance and overhaul Obamacare’s subsidies to help people buy insurance with tax credits.

Leerink Partners analyst Ana Gupte said investors remained in a “wait-and-see” mode regarding the Senate legislation.

(For a graphic on who’s covered under Medicaid, click bit.ly/2u3O2Mu)

(Additional reporting by Susan Heavey, Eric Beech and Doina Chiacu; Writing by Will Dunham; Editing by Tom Brown)

http://www.reuters.com/article/us-usa-politics-healthcare-idUSKBN19V0YP

 

The Health 202: Cruz picks government health care subsidies as lesser of two evils

 July 10 at 9:03 AM
THE PROGNOSIS

Even conservatives acknowledge that the sickest Americans need help in paying their own steep insurance costs. In an ironic twist, some would rather have the government make up the difference rather than spreading expenses among the healthy.

Health insurance markets are so complicated, and the policy around them is so complex and intertwined, that politicians don’t always land ideologically on the issue where you’d think. Just look at how GOP Sen. Ted Cruz of Texas is trying to change the Obamacare overhaul that Senate Republicans will try to pass in the next three weeks before August recess. The former presidential candidate last week touted his ideas and on the Sunday shows yesterday, my colleague Sean Sullivan reports.

Cruz’s so-called “Consumer Freedom Amendment” — which conservatives have been rallying around as the revision they most want — would essentially free the healthiest Americans from covering the costs of the sickest Americans. But the sick would be even more heavily reliant on federal assistance as a result.

“You would likely see some market segmentation” Cruz told Vox last month. “But the exchanges have very significant federal subsidies, whether under the tax credits or under the stabilization funds.”

The Cruz amendment, which is being scored by the Congressional Budget Office as one of several potential changes to the Senate health-care bill, would result in segmenting the individual insurance market into two groups, experts say. Under it, insurers could sell cheaper, stripped-down plans free of Obamacare coverage requirements like essential health benefits or even a guarantee of coverage. These sparser plans would appeal to the healthiest Americans, who would gladly exchange fewer benefits for lower monthly premiums.

But insurers would also have to sell one ACA-compliant plan. The sickest patients would flock to these more expansive and expensive plans because they need more care and medications covered on a day-to-day basis. As a result, premiums for people with expensive and serious medical conditions like diabetes or cancer would skyrocket because all those with such serious conditions would be pooled together.

“The question is, would there be a premium spiral on the ACA-complaint market?” said Cori Uccello, a senior health fellow with the American Academy of Actuaries. “Can they ever price those premiums adequately if it’s just going to be the sickest people in there?”

It’s true that government subsidies — which under the Senate plan would be available to those earning up to 350 percent of the federal poverty level — would be even more crucial in order for these sicker Americans to afford the cost of their coverage, as would an extra infusion of federal “stabilization” money for states to cover their steep expenses.

Cruz hasn’t laid out all the details of how his amendment would work, nor is it even certain Senate Majority Leader Mitch McConnell (R-Ky.) will accept it as part of his health-care bill. But should it be adopted, and the Senate bill ultimately made law, the Cruz amendment would significantly shift how the individual insurance market operates.

But in Cruz’s mind, it would solve one of the biggest problems with Obamacare: that it robs the healthy to pay for the sick. He’s spent the last week pitching it as the legislative solution for passing the Senate bill.

“I think really the consumer freedom option is the key to bringing Republicans together and getting this repeal passed,” Cruz said on ABC yesterday.

Of course, everyone paying into the system for those who most need care is the way insurance is fundamentally supposed to work. The ACA requires insurers to offer a wider ranger of benefits in plans sold to everyone regardless of their health status. But to Cruz and his compatriots, requiring healthier people to buy cushier plans than they want or need is an abridgment of personal freedom and oversteps federal regulatory authority. So they’re more worried at the moment about rolling back more ACA regulations and less worried about federal spending.

“I think for conservatives it’s become a question of picking their poison,” Larry Levitt, president of the Kaiser Family Foundation, told me. “Is it government spending, or regulation? It’s almost like with this amendment, Sen. Cruz is acknowledging the need for a government entitlement program.”

Conservative groups that want a much fuller Obamacare repeal than the Senate bill provides have been jumping on the Cruz bandwagon, including Club for Growth, FreedomWorks and Tea Party Patriots.

.@SenTedCruz@SenMikeLee ‘Consumer Choice’ amendment, aka individual Obamacare Opt Out, is real step toward . We Support it!

From Tea Party Patriots founder Jenny Beth Martin:

If the Senate adopts the Cruz-Lee Amdt to the health care bill, @TPPatriots will be more likely to support the bill http://www.teapartypatriots.org/news/tea-party-patriots-signals-support-for-cruz-lee-amendment-to-senate-health-care-bill/ 

Photo published for Tea Party Patriots Signals Support for Cruz-Lee Amendment to Senate Health Care Bill

Tea Party Patriots Signals Support for Cruz-Lee Amendment to Senate Health Care Bill

Atlanta, GA – Tea Party Patriots President and co-founder Jenny Beth Martin released the following statement today regarding the amendment to the Senate health care bill offered by Senators Ted Cruz…

teapartypatriots.org

On the flip side, the Cruz amendment could help kill the Senate health-care bill in the end because it’s prompting fears among moderates (whose votes are also needed to pass the legislation) that patients with preexisting conditions could be harmed.

“I think that reopens an issue that I can’t support, that it would make it too difficult for people with preexisting conditions to get coverage,” Sen. Shelley Moore Capito (R-W.Va.) told the Charleston Gazette-Mail.

Cruz has said the Senate bill’s $100 billion stabilization fund for states could help cover costs for the resulting pricier coverage for those with preexisting conditions under his amendment. And to parry concerns about the increased federal spending, which to some is more than ironic coming from Cruz? The  talking point Capitol Hill aides and conservative wonks are adopting: Directly subsidizing costs for those with preexisting conditions is a more “honest” approach by the government than forcing healthy people to indirectly pay for their care by buying comprehensive coverage.

“If you’re going to have a subsidy, have it come directly from the taxpayer and call it a subsidy rather than try to dragoon people to do the government’s work,” said Chris Jacobs, a former GOP Hill staffer and founder of Juniper Research Group.

“It’s more honest and fair to have the government than to have healthy, middle-class families pay for it,” Conn Carroll, a spokesman for Sen. Mike Lee (R-Utah) said.

A co-sponsor of Cruz’s amendment, Lee is insisting it be added to the Senate bill before he’ll vote for it. Sens. Rand Paul of Kentucky and Ron Johnson of Wisconsin have sent similar signals. And remember — if more than two Republicans defect, the measure would be sunk in the Senate and the GOP effort to repeal-and-replace Obamacare would most likely meet a bitter end.

Some exciting news over at The Daily 202 from my colleague James Hohmann, whose newsletter makes its debut on Amazon Echo devices and Google Home as a flash briefing called “The Daily 202’s Big Idea.” Every morning, you can listen to James analyze one of the day’s most important political stories, along with three headlines you need to know. To learn how to add The Daily 202’s Big Idea to your flash briefings on your Echo device or Google Home, visit this page. You can also get the briefing on Apple Podcasts or wherever you get your podcasts.

https://www.washingtonpost.com/news/powerpost/paloma/the-health-202/2017/07/10/the-health-202-cruz-picks-government-health-care-subsidies-as-lesser-of-two-evils/59611958e9b69b7071abcae4/?utm_term=.7137a797b4cf

GOP, White House Plot ‘Urgent Blitz’ For Repeal Votes | The Last Word | MSNBC

Story 2: Total Repeal of Obamacare Requires Total Repeal of All Obamacare Regulations Including Requiring Guaranteed Issue In Individual Health Insurance Market For Those With Preexisting Conditions, Community Rating Premiums and 10 Essential Health Care Benefits as Well As Repeal of The Individual and Employer Mandates and All Obamacare-Related Taxes– Address Individuals With Preexisting Conditions by State Special Risk Pools Insurance Coverage With State Subsidies Only and No Federal Subsidies — Otherwise Guaranteed Failure Just Like Obamacare Due To Adverse Selection — Leading To Single Government Payer Health Care System — Total Repeal of Obamacare Now Or Replace Your Representative and Senators Both Democrat and Republican Next November — It’s Now Or Never (O Sole Mio) — Videos

Rush Limbaugh Podcast 7/11/17 – Exclusive: Vice President Mike Pence Calls the Show

AHCA Myth No. 1: People with Pre-existing Conditions Will Lose Coverage

Fox News host says coverage for preexisting conditions is a ‘luxury’

Dr. Siegel breaks down the pre-existing conditions challenge

The Pre-Existing Condition Scam

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Debate over pre-existing conditions stalling health-care reform?

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ObamaCare Revealed – Pre-Existing Conditions Coverage

Why Exactly Trump’s Healthcare Plan Failed

We Now Have Proof Obamacare Was Designed to Fail… and Here’s Why

Why Is Healthcare So Expensive?

Single-Payer Health Care: America Already Has It

Big Government Kills Small Businesses

Are You on the Wrong Side of History?

Socialism Makes People Selfish

Democratic Socialism is Still Socialism

Elvis – It’s Now Or Never (O Sole Mio)

 

 

It’s Now or Never
It’s now or never,
Come hold me tight
Kiss me my darling,
Be mine tonight
Tomorrow will be too late,
It’s now or never
My love won’t wait.
When I first saw you
With your smile so tender
My heart was captured,
My soul surrendered
I’d spend a lifetime
Waiting for the right time
Now that your near
The time is here at last.
It’s now or never,
Come hold me tight
Kiss me my darling,
Be mine tonight
Tomorrow will be too late,
It’s now or never
My love won’t wait.
Just like a willow,
We would cry an ocean
If we lost true love
And sweet

 

FACT VERSUS FEAR: THE AHCA AND PRE-EXISTING CONDITIONS

On May 4, 2017, the House of Representatives passed the American Health Care Act (AHCA), a bill to repeal and replace many provisions of the Affordable Care Act (ACA). Immediately following the vote, misinformation about the bill began spreading like wildfire, stoking fears and outrage. The issue which seems to be getting the most attention is the potential impact this legislation could have on people with pre-existing conditions. However, as the legislation now moves to the Senate for further consideration and amendment, it is important that all stakeholders be well informed, and understand what the legislation actually says and who may realistically be impacted by any possible changes to current law.

  • The number of people in the U.S. with a condition that would likely qualify as pre-existing is not easily known, primarily because there is not a specific, pre-determined list of conditions. Estimates vary depending on how one defines “pre-existing.”
  • Even the range included in a recent report from the Department of Health and Human Services varied by a margin of more than 2:1, from between 61 million to 133 million people.[1] That said, it is likely that approximately as many as a quarter of Americans, and possibly more, have a pre-existing health condition, making it understandable why some are concerned.
  • As the AHCA is currently written, the only people who could be charged a premium based on their health status are those with a pre-existing condition who are not enrolled in a large group health plan, are also living in a state that obtains a waiver, and have let their insurance lapse in the past year for 63 days or more. In this case, the increased premium would only be allowed for one year. Further, no one may be denied insurance because of a pre-existing condition.

Background

Before passage of the ACA, most laws pertaining to the regulation of the individual health insurance market were passed at the state level and could vary widely from one state to another. The McCarran-Ferguson Act of 1945 provided states primary responsibility for regulating the business of insurance.

The Employee Retirement Income Security Act of 1974 (ERISA) imposed federal standards on certain types and with respect to certain provisions of large group (employer-sponsored) health plans, some of which supersede state law.[2] Among the provisions included in ERISA is a requirement that plans be offered on a guaranteed-issue basis, meaning that insurers are prohibited from denying coverage to the group based on medical claims history; though, the policy may be medically underwritten, meaning the premiums are based on the insured’s health status.

In 1996, the Health Insurance Portability and Accountability Act (HIPAA) was passed and imposed additional federal health insurance standards across the individual, small group, and large group markets. In response to concerns of “job-lock”—the fear that leaving a job could result in the inability to regain health insurance if an individual had a pre-existing condition—HIPAA required all states to guarantee renewability of health insurance coverage to anyone who had creditable coverage for the past 18 months, with no more than a 63-day gap in coverage during that time.[3] However, while insurers were required to renew an individual’s policy from one year to the next, they were still not prohibited from medically underwriting individuals. Thus, some individuals found that while a plan was still technically available to them, the premium may have effectively priced them out of the market. Even those without a pre-existing condition may have found the cost of insurance to be significantly higher without the added employer contribution and tax advantage that such plans receive, which could make maintaining coverage, and HIPAA eligibility, more difficult.

Very few states previously had guarantee issue or renewability requirements or other protections for individuals not covered by HIPAA.[4] Most states permitted insurers to impose pre-existing condition exclusions, in which a pre-existing condition could be used to deny coverage altogether, or would not be covered by an individual’s new insurance policy for at least a certain amount of time, if not indefinitely. Varying “look-back” periods were also prevalent, which regulated the amount of time during which the insurer may check an individual’s claims history to make such a determination.

Current Law

The ACA attempted to mitigate these issues by imposing federal guaranteed issue requirements paired with community rating, which prohibits medical underwriting, across all health insurance markets. For many, these protections became the most important provisions of the ACA. However, there are economic consequences associated with such protections; primarily, higher average premiums in the individual market and increased spending by federal taxpayers. Multiple risk mitigation programs were included in order to help subsidize the cost of insuring high-risk, high-cost individuals, but the funding has not been sufficient. Insurers continue to lose money in the individual market, despite tens of billions of dollars in federal payments each year. In fact, many insurers have found the markets to be so unprofitable due to the many enhanced regulations, that they have decided they can no longer participate in the individual market in many states.[5]

The AHCA

The AHCA, passed by the House of Representatives on May 4, would repeal and replace many provisions of the ACA. One of the ACA’s most well-known provisions, the individual mandate which requires everyone to obtain health insurance, would be repealed (practically speaking, though not technically) and replaced with a continuous coverage provision.[6] These two policies are similar. The individual mandate imposes an annual penalty for not being insured equal to the greater of $695 per adult or 2.5 percent of household income.[7] The continuous coverage provision in this legislation would, instead of federally mandating that everyone buy insurance, incentivize individuals to remain insured by allowing for the imposition of a 30 percent premium surcharge for one year on individuals who signed up for coverage if they were uninsured for more than two months in the previous year.[8] After paying the surcharge for one year, individuals would return to paying regular community-rated premiums.

One provision that would not be repealed is the federal guaranteed issue requirement; insurers in every state would still be prohibited from denying insurance coverage to anyone on the basis of a pre-existing condition. In no circumstance would this protection be denied, though it seems much confusion surrounding this protection has stemmed from the adoption of several amendments to the underlying legislation.

The first relevant amendment is one that was negotiated by Rep. Mark Meadows (R-NC), on behalf of the Freedom Caucus. This amendment includes a provision pertaining to the “essential health benefits” established by the ACA—ten categories of care which are now required to be covered under every health insurance plan. The amendment would permit states, rather than the federal government, to define the EHB standards for themselves beginning in 2018.[9] However, this provision was ultimately struck.

A second amendment was offered by Rep. Tom MacArthur (R-NJ) to address concerns that states would drastically reduce benefit requirements. The MacArthur amendment reinstates the federal EHB standards, but would allow states to apply for waivers to a number of provisions, under certain conditions. Waivers would be permitted for the following: beginning in 2018, a change in age-rating restrictions (which determine how much more an insurer may charge an older person relative to a younger person); beginning in 2019, changes to the community rating provisions, which prohibit insurers from medically underwriting individuals; and, beginning in 2020, changes to the federal EHB standards, permitting states to set their own.

Any state seeking to obtain a community rating waiver must first have in place a program to help high-risk individuals enroll in coverage or a program providing incentives to insurers to enter the market and stabilize premiums, or an invisible risk-sharing program, as defined by the Schweikert/Palmer amendment.[10] All of these programs would be at least partially funded by the $138 billion provided over the next ten years by the Patient and State Stability Fund created by AHCA. The state must also specify how the waiver it is requesting would assist in: reducing average premiums in the state, increasing the number insured, stabilizing the health insurance market, stabilizing premiums for people with pre-existing conditions, or increasing plan choice in the state. If a state demonstrates it has met these conditions and obtains such a waiver, then it may permit insurers to waive the community rating protections, though only for individuals who have not maintained continuous coverage (save for the 63-day allowance) seeking to enroll in coverage in the individual and small group markets. In other words, individuals who would otherwise face a 30 percent surcharge as a result of not maintaining continuous coverage, would instead be medically underwritten for one year. However, under no circumstance may the gender rating protections be waived; insurers would continue to be prohibited from charging different rates based on whether an individual is a male or female.

Thus, the only people who could be charged a premium based on their health status are those with a pre-existing condition, not enrolled in a large group health plan, living in a state that obtains a waiver, who have let their insurance lapse in the past year for 63 days or more, and then only for one year. All others would continue to be protected by the community rating provisions currently in place under the ACA. Further, no one could be denied coverage because of the existence of a pre-existing condition, or even face a lock-out period.

Conclusion

The AHCA would not provide for the return to the status quo prior to the ACA. It is unlikely that many Americans will be impacted by the provisions of the MacArthur amendment. Finally, the AHCA must still be passed by the Senate and is likely to undergo significant reforms before it does, in which case, the legislation would again have to be passed by the House.

 

[1] https://aspe.hhs.gov/system/files/pdf/255396/Pre-ExistingConditions.pdf

[2] https://www.nahu.org/consumer/GroupInsurance.cfm

[3] There are some exceptions to the guaranteed renewability requirements.

[4] http://www.ncsl.org/research/health/individual-health-insurance-in-the-states.aspx

[5] http://kff.org/health-reform/issue-brief/2017-premium-changes-and-insurer-participation-in-the-affordable-care-acts-health-insurance-marketplaces/

[6] Technically, the mandate would not be repealed because legislative rules prohibit such a change through the reconciliation process, but the applicable penalty would be set to $0, rendering the mandate moot.

[7] https://www.healthcare.gov/fees/fee-for-not-being-covered/

[8] The continuous coverage provisions which match the 63-day rule of the HIPAA requirements.

[9] https://rules.house.gov/sites/republicans.rules.house.gov/files/115/policymngr-amdt.pdf

[10] https://rules.house.gov/sites/republicans.rules.house.gov/files/115/AHCA/Palmer-Schweikert%20Amendment.pdf

Read more: https://www.americanactionforum.org/insight/fact-versus-fear-ahca-pre-existing-conditions/#ixzz4mSiu1KRn
Follow us: @AAF on Twitter

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The Pronk Pops Show 918, June 26, 2017, Story 1: Supreme Court 9-0 Decision Backs President Trump’s Travel Ban With Temporary Stay But Allows Refugees With A “Bona Fide” Relationship With Legal U.S. Residents To Enter U. S. — Will Hear Case In The Fall whether or not the travel ban is constitutional — Videos — Story 2: Supreme Court Rules in 7-2 Decision State Funding For Religious School Can Use Taxpayer Funds For Playground — Videos — Story 3: American People Optimistic As Consumer Confidence Increases — Awaiting The Trump Tax Cut and Total Repeal Of Obamacare — Videos

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Image result for supreme court decisions june 26, 2017

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Story 1: Supreme Court 9-0 Decision Backs President Trump’s Travel Ban But Allows Refugees With A “Bona Fide” Relationship With Legal U.S. Residents To Enter U. S. — Will Hear Case In The Fall whether or not the travel ban is constitutional — Videos —

US Supreme Court allows part of Trump travel ban to go into effect – BBC News

Part of Trump’s travel ban will go into effect

Supreme Court travel order decision is a Trump win: Fmr. Rep. Hoekstra

Panel Discusses: Supreme Court Allows Part of Trump Travel Ban to Take Effect

Here’s what the Supreme Court ruling on Trump’s travel ban means

Why the travel ban ruling is a political win for Trump

Hume: Admin is in ‘pretty good shape’ with travel ban case

Supreme Court to Hear Trump’s Travel Ban, Orders Temporary Stay

Varney & Co : Sekulow: Trump travel ruling a huge win for administration : 6/26/2017

It’s an absolutely boffo slam dunk for Trump in SCOTUS travel ban case.

Lionel on SCOTUS Travel Ban Decision Inter Alia

Ben Shapiro: Supreme Court’s decisions on Trump’s travel ban & public funds for churches

The Democrat Vitriol Boomerang! Pres Trump Stronger Than Ever!

Trump claims ‘clear victory’ after Supreme Court says his ‘Muslim’ travel ban can go into effect NOW against people without U.S. ties

  • Supreme Court justices will act on Trump’s travel ban in the fall, and allowed a major part of it to go into effect immediately
  • Refugees and others from six Muslim-majority countries who already have a ‘bona fide relationship’ with legal U.S. residents will be allowed to come
  • While the case is pending, the lower court’s injunction will apply only to those people who have no U.S. ties
  • Rumors also abound in Washington, DC that Supreme Court Justice Anthony Kennedy, 80, may announce his retirement on Monday
  • Trump and press secretary Sean Spicer both called the outcome a ‘9-0’ decision, although the court didn’t say how large a majority of the justices approved it

President Donald Trump took a victory lap on Monday after the Supreme Court restored most of his executive order banning incoming travel from six terror-prone countries.

‘Today’s unanimous Supreme Court decision is a clear victory for our national security,’ the president said in a statement shortly after the high court ruled. ‘It allows the travel suspension for the six terror-prone countries and the refugee suspension to become largely effective.’

The Supreme Court said it will decide in the fall whether or not the travel ban is constitutional. Liberal state attorneys general have argued that it amounts to a religious test for entry into the U.S. since the affected countries all have Muslim majorities.

The court said that while the wheels of justice turn, the Trump administration can enforce the executive order against anyone from those nations who doesn’t already have a ‘bona fide relationship’ with a U.S. citizen or legal resident.

The stopgap measure, announced Monday morning, is largely a victory for Trump, who will be allowed – at least temporarily – to stem the flow of immigrants and refugees from Iran, Libya, Somalia, Sudan, Syria and Yemen.

Trump has said he would put his ban into effect 72 hours after the Supreme Court gives him a green light.

Technically, the justices left a lower court injunction in place, but only for people whose cases mirror those of the original plaintiffs – meaning ‘foreign nationals who have a credible claim of a bona fide relationship with a person or entity in the United States.’

‘All other foreign nationals are subject to the provisions of [the executive order],’ the court ruled.

President Donald Trump won a major victory – at least for now – on Monday, as the Supreme Court allowed him to enforce most of his travel ban against people from six terror-prone and Muslim-majority countries

President Donald Trump won a major victory – at least for now – on Monday, as the Supreme Court allowed him to enforce most of his travel ban against people from six terror-prone and Muslim-majority countries

Supreme Court justices decided to limit the reach of a lower court’s injunction against Trump’s travel ban, allowing much of it to take affect – at least until the high court hears the case formally in the fall

There are rumors that Supreme Court Justice Anthony Kennedy, 80, could announce his retirement from the bench as soon as this week

There are rumors that Supreme Court Justice Anthony Kennedy, 80, could announce his retirement from the bench as soon as this week

Trump framed the decision as a win for national security, mirroring his claims that controlling travel entries is a vital anti-terror tool.

‘As President, I cannot allow people into our country who want to do us harm,’ he said Monday. ‘I want people who can love the United States and all of its citizens, and who will be hardworking and productive.’

‘My number one responsibility as Commander in Chief is to keep the American people safe. Today’s ruling allows me to use an important tool for protecting our Nation’s homeland.’

White House press secretary Sean Spicer told reporters in an off-camera news briefing that Trump was ‘honored’ by Monday’s result which ‘allowed him to use an important tool to protect our nation’s homeland.’

Like Trump, he referred to the outcome as a ‘9-0’ decision.

Asked how that can be accurate when the Supreme Court did not publish a list of how many justices approved, he said he would check with the White House counsel’s office for clarification.

‘We’ll probably have further guidance for you as it becomes available,’ Spicer said.

White House press secretary Sean Spicer defended the travel ban and the Supreme Court ruling, but punted on a question about why the president called it a 9-0 ruling

White House press secretary Sean Spicer defended the travel ban and the Supreme Court ruling, but punted on a question about why the president called it a 9-0 ruling

PRESIDENT TRUMP REACTS

‘Today’s unanimous Supreme Court decision is a clear victory for our national security. It allows the travel suspension for the six terror-prone countries and the refugee suspension to become largely effective.

‘As President, I cannot allow people into our country who want to do us harm. I want people who can love the United States and all of its citizens, and who will be hardworking and productive.

‘My number one responsibility as Commander in Chief is to keep the American people safe. Today’s ruling allows me to use an important tool for protecting our Nation’s homeland. I am also particularly gratified that the Supreme Court’s decision was 9-0.’

The media circus that usually accompanies a Supreme Court decision day was evident this morning in Washington outside the high court

The media circus that usually accompanies a Supreme Court decision day was evident this morning in Washington outside the high court

Trump insisted the decision to lift most of a lower court's 'stay' against his travel ban was a unanimous one, but the administration hasn't substantiated that claim

Trump insisted the decision to lift most of a lower court’s ‘stay’ against his travel ban was a unanimous one, but the administration hasn’t substantiated that claim

Democratic National Committee chairman Tom Perez lashed out at the administration for proposing the ban in the first place.

‘Donald Trump’s Muslim ban is an unconstitutional and un-American assault on our country’s foundation of religious freedom,’ Perez said in a statement.

‘As a nation, our diversity is our greatest strength, and we cannot allow such prejudice to shut the doors of progress. Democrats will continue to fight this hatred every step of the way.’

But Attorney General Jeff Sessions called the ruling ‘an important step towards restoring the separation of powers’ between the White House and the federal courts.

‘We have seen far too often in recent months that the threat to our national security is real and becoming increasingly dangerous,’ he added.

‘Groups like ISIS and al Qaeda seek to sow chaos and destruction in our country, and often operate from war-torn and failed countries while leading their global terror network. It is crucial that we properly vet those seeking to come to America from these locations, and failing to do so puts us all in danger.’

The administration has said the ban was needed to allow an internal review of the screening procedures for visa applicants from the six relevant countries.

That review should be complete before October 2, the first day the justices could hear arguments in their new term.

Trump launched a nationwide controversy by signing an executive order a week after his inauguration, barring the entry of refugees and other travelers from Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen; Iraq was removed from a second version that the high court will review

Trump launched a nationwide controversy by signing an executive order a week after his inauguration, barring the entry of refugees and other travelers from Iran, Iraq, Libya, Somalia, Sudan, Syria and Yemen; Iraq was removed from a second version that the high court will review

The Supreme Court could have a vacancy by the time that autumn session rolls around, if Justice Anthony decides to retire as some expect.

Kennedy did not use the occasion of Monday’s scheduled high court announcements to say he would be stepping down.

But if he does, President Donald Trump will have a second pick in the first months of his administration. Kennedy’s departure could also allow conservatives to take firm control of the court.

Kennedy turns 81 next month and has been on the court for nearly 30 years. Several of his former law clerks have said they think he is contemplating stepping down in the next year or so.

Washington was abuzz with talk this weekend that President Donald Trump may soon have another chance to nominate a judge to the highest court in the land.

If the speculation pans out, that would give Trump his second high court pick in the first months of his administration.

The famed 'running of the interns' was a familiar sight on Monday as young staffers to news agencies hurried to bring written case decisions to their reporters and producers

The famed ‘running of the interns’ was a familiar sight on Monday as young staffers to news agencies hurried to bring written case decisions to their reporters and producers

 President Trump’s travel ban will head to the Supreme Court

Kennedy did not address the retirement rumors when he and his clerks gathered over the weekend for a reunion, according to three clerks who were there. The decision to push up the reunion by a year helped spark talk he might be leaving the court.

Kellyanne Conway, senior counselor to President Trump, declined Monday to join in on the conjecture.

‘That is totally Justice Kennedy’s decision and he has served for 30 years, almost 30 years, with distinction and care on the Court and that is entirely his decision,’ she said on Fox & Friends.

‘I do know that the president, when he appointed Neil Gorsuch, made very clear that at any time that he gets a federal appointment, whether it’s the Supreme Court level of the District courts the circuit courts, he will appoint people who have fidelity to the Constitution, they won’t legislate from the bench, make it up as they go along.’

Conway had declined to say in a Sunday interview whether the president and Kennedy had discussed retirement.

‘I will never reveal a conversation between a sitting justice and the president or the White House, but we’re paying very close attention to these last bit of decisions,’ she said on ABC News.

The original travel ban executive order triggered worldwide outrage as well as protests (above) in the United States like this one at New York City’s John F. Kennedy International Airport

In 2015, Kennedy wrote the majority opinion in Obergefell v. Hodges, the landmark case legalizing same sex marriage be made legal nationwide. Madeleine Troupe of Houston, Texas, wipes tears of joy after the Supreme Court legalized same sex marriage on June 26, 2015

In 2015, Kennedy wrote the majority opinion in Obergefell v. Hodges, the landmark case legalizing same sex marriage be made legal nationwide. Madeleine Troupe of Houston, Texas, wipes tears of joy after the Supreme Court legalized same sex marriage on June 26, 2015

If Kennedy does retire, that means President Donald Trump would be able to nominate a second justice to the bench. Trump is seen above during the swearing-in of his first nominee, Neil Gorsuch, at the White House on April 10, 2017

Justice Kennedy, who is known as a moderate Republican, was nominated by then-President Ronald Reagan in 1987.

Since Sandra Day O’Connor retired in 2006, Kennedy has been the key swing vote on a number of 5-4 decisions.

In 2015, Kennedy wrote the majority opinion in Obergefell v. Hodges, the landmark case whose ruling mandated that same sex marriage be made legal nationwide.

The concluding paragraph of Kennedy’s 28-page majority opinion was even used by many same sex and heterosexual couples alike as their wedding vows.

‘No union is more profound than marriage,’ Kennedy’s opinion says, ‘for it embodies the highest ideals of love, fidelity, devotion, sacrifice and family. In forming a marital union, two people become something greater than once they were.’

Several of his former law clerks have said they think he is contemplating stepping down in the next year or so.

Kennedy and his clerks were gathering over the weekend for a reunion that was pushed up a year and helped spark talk he might be leaving the court.

‘Soon we’ll know if rumors of Kennedy’s retirement are accurate,’ one former Kennedy clerk, George Washington University law professor Orin Kerr, said on Twitter Friday.

http://www.dailymail.co.uk/news/article-4640028/Supreme-Court-act-travel-ban-Kennedy-retire.html#ixzz4l9IuSa5T

Story 2: Supreme Court Rules in 7-2 Decision State Funding For Religious School Can Use Taxpayer Funds For Playground — Videos

 

U.S. Supreme Court Rules In Religious Rights Case

Supreme Court Rules Religious School Can Use Taxpayer Funds For Playground

The Supreme Court’s big announcements on religion

 

Story 3: American People Optimistic As Consumer Confidence Increases — Awaiting The Trump Tax Cut and Total Repeal Of Obamacare — Videos

Image result for  cartoons trumpcare

Good Question: How Is Consumer Confidence Measured?

Consumer Confidence Numbers Fall; No Reason To Worry, Still A Good Number

Declining oil prices good for the U.S. economy?

Oil price will see ‘further softness’ before rising through to the end of 2017 | IG

Surprise! Trumps Healthcare is Effectively Obamacare Lite. Conservative Critics Slam Plan

Shields and Brooks on the Senate health care bill unveiled, Trump’s tape clarification

CBO score: 22 million more uninsured under Senate health bill

Rand Paul on the Senate health care bill: Republicans ‘promised too much’ that they ‘can’t provide’

Sen. Rand Paul: We shouldn’t try to fix government intervention with more intervention. – 6/22/17

Fox host shreds Katrina Pierson for attacking anti-Trumpcare GOP senator

Secretary Price Applauds Senate Proposal to Repeal and Replace Obamacare

GOP health care bill will ruin the Republican Party: Ann Coulter

New MSNBC Host Begs Republican To Pass Trumpcare NOW

LYING republican senator gets DEBUNKED on Health care by Democrats 6/22/2017

America’s rising consumer confidence mostly due to the elderly and less-educated

After more than a decade of disappointment, American consumers are now more hopeful than at any point since the housing bubble:

Those who think surveys of expectations have predictive power for spending and saving might therefore conclude the uptick bodes well for America’s growth outlook. However, a closer look at who exactly is excited about the future suggests there is less here than meets the eye.

Deutsche Bank’s Torsten Slok points out that the improvement in expectations is entirely due to Americans without a college degree, rather than those with greater spending power and higher earning potential. Americans with degrees have been getting steadily less optimistic since mid-2015:

Americans without degrees are as optimistic now as they’ve ever been since the survey began nearly four decades ago. Only the peak of the tech bubble compares. By contrast, Americans with degrees are about as confident in the future as they were in September 2007, when the credit crisis had already begun:

The shift since the election looks even starker if you look at the gap in expectations across the two groups over time. The change since November 2016 is unprecedented:

Slightly less dramatic, but nevertheless revealing, is the change in expectations among younger people, who have their most productive years ahead of them, relative to older people, who do not.

Since the start of 2015, the outlook among the young has deteriorated sharply, albeit from a high base. Meanwhile, the expectations of Americans ages 55 and older have soared in the wake of the election to their highest level in more than fifteen years:

(Those in the prime of their working and spending years have had essentially unchanged expectations since the end of 2014.)

It’s less clear what these changes in “expectations” mean for what people will actually do, however. Consumers across the age and education distribution haven’t changed their views since the election when asked whether it’s a good or bad time to buy big-ticket items such as furniture, televisions, appliances, or cars:

By contrast, Americans seem less inclined to think “now is a good time to buy a house”. This was true across all education groups, although it is particularly severe among those who never made it past high school:

(Americans with better education seem to have appreciated that the best time to buy was when prices bottomed in 2012, and that buying has become steadily less attractive as mortgage rates and house prices have both increased.)

Americans over 35 have had more stable views on the housing market than the young. Those under 35 have become far more pessimistic about housing since 2015:

To recap:

The groups responsible for the aggregate change in sentiment are the least likely to experience big real wage increases and therefore the least likely to boost their spending. Moreover, they appear unwilling to translate their vague optimism about the future into specific expectations about behaviour.

So even if those expectations were reliable guides to the actual choices people make — something strongly debated among forecasters — there is little reason to believe the “Trump bump” in consumer sentiment is a harbinger for sharply rising real spending.

Related links:
NY Fed research implies small business expectations are mostly worthless — FT Alphaville
Global surveys or hard data – which are the fake news? — Gavyn Davies

https://ftalphaville.ft.com/2017/05/02/2188069/americas-rising-consumer-confidence-mostly-due-to-the-elderly-and-less-educated/?mhq5j=e1

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The Pronk Pops Show 666, April 26, 2016, Story 1: Trump Predicted To Win All 5 Primary States With 118 Delegates Plus and Cruz Eliminated From First Ballot Victory — Part 2: Decriminalize and Legalize/Regulate All Drugs To Stop The Deaths From Overdoses and Put All Drug Cartels Out of Business — Declare Victory on The War on Drugs — Trump Rockets To Nomination Pushing The Limits — Wow — Videos

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Pronk Pops Show 617: February 4, 2016

Pronk Pops Show 616: February 3, 2016

Pronk Pops Show 615: February 1, 2016

Pronk Pops Show 614: January 29, 2016

Pronk Pops Show 613: January 28, 2016

Pronk Pops Show 612: January 27, 2016

Pronk Pops Show 611: January 26, 2016

Pronk Pops Show 610: January 25, 2016

Pronk Pops Show 609: January 22, 2016

Pronk Pops Show 608: January 21, 2016

Pronk Pops Show 607: January 20, 2016

Pronk Pops Show 606: January 19, 2016

Pronk Pops Show 605: January 15, 2015

Pronk Pops Show 604: January 14, 2016

Pronk Pops Show 603: January 13, 2016

Pronk Pops Show 602: January 12, 2016

Pronk Pops Show 601: January 11, 2015

Pronk Pops Show 600: January 8, 2016

Pronk Pops Show 599: January 6, 2016

Pronk Pops Show 598: January 5, 2016

Story 1: Trump Predicted To Win All 5 Primary States With 118 Delegates Plus and Cruz Eliminated From First Ballot Victory — Part 2: Decriminalize and Legalize/Regulate All Drugs To Stop The Deaths From Overdoses and Put All Drug Cartels Out of Business — Declare Victory on The War on Drugs — Trump Rockets To Nomination Pushing The Limits — Wow — Videos

 

Republican Delegates

1,237 to win nomination
Donald J. Trump
949
Ted Cruz
544
Marco Rubio
171
John Kasich
153

Democratic Delegates

2,383 to win nomination
Hillary Clinton
1,636
Bernie Sanders
1,316

Superdelegates Clinton 519, Sanders 39

Unpledged Democratic party leaders who are free to support any candidate. The majority of the 712 superdelegates have declared support for Mrs. Clinton, though they could switch candidates if she were to lose the lead in pledged delegates, which are awarded based on election results.

http://www.nytimes.com/interactive/2016/us/elections/primary-calendar-and-results.html?_r=0

The Green Papers

2016 Presidential Primaries, Caucuses, and Conventions

Copyright www.flags.net/UNST.htm Republican Convention
Presidential Nominating Process
Debate –  Fox – Cleveland, Ohio: Thursday 6 August 2015
Debate – CNN – Ronald Reagan Presidential Library, Simi Valley, California: Wednesday 16 September 2015
Debate – CNBC – Boulder, Colorado: Wednesday 28 October 2015
Debate – Fox Business News – Milwaukee, Wisconsin: Tuesday 10 November 2015
Debate – CNN – Las Vegas, Nevada: Tuesday 15 December 2015
Debate – Fox Business Channel, Charleston, South Carolina: Thursday 14 January 2016
Debate – Fox – Iowa: Thursday 28 January 2016
Debate – CBS – South Carolina: February 2016 (presumably)
Debate – NBC/Telemundo – Texas: Friday 26 February 2016
Debate – CNN – TBD: March 2016 (presumably)
Debate – Salt Lake City, Utah (announced 20 February 2016): Monday 21 March 2016
41st Republican National Convention: Monday 18 July – Thursday 21 July 2016
Republicans
Candidate Popular
Vote
Delegate Votes
Soft
Pledged
Soft
Unpledged
Soft
Total
Hard Total
Trump, Donald John, Sr. 8,787,753  37.91% 846  35.80% 1   0.92% 847  34.26% 846  34.22%
Cruz, Rafael Edward “Ted” 6,455,199  27.85% 548  23.19% 11  10.09% 559  22.61% 544  22.01%
Rubio, Marco A. 3,475,037  14.99% 173   7.32%   173   7.00% 173   7.00%
Kasich, John Richard 3,182,957  13.73% 149   6.31%   149   6.03% 149   6.03%
Carson, Benjamin Solomon “Ben”, Sr. 699,512   3.02% 9   0.38%   9   0.36% 9   0.36%
Bush, John Ellis “Jeb” 258,110   1.11% 4   0.17%   4   0.16% 4   0.16%
Uncommitted 68,536   0.30% 11   0.47% 17  15.60% 28   1.13% 64   2.59%
Paul, Randal H. “Rand” 59,128   0.26% 1   0.04%   1   0.04% 1   0.04%
Christie, Christopher James “Chris” 54,066   0.23%        
Huckabee, Michael Dale “Mike” 48,766   0.21% 1   0.04%   1   0.04% 1   0.04%
Fiorina, Carleton Sneed “Carly” 35,947   0.16% 1   0.04%   1   0.04% 1   0.04%
Santorum, Richard John “Rick” 16,478   0.07%        
No Preference 9,299   0.04%        
Graham, Lindsey Olin 5,680   0.02%        
Gray, Elizabeth 5,449   0.02%        
(others) 5,433   0.02%        
Others 3,911   0.02%        
Gilmore, James Stuart “Jim”, III 2,901   0.01%        
Pataki, George E. 2,034   0.01%        
Cook, Timothy “Tim” 517   0.00%        
Jindal, Piyush “Bobby” 221   0.00%        
Martin, Andy 202   0.00%        
Spoiled ballots 137   0.00%        
Witz, Richard P.H. 104   0.00%        
Lynch, James P. “Jim”, Sr. 100   0.00%        
Messina, Peter 79   0.00%        
Cullison, Brooks Andrews 56   0.00%        
Lynch, Frank 47   0.00%        
Robinson, Joe 44   0.00%        
Comley, Stephen Bradley, Sr. 32   0.00%        
Prag, Chomi 16   0.00%        
Breivogel, JoAnn 16   0.00%        
Dyas, Jacob Daniel “Daniel”, Sr. 15   0.00%        
McCarthy, Stephen John 12   0.00%        
Iwachiw, Walter N. 9   0.00%        
Huey, Kevin Glenn 8   0.00%        
Drozd, Matt 6   0.00%        
Mann, Robert Lawrence 5   0.00%        
Hall, David Eames          
(available)   620  26.24% 80  73.39% 700  28.32% 680  27.51%
Total 23,177,822 100.00% 2,363 100.00% 109 100.00% 2,472 100.00% 2,472 100.00%

 

States ChronologicallyStates Alphabetically

Democratic Convention
AKALARASAZCACOCTDADCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUNUTVAVIVTWAWIWVWY

Republican Convention
AKALARASAZCACOCTDCDEFLGAGUHIIAIDILINKSKYLAMAMDMEMIMNMOMPMSMTNCNDNENHNJNMNVNYOHOKORPAPRRISCSDTNTXUTVAVIVTWAWIWVWY


 

Connecticut Republican
Presidential Nominating Process
Primary: Tuesday 26 April 2016
State Committee Meeting: Friday 20 May 2016 (presumably)
Republicans
Candidate Popular
Vote
Delegate Votes
Soft
Pledged
Soft
Unpledged
Soft
Total
Hard Total
Carson, Benjamin Solomon “Ben”, Sr.          
Cruz, Rafael Edward “Ted”          
Kasich, John Richard          
Trump, Donald John, Sr.          
Uncommitted          
(available)   28 100.00%   28 100.00% 28 100.00%
Total   28 100.00%   28 100.00% 28 100.00%
Copyright www.flags.net/UNST.htm Rhode Island Republican
Presidential Nominating Process
Primary: Tuesday 26 April 2016
Republicans
Candidate Popular
Vote
Delegate Votes
Soft
Pledged
Soft
Unpledged
Soft
Total
Hard Total
Cruz, Rafael Edward “Ted”          
Kasich, John Richard          
Rubio, Marco A.          
Trump, Donald John, Sr.          
Uncommitted          
(available)   19 100.00%   19 100.00% 19 100.00%
Total   19 100.00%   19 100.00% 19 100.00%
Copyright www.flags.net/UNST.htm Pennsylvania Republican
Presidential Nominating Process
Primary: Tuesday 26 April 2016
Summer Meeting: Saturday 21 May 2016
Republicans
Candidate Popular
Vote
Delegate Votes
Soft
Pledged
Soft
Unpledged
Soft
Total
Hard Total
Bush, John Ellis “Jeb”          
Carson, Benjamin Solomon “Ben”, Sr.          
Cruz, Rafael Edward “Ted”          
Kasich, John Richard          
Rubio, Marco A.          
Trump, Donald John, Sr.          
Uncommitted          
(available)   17 100.00% 54 100.00% 71 100.00% 71 100.00%
Total   17 100.00% 54 100.00% 71 100.00% 71 100.00%
Copyright www.flags.net/UNST.htm Delaware Republican
Presidential Nominating Process
Primary: Tuesday 26 April 2016
State Convention: Friday 29 April – Saturday 30 April 2016
Republicans
Candidate Popular
Vote
Delegate Votes
Soft
Pledged
Soft
Unpledged
Soft
Total
Hard Total
Bush, John Ellis “Jeb”          
Carson, Benjamin Solomon “Ben”, Sr.          
Cruz, Rafael Edward “Ted”          
Kasich, John Richard          
Rubio, Marco A.          
Trump, Donald John, Sr.          
(available)   16 100.00% 16 100.00% 16 100.00%
Total   16 100.00% 16 100.00% 16 100.00%

Copyright www.flags.net/UNST.htm Maryland Republican
Presidential Nominating Process
Primary: Tuesday 26 April 2016
Spring Convention: Saturday 14 May 2016
Republicans
Candidate Popular
Vote
Delegate Votes
Soft
Pledged
Soft
Unpledged
Soft
Total
Hard Total
Bush, John Ellis “Jeb”          
Carson, Benjamin Solomon “Ben”, Sr.          
Christie, Christopher James “Chris”          
Cruz, Rafael Edward “Ted”          
Fiorina, Carleton Sneed “Carly”          
Huckabee, Michael Dale “Mike”          
Kasich, John Richard          
Paul, Randal H. “Rand”          
Rubio, Marco A.          
Santorum, Richard John “Rick”          
Trump, Donald John, Sr.          
(available)   38 100.00%   38 100.00% 38 100.00%
Total   38 100.00%   38 100.00% 38 100.00%

Latest Polls

Monday, April 25
Race/Topic(Click to Sort) Poll Results Spread
2016 Republican Presidential Nomination USA Today/Suffolk Trump 45, Cruz 29, Kasich 17 Trump +16
2016 Democratic Presidential Nomination USA Today/Suffolk Clinton 50, Sanders 45 Clinton +5
Pennsylvania Republican Presidential Primary FOX 29/Opinion Savvy Trump 48, Cruz 28, Kasich 19 Trump +20
Pennsylvania Republican Presidential Primary PPP (D)* Trump 51, Cruz 25, Kasich 22 Trump +26
Pennsylvania Democratic Presidential Primary FOX 29/Opinion Savvy Clinton 52, Sanders 41 Clinton +11
Pennsylvania Democratic Presidential Primary PPP (D)* Clinton 51, Sanders 41 Clinton +10
Pennsylvania Democratic Presidential Primary Harper (R) Clinton 61, Sanders 33 Clinton +28
Connecticut Republican Presidential Primary PPP (D)* Trump 59, Kasich 25, Cruz 13 Trump +34
Connecticut Republican Presidential Primary Gravis Trump 54, Kasich 27, Cruz 9 Trump +27
Connecticut Democratic Presidential Primary PPP (D)* Clinton 48, Sanders 46 Clinton +2
Rhode Island Republican Presidential Primary PPP (D)* Trump 61, Kasich 23, Cruz 13 Trump +38
Rhode Island Republican Presidential Primary Gravis Trump 58, Kasich 21, Cruz 10 Trump +37
Rhode Island Democratic Presidential Primary PPP (D)* Clinton 45, Sanders 49 Sanders +4
Maryland Republican Presidential Primary Gravis Trump 53, Kasich 24, Cruz 22 Trump +29
General Election: Trump vs. Clinton GWU/Battleground Clinton 46, Trump 43 Clinton +3
General Election: Trump vs. Clinton USA Today/Suffolk Clinton 50, Trump 39 Clinton +11
General Election: Cruz vs. Clinton USA Today/Suffolk Clinton 49, Cruz 42 Clinton +7
General Election: Kasich vs. Clinton USA Today/Suffolk Kasich 46, Clinton 41 Kasich +5
General Election: Trump vs. Sanders GWU/Battleground Sanders 50, Trump 40 Sanders +10
General Election: Trump vs. Sanders USA Today/Suffolk Sanders 52, Trump 37 Sanders +15
General Election: Cruz vs. Sanders USA Today/Suffolk Sanders 50, Cruz 38 Sanders +12
General Election: Kasich vs. Sanders USA Today/Suffolk Sanders 44, Kasich 43 Sanders +1
Pennsylvania Senate – Democratic Primary FOX 29/Opinion Savvy McGinty 39, Sestak 34, Fetterman 14 McGinty +5
Pennsylvania Senate – Democratic Primary Harper (R) McGinty 39, Sestak 33, Fetterman 15 McGinty +6
President Obama Job Approval USA Today/Suffolk Approve 46, Disapprove 45 Approve +1
President Obama Job Approval GWU/Battleground Approve 51, Disapprove 46 Approve +5
2016 Generic Congressional Vote GWU/Battleground Democrats 46, Republicans 41 Democrats +5
Direction of Country GWU/Battleground Right Direction 26, Wrong Track 66 Wrong Track +40
Direction of Country USA Today/Suffolk Right Direction 28, Wrong Track 61 Wrong Track +33
Direction of Country Rasmussen Reports Right Direction 26, Wrong Track 67 Wrong Track +41
Sunday, April 24
Race/Topic(Click to Sort) Poll Results Spread
Pennsylvania Republican Presidential Primary NBC/WSJ/Marist Trump 45, Cruz 27, Kasich 24 Trump +18
Pennsylvania Democratic Presidential Primary NBC/WSJ/Marist Clinton 55, Sanders 40 Clinton +15
Rhode Island Republican Presidential Primary Brown University Trump 38, Kasich 25, Cruz 14 Trump +13
Rhode Island Democratic Presidential Primary Brown University Clinton 43, Sanders 34 Clinton +9
Indiana Republican Presidential Primary CBS News/YouGov Trump 40, Cruz 35, Kasich 20 Trump +5
Indiana Democratic Presidential Primary CBS News/YouGov Clinton 49, Sanders 44 Clinton +5
Pennsylvania Republican Presidential Primary CBS News/YouGov Trump 49, Cruz 26, Kasich 22 Trump +23
Pennsylvania Democratic Presidential Primary CBS News/YouGov Clinton 51, Sanders 43 Clinton +8
Pennsylvania: Trump vs. Clinton NBC/WSJ/Marist Clinton 54, Trump 39 Clinton +15
Pennsylvania: Cruz vs. Clinton NBC/WSJ/Marist Clinton 52, Cruz 41 Clinton +11
Pennsylvania: Kasich vs. Clinton NBC/WSJ/Marist Kasich 48, Clinton 45 Kasich +3
Pennsylvania: Trump vs. Sanders NBC/WSJ/Marist Sanders 57, Trump 37 Sanders +20
Pennsylvania: Cruz vs. Sanders NBC/WSJ/Marist Sanders 58, Cruz 36 Sanders +22
Pennsylvania: Kasich vs. Sanders NBC/WSJ/Marist Sanders 50, Kasich 44 Sanders +6
Friday, April 22
Race/Topic(Click to Sort) Poll Results Spread
Indiana Republican Presidential Primary FOX News Trump 41, Cruz 33, Kasich 16 Trump +8
Indiana Democratic Presidential Primary FOX News Clinton 46, Sanders 42 Clinton +4
Indiana Republican Presidential Primary WTHR/Howey Politics Trump 37, Cruz 31, Kasich 22 Trump +6
Indiana Democratic Presidential Primary WTHR/Howey Politics Clinton 48, Sanders 45 Clinton +3
California Republican Presidential Primary FOX News Trump 49, Cruz 22, Kasich 20 Trump +27
California Democratic Presidential Primary FOX News Clinton 48, Sanders 46 Clinton +2

Chris Christie MESMERIZED by Donald Trump during Trumps Victory Speech on Super Tuesday Trump Tower

LIVE: FULL Primary Results – Donald Trump Sweeps – Will TALK NEXT!

Chuck Yeager Pushing The Limits (The Right Stuff)

Old Spice | Rocket Car | #smellegendary

Still Report #817 – More Party Switching in Pennsylvania

Still Report #818 – Cruz Quickly Backstabs Kasich Over Treaty

Ted Cruz Super Tuesday Speech Politics Breaking News Trump Trumps Cruz

Live Stream: Donald J. Trump Victory Speech Live From Trump Tower, New York – (4-26-16)

8 PM Eastern

Super Tuesday Results Coverage LIVE Presidential Primary Election 4-26-16 Politics Breaking News

UNBOUND DELEGATES MAY PLAY BIG ROLE IN GOP NOMINATION PROCESS

Clinton & Trump lead polls in 5 upcoming primaries

american-support-legalizing-marijuanamost_dangerous_drugs.0150818-datadrugage2-graphic.34.53 AMpoppingpills-nida_06harm caused by drugs
drug_overdose_0tim kelly cartoon - war on drugswar-on-drugs-comic-cartoon-rich-argument-criminals-crime-politicalCartoon-War-on-Drugsdrug-wars-finaldrug-wars-final-925x925potmeth-caught-map

Donald Trump: Legalize ALL the Drugs

Donald Trump Weighs in on Marijuana, Hillary Clinton, and Man Buns

Donald Trump Wants To Legalize Marijuana

Legalize All Drugs

Legalize Drugs- A Debate from Intelligence Squared U.S.

Neuroscientist Carl Hart: Science Says We Should Decriminalize Drugs

Milton Friedman – Why Drugs Should Be Legalized

The Truth About Addiction – and The Drug War!

Portugal’s Fix

CATO Institute – Official Portugal Legalized Drugs Report 1 of 6

CATO Institute – Official Portugal Legalized Drugs Report 2 of 6

CATO Institute – Official Portugal Legalized Drugs Report 3 of 6

CATO Institute – Official Portugal Legalized Drugs Report 4 of 6

CATO Institute – Official Portugal Legalized Drugs Report 5 of 6

CATO Institute – Official Portugal Legalized Drugs Report 6 of 6

Dr. Carl Hart Debates Bill O’Reilly

Christopher Hitchens – On Drug Decriminalization

What is decriminalisation of drugs?

IT’S OFFICIAL=> Ted Cruz Is Mathematically ELIMINATED from GOP Race – With Chart

As we predicted on April 2nd….    As of today, April 26, 2016, Ted Cruz is mathematically eliminated from winning the Republican nomination outright.

On April 2nd we predicted that Donald Trump would have 953 delegates as of today (needing only 284 delegates for the nomination) and that Cruz would have 550 delegates as of today (needing 687 to win the nomination).

We also predicted that only 634 delegates would remain and therefore Cruz would need more delegates than would be available.

Ted Cruz is eliminated.
It is clear that Cruz was eliminated tonight.
It is not clear yet on how devastating the final numbers will be for Ted Cruz.

After winning all five primaries tonight —  Connecticut, Rhode Island, Delaware, Maryland and Pennsylvania — Donald Trump has 945 delegates so far.

Ted Cruz finished third in Connecticut, Maryland, Delaware and Rhode Island.

There are fewer delegates remaining than we originally projected because the delegates in Wyoming, Colorado and North Dakota were allocated in shady voter-less elections after April 2nd.

After tonight’s primaries Cruz has — 559 delegates – He did not win a single delegate tonight.
Cruz needs 678 delegates to reach 1,237 delegates.
There are only 651 available.
It’s over.

 

 

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The Pronk Pops Show 627, February 18, 2016, Story 1: Presidents and Candidates With Narcissistic personality disorder? — Clinton, Obama, Clinton, Trump — Videos

Posted on February 18, 2016. Filed under: 2016 Presidential Campaign, 2016 Presidential Candidates, American History, Blogroll, Donald J. Trump, Donald J. Trump, Donald Trump, Donald Trump, Education, Employment, History, Illegal Immigration, Immigration, Legal Immigration, Marco Rubio, Media, Medical, Raymond Thomas Pronk, Security, Ted Cruz, Unemployment, United States Constitution, Videos, Violence, Wealth, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

Project_1

The Pronk Pops Show Podcasts

Pronk Pops Show 627: February 18, 2016

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Pronk Pops Show 624: February 15, 2016

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Pronk Pops Show 620: February 9, 2016

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Pronk Pops Show 618: February 5, 2016

Pronk Pops Show 617: February 4, 2016

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Pronk Pops Show 615: February 1, 2016

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Pronk Pops Show 583: November 30, 2015 

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The Pronk Pops Show 583, November 30, 2015, Story 1: World Wide Watermelon Wacko Wealth Wringers — aka Lying Lunatic Left — Protocol Predators Prowl Paris — Climate Changes Cooling Continues — The Ultimate Resource The Human Mind Will Innovate, Invent, and Invest Toward World Peace and Prosperity — Bill Gates Right On Research and Development and Wrong on Warming — Videos

Posted on November 30, 2015. Filed under: American History, Biology, Blogroll, Breaking News, Budgetary Policy, Business, Chemistry, Coal, Coal, Communications, Computer, Congress, Corruption, Economics, Education, Empires, Employment, Energy, Eugenics, European History, Federal Government, Fiscal Policy, Food, Foreign Policy, Geology, Government, Government Spending, Health, History, Investments, Law, Media, Medical, Natural Gas, Natural Gas, News, Nuclear, Oil, Oil, Philosophy, Photos, Politics, Polls, Pro Life, Progressives, Radio, Rand Paul, Raymond Thomas Pronk, Religion, Resources, Scandals, Science, Solar, Success, Tax Policy, Videos, Wealth, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , |

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Pronk Pops Show 576: November 17, 2015

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The Pronk Pops Show 496, June 30, 2015, Story 1: Supreme Court Rules Against EPA Power Plant Mercury Limits — Videos

Posted on June 30, 2015. Filed under: American History, Biology, Blogroll, Breaking News, Budgetary Policy, Chemistry, Coal, College, Communications, Congress, Consitutional Law, Corruption, Crime, Economics, Education, Employment, Federal Government, Fiscal Policy, Government, Government Spending, Health Care, History, Language, Law, Media, Medical, Natural Gas, News, Philosophy, Politics, Progressives, Radio, Raymond Thomas Pronk, Regulation, Resources, Scandals, Science, Social Science, Tax Policy, Taxation, Taxes, Unemployment, Videos, Violence, Wealth, Wisdom | Tags: , , , , , |

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Pronk Pops Show 458 May 1, 2015 

Pronk Pops Show 457 April 30, 2015 

Pronk Pops Show 456: April 29, 2015 

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Story 1: Supreme Court Rules Against EPA Power Plant Mercury Limits — Videos

Obama’s Promise the Bankrupt the Coal Industry

Obama talked with The Chronicle editorial board Jan. 17 2008 for an interview. In his wide-ranging session with the paper, the Democratic senator from Illinois spoke about his energy plan and an “aggressive” cap-and-trade policy, and spoke about bankrupting the coal industry.

MAJOR REDUCTIONS IN CARBON EMISSIONS ARE NOT WORTH THE MONEY 4 /14- Intelligence Squared U.S.

MAJOR REDUCTIONS IN CARBON EMISSIONS ARE NOT WORTH THE MONEY 6/14- Intelligence Squared U.S.

Supreme Court rules on EPA emissions limits

Supreme Court rules against EPA on power plant regs VIDEO

Supreme Court rules against EPA’s policy on power plants

Justices rule against EPA power plant mercury limits

New EPA Rules Target Power Plants’ Toxic Mercury Emissions

EPA Rule Calling For Power Plant Carbon Emissions To Be Cut By 30% By 2030 – Cavuto

US Power Plants Ordered to Reduce Pollution

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A Rare Loss for Environmentalists at the Supreme Court

The justices had given the EPA wide latitude to limit air pollutants before ruling against the agency on Monday.

Despite its conservative tilt, the Supreme Court has given environmentalists a rather remarkable run of success over the last decade. The justices’ 2007 ruling that the EPA could regulate greenhouse gas emissions under the Clean Air Act set the stage for much of the Obama administration’s ambitious agenda to combat climate change. And just last year, the government largely prevailed in two cases challenging the limits it had placed on industry emissions.

On Monday, that winning streak came to an end when the Supreme Court’s five Republican-appointed justices blocked the Obama administration’s regulations on the emission of mercury and other toxins from coal-fired power plants. The 5-4 decision found that the EPA had violated the Clean Air Act by not considering the cost of compliance before deciding to limit mercury pollution. The government had argued that it considered the cost throughout its process of writing the mercury rules, but not at the outset. Writing for the majority, Justice Antonin Scalia said the EPA failed to meet the law’s requirement that it regulate those pollutants only after determining, based on impact studies, that it was “appropriate and necessary” to do so. He cited the agency’s own finding that the mercury rule would carry a nearly $10 billion annual cost while generating direct benefits of just $4 billion to $6 billion a year.

Read naturally in the present context, the phrase “appropriate and necessary” requires at least some attention to cost. One would not say that it is even rational, never mind “appropriate,” to impose billions of dollars in economic costs in return for a few dollars in health or environmental benefits.

No regulation is “appropriate” if it does significantly more harm than good. There are undoubtedly settings in which the phrase “appropriate and necessary” does not encompass cost. But this is not one of them.
The sharp-tongued Scalia finally had the chance to author a majority opinion after writing a series of fiery, colorful dissents against the court’s rulings in favor of Obamacare and same-sex marriage. He compared the EPA’s logic in arguing that it did not initially need to consider the cost of regulations to a consumer who decides to “buy a Ferrari without thinking about cost, because he plans to think about cost later when deciding whether to upgrade the sound system.” Sparring with Scalia in the dissent, Justice Elena Kagan called the comparison “witty but wholly inapt”:

A better analogy might be to a car owner who decides without first checking prices that it is ‘appropriate and necessary’ to replace her worn-out brake-pads, aware from prior experience that she has ample time to comparison shop and bring that purchase within her budget.
Aside from the Ferrari metaphor, Scalia’s opinion was fairly dry and—dare we say it—bland. Even more importantly for environmental advocates, it was narrow. The ruling did not touch the EPA’s ambitious Clean Power Plan to limit carbon emissions from coal plants, and it said nothing about the substance of the mercury rules—only how they were promulgated. Finally, the court left it entirely up to the EPA to determine how it would consider cost when deciding whether to regulate. “This is clearly a loss,” said John Walke, the clean air director for the Natural Resources Defense Council. But, he told me on Monday, “it’s a narrow loss that turns on a disagreement over the meaning of the word ‘appropriate’ in context. So it’s hard to see it having broader judicial implications or ideological implications, notwithstanding the split. It’s certainly not an ideological broadside against either the EPA or environmental regulations.”
The practical impact of the ruling is also unclear. The case was remanded to a lower court, and environmental advocates said that at minimum, the EPA would have to go back and undertake additional cost studies of the mercury rule. The agency noted that because the regulation was issued three years ago, industry “investments have been made and most plants are already well on their way to making emissions reductions.” Advocates said it was unlikely that plants that had shuttered rather than comply with the rule would reopen and that some companies even found that the compliance costs came in under projections. (The deadline for compliance was this April, although some companies received an extension.) “Much of the industry has kind of moved on,” said Sean Donahue, an attorney who argued the case on behalf of the Environmental Defense Council and public health advocates before the D.C. Circuit Court of Appeals. “Whether they like this rule or not, they’ve decided they could live with it.”

The big question is what, if anything, the Supreme Court’s ruling in the mercury case portends for court challenges to the Obama administration’s more recent regulatory agenda on climate change. Mitch McConnell, the Senate majority leader who has accused the president of waging a “war on coal,” seized on the ruling to urge Republican governors to resist complying with the EPA’s climate regulations:

While much of the damage of this regulation has already been done, the ruling serves as a critical reminder to every governor contemplating the administration’s demands to impose more regressive—and likely illegal—regulations that promise even more middle-class pain. Clearly, there is no reason to subject their states to such unnecessary pain before the courts have even had a chance to weigh in, especially if the Supreme Court simply ends up tossing the regulation out as we saw today.
Environmental advocates don’t seem that worried. The difference in law between the mercury rule and the climate regulations, Walke said, was “apples and oranges.” And the narrow nature of Scalia’s ruling doesn’t offer much of a signal either way about how the Court might rule on EPA regulations going forward. Monday’s ruling may have been a defeat for environmentalists, but it wasn’t a rout.

http://www.theatlantic.com/politics/archive/2015/06/a-rare-loss-for-environmentalists-at-the-supreme-court/397196/

 

Photo

A coal-fired power plant in Ghent, Ky. Industry groups and about 20 states challenged the Environmental Protection Agency’s decision to regulate emissions — one of the Obama administration’s most ambitious environmental initiatives. CreditLuke Sharrett for The New York Times

 The Supreme Court on Monday blocked one of the Obama administration’s most ambitious environmental initiatives, anEnvironmental Protection Agency regulation meant to limit emissions of mercury and other toxic pollutants from coal-fired power plants.

Industry groups and about 20 states had challenged the E.P.A.’s decision to regulate the emissions, saying the agency had failed to take into account the punishing costs its rule would impose.

The Clean Air Act required the regulation to be “appropriate and necessary.” The challengers said the agency had run afoul of that law by deciding to regulate the emissions without first undertaking a cost-benefit analysis.

Writing for the majority, in the 5-to-4 decision, Justice Antonin Scalia wrote: “It is not rational, never mind ‘appropriate,’ to impose billions of dollars in economic costs in return for a few dollars in health or environmental benefits. Statutory context supports this reading.”

The E.P.A. had argued that it was not required to take costs into account when it made the initial determination to regulate. But the agency added that it had done so later in setting emissions standards and that, in any event, the benefits far outweighed the costs.

The two sides had very different understandings of the costs and benefits involved. Industry groups said the government had imposed annual costs of $9.6 billion to achieve about $6 million in benefits. The agency said the costs yielded tens of billions of dollars in benefits.

In dissent, Justice Elena Kagan wrote: “The agency acted well within its authority in declining to consider costs at the opening bell of the regulatory process given that it would do so in every round thereafter — and given that the emissions limits finally issued would depend crucially on those accountings.”

The decision, Michigan v. Environmental Protection Agency, No. 14-46, does not strike down the rule, but it means the E.P.A. will have to review and rewrite it, taking costs into consideration.

Pollution Limits
In three environmental regulation cases, the court found the Environmental Protection Agency violated the Clean Air Act by failing to undertake a cost-benefit analysis in deciding whether to set limits on emissions of mercury and other toxic pollutants from power plants.
5-4
DISSENT
MAJORITY
Sotomayor
Kagan
Ginsburg
Breyer
Kennedy
Roberts
Scalia
Alito
Thomas
• In the mercury case, the United States Court of Appeals for the District of Columbia Circuit ruled that the agency’s interpretation of the Clean Air Act was reasonable.

“The E.P.A. will have to do more homework on costs,” said Sean Donahue, who represents environmental and public health groups that signed on to the agency’s case. “But I’m very confident that the final rule will be up and running and finally approved without a great deal of trouble. This is a disappointment. It’s a bump in the road, but I don’t think by any means it’s the end of this program.”

An E.P.A. spokeswoman, Melissa Harrison, said the agency intended to move forward with the rule.

Ms. Harrison said that since the court’s ruling was about how and when the agency considered costs in its decision about limiting mercury and other toxic emissions and not the agency’s authority to limit them over all, the E.P.A. was committed to protecting the public “from the significant amount of toxic emissions from coal- and oil-fired electric utilities and continue reducing the toxic pollution from these facilities.”

The mercury regulation was one in a series of new Clean Air Actregulations from the Obama administration that President Obama hopes to build into a major environmental legacy. Later this summer the agency is expected to release a set of landmark climate change rules limiting greenhouse gas pollution from power plants — restrictions that have faced legal challenges from industry.

In the term that ended in June 2014, the justices heard cases on two other sets of Clean Air Act regulations — one aimed at limiting power plant pollution that wafts across state lines, the other at cutting planet-warming greenhouse gas emissions. The E.P.A. won the first case and largely prevailed in the second, though the Supreme Court indicated that it remained prepared to impose limits on the agency’s regulatory authority.

“From its ozone to greenhouse gas to navigable waters rules, the E.P.A. continues to burden the public with more and more costs even as so many are still struggling to get by and improve their lives in this economy,” said Kevin McCarthy of California, the House majority leader. “The Supreme Court’s decision today vindicates the House’s legislative actions to rein in bureaucratic overreach and institute some common sense in rule making.”

Among the remaining questions is whether the current rule will stay in place as the E.P.A. completes its revision of the language, and how long that revision will take.

“The Obama administration will be hard pressed to get that job done before it goes out of office,” said Richard Lazarus, a professor of environmental law at Harvard.

In the meantime, companies could be forced to comply with the existing regulation. The question will go before the United States Court of Appeals for the District of Columbia Circuit, which has frequently decided in favor of Mr. Obama’s E.P.A. rules.

“Given the fact that the E.P.A. has already done a detailed cost benefit analysis justifying the rule, and the fact that the majority of the affected industries have already invested heavily in compliance, there is a good chance that the D.C. Circuit will allow the rule to remain on the books” while the agency makes its revisions, said Patrick Parenteau, an expert on environmental law at Vermont Law School.

Scott Segal, who lobbies on behalf of electric utilities for the firm Bracewell & Giuliani, said the decision should come as a warning to the Obama administration as the E.P.A. prepares to unveil the climate changeregulations this summer.

“They’ll need to take a hard-nosed economic analysis that the Supreme Court calls for,” he said.

http://www.nytimes.com/2015/06/30/us/supreme-court-blocks-obamas-limits-on-power-plants.html

U.S. top court rules against Obama administration over air pollution rule

Cleaner Power Plants

On this page:

On December 16, 2011, the Environmental Protection Agency (EPA) finalized the first ever national standards to reduce mercury and other toxic air pollution from coal and oil-fired power plants. More than 20 years after the 1990 Clean Air Act Amendments, some power plants still do not control emissions of toxic pollutants, even though pollution control technology is widely available.

There are about 1,400 coal and oil-fired electric generating units (EGUs) at600 power plants covered by these standards. They emit harmful pollutants including mercury, non-mercury metallic toxics, acid gases, and organic air toxics including dioxin.

Power plants are currently the dominant emitters of mercury (50 percent), acid gases (over 75 percent) and many toxic metals (20-60 percent) in the United States.

While newer, and a significant percentage of older power plants already control their emissions of mercury, heavy metals, and acid gases, approximately 40 percent of the current EGUs still do not have advanced pollution control equipment.

The other big sources of mercury have already reduced their emissions.

In 1990, three industry sectors made up approximately two-thirds of total U.S. mercury emissions: medical waste incinerators, municipal waste combustors, and power plants. The first two of these sectors have been subject to emissions standards for years and as a result have reduced their mercury emissions by more than 95 percent. In addition, mercury standards for industries such as cement production, steel manufacturing and many others have reduced mercury emissions from these sources.

Sources of Mercury Emissions in the U.S.
Industrial Category 1990 Emissions tons per year (tpy) 2005 Emissions (tpy) Percent Reduction
Power Plants 59 53 10%
Municipal Waste Combustors 57 2 96%
Medical Waste Incinerators 51 1 98%

The final rule establishes power plant emission standards for mercury, acid gases, and non-mercury metallic toxic pollutants which will result in: preventing about 90 percent of the mercury in coal burned in power plants being emitted to the air; reducing 88 percent of acid gas emissions from power plants; and reducing 41 percent of sulfur dioxide emissions from power plants beyond the reductions expected from the Cross State Air Pollution Rule.

Top of page

Controls to Meet Limits are Widely Available

The Mercury and Air Toxics Standards provide regulatory certainty for power plants. Additionally, these standards level the playing field so that all plants will have to limit their emissions of mercury as newer plants already do.

Use of widely-available controls will reduce harmful air toxics and help modernize the aging fleet of power plants, many of which are over 50 years old.

Widely-available control technologies that reduce mercury and other air toxics
Pollutant Addressed Existing Control Technologies to Address Toxic Pollutants
Mercury Selective Catalytic Reduction (SCR )with Flue-gas Desulfurization (FGD), Activated Carbon Injection (ACI), ACI with Fabric Filter (FF) or Electrostatic Precipitators (ESP)
Non-mercury metals FF, ESP
Dioxins & furans Work Practice Standard ( inspection, adjustment, and/or maintenance and repairs to ensure optimal combustion)
Acid gases FGD, Dry Sorbent Injection (DSI), DSI with FF or ESP
Sulfur dioxide FGD, DSI

Top of page

Setting Emissions Limits for Toxic Air Pollutants

The MATS sets standards for all Hazardous Air Pollutants (HAPs) emitted by coal- and oil-fired EGUs with a capacity of 25 megawatts or greater. These are called national emission standards for hazardous air pollutants (NESHAP), also known as maximum achievable control technology (MACT) standards.  Coal- and/or oil-fired electric utilities emit many of the 187 hazardous air pollutants listed in the Clean Air Act.

Emissions standards set under the toxics program are federal air pollution limits that individual facilities must meet by a set date. MACT for new sources must be at least as stringent as the emission reduction achieved by the best performing similar source.  Existing source MACT standards must be at least as stringent as the emission reductions achieved by the average of the top 12 percent best controlled sources.  These standards must address all hazardous air pollutants emitted at a source category.

Setting a MACT standard is a two step process:

  1. The “MACT floor” is established based on what is currently achieved by sources – costs may not be considered.
  2. EPA may regulate “beyond the floor” where justified – costs and other issues must be considered.

Top of page

Power Plants Have Time to Meet the Standards

Existing sources generally will have up to 4 years if they need it to comply with MATS.

  • This includes the 3 years provided to all sources by the Clean Air Act. EPAs analysis continues to demonstrate that this will be sufficient time for most, if not all, sources to comply.
  • Under the Clean Air Act, state permitting authorities can also grant an additional year as needed for technology installation. EPA expects this option to be broadly available.

EPA is also providing a pathway for reliability critical units to obtain a schedule with up to an additional year to achieve compliance. This pathway is described in a separate enforcement policy document. The EPA believes there will be few, if any situations, in which this pathway will be needed.

In the unlikely event that there are other situations where sources cannot come into compliance on a timely basis, consistent with its longstanding historical practice under the Clean Air Act, the EPA will address individual circumstances on a case-by-case basis, at the appropriate time, to determine the appropriate response and resolution.

Top of page

Reliable Energy

In EPA’s 40 year history, the Clean Air Act has not impacted power companies’ ability to keep the lights on in communities across the United States. EPA’s analysis shows that the MATS rule and the Cross State Air Pollution Rule will not adversely affect resource adequacy in any region of the country. More information is available in EPA’s resource adequacy analysis (PDF) (9pp, 418k).

A number of other analyses have reached conclusions consistent with EPA’s, including a report from the Department of Energy (PDF).

http://www.epa.gov/mats/powerplants.html

 

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The Pronk Pops Show 493, June 25, 2015, Story 1: Supreme Court Obamacare Attacks American Consumer Sovereignty and Individual Freedom — Big Government Tyranny and Coercion — Repeal Obamacare Completely — Videos

Posted on June 26, 2015. Filed under: Addiction, American History, Biology, Blogroll, Breaking News, Budgetary Policy, Business, Chemistry, College, Communications, Congress, Constitutional Law, Corruption, Crime, Culture, Economics, Education, Elections, Employment, Fiscal Policy, Government, Government Dependency, Health Care, Health Care Insurance, High Crimes, History, Independence, Insurance, Investments, Law, Media, Medical, Medicine, News, Philosophy, Photos, Politics, Polls, President Barack Obama, Public Sector Unions, Radio, Raymond Thomas Pronk, Regulation, Resources, Scandals, Science, Security, Success, Tax Policy, Taxation, Taxes, Technology, Unemployment, Unions, Videos, Wealth, Wisdom | Tags: , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |

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Story 1: Supreme Court Obamacare Attack On American Consumer Sovereignty and Individual Freedom — Big Government Tyranny and Coercion — Videos

“The state is that great fiction by which everyone tries to live at the expense of everyone else.”

“Each of us has a natural right, from God, to defend his person, his liberty, and his property.”

~ Frederic Bastiat

“Liberty is always freedom from the government.”

“The fact is that, under a capitalistic system, the ultimate bosses are the consumers.

The sovereign is not the state, it is the people.”

“The common man is the sovereign consumer whose buying or abstention from buying ultimately determines what should be produced and in what quantity and quality.”

“It is important to remember that government interference always means either violent action or the threat of such action.

The funds that a government spends for whatever purposes are levied by taxation.

And taxes are paid because the taxpayers are afraid of offering resistance to the tax gatherers.

They know that any disobedience or resistance is hopeless.

As long as this is the state of affairs, the government is able to collect the money that it wants to spend.

Government is in the last resort the employment of armed men, of policemen, gendarmes, soldiers, prison guards, and hangmen.

The essential feature of government is the enforcement of its decrees by beating, killing, and imprisoning.

Those who are asking for more government interference are asking ultimately for more compulsion and less freedom.”

~Ludwig von Mises

“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined —’to say what the law is.’ … That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

~Chief Justice John Roberts

“Today’s interpretation is not merely unnatural; it is unheard of. Who would ever have dreamt that ‘Exchange established by the State’ means ‘Exchange established by the State or the Federal Government’? Little short of an express statutory definition could justify adopting this singular reading.”

“We should start calling this law SCOTUScare.”

~Justice Antonin Scalia

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The Truth About Obamacare

In Upholding Obamacare’s Subsidies, Justice Roberts Rewrites the Law—Again

Time to start calling the Affordable Care Act SCOTUScare.

Supreme Court Chief Justice John Roberts has rewritten the law to save Obamacare—again.

Roberts’ majority opinion today in King v. Burwell, which ruled that the Obama administration’s decision to allow health insurance subsidies flow through the law’s federal exchanges, leaves no doubt that Roberts considers it his duty to keep the law afloat.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” he writes. “If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

And so Roberts decided that a law which explicitly and repeatedly states that subsidies are limited to exchanges “established by a State,” and which defines “State” as one of the 50 states or the District of Columbia, actually allows subsidies in exchanges established by a State or the federal government. Roberts’ decision does not interpret Obamacare; it adds to it and reworks it, and in the process transforms it into something that it is not.

Roberts has not merely tweaked the law; he has rewritten it to mean the opposite of what it clearly means. Why include the phrase “established by a State under Section 1311″—the section dealing with state-based exchanges—except to limit the subsidies to those particular exchanges? Roberts’ opinion reconceptualizes this limiting language as inclusive.

The Chief Justice frames his decision as a form of respectful deference to congressional intent. As my colleague Damon Root noted earlier, his opinion cautions that in “every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan.”

But Roberts’ opinion is far more than a fair reading of the legislative plan; it is a Court-imposed decision as to what that plan must be.

As Justice Antonin Scalia writes in a scathing dissent, Roberts presumes, with no definitive evidence, that his interpretation is the one that Congress intended. “What makes the Court so sure that Congress ‘meant’ tax credits to be available everywhere?” Scalia asks. “Our only evidence of what Congress meant comes from the terms of the law, and those terms show beyond all question that tax credits are available only on state Exchanges.”

Roberts’ opinion declares its intent to uphold the law’s basic policy scheme, arguing that there would be adverse insurance market effects to a decision in favor of the challengers. In other words, there would have been policy implications to a ruling for the plaintiffs. That is almost certainly true, but it is not an excuse to rewrite the clear language of the law.

As Scalia says in the dissent, “The Court protests that without the tax credits, the number of people covered by the individual mandate shrinks, and without a broadly applicable individual mandate the guaranteed-issue and community-rating requirements ‘would destabilize the individual insurance market.’ If true, these projections would show only that the statutory scheme contains a flaw; they would not show that the statute means the opposite of what it says.” The majority has decided how Obamacare’s policy scheme should work, and redrafted the statute accordingly.

If Roberts had truly wanted to defer to Congress, he could have ruled that the law means what says rather than what it does not, and effectively handed the issue back to the legislature, letting Congress decide whether and how to update the law in accordance with its own wishes. Instead, Roberts made the choice for Congress—taking its power to craft law for itself. As Scalia writes, “the Court’s insistence on making a choice that should be made by Congress both aggrandizes judicial power and encourages congressional lassitude.”

This is not the first time that Roberts has rewritten the law in order to uphold it. In 2012, he declared that the law’s individual mandate to purchase insurance was unconstitutional under the Constitution’s Commerce Clause—and yet upheld it by declaring that the law’s penalty was instead permissible as a tax. In the same decision, he also found that the law’s threat to revoke all federal Medicaid funding from states that decline to participate in Obamacare’s expansion of the program was unconstitutionally coercive. But rather than strike the whole thing down, Roberts rewrote it, allowing the Medicaid expansion, and the rest of the law, to continue but without the same threat to state budgets.

In his dissent, Scalia argues that there’s a pattern to these rulings. “Under all the usual rules of interpretation, in short, the Government should lose this case. But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved.”

If anything, it’s even worse. What Roberts has saved is not the law so much as the Obama administration’s dubious, textually unsupported interpretation and implementation of Obamacare. This is not judicial restraint. It is judicial hubris.

And while it would be overstatement to say that this damages the legitimacy of the Court, it certainly reflects on the legacy and status of the law. As even Roberts admits in his opinion, the law “contains more than a few examples of inartful drafting” and generally “does not reflect the type of care and deliberation that one might expect of such significant legislation.” It is a shoddy, messy piece of legislation, held together, barely, by Supreme Court duct tape.

At this point, then, the law is as much a joint project between the administration and the Roberts court as it is a creation of Congress. As Scalia snarks at the end of his dissent, “we should start calling this law SCOTUScare.” Regardless of what we call it, that’s effectively what it has become.

http://reason.com/blog/2015/06/25/in-upholding-obamacares-subsidies-justic

Supreme Court Rules Obamacare Subsidies Are Legal

By Krishnadev Calamur

The U.S. Supreme Court on Thursday handed the Obama administration a major victory on health care, ruling 6-3 that nationwide subsidies called for in the Affordable Care Act are legal.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” the court’s majority said in the opinion, which was written by Chief Justice John Roberts. But they acknowledged that “petitioners’ arguments about the plain meaning … are strong.”

The majority opinion cited the law’s “more than a few examples of inartful drafting,” but added, “the context and structure of the Act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

Roberts was joined by the court’s liberal justices, Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan, as well as by Anthony Kennedy.

In his dissent, Justice Antonin Scalia said: “We should start calling this law SCOTUScare,” an apparent reference to the fact the Supreme Court has now saved the Affordable Care Act twice. Scalia called the majority’s reading of the text “quite absurd, and the court’s 21 pages of explanation make it no less so.”

As NPR’s Nina Totenberg reported in March, opponents of the law contended “that the text of the law does not authorize subsidies to make mandated insurance affordable in 34 states.”

At issue were six words in one section of the law. As Nina pointed out: “Those words stipulate that for people who cannot afford health coverage, subsidies are available through ‘an exchange established by the state.’ ” She added:

“The government [contended] that those words refer to any exchange, whether it is set up by the state itself or an exchange run for the state by the federal government in accordance with individual state insurance laws and regulations. The challengers [said] the statute means what it says and no more.”

The court agreed Thursday with the government’s position.

The decision comes three years after a bitterly divided high court upheld the Affordable Care Act as constitutional by a 5-4 vote.

President Obama made a statement on the ruling late Thursday morning, saying the Affordable Care Act “is here to stay.”

http://www.npr.org/sections/thetwo-way/2015/06/25/417425091/supreme-court-rules-obamacare-subsidies-are-legal

Supreme Court Upholds Obamacare Subsidies in King v. Burwell

SCOTUS rules 6-3 in favor of administration in major defeat for critics of the health law.

Obamacare’s health insurance subsidies will live, thanks to the Supreme Court.

The High Court has ruled 6-3 in favor of the administration to uphold the subsidies in Obamacare’s federal exchanges. The case challenged the administration’s decision, through the Internal Revenue Service, to allow subsidies in the 36 exchanges run by the federal government under the law.

The challengers argued that the plain text of the law, which states that subsidies are only available in an exchange “established by a State,” defining “State” to mean the 50 states or the District of Columbia, prohibited subsidies in the federal exchanges. The administration argued that the IRS rule allowing those subsidies was consistent with the overall structure of the law, and with congressional intent.

Writing for the majority, Chief Justice John Roberts sided with the administration’s position, saying that although the health law contains “more than a few examples of inartful drafting,” the Court nevertheless believes that the relevant section of the law “can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt.” The complete ruling can be read here.

Basically, the Supreme Court, decided they’d rather squint at the law and look at its general shape rather than bother too much with the plain meaning of the relevant text.

This is a major victory fo the administration and backers of the health law, whose decision to ignore the plain text of the law has been blessed by the Court. It’s also a big loss for critics of Obamacare, who hoped to see the law’s implementation restrained by its legislative text, and for straightforward interpretation of congressional statute.

What it means is that the crazy array of post-King scenarios that many had speculated about over the last few months will never come to pass. Obamacare stays the same, in terms of both policy and politics. It’s a ruling for the status quo.

Reason will have much more on this throughout the day.

http://reason.com/blog/2015/06/25/supreme-court-upholds-obamacare-subsidie

Supreme Court Allows Nationwide Health Care Subsidies

The Supreme Court ruled on Thursday that President Obama’s health care law allows the federal government to provide nationwide tax subsidies to help poor and middle-class people buy health insurance, a sweeping vindication that endorsed the larger purpose of Mr. Obama’s signature legislative achievement.

The 6-to-3 ruling means that it is all but certain that the Affordable Care Act will survive after Mr. Obama leaves office in 2017. For the second time in three years, the law survived an encounter with the Supreme Court. But the court’s tone was different this time. The first decision, in 2012, was fractured and grudging, while Thursday’s ruling was more assertive.

“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice John G. Roberts Jr. wrote for a united six-justice majority. In 2012’s closely divided decision, Chief Justice Roberts also wrote the controlling opinion, but that time no other justice joined it in full.

Photo

Demonstrators expressed their support for the Affordable Care Act outside of the Supreme Court on Thursday. CreditDoug Mills/The New York Times

In dissent on Thursday, Justice Antonin Scalia called the majority’s reasoning “quite absurd” and “interpretive jiggery-pokery.”

He announced his dissent from the bench, a sign of bitter disagreement. His summary was laced with notes of incredulity and sarcasm, sometimes drawing amused murmurs in the courtroom as he described the “interpretive somersaults” he said the majority had performed to reach the decision.

“We really should start calling this law Scotus-care,” Justice Scalia said, to laughter from the audience.

In a hastily arranged appearance in the Rose Garden on Thursday morning, a triumphant Mr. Obama praised the ruling. “After multiple challenges to this law before the Supreme Court, the Affordable Care Act is here to stay,” he said, adding: “What we’re not going to do is unravel what has now been woven into the fabric of America.”

The ruling was a blow to Republicans, who have been trying to gut the law since it was enacted. But House Speaker John A. Boehner vowed that the political fight against it would continue.

“The problem with Obamacare is still fundamentally the same: The law is broken,” Mr. Boehner said. “It’s raising costs for American families, it’s raising costs for small businesses and it’s just fundamentally broken. And we’re going to continue our efforts to do everything we can to put the American people back in charge of their health care and not the federal government.”

The case concerned a central part of the Affordable Care Act that created marketplaces, known as exchanges, to allow people who lack insurance to shop for individual health plans. Some states set up their own exchanges, but about three dozen allowed the federal government to step in to run them. Across the nation, about 85 percent of customers using the exchanges qualify for subsidies to help pay for coverage, based on their income.

The question in the case, King v. Burwell, No. 14-114, was what to make of a phrase in the law that seems to say the subsidies are available only to people buying insurance on “an exchange established by the state.”

A legal victory for the plaintiffs, lawyers for the administration said, would have affected more than six million people and created havoc in the insurance markets and undermined the law.

Chief Justice Roberts acknowledged that the plaintiffs had strong arguments about the plain meaning of the contested words. But he wrote that the words must be understood as part of a larger statutory plan. “In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.”

The court decided in King v. Burwell that tax subsidies are being provided lawfully in three dozen states that have decided not to run the marketplaces for insurance coverage. Full analysis »
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This was challenging, he said, in light of the law’s “more than a few examples of inartful drafting,” a consequence of rushed work behind closed doors that “does not reflect the type of care and deliberation that one might expect of such significant legislation.”

But he said the law’s interlocking parts supported a ruling in favor of the subsidies, particularly given that a contrary decision could have given rise to chaos in the insurance markets. A ruling rejecting subsidies in most of the nation would have left in place other parts of the law, including its guarantee of coverage regardless of pre-existing conditions, its requirement that most Americans obtain insurance or pay a penalty, and its expansion of Medicaid.

Without the subsidies, many people would be unable to afford insurance, and healthier consumers would go without coverage, leaving insurers with a sicker, more expensive pool of customers. That would raise prices for everyone, leading to what supporters of the law called death spirals.

“The statutory scheme compels us to reject petitioners’ interpretation,” Chief Justice Roberts wrote, referring to the challengers, “because it would destabilize the individual insurance market in any state with a federal exchange, and likely create the very ‘death spirals’ that Congress designed the act to avoid.”

In dissent, Justice Scalia wrote that the majority had stretched the statutory text too far.

Photo

Copies of the court’s ruling in favor of nationwide health insurance subsidies were rushed to television news reporters. CreditDoug Mills/The New York Times

“I wholeheartedly agree with the court that sound interpretation requires paying attention to the whole law, not homing in on isolated words or even isolated sections,” Justice Scalia wrote. “Context always matters. Let us not forget, however, why context matters: It is a tool for understanding the terms of the law, not an excuse for rewriting them.”

“Reading the act as a whole leaves no doubt about the matter,” he wrote. “ ‘Exchange established by the state’ means what it looks like it means.”

Justice Scalia said the decision had damaged the court’s reputation for “honest jurisprudence.”

The court, he said, had taken into its own hands a matter involving tens of billions of dollars that should have been left to Congress.

“It is up to Congress to design its laws with care,” he added, “and it is up to the people to hold them to account if they fail to carry out that responsibility.”

Justices Clarence Thomas and Samuel A. Alito Jr. joined Justice Scalia’s dissenting opinion.

Chief Justice Roberts rejected the argument that Congress had limited the availability of subsidies in order to encourage states to create their own exchanges, a notion that had occurred to almost no one at the time the law was enacted.

Sixteen states and the District of Columbia have established their own exchanges. Under the law, the federal government has stepped in to run exchanges in the rest of the states.

“The whole point of that provision,” Chief Justice Roberts wrote, “is to create a federal fallback in case a state chooses not to establish its own exchange. Contrary to petitioners’ argument, Congress did not believe it was offering states a deal they would not refuse — it expressly addressed what would happen if a state did refuse the deal.

The case started when four plaintiffs, all from Virginia, sued the Obama administration, saying the phrase meant that the law forbids the federal government to provide subsidies in states that do not have their own exchanges.

The plaintiffs challenged an Internal Revenue Service regulation that said subsidies were allowed whether the exchange was run by a state or by the federal government. They said the regulation was at odds with the Affordable Care Act.

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. interpretation was entitled to deference.

The Supreme Court’s ruling was more forceful. “This is not a case for the I.R.S.,” Chief Justice Roberts wrote. “It is instead our task to determine the correct reading.”

http://www.nytimes.com/2015/06/26/us/obamacare-supreme-court.html

SUPREME COURT OF THE UNITED STATES

Syllabus

KING ET AL. v. BURWELL, SECRETARY OF HEALTH AND HUMAN SERVICES, ET AL.

CERTIORARI TO THE UNITED STATES COURT OF APPEALS FOR THE FOURTH CIRCUIT

Supreme Court Ruling – Obamacare Subsidies Stay

Posted by William A. Jacobson

Decision just in in King v. Burwell. Here.

In a 6-3 ruling authored by Chief Justice Roberts, the Court held that subsidies are available on the federal exchanges. Those voting in the majority were Roberts, Kennedy, Ginsburg, Breyer, Sotomayor, and Kagan.

Had the court ruled otherwise, it would have put all of Obamacare in jeopardy, since 38 states do not have exchanges and Obamacare is too expensive for most people without a subsidy.

The issue was whether only state-established exchanges could issue tax credits, or whether the federal exchanges could also. Challengers to IRS regulations pointed to the words “established by the State” in the legislation as clear and unambiguous that subsidies were limited to state exchanges.

The Court rejected this assertion:

These provisions suggest that the Act may not always use the phrase “established by the State” in its most natural
sense. Thus, the meaning of that phrase may not be as clear as it appears when read out of context. [at 11.]

As he did in upholding an Obamacare constitutional challenge in 2012, Roberts found a way to read the law so as to save the law:

The upshot of all this is that the phrase “an Exchange established by the State under [42 U. S. C. §18031]” is properly viewed as ambiguous. The phrase may be limited in its reach to State Exchanges. But it is also possible that the phrase refers to all Exchanges—both State and Federal—at least for purposes of the tax credits. If a State chooses not to follow the directive in Section 18031 that it establish an Exchange, the Act tells the Secretary to establish “such Exchange.” §18041. And by using the words “such Exchange,” the Act indicates that State and Federal Exchanges should be the same. But State and Federal Exchanges would differ in a fundamental way if tax credits were available only on State Exchanges—one type of Exchange would help make insurance more affordable by providing billions of dollars to the States’ citizens; the other type of Exchange would not.2 [at 12-13]

The Court found Obamacare so “inartfully drafted” that the Court essentially wrote the law for Congress through “statutory interpretation.”

The Affordable Care Act contains more than a few examples of inartful drafting. (To cite just one, the Act creates three separate Section 1563s. See 124 Stat. 270, 911, 912.) Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through “the traditional legislative process.” Cannan, A Legislative
History of the Affordable Care Act: How Legislative Procedure Shapes Legislative History, 105 L. Lib. J. 131, 163 (2013). And Congress passed much of the Act using a complicated budgetary procedure known as “reconciliation,” which limited opportunities for debate and amendment, and bypassed the Senate’s normal 60-vote filibuster requirement. Id., at 159–167. As a result, the Act does not reflect the type of care and deliberation that one mightexpect of such significant legislation….

Anyway, we “must do our best, bearing in mind the fundamental canon of statutory construction that the words of a statute must be read in their context and with a view to their place in the overall statutory scheme.” Utility Air Regulatory Group, 573 U. S., at ___ (slip op., at 15) (internal quotation marks omitted). After reading Section 36B along with other related provisions in the Act, we cannot conclude that the phrase “an Exchange established by the State under [Section 18031]” is unambiguous. [at 14-15]

Nowhere in any of the opinions is the term “Gruber” mentioned. Jonathan Gruber, one of the architects of the law, stated on numerous occasions that there was a specific purpose of the language to exclude the federal exchange, so as to pressure states to get subsidies for their citizens by establishing exchanges.

Architect of Obamacare: Only get tax credits if buy on state exchanges

The Court rejected the Gruber view of Congressional intent:

The whole point of that provision is to create a federal fallback in case a State chooses not to establish its own Exchange. Contrary to petitioners’ argument, Congress did not believe it was offering States a deal they would not refuse—it expressly addressed what
would happen if a State did refuse the deal.

Having found the term “established by the State” ambiguous, the Court read it in a way such as to save Obamacare and prevent a “death spiral” of the law:

Given that the text is ambiguous, we must turn to the broader structure of the Act to determine the meaning of Section 36B. “A provision that may seem ambiguous in isolation is often clarified by the remainder of the statutory scheme . . . because only one of the permissible meanings produces a substantive effect that is compatible with the rest of the law.” United Sav. Assn. of Tex. v. Timbers of Inwood Forest Associates, Ltd., 484 U. S. 365, 371 (1988). Here, the statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very “death spirals” that Congress designed the Act to avoid. [at 15]

Reliance on context and structure in statutory interpretation is a “subtle business, calling for great wariness lest
what professes to be mere rendering becomes creation and attempted interpretation of legislation becomes legislation itself.” Palmer v. Massachusetts, 308 U. S. 79, 83 (1939). For the reasons we have given, however, such reliance is appropriate in this case, and leads us to conclude that Section 36B allows tax credits for insurance purchased on any Exchange created under the Act. Those credits are necessary for the Federal Exchanges to function like their State Exchange counterparts, and to avoid the type of calamitous result that Congress plainly meant to avoid. [at 21]

Roberts and the majority did not want to be the ones to take down Obamacare, and that drove everything:

Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter. Section 36B can fairly be read consistent with what we see as Congress’s plan, and that is the reading we adopt. [at 21]

Scalia’s dissent, joined by Thomas and Alito, was stinging, and in my opinion correct as to the absurdity of the Court contorting itself to save the law (as Roberts did in the original Obamacare challenge):

The Court holds that when the Patient Protection and Affordable Care Act says “Exchange established by the State” it means “Exchange established by the State or the Federal Government.” That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so. [at 1]

Scalia points out that the words have a plain meaning:

This case requires us to decide whether someone who buys insurance on an Exchange established by the Secretary gets tax credits. You would think the answer would be obvious—so obvious there would hardly be a need for the Supreme Court to hear a case about it. In order to receive any money under §36B, an individual must enroll in an insurance plan through an “Exchange established by the State.” The Secretary of Health and Human Services is not a State. So an Exchange established by the Secretary is not an Exchange established by the State—which means people who buy health insurance through such an Exchange get no money under §36B.

Words no longer have meaning if an Exchange that is not established by a State is “established by the State.” …. [at 2, italics in original]

Scalia argued — persuasively — that the overriding goal seems to be saving Obamacare, not exercising normal judicial interpretation of plain language:

“[T]he plain, obvious, and rational meaning of a statute is always to be preferred to any curious, narrow, hidden sense that nothing but the exigency of a hard case and the ingenuity and study of an acute and powerful intellect would discover.” Lynch v. Alworth-Stephens Co., 267 U. S. 364, 370 (1925) (internal quotation marks omitted). Under all the usual rules of interpretation, in short, the Government should lose this case. But normal rules of interpretation seem always to yield to the overriding principle of the present Court: The Affordable Care Act must be saved. [at 2-3]

Scalia wrote that the majority opinion rewrote the law “with no semblance of shame”:

The Court interprets §36B to award tax credits on both federal and state Exchanges. It accepts that the “most natural sense” of the phrase “Exchange established by the State” is an Exchange established by a State. Ante, at 11. (Understatement, thy name is an opinion on the Affordable Care Act!) Yet the opinion continues, with no semblance of shame, that “it is also possible that the phrase refers to all Exchanges—both State and Federal.” Ante, at 13. (Impossible possibility, thy name is an opinion on the Affordable Care Act!) [at 3]

Scalia then delivered the best line of the day. Looking back over multiple decisions from the Court to rewrite Obamacare in order to save it, Scalia insisted that the law now should be called SCOTUScare:

Today’s opinion changes the usual rules of statutory interpretation for the sake of the Affordable Care Act. That, alas, is not a novelty. In National Federation of Independent Business v. Sebelius, 567 U. S. ___, this Court revised major components of the statute in order to save them from unconstitutionality. The Act that Congress passed provides that every individual “shall” maintain insurance or else pay a “penalty.” 26 U. S. C. §5000A. This Court, however, saw that the Commerce Clause does not authorize a federal mandate to buy health insurance. So it rewrote the mandate-cum-penalty as a tax. 567 U. S., at ___–___ (principal opinion) (slip op., at 15–45).

The Act that Congress passed also requires every State to accept an expansion of its Medicaid program, or else risk losing all Medicaid funding. 42 U. S. C. §1396c. This Court, however, saw that the Spending Clause does not authorize this coercive condition. So it rewrote the law to withhold only the incremental funds associated with the Medicaid expansion. 567 U. S., at ___–___ (principal opinion) (slip op., at 45–58). Having transformed two major parts of the law, the Court today has turned its attention to a third. The Act that Congress passed makes tax credits available only on an “Exchange established by the State.” This Court, however, concludes that this limitation would prevent the rest of the Act from working as well as hoped. So it rewrites the law to make tax credits available everywhere.

We should start calling this law SCOTUScare. [at 20-21, emphasis and hard paragraph breaks added.]

The legacy of this Court, Scalia wrote, will live on just as Obamacare, but in infamy:

Perhaps the Patient Protection and Affordable Care Act will attain the enduring status of the Social Security Act or the Taft-Hartley Act; perhaps not. But this Court’s two decisions on the Act will surely be remembered through the years. The somersaults of statutory interpretation they have performed (“penalty” means tax, “further [Medicaid] payments to the State” means only incremental Medicaid payments to the State, “established by the State” means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.

I dissent.

http://legalinsurrection.com/2015/06/supreme-court-ruling-obamacare-subsidies/

From ‘Jiggery-Pokery’ to ‘SCOTUScare,’ Read the Best Quotes From Today’s Obamacare Ruling

Justice Antonin Scalia’s flair for the dramatic shines through, while Chief Justice John Roberts plays it straight.

Jessica Ellis, right, with

Supporters of the Affordable Care Act react with cheers as the opinion for health care is reported outside of the Supreme Court in Washington on Thursday .

By U.S. News Staff
Thursday’s 6-3 ruling by the Supreme Court upholding the validity of tax credits that help millions of people afford health insurance under the Affordable Care Act came down to a literal matter of interpretation.

At issue were words in the law that subsidies could be distributed for health coverage purchased through “an Exchange established by the State.” The plaintiffs argued the law should be read literally, nullifying subsidies provided through exchanges that relied on the federal government. The Obama administration countered that the law never intended to limit subsidies in such a way.

Chief Justice John Roberts authored the court’s majority opinion, and was countered by Justice Antonin Scalia’s dissent. Here are some select quotes from both.

Roberts:

John Paul Stevens, Supreme Court Justice 13
Chief Justice John Roberts authored the court’s majority opinion.

“The upshot of all this is that the phrase ‘an Exchange established by the State under [42 U. S. C. §18031]’ is properly viewed as ambiguous. The phrase may be limited in its reach to State Exchanges. But it is also possible that the phrase refers to all Exchanges—both State and Federal—at least for purposes of the tax credits.”

“It would be odd indeed for Congress to write such detailed instructions about customers on a State Exchange, while having nothing to say about those on a Federal Exchange.”

“The Affordable Care Act contains more than a few examples of inartful drafting. Several features of the Act’s passage contributed to that unfortunate reality. Congress wrote key parts of the Act behind closed doors, rather than through ‘the traditional legislative process’ … As a result, the Act does not reflect the type of care and deliberation that one might expect of such significant legislation.”

“The statutory scheme compels us to reject petitioners’ interpretation because it would destabilize the individual insurance market in any State with a Federal Exchange, and likely create the very ‘death spirals’ that Congress designed the Act to avoid.”

“In petitioners’ view, Congress made the viability of the entire Affordable Care Act turn on the ultimate ancillary provision: a sub-sub-sub section of the Tax Code. We doubt that is what Congress meant to do.”

“In a democracy, the power to make the law rests with those chosen by the people. Our role is more confined —’to say what the law is.’ … That is easier in some cases than in others. But in every case we must respect the role of the Legislature, and take care not to undo what it has done. A fair reading of legislation demands a fair understanding of the legislative plan. Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them. If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter.”

Scalia:

widemodern_scalia_091613.jpg

Justice Antonin Scalia authored the court’s dissenting opinion.

“Today’s interpretation is not merely unnatural; it is unheard of. Who would ever have dreamt that ‘Exchange established by the State’ means ‘Exchange established by the State or the Federal Government’? Little short of an express statutory definition could justify adopting this singular reading.”

“We should start calling this law SCOTUScare.”

“The Court holds that when the Patient Protection and Affordable Care Act says ‘Exchange established by the State’ it means ‘Exchange established by the State or the Federal Government.’ That is of course quite absurd, and the Court’s 21 pages of explanation make it no less so.”

“Yet the opinion continues, with no semblance of shame, that ‘it is also possible that the phrase refers to all Exchanges—both State and Federal.’ (Impossible possibility, thy name is an opinion on the Affordable Care Act!)”

“The Court’s next bit of interpretive jiggery-pokery involves other parts of the Act that purportedly presuppose the availability of tax credits on both federal and state Exchanges.”

“Much less is it our place to make everything come out right when Congress does not do its job properly. It is up to Congress to design its laws with care, and it is up to the people to hold them to account if they fail to carry out that responsibility.”

“Pure applesauce.”

“The somersaults of statutory interpretation they have performed (‘penalty’ means tax, ‘further [Medicaid] payments to the State’ means only incremental Medicaid payments to the State, ‘established by the State’ means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence. And the cases will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.”

Read the full opinion and dissent below: 

http://www.usnews.com/news/articles/2015/06/25/read-the-best-quotes-from-roberts-and-scalia-in-the-king-v-burwell-obamacare-opinion

Key Facts about the Uninsured Population

Decreasing the number of uninsured is a key goal of the Affordable Care Act (ACA), which provides Medicaid coverage to many low-income individuals in states that expand and Marketplace subsidies for individuals below 400% of the poverty line. Baseline estimates show that over 41 million individuals were uninsured in 2013, prior to the start of the major ACA coverage provisions, and early evidence suggests that the ACA has reduced this number. This brief describes trends in coverage leading up to the ACA, reviews early estimates of the impact of the ACA on the uninsured, examines the characteristics of the uninsured population, and summarizes the access and financial implications of not having coverage.

Summary: Key Facts about the Uninsured Population

What was happening to the uninsured leading up to the ACA?

Trends in the uninsured have historically tracked economic conditions, with the number of uninsured people increasing during recessionary periods when people lost their jobs. Public programs provided a safety net during the Great Recession and prevented many from going uninsured. On the eve of the ACA, as the economy stabilized, coverage losses slowed. However, over 41 million people were still without coverage in 2013.

What has been happening to the uninsured under the ACA?

As of 2014, the ACA helps expand coverage to millions of currently uninsured people through the expansion of Medicaid eligibility and establishment of Health Insurance Marketplaces. The ACA also includes reforms to help people maintain coverage and make private insurance affordable and accessible. Early evidence on coverage in the first few months of 2014 indicates that the number of uninsured has declined since the availability of these new provisions.

Why are so many Americans uninsured?

The high cost of insurance has been the main reason why people go without coverage. In 2013, 61% of uninsured adults said the main reason they were uninsured was because the cost was too high or because they had lost their job. Many people do not have access to coverage through a job, and gaps in eligibility for public coverage in the past have left many without an affordable option.  Even after ACA coverage expansions, Medicaid eligibility for adults remains limited in states that did not expand their programs.

Who are the uninsured?

Most of the uninsured are in low-income working families. In 2013, nearly 8 in 10 were in a family with a worker, and nearly 6 in 10 have family income below 200% of poverty. Reflecting the more limited availability of public coverage, adults have been more likely to be uninsured than children. People of color are at higher risk of being uninsured than non-Hispanic Whites.

How does the lack of insurance affect access to health care?

People without insurance coverage have worse access to care than people who are insured. Almost a third of uninsured adults in 2013 (30%) went without needed medical care due to cost. Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.

What are the financial implications of lack of coverage?

The uninsured often face unaffordable medical bills when they do seek care. In 2013, nearly 40% of uninsured adults said they had outstanding medical bills, and a fifth said they had medical bills that caused serious financial strain.  These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.

What was happening to the uninsured leading up to the ACA?

The number of uninsured people steadily increased throughout most of the past decade due to decreasing employer sponsored insurance coverage and rising health care costs. The recent recession led to a steep increase in uninsured rates from 2008 to 2010 as a high jobless rate led millions to lose their employer sponsored coverage.1Medicaid and CHIP prevented steeper drops in insurance coverage, as many Americans became newly eligible for these programs when their income declined during the recession. From 2011 to 2013, uninsured rates dropped as the economy improved and early provisions expanding coverage under the ACA went into effect.

Key Details:

Figure 1: Uninsured Rates Among the Nonelderly, 2000-2013

  • The share of the nonelderly population with employer-sponsored coverage declined steadily between 2000 and 2010, dropping nearly ten percentage points over the decade.2 In 2011, this trend ended as the share with employer-sponsored coverage held nearly constant at around 58% between 2011 and 2013. This break in trend was likely due to uptake of the ACA provision that allowed young adults to continue as dependents on parents’ private plans until age 26. It also reflects improving economic conditions. The unemployment rate peaked at 10.0 percent in October 2009. From 2010 on, the unemployment rate improved steadily, corresponding with a drop in the uninsured rate from 2010 to 2013 (Figure 1).
  • The share of people covered by Medicaid increased significantly during the recent recession due to the weak economy and loss of jobs, which led to declining family incomes and decreasing employer-sponsored coverage among families. Between 2007 and 2013, over 10 million people—primarily children—gained Medicaid coverage. These gains offset some of the loss of employer coverage over the period.
  • In 2013, the uninsured rate among nonelderly individuals was at 16.7%, a level comparable to pre-recession uninsured rates (Figure 1). Still, many uninsured individuals had been uninsured for long periods, often five years or more,3 indicating that their lack of coverage was related to forces outside the recession. With the major ACA coverage provisions going into effect in 2014, many are newly-insured.

What has been happening to the uninsured under the ACA?

Under the ACA, as of 2014, Medicaid coverage is expanded to nearly all adults with incomes at or below 138% of poverty in states that expand, and tax credits are available for people who purchase coverage through a health insurance Marketplace. Early data suggest that the ACA has helped expand coverage to millions of previously uninsured people, but some—particularly poor adults in states that do not expand Medicaid—are still left without affordable coverage.

Key Details:

Figure 2: Percentage Point Decrease in Uninsured by State Medicaid Expansion Status, 2013- Q1 2014

  • As of mid-April 2014 (after the first open enrollment period), over 8 million people selected plans through the federal or state Marketplaces.4 The vast majority of Marketplace enrollees (85%) were eligible for premium tax credits. Many Marketplace enrollees are newly-insured. A survey of people with private non-group plans after open enrollment found that nearly six in ten (57 percent) of those with Marketplace coverage were uninsured prior to purchasing their current plan.5 Other data from insurers suggest a large increase in the individual market in the first quarter attributable to the ACA.6
  • Enrollment data also show that as of July 2014, Medicaid enrollment has grown by 8 million since the period before open enrollment (which started in October 2013).7 This growth is an increase of 14% in monthly Medicaid enrollment.8 Enrollment increases were higher (20%) among states that chose to expand Medicaid eligibility. These data suggest that Medicaid enrollment growth is related to ACA expansions.9
  • Early survey data suggest that the uninsured rate is falling. The early release of estimates from the first quarter (January through March) of the 2014 National Health Interview Survey indicates that the uninsured rate dropped for nonelderly individuals in the first quarter of 2014 by a full percentage point relative to the first quarter of the previous year.10 However, the NHIS early results were not likely to have captured most or all of the ACA’s effects, as many people enrolled in coverage after survey data were collected. NHIS early results also show that states that chose to expand Medicaid saw significant declines in uninsured rates among adults from 2013 to the first quarter of 2014 (Figure 2). States that did not choose to expand Medicaid did not see corresponding declines. Several private polls and surveys also indicate that the uninsured rate has been decreasing since the period prior to ACA open enrollment. While these surveys have different methodologies and often have high error margins that make point estimates unreliable, they are all in agreement that the uninsured rate has dropped in 2014.
  • Even with the availability of new coverage options, millions remain uninsured. Previous analyses show that many poor adults in states that do not expand Medicaid will continue to be at risk to be uninsured.11 People of color, people living in the South,12 and individuals living in rural areas are especially at risk to be left out of ACA coverage expansions.13

Why are so many Americans uninsured?

Insurance is expensive, and few people can afford to buy it on their own. Most Americans obtain health insurance coverage through an employer, but not all workers are offered employer-sponsored coverage. Also, not all who are offered coverage by an employer can afford their share of the premiums. Medicaid and the Children’s Health Insurance Program (CHIP) cover many low-income individuals, particularly children. However, Medicaid eligibility for adults remains limited in some states, and few people can afford to purchase coverage on their own without financial assistance.

Key Details:

Figure 3: Reasons for Being Uninsured among Uninsured Nonelderly Adults, 2013

  • Uninsured individuals report that cost poses a major barrier to purchasing coverage. In 2013, 61% of adults said that the main reason they are uninsured is either because the cost is too high or because they lost their job, compared to 1.7% who said they are uninsured because they do not need coverage (Figure 3). Under the ACA, financial assistance is available to help many uninsured people afford coverage.
  • Not all workers have access to coverage through their job. Most uninsured workers are self-employed or work for small firms where health benefits are less likely to be offered.14 Low-wage workers who are offered coverage often cannot afford their share of the premiums, especially for family coverage.15,16
  • Workers usually enroll in employer-sponsored health insurance if they are eligible.17 However, it has become increasingly difficult for many workers to afford coverage. In 2014, the average annual total cost of employer-sponsored family coverage was $16,834, and the worker’s share averaging $4,823 per year.18 Between 2004 and 2014, total premiums have increased by 69%, and the worker’s share has increased over 81%.19 Starting in 2015, under the ACA, employers with 50 or more workers will be penalized if they do not offer affordable coverage. As of 2014, the ACA provides Marketplace tax credits or Medicaid coverage for many employees without access to affordable employer-sponsored insurance.20
  • In 2013, over 51 million nonelderly individuals were covered by Medicaid and CHIP.21 Historically, Medicaid was only available to low-income children, parents, pregnant women, people with disabilities, and the elderly. While states have increasingly expanded eligibility for children over time, eligibility for parents remained much more limited before ACA coverage expansions.22
  • As of September 2014, 28 states are moving forward or will be moving forward with expanded Medicaid eligibility for most nonelderly individuals under 138% FPL.23 This expansion will fill in historical gaps in eligibility for public coverage. However, in states that do not expand their Medicaid programs, eligibility for adults remains limited: the median eligibility level for parents is just 47% of poverty, and adults without dependent children are ineligible in nearly all states not expanding.

Who are the Uninsured?

The majority of the uninsured are in low-income working families. Reflecting the more limited availability of public coverage, adults are more likely to be uninsured than children. People of color are at higher risk of being uninsured than non-Hispanic Whites.

Key Details:

Figure 4:  Characteristics of the Nonelderly Uninsured, 2013

  • Based on the most recent data that is available (which reflects coverage prior to the major ACA provisions), over six in ten of the uninsured have at least one full-time worker in their family, and 16% have a part-time worker in the family (Figure 4).
  • Individuals below poverty are at the highest risk of being uninsured, and this group accounted for 27% of all the uninsured in 2013 (the poverty level for a family of three was $19,530 in 2013). In total, almost nine in ten of the uninsured are in low- or moderate-income families, meaning they are below 400% of poverty (Figure 3).
  • While a plurality (46%) of the uninsured are White, non-Hispanic, people of color are at higher risk of being uninsured than White non-Hispanics. People of color make up 40% of the population but account for over half of the total uninsured population. The disparity in insurance coverage is especially high for Hispanics, who account for 19% of the total population but more than 30% of the uninsured population. Hispanics and non-Hispanic Blacks have significantly higher uninsured rates (25.6% and 17.3%, respectively) than Whites (11.7%).24
  • About eight in ten of the uninsured are U.S. citizens and 19.7% are non-citizens. Uninsured non-citizens include both lawfully present and undocumented immigrants. Undocumented immigrants and legal immigrants residing in the U.S. for less than five years are ineligible for federally funded health coverage.
  • Uninsured rates vary widely by state and by region, with individuals living in the South and West the most likely to be uninsured (Figure 5). This variation reflects different economic conditions, availability of employer-based coverage, demographics, and eligibility for public coverage.

How does the lack of insurance affect access to health care?

Figure 5: Uninsured Rates Among the Nonelderly by State, 2013

Almost a third of uninsured adults (30%) in 2013 went without needed care each year due to cost (Figure 5). Studies repeatedly demonstrate that the uninsured are less likely than those with insurance to receive preventive care and services for major health conditions and chronic diseases.25, 26, 27, 28 Research also has suggested that insurance can decrease likelihood of depression and stress.29

Key Details:
  • Health providers can choose to not provide care to the uninsured. Only emergency departments are required by federal law to screen and stabilize all individuals. However, the uninsured are not necessarily more likely to use the emergency room than those with insurance.30 If the uninsured are unable to pay for care in full, they are often turned away when they seek follow-up care for urgent medical conditions.31
  • The uninsured receive less preventive care and recommended screenings than the insured. In 2013, only 1 in 3 uninsured adults (33%) reported a preventive visit with a physician in the last year, compared to 74% of adults with employer coverage and 67% of adults with Medicaid.32 Uninsured older adults (ages 50-64) were far less likely than their insured counterparts to report having been screened for cancer in the past five years.33

Figure 6:  Barriers to Health Care Among Nonelderly Adults by Insurance Status, 2013

  • Receiving needed care is especially important for the uninsured since they are generally not as healthy as those with private coverage. The uninsured are at higher risk for preventable hospitalizations and for missed diagnoses of serious health conditions.34 After a chronic condition is diagnosed, they are less likely to receive follow-up care and as a result are more likely to have their health decline.35 Lack of follow-up attributed to being uninsured can delay the detection of certain cancers, which can result in adverse outcomes.36 It follows that the uninsured also have significantly higher mortality rates than those with insurance.37,38
  • The uninsured report higher rates of postponing care and forgoing needed care or prescriptions due to cost compared to those enrolled in Medicaid and other public programs (Figure 6). A seminal study of health insurance in Oregon found that the uninsured were less likely to receive care from a hospital or doctor than newly insured Medicaid enrollees.39A follow-up study found that newly insured Medicaid enrollees were much less likely to delay care because of costs than the uninsured.40

What are the financial implications of lack of coverage?

The uninsured often face unaffordable medical bills when they do seek care. These bills can quickly translate into medical debt since most of the uninsured have low or moderate incomes and have little, if any, savings.

Key Details:

Figure 7: Financial Consequences of Medical Bills by Insurance Coverage, 2013

  • Those without insurance for an entire year pay for one-fifth of their care out-of-pocket.41 They are typically billed for any care they receive, often paying higher charges than the insured.42
  • Medical bills can put great strain on the uninsured and threaten their physical and financial well-being. The uninsured are significantly more likely than individuals covered by employer coverage, non-group insurance or Medicaid to have trouble paying medical bills (Figure 7). Almost 40% of uninsured adults have outstanding medical bills.
  • A study based on the Oregon Health Insurance Experiment found that the uninsured were more likely to experience financial strain from medical bills and out-of-pocket expenses than those with Medicaid coverage. The uninsured were also more likely than the insured to have to postpone care because of costs.43
  • The uninsured live with the knowledge that they may not be able to afford to pay for their family’s medical care, which can cause anxiety and potentially lead them to delay or forgo care. Almost three-quarters (70%) of the uninsured are not confident that they can pay for the health care services they think they need, compared to 13% of those with employer coverage and 37% with Medicaid.44
  • The average uninsured household has no net assets.45 Without sufficient income or assets to pay their medical bills, uninsured individuals often see their debts accumulate while their credit ratings are compromised. Medical debts contribute to almost half of all bankruptcies in the United States.46

Conclusion

Over 41 million nonelderly individuals were uninsured in 2013.  This figure represents the baseline against which most changes in the ACA will be measured. While we do not yet know the full effect of the major coverage provisions of the ACA, early evidence indicates that it is working to expand insurance to those who need it.

Going without coverage can have serious health consequences for the uninsured because they receive less preventive care, and delayed care often results in more serious illness requiring advanced treatment. Being uninsured also can have serious financial consequences. The ACA holds promise for many people who will gain access to health insurance coverage, but monitoring how coverage changes and who is left out of coverage expansions is also important.

http://kff.org/uninsured/fact-sheet/key-facts-about-the-uninsured-population/

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The Pronk Pops Show 371, November 14, 2014, Story 1: Obama’s Affordable Care Act, aka Obamacare, Cadillac Tax Crashes and Burns Killing Obarecare and Injuring MIT Economics Professor Jonathan Gruber (Architect of Obamacare) — Rest In Peace — Obamacare Is Shovel Ready — Videos

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Pronk Pops Show 326: September 10, 2014

Pronk Pops Show 325: September 9, 2014

Pronk Pops Show 324: September 8, 2014

Pronk Pops Show 323: September 5, 2014

Pronk Pops Show 322: September 4, 2014

Pronk Pops Show 321: September 3, 2014

Pronk Pops Show 320: August 29, 2014

Pronk Pops Show 319: August 28, 2014

Pronk Pops Show 318: August 27, 2014 

Pronk Pops Show 317: August 22, 2014

Pronk Pops Show 316: August 20, 2014

Pronk Pops Show 315: August 18, 2014

Pronk Pops Show 314: August 15, 2014

Pronk Pops Show 313: August 14, 2014

Pronk Pops Show 312: August 13, 2014

Pronk Pops Show 311: August 11, 2014

Pronk Pops Show 310: August 8, 2014

Pronk Pops Show 309: August 6, 2014

Pronk Pops Show 308: August 4, 2014

Pronk Pops Show 307: August 1, 2014

Story 1: Obama’s Cadillac Tax Crashes and Burns Killing Obarecare and Injuring MIT Professor Gruber — Rest In Peace — Obamacare Is Shovel Ready — VideosObama-lyingking )bamaObamaCare-CadillacTaxPPACA-Sec-9001-cadillac-tax-2120701-10-obamacare21-new-taxes-under-Obamacareexcise-tax-140820Cadillac-Tax-penetrationtax_apple_piecorrected_pie_graph_verticalObamacare taxes 1obamacare-warning-lights-on-the-job-training-political-cartoon130402-obamacare-cartoon-cadillac_taxpink_cazdillacCadillacJonathan-Gruber

jonathan_gruberGruberobamacare_shovel_

ObamaCare a Trojan Horse for Single-Payer

Obama lies about “cadillac” plan taxation

36 Times Obama Said You Could Keep Your Health Care Plan | SuperCuts #18

ACA Architect Confession: Created Lies For Obama

Stupid Is as Stupid Does’: Judge Jeanine Slams Obama, Pelosi and Gruber

Obamacare – Concerns “Cadillac Tax” Forcing Employers To Cut Back Health Plans

What is the “cadillac tax?”

Obamacare’s Cadillac Tax Pushing People To Plans With High Deductible- Union You Got What You Wanted

Obamacare – Concerns “Cadillac Tax” Forcing Employers To Cut Back Health Plans

The Five: Large Employers Cite ObamaCare “Cadillac” Tax In Reducing Benefits

SMOKING GUN! Gruber Admits Obama Was in Room During Planning of Cadillac Lie

GRUBER: “Lack of transparency is a huge political advantage.”

GRUBER; Deceive Americans Critical to Pass Obamacare-Calls us ‘Stupid Americans’; Part 1 of 3

Gruber Remarks Puts Obama Administration on Scramble; Part 2 of 3

Jonathan Gruber: States Which Do Not Set Up an Exchange Do Not Get Tax Subsidies

BookTV: Jonathan Gruber, “Health Care Reform: What It Is, Why It’s Necessary, How It Works”

Jonathan Gruber admits Obamacare is inherently unaffordable

Obamacare – Concerns “Cadillac Tax” Forcing Employers To Cut Back Health Plans

Krauthammer rips Jonathan Gruber: “We’re hearing the true voice of liberal arrogance”

Megyn Slams ObamaCare Architect Who Declined to Appear on ‘Kelly File’

Democrats Loved Jonathan Gruber Before They Forgot Who He Was

Sen. Harry Reid, 2009: Gruber Is One Of The ‘Most Respected Economists’ Out There

Sen. Harry Reid (D-NV) in a December 2009 floor speech on Capitol Hill lauded Jonathan Gruber as one of the most “respected economists in the world” as Reid cited facts defending the Senate’s Obamacare bill.

Nancy Pelosi In 2009: Americans Should Read Jonathan Gruber’s ObamaCare Analysis

Nancy Pelosi In 2009: Americans Should Read Jonathan Gruber’s ObamaCare Analysis (November 5, 2009)

AHEC 2013 Conference

As part of the 24th Annual Health Economics Conference hosted by PennLDI, Mark Pauly and Jonathan Gruber were featured in the Plenary Panel discussing the role of economics in shaping (and possibly reshaping) the ACA. See below for the conference agenda with links to working papers. See the full AHEC agenda: http://ldi.upenn.edu/ahec2013/agenda

Jonathan Gruber at Noblis – January 18, 2012

The Noblis Technology Tuesday speaker series covers a broad spectrum of political, technical and innovative ideas. Noblis is a nonprofit science, technology, and strategy organization that brings the best of scientific thought, management, and engineering expertise with a reputation for independence and objectivity. The opinions expressed in this video are those of the speaker and do not necessarily reflect the views or opinions of Noblis.

Jonathan Gruber spoke to a Noblis audience on January 18, 2012 Few experts know more about America’s dire need of health care reform than Gruber. And of that short list, he is the only one prepared to enter the pages of a comic book to make the case. To be clear: Gruber is not an expert; he is “the” expert. An award-winning MIT economist and the director of the Health Care Program at the National Bureau of Economic Research, he was a key architect of the ambitious health care reform effort in Massachusetts and is a member of the Health Connector Board now implementing it; in 2006 he was named by “Modern Healthcare” as the nineteenth most powerful person in health care in the United States. In 2008 he was a consultant to the Clinton, Edwards, and Obama presidential campaigns. The national legislation passed by Congress in 2009 derives directly from Gruber’s insights learned during the Massachusetts health care debate.

Honors Colloquium 2012 – Jonathan Gruber

Dr. Jonathan Gruber is a Professor of Economics at the Massachusetts Institute of Technology, where he has taught since 1992. He is also the Director of the Health Care Program at the National Bureau of Economic Research, where he is a Research Associate. He is an Associate Editor of both the Journal of Public Economics and the Journal of Health Economics. In 2009 he was elected to the Executive Committee of the American Economic Association. He is also a member of the Institute of Medicine, the American Academy of Arts and Sciences, and the National Academy of Social Insurance.

Dr. Gruber received his B.S. in Economics from MIT, and his Ph.D. in Economics from Harvard University. Dr. Gruber’s research focuses on the areas of public finance and health economics. He has published more than 140 research articles, has edited six research volumes, and is the author of Public Finance and Public Policy, a leading undergraduate text, and Health Care Reform, a graphic novel. In 2006 he received the American Society of Health Economists Inaugural Medal for the best health economist in the nation aged 40 and under. During the 1997-1998 academic year, Dr. Gruber was on leave as Deputy Assistant Secretary for Economic Policy at the Treasury Department. From 2003-2006 he was a key architect of Massachusetts’ ambitious health reform effort, and in 2006 became an inaugural member of the Health Connector Board, the main implementing body for that effort. In that year, he was named the 19th most powerful person in health care in the United States by Modern Healthcare Magazine.

BookTV: Jonathan Gruber, “Health Care Reform: What It Is, Why It’s Necessary, How It Works

Jonathan Gruber, economics professor at the Massachusetts Institute of Technology and director of the health care program at the National Bureau of Economic Research, presents his thoughts on health care. Mr. Gruber a leading architect of Massachusetts’ health care reform also consulted with Congress and President Obama on the creation of the Affordable Care Act, signed into law by the President in 2010.

Obamacare architect Jonathan Gruber suddenly recast as bit player after uproar

Nancy Pelosi, fellow Democrats scramble to distance themselves from MIT professor, economist

For years, Massachusetts Institute of Technology professor Jonathan Gruber was deemed an architect of Obamacare and his economic modeling was cited regularly by the health care law’s defenders on Capitol Hill and in legal briefs defending the Affordable Care Act in federal courts.

But after tapes surfaced of the economist saying “stupid” voters needed to be bamboozled and the books cooked to get the legislation passed in 2010, Democrats are scrambling to reduce Mr. Gruber to a bit player — and raising questions about whether he needs to be expunged from their defense strategy as they face yet another Supreme Court review.

House Minority Leader Nancy Pelosi, who as speaker in 2009 posted an Obamacare “myth buster” citing Mr. Gruber, vehemently distanced herself from him Thursday.


SEE ALSO: EDITORIAL: Jonathan Gruber’s payday


“I don’t who he is. He didn’t help write our bill,” she said, but added that Mr. Gruber’s comments were a year old and he had recanted them.

In the comments that have just come to light, Mr. Gruber said the health care bill was written in a “tortured” way to ensure the Congressional Budget Office didn’t score the individual mandate as a tax, even though the U.S. Supreme Court ultimately upheld the mandate as constitutional under Congress’ taxing power.

“Lack of transparency is a huge political advantage,” Mr. Gruber said at the time. “And basically, call it the stupidity of the American voter or whatever, but basically that was really, really critical to get the thing to pass.”

Mr. Gruber said this week that he regretted the remarks. But House Speaker John A. Boehner, Ohio Republican, said Thursday that American voters are “anything but stupid” and oppose the health care system’s overhaul for valid reasons.

Mitch McConnell, the Kentucky Republican selected as the next Senate majority leader, said Mr. Gruber made a classic “Washington gaffe — when a politician mistakenly tells you what he really thinks.”

However, Mr. Gruber’s explanation in 2012 of how Obamacare’s subsidies should be paid put the Justice Department in a tough spot.

In legal briefs submitted last year to a federal district court in Virginia, Obama administration attorneys cited Mr. Gruber in a case defending their ability to pay subsidies to enrollees regardless of whether they are part of state-run or federally run health care exchanges.

“According to the calculations of one health care economist, without the minimum coverage provision and subsidized insurance coverage, premiums for single individuals would be double the amount anticipated under the ACA,” the Justice Department wrote in a legal brief last November, citing Mr. Gruber’s work in a footnote.

The Supreme Court decided this month to take up the case, King v. Burwell, after the challengers lost to the administration in the 4th U.S. Circuit Court of Appeals.

Neither the Justice Department nor the White House responded to questions about Mr. Gruber — who declined to comment for this story — and his role in their legal strategy.

But Sam Kazman, general counsel for the Competitive Enterprise Institute, which is funding the administration’s opponents in the King case, said Mr. Gruber’s 2012 remarks about subsidies bolster their own arguments.

Mr. Gruber at the time said subsidies would flow only to states that set up their own exchanges.

“What’s important to remember politically about this is if you’re a state and you don’t set up an exchange, that means your citizens don’t get their tax credits — but your citizens still pay the taxes that support this bill,” the economist told an audience.

That would mean consumers in most states wouldn’t be eligible for subsidies, which would puncture a big hole in Obamacare. The Obama administration has argued that even though the law says subsidies go to state exchanges, they also should include states that have opted for the federal exchange.

Mr. Kazman said the Gruber comments create a major problem for Mr. Obama.

“He’s not toxic to us,” Mr. Kazman said in an interview Thursday. “We may give him an award for public service.”

In a parallel case before the D.C. Circuit, the administration tried to downplay Mr. Gruber in its latest court filings. On Nov. 3, the Justice Department said in a footnote that “post-enactment statements by a non-legislator are entitled to no weight.”

“In any event, Professor Gruber has since clarified that the remarks on which plaintiffs rely were mistaken,” the attorneys told the D.C. Circuit, which has suspended its proceedings until the Supreme Court weighs in.

In the King case, Obama administration attorneys who cited Mr. Gruber in briefs at the lower court dropped him from their arguments to the Supreme Court, said Michael A. Carvin, an attorney for the health care law’s opponents.

He wasn’t about to let the justices forget.

“Tellingly,” Mr. Carvin said in a reply brief, “the government also ignores that Jonathan Gruber — the ACA architect whose work it cited in every brief below but is nowhere mentioned now — articulated the incentive purpose of [subsidies] as early as 2012.”

Mr. Gruber has made hundreds of thousands of dollars off Obamacare, serving as a consultant to the Department of Health and Human Services and to states that used health care grant money to pay him for his services.

Timothy Jost, a law professor at Washington and Lee University who closely tracks the health care law, said the controversy has been overblown.

“This whole thing just puzzles me,” he said. “He wasn’t a legislator. He didn’t write the bill. He didn’t vote on the bill.”

http://www.washingtontimes.com/news/2014/nov/13/jonathan-gruber-obamacare-architect-recast-as-bit-/

Transcending Obamacare: An Introduction To Patient-Centered, Consumer-Driven Health Reform

Today, the Manhattan Institute is publishing my 20,000-word, 68-page health reform proposal entitled “Transcending Obamacare: A Patient-Centered Plan for Near-Universal Coverage and Permanent Fiscal Solvency.” It represents a novel approach to health reform: neither accepting Obamacare as is, nor requiring the law’s repeal to move forward. And yet its ambition is to permanently solve our health care entitlement problem, while also expanding coverage for the uninsured.

As most Apothecary readers know, I’ve long been critical of Obamacare, the so-called Affordable Care Act. The law expands Medicaid, the worst health insurance program in the developed world. It significantly drives up the underlying cost of health insurance for those who shop for coverage on their own. And regardless of what John Roberts has to say about it, Obamacare’s individual mandate—forcing most Americans to buy government-certified health coverage—is an injury to the Constitution.

But I’ve also long supported the principle of universal coverage. Universal coverage, done right, is a core part of a conservative worldview that values equality of opportunity for the sick and the poor. If 10 of the 11 freest economies in the world can establish universal coverage, it’s not impossible for the United States to do so in a way that is consonant with economic freedom.

Switzerland and Singapore: Market-based health reform models

The most market-oriented health care systems in the developed world—those ofSwitzerland and Singapore—have much to teach us about how to achieve universal coverage in a way that spends far less than what the U.S. does. In 2012, U.S. government entities spent $4,160 per capita on health care. That’s more than twice as much as Switzerland, and nearly five times as much as Singapore.

OECD 2012 public expenditures

And that brings us right back to Obamacare. The vast majority of the law is misguided and misconceived. But a handful of its provisions can provide the basis of constructive health care reform: in particular, its use of Swiss-style means-tested tax credits to subsidize private health insurance premiums. Most importantly, those tax credits are applied to insurance plans that people shop for on their own, substantially expanding the market for individually purchased health coverage.

The Swiss system is far from perfect, as I have discussed on many occasions. But the basic idea in Switzerland is to offer premium subsidies to the people who really need them. In Switzerland, one-fifth of the population gets subsidized health coverage. In the U.S., around four-fifths do. That’s the difference between a safety net and an entitlement leviathan.

Conservative health reform after Obamacare

One of the fundamental flaws in the conservative approach to health care policy is that few—if any—Republican leaders have articulated a vision of what a market-oriented health care system would look like. Hence, Republican proposals on health reform have often been tactical and political—in opposition to whatever Democrats were pitching—instead of strategic and serious.

Those days must come to an end. The problems with our health care system are too great. Health care is too expensive for the government, and too expensive for average Americans.

In 2012, as the Romney campaign came to a close, Rich Lowry, the editor ofNational Review, asked me to write an article with my thoughts about the best path forward for conservative health care reform. I outlined a four-step plan to take the entire gamish of government health care programs and reform them into something consumer-driven and fiscally sustainable: (1) deregulate Obamacare’s insurance exchanges, including repeal of the individual mandate, while preserving guaranteed issue for individuals with pre-existing conditions; (2) migrate future retirees onto the reformed exchanges; (3) repeal Obamacare’s employer mandate; (4) migrate Medicaid acute-care and dual-eligible enrollees onto the exchanges.

“After these four relatively simple steps,” I wrote, “we would be left with a health-care system that would look a lot like Switzerland’s. Rises in premium subsidies could be held to a sustainable growth rate to ensure their long-term fiscal stability. And Americans might finally have the opportunity to purchase insurance for themselves, gain control of their own health-care dollars, and enjoy a wide range of low-cost, high-quality coverage options.”

A few months later, former Congressional Budget Office director Douglas Holtz-Eakin and I wrote a similar piece for Reuters, which elicited a broad range of responses from both the left and the right.

It became clear that I had to do more than write op-eds, that I had to develop this idea in detail, with credible fiscal and economic modeling.

Modeling market-based health reform

So, over the last 18 months, I’ve done just that. Stephen Parente, a health economist at the University of Minnesota, and his team modeled the fiscal and coverage impact of the bulk of my proposed set of reforms. (I then modeled the remainder, using analyses from the Congressional Budget Office, the Centers for Medicare and Medicaid Services, and the like.)

The Manhattan Institute for Policy Research, where I am a Senior Fellow, raised money to fund Parente’s work on this project. Steve and his team and I went back and forth for months, refining and tweaking the proposal until it met five non-negotiable goals. The end result had to:

  1. Reduce the deficit without raising taxes
  2. Expand coverage meaningfully above ACA levels
  3. Repeal the individual mandate
  4. Reduce the cost of private health insurance
  5. Improve health outcomes for the poor

Based on our modeling, the plan, over a thirty-year period, reduces federal spending by $10.5 trillion and federal revenue by $2.5 trillion, for a net deficit reduction of $8 trillion. We project that it will expand coverage by more than 12 million individuals over its first decade, despite the fact that it repeals the individual mandate. It reduces the cost of private-sector insurance policies by 17 percent for single policies and 4 percent for family policies.

But the most dramatic improvement, we estimate, is in the Medicaid population. A group that today receives substandard care and substandard access to care will see a dramatic increase in provider access and health outcomes, based on Parente-developed indices that measure these things.

Breaking free of the repeal-or-reform debate

Importantly, while this plan is compatible with “repealing and replacing” Obamacare, it does not require the repeal of Obamacare. To achieve the former, you would repeal Obamacare and replace it with a universal system of state-based health insurance exchanges. To achieve the latter, you’d reform the pre-existing ACA exchanges, and gradually migrate future retirees and Medicaid enrollees onto the reformed exchanges.

In this way, perhaps the plan can attract interest from both the right and the center.

We’ll soon find out.

http://www.forbes.com/sites/theapothecary/2014/08/13/transcending-obamacare-an-introduction-to-patient-centered-consumer-driven-health-reform/

Jonathan Gruber Embraced Misleading the Public About Obamacare Even While It Was Still Being Debated
Peter Suderman

In the week since video surfaced of Obamacare architect Jonathan Gruber saying that “lack of transparency” and “the stupidity of the American voter” were critical to passing the health law, two more videos of Gruber making statements with similar themes or tones have received attention.

Both clips reveal a gleefully dismissive attitude toward public concerns about the law, and offer a telling reminder of the attitude that played a crucial role in shaping and selling the law to the public.

In the first video, recorded in March of 2010, just a few days before the law would pass the House, Gruber argues that the public does not really care about the uninsured. What it cares about is cost control. Therefore, he says, the law had to be sold on the basis of its cost control.

Yet as Gruber admits in the video, the bill was not primarily focused on cost control—the bill “is 90% health insurance coverage and 10% about cost control.” Indeed, the problem with cost control, he says, is that “we don’t know how” to do it.

The primary quote. Via CNN:

“Barack Obama’s not a stupid man, okay?” Gruber said in his remarks at the College of the Holy Cross on March 11, 2010. “He knew when he was running for president that quite frankly the American public doesn’t actually care that much about the uninsured….What the American public cares about is costs. And that’s why even though the bill that they made is 90% health insurance coverage and 10% about cost control, all you ever hear people talk about is cost control. How it’s going to lower the cost of health care, that’s all they talk about. Why? Because that’s what people want to hear about because a majority of American care about health care costs.”

Elsewhere in the same speech, Gruber says:

“The only way we’re going to stop our country from being a latter day Roman Empire and falling under its own weight is getting control of the growth rate of health care costs. The problem is we don’t know how.”

Remember, this is what Gruber was saying as the law was still being debated. It didn’tpass in the House, the critical step before hitting President Obama’s desk, until more than a week later. And what Gruber was saying, even before the bill was law, was that supporters had intentionally emphasized parts of the bill that were relatively minor, and that were not certain to even produce their intended effects.

This is not lying, exactly; the bill did in fact include some attempts at cost control, although as Gruber said, it was unclear at the time if or how well they would work. And Gruber may well have been right that the public was more concerned with cost control than expanding coverage. But, especially in combination with the other video released this week, it indicates that Gruber believed that the law’s advocates were not being completely straight with the public, that supporters of Obamacare were telling the public what they believed the public wanted to hear instead of giving them the full story, and that they were doing so on the understanding that telling the full story would make the bill impossible to pass.

What it shows, in other words, is Gruber openly embracing a strategy of messaging manipulation and misleading emphasis even while the bill was still being debated. If the public understood the bill clearly, he believed, they would reject it. It was more important to pass the bill.

Another video, posted today by The Daily Signal, shows Gruber taking a similarly dismissive attitude toward public concerns about the bill.  At a meeting with the Vermont House Health Care Committee, Gruber is presented with a question about whether systems like those described in a report by Gruber and Harvard health economist William Hsiao, might result in “ballooning costs, increased taxes and bureaucratic outrages” as well “shabby facilities, disgruntled providers” and destructive price controls.

Gruber’s response begin with: “Was this written by my adolescent children by any chance?” The Signal quotes two-term Vermont state senator and Reagan-adviser John McClaughry as saying that the question had been submitted “by a former senior policy adviser in the White House who knew something about health care systems.”

Gruber’s response is intended as a joke, and it reveals little about the health care law (the reforms in question are specific to Vermont). But it says plenty about Gruber, and the flippant, arrogant way he treats concerns and criticism.

This is the person whom the White House relied on to help craft the bill; he was paid handsomely to model its effects (a fact he did not disclose, even when asked), and he was in the room when important decisions were made about how it would work. He claims to have helped write specific portions of the law himself. Gruber was not the sole architect of the law, but he was one of its biggest single influences on both its design and on how the media, which quoted him repeatedly, reported and understood the law.

The White House and its allies are desperately trying to distance themselves from Gruber right now by downplaying his role in the law’s creation. But the record of his involvement is clear enough: At The Washington Post, Ezra Klein has variously described Gruber as “one of the key architects behind the structure of the Affordable Care Act” and “the most aggressive academic economist supporting the reform effort.” The New York Times in 2012 described his role as helping to design the overall structure as well as being “dispatched” by the White House to Congress to write the legislative text. Gruber’s work was cited repeatedly by the White House, Democratic leadership, and the media.

So when he describes the thinking about how the law was crafted and sold to the public, it’s worth taking note. This is the posture of one of the law’s authors and chief backers. It’s part of the spirit in which the law was created and passed. Gruber’s ideas were embedded in the law’s structure and language, and so was his attitude.

http://reason.com/blog/2014/11/14/jonathan-gruber-embraced-misleading-the 

 

White House says Gruber’s wrong, attacks GOP

By LUCY MCCALMONT

The White House is denouncing comments from key Obamacare architect Jonathan Gruber that a lack of transparency and the stupidity of voters helped in the passage of the health care law and is instead pointing a finger at Republicans.
“The fact of the matter is, the process associated with the writing and passing and implementing of the Affordable Care Act has been extraordinarily transparent,” White House press secretary Josh Earnest said during a news briefing in Myanmar, according to a transcript provided by the White House.
Story Continued Below

“I disagree vigorously with that assessment,” Earnest responded when asked about Gruber’s claim that Obamacare wouldn’t have passed if the administration was more transparent and voters more intelligent.
He added, “It is Republicans who have been less than forthright and transparent about what their proposed changes to the Affordable Care Act would do in terms of the choices are available to middle class families.”
Earnest said the president “is proud of the transparent process that was undertaken to pass that bill into law.”
The response from the White House comes as a third video of Gruber criticizing the intelligence of American voters has surfaced.
“We just tax the insurance companies, they pass on higher prices that offsets the tax break we get, it ends up being the same thing. It’s a very clever, you know, basic exploitation of the lack of economic understanding of the American voter,” Gruber said in remarks from 2012 that aired Wednesday evening on “On the Record with Greta Van Susteren.”
Gruber has been causing headaches for the White House as conservatives have had a field day that began with comments the MIT professor made in 2013.
“Lack of transparency is a huge political advantage. And basically, call it the stupidity of the American voter, or whatever, but basically that was really, really critical for the thing to pass,” Gruber said at the time, according to one of the videos that has recently come to light.
In another video clip of a separate event, while talking about tax credits in the Affordable Care Act, he said, “American voters are too stupid to understand the difference.”
Gruber apologized for the comments during an appearance earlier this week on MSNBC’s “Ronan Farrow Daily”:
(Also on POLITICO: Ted Cruz out on a limb on Obamacare repeal)
“I was speaking off the cuff, and I was basically speaking inappropriately, and I regret having made those comments.”
Meanwhile, House Minority Leader Nancy Pelosi dismissed Gruber’s role in Obamacare on Thursday, telling the press, “I don’t know who he is. He didn’t help write our bill.”
Many outlets were quick to point out that Pelosi cited Gruber in a “Health Insurance Reform Mythbuster” on her official website in 2009.
House Speaker John Boehner released a statement Thursday, slamming Gruber for his comments.
“If there was ever any doubt that ObamaCare was rammed through Congress with a heavy dose of arrogance, duplicity, and contempt for the will of the American people, recent comments by one of the law’s chief architects, Jonathan Gruber, put that to rest,” the top Republican said.
The statement continues, “The American people are anything but ‘stupid.’ They’re the ones bearing the consequences of the president’s health care law and, unsurprisingly, they continue to oppose it.”
http://www.politico.com/story/2014/11/jonathan-gruber-obamacare-voters-white-house-response-112856.html

 

Cadillac insurance plan

From Wikipedia, the free encyclopedia
Health care reform in the United States
Legislation
Preceding
Superseded
Proposed
Latest enacted
Reforms
Systems
Third-party payment models

Informally, a Cadillac plan is any unusually expensive health insurance plan, usually arising in discussions of medical-cost control measures in the United States.[1][2][3][4] The term derives from the Cadillac automobile, which has represented American luxury since its introduction in 1902,[1] and as a health care metaphor dates to the 1970s.[1] The term gained popularity in the early 1990s during the debate over the Clinton health care plan of 1993,[1] and was also widespread during debate over possible excise taxes on “Cadillac” plans during the health care reforms proposed during the Obama administration.[1] (Bills proposed by Clinton and Obama did not use the term “Cadillac”.)

The Patient Protection and Affordable Care Act (as amended by the Health Care and Education Reconciliation Act of 2010) imposes an annual 40% excise tax on plans with premiums exceeding $10,200 for individuals or $27,500 for a family (not including vision and dental benefits) starting in 2018.[4]

Criticisms of these plans generally center on the small or nonexistent co-pays, deductibles, or caps that encourage the overuse of medical care, driving the cost up for the uninsured or those on other plans, which some say necessitates aCadillac tax.[citation needed]

A study published in Health Affairs in December 2009 found that high-cost health plans do not provide unusually rich benefits to enrollees. The researchers found that only 3.7% of the variation in the cost of family coverage in employer-sponsored health plans is attributable to differences in the actuarial value of benefits. Only 6.1% of the variation is attributable to the combination of benefit design and plan type (e.g., PPO, HMO, etc.). The employer’s industry and regional variations in health care costs explain part of the variation, but most is unexplained. The researchers conclude “…that analysts should not equate high-cost plans with Cadillac plans, but that in fact other factors—industry and cost of medical inputs—are as important in predicting whether a plan is a high-cost plan. Without appropriate adjustments, a simple cap may exacerbate rather than ameliorate current inequities.”[5]

See also

References

External links

http://en.wikipedia.org/wiki/Cadillac_insurance_plan

 

How ObamaCare Taxes Affect You: New Taxes, Hikes, Breaks, Credits, and Other Changes

Here’s a full list of ObamaCare Taxes. The 21 new ObamaCare tax hikes and breaks impact us all, but which ObamaCare taxes will you actually pay? Find out how the tax related provisions in the Affordable Care Act (ObamaCare) will affect you, your family, your business, and your tax returns for 2013 and beyond.

Obamacare Taxes

The Bottom Line on the ObamaCare Tax Plan

The new tax related provisions in theAffordable Care Act(ObamaCare) include tax hikes, limits to deductions, tax credits, tax breaks, and other changes. While a few of the changes directly affect the average American, tax increases primarily affect high earners (those making over $200,000 as an individual or $250,000 as a family), large businesses (those making over $250,000), and the health care industry, while tax credits primarily affect low-to-middle income Americans and small businesses.

Here are some quick facts to help you understand how ObamaCare affects taxes:

• For the majority of the 85% of Americans with health insurance the percentage of income paid in taxes won’t change much, if at all. However, some of the changes may directly or indirectly affect specific groups.

• The majority of the 15% of Americans without health insurance will primarily be affected by the Individual Mandate (the requirement to buy health insurance), the Employer Mandate (the requirement for large employers to insure full-time employees), and Tax Credits (tax credits reduce premium costs for individuals, families, and small businesses).

• Many Americans will be affected by changes to new limits on medical tax deduction thresholds MSAs, FSAs, and HSAs.

• Small businesses will not be required to provide health insurance, but will gettax credits to reduce premium costs if they choose to offer group plans.

• Even if you won’t see higher taxes under the Affordable Care Act, it doesn’t mean there aren’t costs associated with the law. You’ll still need to buy health insurance, unless you qualify for Medicaid or an exemption, and that will cost you money.

• As a rule of thumb those who make less pay less and those who make more pay more, both in regard to health insurance costs and taxes under theAffordable Care Act.

• The Congressional Budget Office has shown that the revenue generated from the new taxes, along with cuts to spending, will help to pay for the Affordable Care Act’s many provisions, fund tax credits and lower the deficit by 2023.Learn More.

Why Does ObamaCare Create New Taxes?

ObamaCare includes many new benefits, rights, and protections including the requirement for health insurers to cover people with pre-existing conditions. It also expands access to affordable health insurance to almost 50 million low-to-middle income men, women, and children across the country by offering reduced premiums via tax credits and expanding Medicaid and CHIP. Expanding the quality, affordability and availability of health insurance (along with other aspects of the law) come at a high cost. Assuming all tax provisions remain in place, the revenue generated from these new taxes help to cover the costs of the program and reduces the deficit. Learn more about the new benefits, rights, protections offered by the Affordable Care Act.

A Quick Overview of Key Taxes in the Affordable Care Act

Before we get to the full list of taxes here is a quick overview of the key tax related provisions that may affect those without insurance, those who plan to go without insurance, and those who are struggling to afford insurance now.

Individual Mandate (new tax): Americans who can afford to must obtain minimum essential health coverage for 2014, get an exemption or pay a per month fee.

Employer Mandate (new tax): Come 2015 large employers must insure full time employees or pay a per employee fee. Over half of Americans get their insurance through work and the largest group of uninsured is currently the working poor.

Advanced Premium Tax Credits (tax break): Low-to-middle income Americans are eligible for tax credits which reduce the upfront cost of premiums on health insurance purchased through their State’s “Health Insurance Marketplace”.

Small Business Tax Credits (tax break): Small businesses may be eligible for tax credits of up to 50% of their cost of employee premiums through theSmall Business Health Options Program.

Taking all the tax provisions in the ACA into account ObamaCare technically provides the greatest middle class tax cut to healthcare in history.

Full List of All Taxes in ObamaCare / All Taxes in the Affordable Care Act

The following list of new ObamaCare taxes collectively raise over $800 billion by 2022. Here is a complete list of new fees and taxes contained withinObamaCare:

ObamaCare Taxes That Most Likely Won’t Directly Affect the Average American

• 2.3% Tax on Medical Device Manufacturers 2014

• 10% Tax on Indoor Tanning Services 2014

• Blue Cross/Blue Shield Tax Hike

• Excise Tax on Charitable Hospitals which fail to comply with the requirements of ObamaCare

• Tax on Brand Name Drugs

• Tax on Health Insurers

• $500,000 Annual Executive Compensation Limit for Health Insurance Executives

• Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D

• Employer Mandate on business with over 50 full-time equivalent employees to provide health insurance to full-time employees. $2000 per employee $3000 if employee uses tax credits to buy insurance on the exchange (marketplace). (pushed back to 2015)

• Medicare Tax on Investment Income 3.8% over $200k/$250k

• Medicare Part A Tax increase of .9% over $200k/$250k

• Employer Reporting of Insurance on W-2 (not a tax)

• Corporate 1099-MISC Information Reporting (repealed)

• Codification of the “economic substance doctrine” (not a tax)

ObamaCare Taxes That (may) Directly Affect the Average American

• 40% Excise Tax “Cadillac” on high-end Premium Health Insurance Plans 2018

• An annual $63 fee levied by ObamaCare on all plans (decreased each year until 2017 when pre-existing conditions are eliminated) to help pay for insurance companies covering the costs of high-risk pools.

• Medicine Cabinet Tax
Over the counter medicines no longer qualified as medical expenses for flexible spending accounts (FSAs), health reimbursement arrangements (HRAs), health savings accounts (HSAs), and Archer Medical Saving accounts (MSAs).

• Additional Tax on HSA/MSA Distributions
Health savings account or an Archer medical savings account, penalties for spending money on non-qualified medical expenses. 10% to 20% in the case of a HSA and from 15% to 20% in the case of a MSA.

• Flexible Spending Account Cap 2013
Contributions to FSAs are reduced to $2,500 from $5,000.

• Medical Deduction Threshold tax increase 2013
Threshold to deduct medical expenses as an itemized deduction increases to 10% from 7.5%.

• Individual Mandate (the tax for not purchasing insurance if you can afford it) 2014
Starting in 2014, anyone not buying “qualifying” health insurance must pay an income tax surtax at a rate of 1% or $95 in 2014 to 2.5% in 2016 on profitable income above the tax threshold. The total penalty amount cannot exceed the national average of the annual premiums of a “bronze level” health insurance plan on ObamaCare exchanges.

• Premium Tax Credits for Small Businesses 2014 (not a tax)

• Advanced Premium Tax Credits for Individuals and Families 2014 (not a tax)

• Medical Loss Ratio (MRL): Premium rebates (not a tax)

The link below provides a full list of ObamaCare Taxes by the IRS.

For a full list of taxes provisions from the IRS

Or see the latest publication by the joint tax committee on the Affordable Care Act.

Who Does ObamaCare Tax?

Let’s take a look at how ObamaCare’s taxes affect certain income groups.

ObamaCare Taxes for High Earners and Large Businesses

Most of the new taxes are on high-earners (individuals making over $200,000 and families making over $250,000), large businesses (over 50 full-time equivalent employees making over $250,000), and industries that profit from healthcare. Essentially those who will see gains under ObamaCare are required to put money back in the program via taxes.

FACT: Tax increases generally affect single filers with an adjusted gross income (AGI) above $200,000 and married couples filing jointly above $250,000. Some of the tax increases don’t kick in until single AGI hits $400,000 and married filing jointly AGI hits $450,000.

ObamaCare Taxes for the Average American With Health insurance

For most of the 85% of Americans with health insurance, making less than $250,000, most of the new taxes won’t mean much of anything although certain taxes below will affect specific individuals and families.

ObamaCare Taxes for the Average American Without Health insurance

The 15% of Americans without health insurance will be required to obtain health insurance (Individual Mandate) or will face a “tax penalty”.

The good news is that many uninsured will be exempt from the Individual mandate due to income, offered cost assistance through the marketplaceincluding Tax Credits (also available to small businesses), qualify for Medicaid, or will get insurance through work (the Employer Mandaterequires large employers to insure full-time employees by 2015). Adults who are under 26 will be able to stay on their parents plan as well, this will help to limit the number of young people who will pay the fee. Both the employer and individual mandates are part of our “shared responsibility” to expand the quality and affordability of health insurance in the United States as a trade for our new benefits, rights and protections.

ObamaCare Taxes for Small Businesses

Small businesses with less than 25 full-time equivalent employees will have access to tax credits to reduce premium costs of group plans.

ObamaCare Taxes for Specific Groups With Health Insurance

Here are a few changes that my affect specific groups of Americans with health insurance:

• Other tax provisions such as changes medical deduction thresholds, HSAs, MSAs, and FSAs may impact some Americans by limiting tax deductions.

• The Medical Loss Ratio (MLR or 80/20 rule) will mean that some Americans may get rebates if health insurance companies spend on non-healthcare related expenses.

• Tax provisions like the 10% tanning bed tax, taxes on drug companies, taxes on medical devices and taxes on health insurance companies selling insurance on and off the exchange may affect the amount of money we pay for some health care related goods and services, but will not have a significant impact on our daily lives.

• The employer mandate has caused some companies to cut down full-time workers to part-time to avoid providing benefits, however major employers like Disney and Walmart have actually increased their full-time workforce in response to the looming 2015 deadline.

• Overall the benefits tend to outweigh the costs for the average American as even those who pay a little more, get a lot more in return due to the increased quality of their health insurance.

Will I pay More Taxes and High Premiums Because of ObamaCare?

As mentioned above premium rates and the taxes you will have to pay are primarily based on income. Aside from income premium prices are based on which plan you choose, family size, age, smoking status and geography. Subsidies reduce the overall rate of your premiums (however smoking is calculated after subsidies). Come 2018 there will be a 40% excise tax on high end health insurance plans.

Aside from the tax provisions that require Americans to obtain insurance and subsidize it’s costs, ObamaCare also includes a few tax related provisions that work as consumer protections including requirements for better reporting and the Medical Loss Ratio.

ObamaCare Tax Rebates

Some consumers in both individual and group markets will see tax rebates due to ObamaCare’s Medical Loss Ratio (MLR). Health insurance companies will have to provide rebates to consumers if they spend less than 80 to 85% of premium dollars on medical care.

Medical Loss Ratio (MLR)

The Medical Loss Ratio (MLR) means that Insurance companies are now required to spend at least 80% of premium dollars (85% in large group markets) on medical care and quality improvement activities. Insurance companies that are not meeting this standard will be required to provide rebates to their consumers. The MLR isn’t a tax, but it does have implications in regards to filing taxes and rebates can be given in the form of reduced premiums. See our page on ObamaCare Health Insurance Regulations for more details.

ObamaCare Income Tax Penalty For Not Having Insurance “Individual Mandate”

Starting in 2014, most people will have to have insurance or pay a “penalty deducted from your taxable income”. For individuals, penalty starts at $95 a year, or up to 1% of income, whichever is greater, and rise to $695, or 2.5% of income, by 2016.

For families the tax will be $2,085 or 2.5% percent of household income, whichever is greater. The requirement can be waived for several reasons, including financial hardship or religious beliefs. If the tax would exceed 8% of your income you are exempt, also some religious groups are exempt. That tax cannot exceed the cost of a “bronze plan” bought on the exchange.

Many individuals who are exempt from the mandate to buy insurance will still be eligible for free or low-cost insurance through the health insurance marketplace.

While some states, including Alabama, Wyoming and Montana, have passed laws to block the requirement to carry health insurance, those provisions do not override federal law. Get more information on the ObamaCare Individual Mandate.

The Individual Mandate is officially called the “individual shared responsibility provision”.

What Are ObamaCare Tax Credits?: Advanced Premium Tax Credits

Premium tax credits are a form of cost assistance that reduce premium costs for coverage purchased on your State’s “health insurance marketplace” for individuals, families, and small businesses.

Advanced Premium Tax Credits for Individuals and Families

Individuals and families will have access to Advanced premium tax credits on the marketplace. Tax Credits are deducted from your premium cost by your health insurance provider and are adjusted on your Modified Adjusted Gross Income (MAGI). You can choose how much advance credit payments to apply to your premiums each month, up to a maximum amount. If the amount of advance credit payments you get for the year is less than the tax credit you’re due, you’ll get the difference as a refundable credit when you file your federal income tax return. If your advance payments for the year are more than the amount of your credit, you must repay the excess advance payments with your tax return.

Aside from premium tax credits individuals and families can also get lower cost sharing on out-of-pocket expenses like coinsurance, copays, deductibles and out-of-pocket maximums through the marketplace.

Eligibility for Tax Credits

In general, you may be eligible for the credit if you meet all of the following:

  • buy health insurance through the Marketplace;
  • are ineligible for coverage through an employer or government plan;
  • are within certain income limits;
  • file a joint return, if married; and
  • cannot be claimed as a dependent by another person.

If you are eligible for the credit, you can choose to:

  • Get It Now: have some or all of the estimated credit paid in advance directly to your insurance company to lower what you pay out-of-pocket for your monthly premiums during 2014; or
  • Get It Later: wait to get all of the credit when you file your 2014 tax return in 2015.

How Will Advanced Premium Tax Credits Affect My Health Insurance Costs?

Under the Affordable Care Act health insurance that costs less than 8% of your MAGI is considered affordable. Although the law doesn’t guarantee lower costs, premium tax credits help to ensure that more Americans will have access to affordable insurance.

s a rule of thumb most Americans will pay between 1.5% and 9.5% on their Modified Adjusted Gross Income (MAGI) when using tax credits to buy a basic Silver Plan on the marketplace.

If the lowest-priced coverage available to you would cost more than 8% of your household income are exempt from the individual mandate.

The amount you pay is on a sliding scale based on your income. Use the chart below to get an idea of what you and your family may pay for insurance purchased through the Health Insurance Marketplace. Make sure to check outObamaCare Subsidies for more detailed information on Premium Tax Credits.

The 2013 Federal Poverty Level Guidelines below are used to Determine if your percentage of the poverty level for both taxes and cost-assistance.

 Household Size

 100%

 133%

150%

200%

 300%

400%

 1

$11,170

$14,856

$16,755

$22,340

$33,510

$44,680

 2

15,130

 20,123

22,695

  30,260

45,390

60,520

 3

19,090

 25,390

28,635

  38,180

57,270

76,360

 4

23,050

 30,657

34,575

  46,100

69,150

92,200

 5

27,010

 35,923

40,515

  54,020

81,030

108,040

 6

30,970

 41,190

46,455

  61,940

92,910

123,880

 7

34,930

 46,457

52,395

  69,860

104,790

139,720

 8

38,890

 51,724

58,335

  77,780

116,670

155,560

 For each additional person, add

$3,960

 $5,267

$5,940

  $7,920

$11,880

$15,840

This following table is an example of how premium tax credits work. Please note that the numbers below are purely for example and don’t reflect your personal rates.

Health Insurance Premiums and Cost Sharing under PPACA for Average Family of 4
For “Silver Plan”
Income % of federal poverty level Premium Cap as a Share of Income Income $ (family of 4) Max Annual Out-of-Pocket Premium Premium Savings Additional Cost-Sharing Subsidy
133% 3% of income $31,900 $992 $10,345 $5,040
150% 4% of income $33,075 $1,323 $9,918 $5,040
200% 6.3% of income $44,100 $2,778 $8,366 $4,000
250% 8.05% of income $55,125 $4,438 $6,597 $1,930
300% 9.5% of income $66,150 $6,284 $4,628 $1,480
350% 9.5% of income $77,175 $7,332 $3,512 $1,480
400% 9.5% of income $88,200 $8,379 $2,395 $1,480
In 2016, the FPL is projected to equal about $11,800 for a single person and about $24,000 for family of four. Use the Kaiser ObamaCare Cost Calculator for more information. DHHS and CBO estimate the average annual premium cost in 2014 to be $11,328 for family of 4 without the reform. Source: Wikipedia

ObamaCare Employer / Employee Taxes

ObamaCare’s taxes mean large employers will have to provide health insurance to their employees and will see a raised Medicare part A tax, small businesses may be eligible for tax breaks.

Medicare part A Tax Hike for Employers and Employees

The Medicare part A tax is paid by both employees and employers who earn over a certain amount. ObamaCare’s Medicare tax hike is a .9% increase (from 2.9% to 3.8%) on the current total Medicare part A tax. This tax is split between the employer and employee meaning that they will both see a .45% raise.  Small businesses making under $250,000 are exempt from the tax. Employees making less than $200,000 as an individual or ($250,000) as a family are also exempt. Employers must withhold and report an additional 0.9 percent total on employee wages or compensation that exceed $200,000.

Tax Penalty for Not Providing Full-time Workers with Health Insurance the “Employer Mandate”

Employers with over 50 full-time equivalent employees must either insure their full-time employees or pay a penalty or “employer shared responsibility fee”. The penalty is $2000 per employee. If however, at least one full-time employee receives a premium tax credit because coverage is either unaffordable or does not cover 60 percent of total costs, the employer must pay the lesser of $3,000 for each of those employees receiving a credit or $750 for each of their full-time employees total.

Employers with under 25 full time employees, whose average income doesn’t exceed $50,000, can apply for tax credits of up to 50% for insuring their employees.

Tax Credits for Small Businesses

Small businesses with under 25 full-time equivalent employees with average annual wages of less than $50,000 can apply for tax breaks of up to 50% of their share of employee premium costs via ObamaCare’s Small Business Health Options Program (accessible through your State’s Health Insurance Marketplace). The credit can be as much as 50% of employer premiums (35% for not-for-profits in 2014). The credit is only available if the employer is paying at least 50% of the total premiums.

Small Business Health Options Program

Employers with 50 or fewer employees, you can purchase affordable insurance through the Small Business Health Options Program (SHOP) even if they don’t qualify for tax credits.

Reporting

Along with the new law there are new requirements for reporting.

    • Effective for calendar year 2015, you must file an annual return reporting whether and what health insurance you offered your employees. This rule is optional for 2014. Learn more.

 

    • Effective for calendar year 2015, if you provide self-insured health coverage to your employees, you must file an annual return reporting certain information for each employee you cover. This rule is optional for 2014. Learn more.

 

    • Beginning Jan. 1, 2013, you must withhold and report an additional 0.9 percent on employee wages or compensation that exceed $200,000. Learn more.

 

Other ObamaCare Taxes on Big Business

Aside from having to adhere to the “employer mandate” ObamaCare also imposes taxes and fees that are unique to big business. ObamaCare taxes some medical device manufactures, drug companies and health insurance companies. Beginning in 2013, medical device manufacturers and importers must pay a 2.3% tax on the sale of a taxable medical device. This raises $29 billion over a 10 years. However, many states are asking to delay the medical device excise tax to protect jobs in states that produce the devices. An annual fee for health insurers is expected to raise more than $100 billion over 10 years, while a fee for brand name drugs will bring in another $34 billion.

  • Employers that have employees who earn more than $200,000 will have to look at the potential for additional Medicare withholding due to the Medicare part A tax.
  • Employers that issued 250 or more W-2 forms in 2012 must report the cost of employer-sponsored health coverage for 2013 on the 2013 W-2 forms.

Medical Device Excise Tax

There is a 2.3% medical excise tax on medical device manufacturers and importers on the sale of taxable medical devices. Section 4191 of the Internal Revenue Code imposes an excise tax on the sale of certain medical devices by the manufacturer or importer of the device. The tax applies to sales of taxable medical devices after Dec. 31, 2012. You can learn more from the official IRS page on the Medical Device Tax.

What Increases Do the ObamaCare Taxes Include for The $200k/$250k Earners?

ObamaCare Medicare Part A Payroll Tax

Starting in 2013, individuals with earnings above $200,000 and married couples making more than $250,000 will see an increase in the Medicare part A payroll tax. It’s an increase of 2.35%, up from the current 1.45% ( a .9% Medicare part A payroll tax hike), on adjusted income over the threshold.

ObamaCare Unearned Income Tax

This group will also pay a 3.8% unearned income (capital gains) tax on interest, dividends, annuities, royalties, rents, and gains on the sale of investments over the threshold.

Taxable income under the $200,000 for individuals and $250,000 threshold for families is subject to the same benefits and tax cuts as those who make under the threshold.

ObamaCare Home Sales Tax / ObamaCare Real Estate Tax Increase

ObamaCare increases taxes on unearned income by 3.8% and this can add additional taxes to the sales of some homes, but many limitations apply which means it won’t affect most sellers. The 3.8% capital gains tax typically doesn’t apply to your primary residence. It also doesn’t usually apply to homes you have owned for over 5 years or on profits of less than $250,000 for individuals and $500,000 for couples due to a capital gains tax exclusion rule for sales of a primary home.

In short the ObamaCare home sales tax isn’t something that most of us will pay, it is a tax is aimed at those selling non-primary residences in short term periods for profit and not at the average American buying and selling their primary residence.

ObamaCare Medical Expense Deductions

ObamaCare increases the medical expense deduction threshold. Unreimbursed medical expense deductions will now be available only for those medical expenses in excess of 10% of AGI, which has been raised from 7.5%. There is a temporary exemption for individuals ages 65 and older and their spouses from 2013 through 2016.

ObamaCare “Cadillac” Tax

Starting in 2018, the new health care law imposes a 40% excise tax on the portion of most employer-sponsored health coverage (this excludes dental and vision) that exceed $10,200 a year and $27,500 for families. The tax has been dubbed a “Cadillac” tax because it hits only high-end “gold”, “platinum” and high-end health care plans not purchased on the exchange. The tax raises over $150 billion over the next 10 years.

New ObamaCare Taxes Summary

Going through the new ObamaCare taxes line by line is, in itself, taxing. The bottom line is that a majority of Americans will find themselves paying less for better healthcare, while higher-earners will pay tax rates closer to what they did in the Clinton years. ObamaCare pays for most of itself via the above taxes, reforms to Medicare, and health care as a whole, as well as cutting out billions in wasteful spending.

ObamaCare Taxes Moving Forward into 2014

We hope this helps you to understand the new ObamaCare taxes and how they work. Many of the ObamaCare’s taxes won’t be fully implemented until 2022, but most will be in effect by 2014. ObamaCare helps all Americans get access to quality affordable healthcare, and new benefits, rights and protections. Make sure to look out for ObamaCare tax breaks, credits, subsidies and breaks on up front costs moving forward into 2014. As we learn more we will update our full ObamaCare tax list.

 

ObamaCare Taxes: New Health Care Taxes

http://obamacarefacts.com/obamacare-taxes/

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The Pronk Pops Show 370, November 13, 2014, Story 1: Part II More On Jonathan Gruber, Basically PhD (Piled Higher and Deeper) on Healthcare, Obamacare and Lack of Transparency — The American Voters Were Not Stupid And Rejected Democrats Who Supported Obamacare By Voting Them Out of Office — But The Democratic Progressive Elitist Establishment Are Liars and Losers — Stupid Is As Stupid Does — Death Knell of Socialized Medicine — Repeal Obamacare Now! — Videos

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