Tuesday, July 22, 2014

Obamacare Taxes, Subsidies and Mandates: Why Obamacare is getting legally interesting.

Obamacare is probably headed back to SCOTUS.  Today, 2 different federal courts made conflicting rulings on the issue of subsidies. Politico reports:
First, the U.S. Court of Appeals for the D.C. Circuit in a 2-1 decision said the insurance subsidies can’t be awarded through the 36 federal-run exchanges, that they can only flow through the state-run markets. Hours later, the Fourth Circuit court ruled 3-0 that people can draw on the subsidies in both kinds of exchanges. The divergent opinions set up a clash that could eventually end up at the Supreme Court — and reverberate through the fall campaign.

The ruling against the subsidies is the second Obamacare strike against the White House in less than a month, after it lost in the Supreme Court’s Hobby Lobby ruling on birth control coverage. But unlike the contraception rule, which is a small piece of the health law, the subsidies go to the heart of coverage expansion in the Affordable Care Act.....

Unlike other major Obamacare challenges, this controversy hinges on just a few words in a lengthy law. The D.C. Circuit concluded — “frankly, with reluctance,” as one judge wrote — that the statute narrowly but explicitly authorizes only state-run exchange subsidies, no matter what Congress may have intended. The Richmond court saw ambiguity in the text, but said the IRS had the power to interpret the statute broadly as it set the rules.

Read the rest here.
Obamacare is an expensive and complicated maze of subsidies, taxes, mandates and Medicaid expansion but the subsidies are indeed the mother's milk of Obamacare because without the subsidies health insurance costs will soar for tens of millions of Americans who depend on them.  Right now, the only endangered subsidies are the subsidies for health insurance policies bought on federal exchanges.  Subsidies for state run Obamacare exchanges remain in tact. 

Thus far, the only major Obamacare SCOTUS case, besides the Hobby Lobby case, was the 6/13 SCOTUS decision upholding Obamacare.  While conservatives went ballistic and would have preferred that SCOTUS strike down the entire legislation as unconstitutional, that SCOTUS decision was embraced as constitutional by many Libertarian jurists who claimed that Justice Roberts got it constitutionally right. 
Yes, there was conservative mass hysteria over the SCOTUS 6/13 Obamacare decision but does Chief Justice Roberts deserve the thrashing he got from conservatives? While conservatives were moaning the decision with fear and loathing, liberals were probably uncorking the Champagne. As sane observers took another look at the decision from the jurisprudence perspective, it's believed by some who embrace conservative-Libertarian politics that the Roberts decision was indeed the right decision and for the reasons outlined in an interesting article from the Testosterone Pit.
Conservatives should be ecstatic that Chief Justice of the Supreme Court John Roberts sided with the four liberal Justices in ruling the Affordable Care Act (Obamacare) is constitutional as a tax, while siding with the four conservative Justices that the law is un-constitutional under the Commerce Clause. Roberts just humiliated President Obama, gutted the social welfare and regulatory state, and appears to have set-up the entire Obamacare law to be constitutionally invalidated.

Chief Justice Roberts Gutted Congressional Power And May Still Have Invalidated Obamacare

Those are very powerful words:  "Roberts just humiliated President Obama, gutted the social welfare and regulatory state, and appears to have set-up the entire Obamacare law to be constitutionally invalidated."

The Obamacare decision is not a simple cut and dry decision.  It's got several critically important moving parts.  Justice Roberts did uphold the power of the Federal government to tax even though he also opposed the mandate.   Yes, the federal government does have the constitutional authority to tax.  More importantly, he did not uphold Obamacare under the Commerce ClauseAnother very important aspect of the decision involved the constitutional authority of the federal government to force the states to tax its citizens to fund increased Medicaid enrollments.  While the federal government does have the power to tax, Justice Roberts indicated that the federal governments' powers of taxation do not extend to the states.  In other words, the federal government does not have the constitutional authority to force the state to tax its citizens to fund Obamacare.

Medicaid expansion is the heart and soul of Obamacare because it not only forces folks into Medicaid, it forces taxpayers at the state level to fund it.

I wondered how long it would take liberals to recover from the fog of their celebratory hangovers and realize what really happened.  Not long!
Of all the ways President Obama’s health care law is poised to alter the U.S. medical system, the extension of new health insurance coverage to some 32 million people has been billed as its most important.....
But thanks to the Supreme Court's decision on the Affordable Care Act (ACA) last week, which upheld the law's basic architecture and the controversial individual mandate, fixing the problem of the uninsured could be a lot more difficult that Democrats were hoping. In a move that surprised court watchers and progressive advocates, the Supreme Court, by a 7-2 vote, ruled that states don’t have to participate in a huge expansion of Medicaid, the state-federal insurance program for the poor, called for in the ACA. (The ACA was written so that states that decided not to expand their Medicaid programs would lose their existing Medicaid funding, but the court said funding already in place should not be affected by states' decisions on the ACA changes.)
Whether states want to participate in the Medicaid expansion isn't just a matter of dollars. Republicans governors across the country, who have been vocal critics of the Affordable Care Act since it passed, are now signaling they may not opt into the Medicaid expansion. (Similarly, many of them turned down federal stimulus dollars.) Gov. Rick Scott of Florida has said he won't support a Medicaid expansion, although the state legislature might feel otherwise. New Jersey Gov. Chris Christie said after last week's ruling that he was glad the Medicaid expansion was ruled optional, but didn't say whether his state would participate. Other Republican governors, like Nikki Haley of South Caroline and Bobby Jindal of Louisiana, have said they will not make moves to implement the ACA in their states, although it's not yet clear if this means they intend to reject billions in Medicaid funding.
Medicaid Ruling Endangers Universal Coverage

While liberals perceived Obamacare as a backdoor to universal healthcare coverage, Chief Justice Roberts stuck a stake straight through the heart of that dream and yes Medicaid was the superhighway for forced universal government controlled healthcare. The Roberts roadblock has infuriated the left.

In fact, the issue of Medicaid expansion has so upset the Obama Administration that the the website of the White House (whitehouse.gov) is moaning that 24 states have refused to expand Medicaid.

24 States Are Refusing to Expand Medicaid.

Here's What That Means for Their Residents: Nearly half of states are so locked into the politics of Obamacare that they're willing to leave nearly 5.7 million of their own people uninsured. Take a look at our map -- and make sure you share it.

Clearly, the Roberts ruling opened up whole new cans of worms in the continuing saga of America's healthcare nightmare.  How it will ultimately shakeout is an issue of pure conjecture.  Moreover, the courts have not seen the last of Obamacare.  The only issue that was settled in the 6/13 SCOTUS decision was that the federal government has the power to tax and we already knew that.  The fact that the federal government does not have the power to force the state to tax folks to fund Obamacare is incredible relevant.  What is even more relevant is that while Roberts did uphold federal powers of taxation, he did stun America when he refused to uphold Obamacare under the Commerce Clause.  Exactly how that will play out in future decisions remains to be seen.

The far dicier issues of Obamacare are nowhere near resolved and now the subsidy issue is on the judicial table.

For more information on the absurdity known as the US healthcare system, see:

The Absurdity of US Healthcare and OMG, the Hysteria over SCOTUS upholding the Obamacare Tax! Under What Circumstances Would This Government Hating Libertarian Reluctantly Support a Single Payer Healthcare System?

America Already Has Socialized Medicine - A Trillion for Medicare & Medicaid and Another Trillion for Obamacare Subsidies 

No comments:

Post a Comment

Popular Posts