Every time the Times uses the term, "Obama care", another 100,000 republicans want it overturned.
Use the correct title of the bill: ACA!
What's in a name? Everything!
6
The mandate forces young people that are struggling to make a living to subsidize the old, that on average , are better off than the young.
It is deeply unjust. That it has become SOP in the US to defer payments from current to future generation, is no justification
2
@Lars
All young people become old people. Whatever savings younger policyholders would have had under a non-community rated policy (which, btw, the ACA still allowed policies to be charged 3x the amount for older recipients) would be in the negative as they age into the system. Also, the policy protections are cross-subsidized, getting older people purchasing policies enabled the subsidization of benefits used by younger policy holders like maternity care, deliveries and pediatric care.
It's absurd to segment our health care system into fixed boxes as though people don't have their situations change over a lifetime. As I said, *everyone* gets older. Some people start off sick at birth and need a lifetime of care, some have early life care needs that stabilize out over time, others start healthy and need more care later on. And so on. Establishing a system like private health insurance whose business model is built around ignoring those realities and withholding the very product it is selling is a terrible way to administrate human health care needs.
24
Are we politically and economically prepared for “free” gov healthcare?
Medicaid and CHIP recipients now receive free healthcare.
Their care would not be free under one payer.
As in other countries with a one payer government system, everyone including these 75M Medicaid/CHIP people would have to pay taxes for their government healthcare and also pay for supplemental insurance to be covered.
Will that be acceptable to Democratic politicians?
3
It’s simple:
Trumplicans take people’s human rights away.
Dems, like Warren & Bernie, give people more human rights.
In this case, with no alternative plan in hand (witness that piece of paper Trump was waving around, claiming it was a treaty with Mexico) Trumplicans will throw tens of millions off healthcare.
When Bernie is President in 2021, EVERYONE will have healthcare! Even Trump in his New York State pen cell.
8
You can’t give people human rights. They are innate so Bernie and friends can’t bestow them.
2
@Patrick Campbell
Reclaim, you like that better ?
Reclaim our human rights.
4
My business and my family hope this law in its entirety gets struck down. We have suffered from exorbitant premiums and lack of being able to grow our business directly because of this garbage law. If our government wanted to do it right we should have went single payer all the way. Instead you now have small businesses like ours who cannot afford to fully insure 50 coworkers and cannot grow and prosper.
60
@Nature Voter
While you, Donald Trump and some others who call themselves conservatives, prefer that sick and disabled citizens who can't fully pay their way just vanish to pay for the tax cut for the Republican Party financiers, that is not what will happen.
Without good health insurance, ill and injured working Americans often become poor and unemployed Americans. They stop paying taxes, families lose breadwinners and society picks up the cost of both healthcare and welfare for them and their dependents.
There is no doubt that giving all Americans good healthcare, would extend their ability to work; make them more productive; Keep families together; Avoid bankruptcies, and actually do more to make America great than slogans on hats.
The Affordable Care Act, (Obamacare), should have been named the keep Americans Working Act, because that is exactly what it accomplishes in the long run.
108
@Nature Voter. One good sized bad health event for you or yours and you will change your tune. Back in the 80s and prior, my husband could not get ANY heath insurance because he was diabetic and not employed by an employer who offered group coverage of any kind. If he'd been hit by a car, he STILL had no coverage. Before we were married, he had a heart attack and STILL had no coverage. Medicaid saved him, but Medicaid is disappearing now too. When we married, I was able to get him in my group coverage through my employer, but just after my husband died a few years ago, my employer dropped its health care benefit and I was stuck in the private market - cost me a fortune but at least I was able to get it because I wasn't diabetic or suffering from any other serious pre-existing condition. Now I'm on Medicare and praying the GOP doesn't get so much power they try to drop it, because they have repeatedly said they want to. Get with reality NV. We can't just dump the ACA because the GOP will NEVER replace it with anything much less anything better.
104
@Nature Voter Sorry, but look at the overall health of our citizens and beyond your own life and prosperity. Sometimes giving up a little for the benefit of others is what is called for. I’m sure your 50 employees appreciate it and would rather you keep insuring them than cutting them out to increase your profits. Growing your business is for your benefit - not your employees, whatever you may have convinced yourself. One reason I am sticking with my employer is because they care about me and feel keeping me healthy and productive is good for their business. Maybe you can’t grow your business because your employees feel they are not important and just another expense to your wealth, I suspect this is not the only thing you’d like removed that protect employees.
70
Reality Check believe it or not A,C,A was an is biggest tax on american people since conception of taxs . Making manditory to have health care made it possible to force healthy people to have health care dont use. It allowed insurance companys to raise premiuns an lower the cost they paid for covered expenses making person cover more of the cost for procedures. In end insurance companys made trills an our government made trillions in capital gains in stock market.
1
@jerry lee - No one stays healthy forever and preventative care is a major factor in staying healthy. We all need health care and we should all pay something towards it.
12
@jerry lee - How many people do you know who can be absolutely certain that they will never get sick or be in an accident?
I don't know any.
12
@jerry lee My taxes didn't go up. I don't know anyone whose taxes went up. Don't believe the lies.
10
No matter what happens, the Affordable Care Act is not even remotely affordable for anyone who doesn't get a premium subsidy. The subsidy is a taxpayer sink although I recognize there are much larger taxpayer sinks (military). This was a flawed law as a result of compromise politics that get us garbage solutions that benefit big business. Go single payer and get rid of private insurance or go home. Vote for true progressives like Sanders and Yang rather than fake progressive Democrats that cater to Wall Street. We've done compromise politics for decades and it hasn't worked. It's time to go all the way or don't bother at all.
141
@FrankM
Unfortunately if we go by your wishes there will be a gap or maybe no coverage for hose now covered,
24
@FrankM
Agreed. ACA did nothing to make 'medical care' more affordable, but it did make insurance premiums more affordable for some, but that isn't the same as 'care' as those with high deductibles know.
We need to rethink the medical model which is currently based on chasing profits.
There are a lot of doctors out there who would likely opt to take a salary and just practice good old medicine for a change instead of feeling pressured to do more to make more. Perhaps a transition to a public option allowing folks to go to 'community' docs on salary would be a good experiment to see how single payer would work out.
Also, allowing cash-paying patients to self-direct for preventative screenings like blood and colon cancer tests would help decrease the financial burden created by the 'worried-well'. Labs/facilities would actually compete for instant cash payments and innovate in terms of 'interpretation' to accommodate the lack of physician involvement. This is where AI will be superior.
Creative incentives like premium or tax reductions for those who use cash for services instead of using insurance could help reduce costs and sustain a single payer system.
I've paid for my own insurance plan for decades and have never used it yet. A single payer with no patient skin in the game will lead to over-utilization and won't be sustainable, just as we are seeing the U.K develop into a two tier system.
12
@FrankM False. There are a number of plans on the New York State marketplace that are hundreds of dollars cheaper than the last COBRA plan I was eligible for. Still waiting for the “great healthcare” Trump promised...
48
yet another great success for Trump
creating jobs for funeral homes, cremetorians, and pauper cemeteries
15
... aaaaaand the GOP just lost the election.
9
The GOP is a calamity.
11
What a joke. If Congress intended for the whole law to fail, why didn’t it repeal the entire law? Duh. This is why people hate lawyers.
6
The GOP are praying that the wacko decision on severability is reversed. If it isn't, the GOP will be a disaster in 2020.
3
Texas leads the law suit. They have one of the highest uninsured rates in the US. Not sure what their endgame is. Maybe it's cutting off your nose to spite the face
9
The Democrats pushed the travesty of Obamacare though Congress.
Doing so required bribes to their members and secret midnight votes.
Even then Obama himself exempted hundreds of firms from the law, preventing millions of working citizens from receiving healthcare coverage.
Now the Democrats want Medicare for all.
Now the Democrats want free care for illegals.
And now the Democrats blame Republicans for not wanting to force Obamacare mandatory payments on everyone.
Truly Priceless.
I know evil when I see it, and right now it’s a bunch of Republican attorneys general.
10
I don't think a lot of Americans know this is going on.
5
So, we're just going to kick kids with cancer off their ACA-funded chemotherapy, and that's that?
That's the monstrosity we've become?
13
ACA was a republican idea. Mitt Romney was the dress rehearsal. They hated the idea Obama ran with the ball.
What ever happened to The Heartland's generosity in barn raising? It stopped before the coasts?
5
If you are now on Medicare, how many years and how much money did you pay into Medicare prior to turning 65.
And how much do you now also pay in monthly Medicare premiums, deductibles, and for supplemental policies?
Now the Democrats tell us how everyone will receive “Medicare for All” for free??
Will those receiving “free” care have to pay the equivalent of 45 years of tax withholding and employee contributions? As also pay monthly premiums, deductibles and for supplemental coverage?
Or have they been brainwashed by their Liberal politicians thinking their care will be free?
It’s not this case but the Republicans and establishment Democrats who threaten the health coverage of millions. Every country in the world where this article is being read has figured out a way to provide healthcare to all its citizens as a right, except where this article is being printed. And still Bernie Sanders is portrayed in these pages as a loony bee.
5
Why is the ACA unconstitutional and not the tax and mandate repeal? Especially given that they tried to kill the ACA and failed?
6
What will be interesting to watch is when the 5th circuit, who has proven itself again and again to be far outside the norm of jurisprudence, and has been repeatedly reprimanded for its rulings by the SCOTUS, will deliver this poisoned chalice to Trump. And then, how Trump will react. He will then have to come up with a plan, and he has nothing. The Republicans, hopefully, will be crucified in the 2020 election for this. In the meantime, millions of people will suffer because of this greed and political theater.
10
OK Repubs you may have destroyed the health care for millions. The ball is in your court. Oops, the ball has been in your court for years and no idea how to solve this.
Trump promised cheaper and better health care. So ?
Private guys want to stop any restrictions on preconditions, raise rates, cut services make more $$. That seems to be the repub plan.
Folks, regardless of your politics elect total Democrats and get an affordable health and education system.
8
If we want to stop the madness, then we should all donate to Amy McGrath in her effort to unseat McConnell.
It is a statewide race and not subject to the gerrymandering.
Long shot I know. But McConnell is just awful.
16
Maybe if Tom Steyer really wants to help he could offer to pay the way for millions of ACA subscribers about to be kicked to the curb to be able to come and protest in DC. That’s what we need. A massive show of force.
3
Go for it. Strip away protections for preexisting conditions and students, blow up the health care system as we know it, right in time for an election. Democrats can ride the wave!
6
Obamacare was written by insurance companies for their healthcare, not ours.
It's got to go.
The Hill on 02/28/19 published: Pelosi on single-payer health care: "How do you pay for that?"
Single payer is the only sensible choice for any first world country, if we agree that we are one.
But we have to make it affordable first.
Here is how:
Deport every single illegal, and reduce our population by 10-25 million low income earners living in medically high risk conditions. If we want good healthcare for our citizens, get rid of the deleterious fat and get lean first.
1
Republicans are completely clueless, mean spirited and anti-freedom.
Unless America repeals EMTALA law which mandates hospitals stabilize and see to the care of patients seeking care, the Republican Party is pushing a false narrative and driving up total cost. They should be straight with people and say in law that if you can’t pay you can be denied care and will suffer whatever consequences that come from that. This should include uninsured children too. Of course, the Republican made for tv politicians would NEVER explicitly stand up for it like this.
“What is EMTALA? EMTALA is a federal law that requires hospital emergency departments to medically screen every patient who seeks emergency care and to stabilize or transfer those with medical emergencies, regardless of health insurance status or ability to pay”
2
I find it interesting that commenters are saying, "Sure, strike ACA down. Then we'll go to single payer."
Really? It took over 100 years to get ACA through. From all that you've seen thus far, do you really believe the GOP will do anything but have us go back to the way it was?
18
I'm seeing a lot on here about the ACA's flaws, which are real enough. Health insurance still isn't affordable for far too many.
But please, don't throw out the baby with the bathwater. I would give anything for single payer, but until that exists and is up and running and is signed into law (so, never), I'll keep the ACA, thanks. My insurance is stupidly expensive, but at least I have it. Before the Affordable Care Act I was uninsurable. I called every insurer operating in the state of California and the second I said 'lupus' they told me not to even bother applying. The representative from Kaiser quite literally laughed and hung up on me.
I'm seriously ill, and you may not be, so the ACA and its requirements may seem onerous to you. But you could be me, sooner than you think. Before my illness I was ridiculously healthy - I never had a cavity, a broken bone, I never had chicken pox let alone a serious illness. My healthcare needs were an annual physical, until they weren't. I was twenty three when everything changed for me, with no warning and no hope of a cure. None of us know what is coming - you could be fine today and very, very ill indeed tomorrow, and if that happens you, like me, will be down on your knees thanking whatever deity you pray to that pre-existing conditions are no longer tossed out on the street to die, thanks to the ACA.
28
If this total elimination of the ACA is upheld, and also upheld at SCOTUS, then there is still a solution. Congress has the power to strip the federal judiciary of any appellate jurisdiction. THey have done so before, just google "jurisdiction stripping united states". Congress can strip the judiciary of jurisdiction over healthcare, neutering the ever growing far-right coalition of judges that McConnell has fast tracked into office.
The only question is, assuming the ruling is upheld, how long will the tens of millions who lose their health insurance in the blink of an eye (or slowly? SCOTUS would probably set a timeline for the winding down of the programs, but since the American right wing is evil, maybe not) lack coverage.
5
Perhaps one day what will be found unconstitutional is the government not guaranteeing everyone equal healthcare.
11
One thing that annoys the heck out of me is the constant attempts one way or another after the Supreme Court ruling that either Trump, Republican Governors or other individuals have tried to kill ACA through nitpicking at legal technicalities to have it killed. Right now it just seems so Democrat versus Republican almost like slave states vs free states of the pre Civil War era.
I for one greatly appreciate ACA because I developed cataracts in both eyes and had a detached retina.
But it puzzles me a lot with all the failings of ACA why the Democrats while holding Congress have failed to improve it. True the Senate is Republican controlled... well kind of.. I think some Republican Senators would be willing to try to improve it.
2
Republicans, even their judges and justices, can’t see the forest for the trees. Book smart but not wise. They seem to be ready to deny health care coverage to millions on a technicality, which is judicial malpractice that even ordinary people can see through. There’s no sense of proportion, no understanding of or appreciation for the fallout of a potentially narrow ruling on the health of millions of people. It would be a catastrophe plain and simple. How did we get so dumb in this country?
9
Shouldn’t the Times be more concerned with “threats” to the Constitution than to giveaways and subsidies?
1
Wait till working Americans are forced by Democrats to pay 3X more than they pay now for great private insurance - to pay for Medicaid For All - for themselves and three other able-bodied people who refuse to work.
1
Cruelty is the whole point, isn't it Mr. Trump?
9
GOP will rather see gun in everyone’s hand but would do everything to stop everyone having health insurance. This country is living in 18th century with the outdated constitution. Why do I have to pay SS tax? It SS constitutional?
4
In a perverse way I hope the ACA goes down. The chaos in the health markets that will ensue will doom the Republican Party for years to come.
4
It could have been so easy. The compulsory element of the ACA has forever been labelled as a “fine” for noncompliance and that poisons the well for so many people. The stated position from the first day should have been the following. All Americans should submit a tax return (almost all do now). On the front page of the return there will be a box, for you to provide the number of a health insurance policy, as proof of coverage. If you can’t or refuse to provide proof of coverage (but why would you) , you will be assessed a percentage of your gross income, on a sliding scale, up to a maximum of, say, 4%, with which you will be provided automatic coverage. The point of all this is that everyone will be covered. You can insure yourself, your employer can cover you, or the ACA will cover you, but there will no longer be any uninsured people. The sliding-scale assessment can not be described as a fine, because it isn’t. There won’t be any incentive to refuse to participate, and an ideal outcome would be for those who earn nothing to pay nothing, those with a lot would pay a lot (up to a defined maximum) and the rest of us would reside somewhere in the middle. If supporters of the ACA could stick to that narrative and refuse to be deflected by talk of “fines” and “compulsion” the public would, in time, understand it as a good thing.
4
"“Why would the Senate not also be here to say, ‘Oh, this is what we meant" -- umm, because what Senate "meant" is expressed solely through its votes? In 2017 the Senate voted "no" on repealing Obamacare but "yes" on zeroing out the tax penalty for lacking insurance. What's not clear?
2
This is not - and has never been about - healthcare. If it were, there would be a replacement plan. This is about power and control. Healthy citizens can protest and resist abuses of power. Sick, poor citizens cannot.
4
"These recently raised questions will most likely be the first ones addressed during the arguments, which are before a three-judge panel in the appeals court in New Orleans: Carolyn Dineen King, appointed by President Jimmy Carter in 1979; Jennifer Walker Elrod, appointed by President George W. Bush in 2007; and Kurt Engelhardt, appointed by Mr. Trump in 2018."
-Why is it that in the above paragraph that two of the judges were appointed by "Presidents" (President Bush, President Carter), and the last judge was appointed by "Mr. Trump"? Trump is a president, why refer to him as "Mr", especially since you referred to the other two presidents in the paragraph as "presidents"?
1
The Republicans must secretly want single-payer healthcare.
Because if they win this lawsuit and cancel Obamacare, that will pretty much guarantee that single-payer will actually happen in the U.S., and sooner than anyone expected.
4
I find the position the Republicans find themselves in, with no alternative if there ever was one. Mitch McConnell, Senator from Kentucky and Senate Majority Leader, comes from a state that still has not approved ACA. Kentucky has a pathetic record of health hardship. Consider this when politicos talk about "Medicare for All" whatever that is. These figures come off the top of my head but are close enough. My wife and I pay $3500 a year for Medicare, the monthly payment and annual deductible. We qualified for A and B. Then we had a medi-gap which was another $3400 a year which has deductibles, etc. and includes Part D with more deductibles. Until about four years ago I kept track of annual medical expenses which I stopped doing. The last summary was that for a year our out-of-pocket, not to be confused with the way Medicare figures it, was $11,000 that really came directly out of our pocket. Do not get any ideas about Medicare as a "gift". The wisdom of my pension group decided on Medicare Advantage this year, another story, but an attempt years ago for Republicans to gift insurance companies, and it is costing us significantly more. Republicans talk the talk, but really must see us as cash cows? We are willing to pay more in taxes but expect Big Pharma, hospitals, and doctors to also contribute. Why do doctor's offices for example have a staff of it seems a dozen?
4
I suppose this means we can next all opt out of Social Security and Medicare payments? The sweater will unravel back to 1900--fine job winding up a backlash, Rebublicans.
4
If only it were so easy:
"This is why we need to expand Medicare gradually to cover everyone who wants it. The ACA will never be on solid legal ground..."
Why wouldn't opponents of Medicare-for-all make the same arguments, or even more? Answer: They would; of course they would.
I'm confident there are ways to sidestep even imaginative Constitutional objections to either the ACA or Medicare-for-all, but proponents don't seem to have thought of them yet -- or at least they haven't yet drafted laws that incorporate unassailability. Proponents should keep clearly in mind that many judges will be ideologically opposed to them, probably more so as time passes and Trump picks more judges. This means that proponents must come up with very strong arguments. I don't know what those arguments might be, but I'm confident that proponents will win if the arguments are solid and well-presented. Easier said than done, I understand, but that's what will be required. If it's any consolation, strong arguments probably would persuade all but a few judges -- even some who are strong ideological opponents. Judges relish power, but they don't like to get reversed.
This predictable requirement of very strong arguments may not be "fair" but, as Jimmy Carter famously said, "life is not fair." Fair or not, proponents of the ACA or Medicare-for-all should do their best to think up and refine those arguments now, not wait until a case arises and they're stuck with unfavorable statutory language.
2
The irony here is that US lawyers assiduously avoided calling the ACA penalty a "tax" in their 2012 Supreme Court briefs and oral arguments, but the Supreme Court upheld the ACA on that ground alone; Roberts (at least) -- the "swing vote" in that 5-4 ruling -- was prepared to hold the ACA unconstitutional were it not for Congress' power to levy taxes.
That tax wasn't actually eliminated by the 2017 tax act. It was reduced to $0, but left in place (formally), which means a later Congress could simply undo the effect of the 2017 tax act by raising the "tax" to some non-zero level.
I'd emphasize that distinction -- not a strong argument but, frankly, I don't see much else to argue. The Texas district court ruled that reducing the "tax" to $0 was the same thing as eliminating it. This, he concluded, meant that the Supreme Court's 2012 rationale for upholding the ACA no longer existed. Accordingly, he ruled, the ACA is unconstitutional.
The Texas judge also ruled that the remainder of the ACA must fall too. I disagree that that follows, though I don't think it matters much: Without the "mandate," it's hard to imagine the rest of the ACA will remain. Most taxpayers would continue to declare themselves exempt because they're covered by other medical insurance (mostly through employers), and many others would simply do without medical insurance and pay the $0 "penalty."
As this article makes clear, ACA proponents (I'm one) have assigned too little weight to the Texas ruling.
1
This is why we need to expand Medicare gradually to cover everyone who wants it. The ACA will never be on solid legal ground, and Republicans will continue to attack it forever.
Start reducing the Medicare opt-in age from 65 down to 60, then 55, etc. (And Medicare is an opt-in program: no one is required to take it, but almost everyone does.) Let's get this done.
5
Interesting that we have so many "progressives" arguing they should throw away the ACA. Do you really think Democrats can pass Bernie's single payer plan into law in 2020? I don't think it can be done even if we take over the senate.
4
This is like asking, if an aircraft cannot have wings, can the aircraft continue transporting passengers.
The only reason why an Obamacare policy is available to a person with serious prior conditions is that the mandate assures the insurance company it will have healthy customers as well as sick ones,, and therefore it is actuarially feasible to insure them all as a pool. The sick will always buy insurance if they can scrape together the monthly premium. But younger, and healthier people, which the system depends on to be feasible, might prefer to spend their money on other things.
All of which tells us that a system that forces people to buy things they do not want to buy from private sector vendors will never gain universal public acceptance. Better we have a single payer non profit system paid for with taxes, which everyone must pay.
10
The mandate was only a sop to people who couldn't stomach a public option anyway, to keep private insurance companies standing on our throats. Good riddance to it, and welcome our new medicare for all system.
6
As others pointed out, Obamacare is not affordable unless one's income is so low to obtain credits, and small businesses are hamstrung by the cost of insuring their workers.
I had to retire early. A major hurdle to this need was affordable health insurance. Thankfully due to living an austere life, slashing my expenses by moving to a cheaper state and having enough savings, I have manipulated my income by not drawing most of my pension, thus becoming artificially eligible for the tax credits. Otherwise I would have had to break the law and go uninsured. That will end when I hit 65 (praise the lord). Most people cannot do this (I will be glad to end this next year).
I cannot help but wonder if the lack of income growth in this otherwise good economy is due to the expensive health insurance problem...small businesses are the bedrock of our economy (ignoring that part of the economy based on trading stocks) but been married to a small business owner I know well how difficult it is to meet the mandate -no to small raises to pay for insurance and stay in business.
Health care in the . USA has gotten ridiculously expensive. Clinics look like luxury resorts and the costs of some lab tests done by machines is laughable. Insurance companies, like Wall Street businesses are beholden to shareholders. A lot of people will be unemployed if health insurance goes away but many more will benefit & there's ample job retraining available these days.
Medicare for all, PLEASE.
4
We don't have a mandate, I have not had Obamacare since it morphed into the overpriced con job it was originally engineered to be by the lobbyists that wrote it. And I thank Trump for this, no penalty, no Obamacare, saved me a ton of dough (and anger). Btw I'm a Sanders democrat.
2
The ACA is sufficiently financed for constitutional purposes by much more tax revenue than the amount associated with the eliminated fines under the insurance mandate.
1
My premium was $75 before Obama took office. When he left it was $800. I don't qualify for the subsidy. That doesn't mean I'm wealthy, it just means the law did not take into account people like me. I was some what hopeful for ACA but its been a mess. I also pay more for my doctor visits now primarily because the insurance wants me to go to a less desirable neighborhood versus the boro. I've been seeing the boro doctor for 20 years. I trust him, he knows me which provides a mutual trust. He knows when I request a script it is for a reason. I was not about to switch doctors, so I pay the expensive co-pay.
ACA should end. We should go back to how it was. And no. No single payer. Enough big government. This goes for both parties. We need to cut military spending as well. Probably the biggest weak point we have with the military right not is while it's big and powerful, it is not flexible nor agile. Future Pearl Harbors will not look like the past and will take advantage of weak points in the system. Bloated military is less able to adapt to it.
So here hoping ACA ends. Trump wins 2020, another opening for the court happens and the citizenship question is added. We're going to need it as the democrats move towards socialism and younger voters can't think for themselves and just want free things.
4
@DavidLibraryFan I detect some selfishness there. Do you think that anyone with a chronic condition, that insurance companies don't want to touch with a 10-foot pole would be in good shape if the ACA was eliminated?
You say that younger voters want free things, when it is them that subsidize Social Security and Medicare for seniors who get much more out of them than they paid in taxes plus interest.
It's great to be able to put blinder on and focus on just your personal situation.
4
There's no way any decent policy had a $75 premium. The ACA eliminated junk policies that didn't cover anything.
5
First of all, the insurance company is the one ripping you off, not the ACA. Second, you are not going to have the same coverage for a lower price after the ACA is gone. You will find out the hard way.
7
Isn't it a requirement that everyone who drives a car has auto insurance?
If it is constitutional to require car insurance, then why isn't it the same for health insurance?
An ailing person requiring health care but doesn't have insurance has to have enough cash to pay the bill, or else it is a write-off, eventually affecting all of the taxpayers.
15
We are in the land of murky waters and good intentions. Not to surprising that the appeals court was skeptical of the argument of the concept of you either have ACA mandated medical insurance or pay a penalty. Let us remember the pseudo Tax Reform passed in 2017 is silent on overall mandate of ACA but not tax penalties. The United States began on this slippery slope with the enactment of what is called Social Security, followed by Medicare and Medicaid. I believe essential medical care should be available to everyone and the states not the federal government should determine how to provide it. I am still waiting for someone to challenge mandatory participation in Social Security. No I don't support any laws that place the individual responsibility for taking care of ones self on taxpayers. Let individuals, Church's and families be responsible to carry the burden not the nations taxpayers. I also do not believe in Disaster Assistance or tax breaks for people who invest in real estate or have rental property. In case you haven't noticed we may have another disaster this weekend and how many will than make for Mississippi, Louisiana and Texas in the past 10 years.
If states can require drivers to have auto insurance, why can't the federal government require people to have health insurance?
8
Imagine for just a minute if we directed all the time and resources spent on arguing over the ACA instead towards transitioning to how the rest of the world lives - with government-sponsored healthcare at half the price and better results than we boast. At a certain point - say, now - this is madness.
15
The only good that can come from this decision is for Trump to lose the election because most of his base relies on the ACA.
14
I’m beginning to think that the only good to come out of this is for tRump’s base to lose ACA coverage in its entirety. Whatever can be said of this base (so accurately referred to as such, since they lack any higher qualities of mind or spirit) there seems no reason to provide them with any structures that support them. Thus they won’t need to be burdened with health care, assistance with opioid dependency, education, nor financial security when they are old. It would also save them from the burdens of information, and gratitude with which they are seemingly unfamiliar.
5
Until America takes the big money aspect out of the political process nothing for the benefit of the average Joe will happen. To take the profit motive out of the insurance and hospital entities leaving a system that is privately run but publicly subscribed is the only way to make sure the elected representatives know to whom they have to answer. And it shouldn't be big insurance and the big. pharma/medical cartels. I am puzzled that why so many nations figured that out, the US hasn't got there......yet.
8
Republicans: be careful what you wish for. The ACA took years to rollout. Many other bills depend on it. You may have to actually offer a health plan. And explain to millions of people why they have lost insurance and millions more why their rates have skyrocketed.
18
@Stay loose They have to explain to people or their family members why they allowed them to die or suffer. That is what happens when people can't access healthcare. It goes beyond the rates.
1
Why is it constitutional for the government to require I purchase car insurance, but unconstitutional to require me to have health insurance?
17
The requirement to have car insurance is imposed by your state government. State governments generally have greater powers than the federal government, the powers of which are limited by the federal constitution. We have had an individual insurance mandate here in Massachusetts for many years. If the federal mandate falls, I think you’ll see many state governments fill the void by enacting Massachusetts-style plans.
5
No one is required to have car insurance. No one.
Only proof of financial responsibility.
I hate to say it, but the ACA was doomed when Congress killed the penalty (or tax) attached to the individual mandate. Pro-ACA lawyers argued before the Roberts court that the mandate is the linchpin of the ACA, for a simple reason. Without broad participation in an insurance system, only the unwell, protected by the preexisting condition clause, sign up. That means higher insurer costs even as fewer well people take part.
It’s called a death spiral for insurers. If the appeals court is honest, it will severe and strike down the private, subsidized insurance portion of the law. Too bad. Thank the Republicans, including Trump. It’s especially egregious because it has always been Republicans who wanted a health care system of private insurers.
7
All of the so called moderate Republicans who voted to end the mandate but who claimed to support the health care law have gotten us into this mess and now we are going to have to live with the consequences. It is time for Susan Collins to go.
22
Democrats make a particularly important mistake when they cast this as "Republicans want to take away our healthcare." Rather, their goal is to eliminate government intervention no matter how sensible/doable/essential it is. And why?--because it getting rid of it makes it easier for the oligarchs in charge to buy that third or fourth mansion. It is not that Republicans in Washington want to take away healthcare, but that they want to guard their, and their benefactors, fortunes no matter the cost to the rest of society.
11
@PJM - your average Trump voter doesn’t care about oligarchs getting richer, they just care about “owning the Libs” Trump has them holding tight to their grievances. Many won’t listen when Dems talk about the Republicans taking away their healthcare- because Trump is telling them they are “winning”
Sadly- once they realize they have been had- it will be too late.
1
Voters are not without any power in this brawl. But first they have to fully recognize that the Republicans in general and Trump in particular have no health plan sitting in a binder on a shelf somewhere. It doesn't exist. At all. So if ACA falls apart, it's either back to the insurance companies where clerks can and do make very serious decisions about our health care or it's time to take a hard look at single payer.
21
The purpose of the ACA was to accelerate the implosion of the system as it exists. It is working.
We continue to talk about the wrong thing. The real issue is why does health care, including drugs, cost so much, and we just keep talking about how to pay for it without paying attention to the underlying problem.
10
@Zan
One reason is when Republicans wrote the Medicare Part D law, there would not be enough votes unless government negotiating buying power was written out of the law. And so it was.
It should have been a priceless learning moment: When Republicans vote for an “Entitlement,” one should ask who the “entitled” would be. In this case, it was Big Pharma, not the sick and dying.
11
This is what happens when you ramrod through a single-party solution. Pieces of the law that are constitutionally vulnerable cannot be fixed because once the Dems lost their near super majority, the policy cannot really return to Congress to be modified.
5
Obamacare is perfect just the way it is. I lost my insurance but I kept my doctor. However, I wonder why almost all Democrat Presidential candidates want to get rid of Obamacare. Adoption of single payer obviously means Obamacare would be repealed. Where’s the marches complaining about the Democrats plans to end current coverage for preexisting conditions?
I expect the ACA to be abolished. Our governmental system is purely taken by "winner take all-loser dies" partisanship and they have control of the most important court and have specifically removed the only support Roberts cited in his defense. Functionally Roberts demonstrated explicitly how to attack the ACA properly in his upholding of it. It was obvious the moment that the Tax Cut sought to remove the penalty that this would be the outcome.
Now the question is how much faith will the people of this country have in Republicans to actually offer us a workable solution. I know I have no appetite for Republican claims that privatization of healthcare leads to better healthcare always.
What it does do is make healthy people pay for corporate profits. If you want to talk about death panels lets talk about insurance companies and their constant games of denial of service or coverage.
The only silver lining to the demise of the ACA is the fact that it will have been proven, for all Americans to see, that Republicans and the For Profits First Healthcare industry are not good faith actors when it comes to American's health or well being. They will not work to improve, they will not work to correct, and they will not work to offer an alternative. But what they will do is deny the sick and working class and working poor coverage and treatment to 'pwn the libs'.
Let us remember what compromise brought us. Let us remember that as we push unapologetically for Medicare for All.
18
Well, I guess I'll browse elsewhere to find out *why* the law may be unconstitutional. No information whatsoever on the details of the case here, just the politics of it.
2
This is yet another argument for a single-payer system, which would undeniably be constitutional.
14
@Chris Rasmussen
Yes. That will be the only way to provide universal care.
But for now, Republican voters will not support a single payer plan. They will only accept private systems, for now. They will have to see themselves facing poor care or insolvency before they will any plan that involves government control.
13
Under what Constitutional provision? And no, don’t say “general welfare”.
1
I have no doubt that the ACA will be eliminated.
Along with those who are only hanging on because of it.
What replaces it? What we had before? And now we are back to those who are only hanging on because of it.
In a normal world, there would be options for those who rely on it. But what will happen is the ACA gets struck down, and millions will be left out in the cold. Like before.
Sad.
11
If someone wants to declare their 'independence' from the 'welfare state,' then I'm fine with letting them go without insurance. But, as long as there is CHIP, medicaid, medicare and subsidized plans that make insurance available to all, I am unwilling to subsidize their care. They are free to pay full freight with any doctor, lab or hospital they choose!
But all of this is missing the larger point... we now have greater access to insurance than ever before. The actual cost of healthcare is out of control. Fix THAT one.
2
This may be the wake-up call that Republican voters need. The intricacies of the downstream effects of Trump’s trade policies are abstract. His climate change policies will have devastating but currently invisible effects on the US’s economy. This, though, will hurt almost immediately.
19
I had some minor symptoms which came on very abruptly. Zero history was taken before multiple, repetitive, and expensive tests were ordered. Tests which were unnecessary, and would never have been ordered if I didn't have insurance.
No, I am not going back for another CT. This is pure baloney.
1
I have been practicing law for almost 40 years. The court of appeals should be asking if the Republican states had standing to bring the case in the first place, not whether the Democrat states have standing to appeal it. If the Republican states could bring it, why couldn't the Democrat states appeal it? I have appeared before Judge Elrod in other cases. She is not a Trump republican. She will be the deciding vote on the panel and will uphold ACA.
16
The House Democrats should simply move to make the lawsuit "moot." Pass a bill making the penalty for not having insurance $5-10. If it became law, the Roberts ruling upholding the ACA would still stand (since the premise for this case is that Congress completely eliminated the penalty Chief Justice relied upon as a "tax"). Of course the Republican Senate and/or President likely won't go along, a failure that will make THEM totally responsible for the loss of health care coverage for the 20 million or so affected should the Court of Appeals strike down all or most of the ACA.
6
They can’t pass anything without the senate.
US citizens are not being told the truth about who would have to pay increased taxes for Medicare for all (as in other countries, everyone would have to pay taxes, to include the 60M+ people now on free Medicaid), and that everyone would have to purchase private supplemental insurance if they wanted to see a specialist in a timely manner.
No one would get a free ride like they do today.
1
@Dr. John:
Who, exactly, is getting a "free ride"?
And what in the world is so awful about paying more to see to it that everyone has health insurance and health care, no matter their personal circumstances?
I mean, what's so wonderful about denial of pre-existing conditions?
24
@Dr. John
Yes they might. However, Medicare premiums are nowhere near the premiums for the current ACA or private insurance. I have been on Medicare for 10 years. Appointments have always been in a timely manner.
9
Actually, if I add up 2 Medicare premiums for me and my husband, plus the monthly premiums for our supplemental policies, they are far more expensive than my monthly premiums through my former employer that covered the both of us. My employer was self-insured, so that held down premium costs some, but there are many of us paying more per month for Medicare than we did for insurance through former employers.
5
"question is whether the rest of the Affordable Care Act can function without" [mandate to buy insurance] -- question is whether Congress would've passed the ACA without the mandate. It did: it passed the ACA without an (unconstitutional) mandate, per SCOTUS. It wouldn't have passed it without the (constitutional) tax, which a later Congress zeroed out, but so what? Later Congresses change laws all the time in ways that earlier Congresses wouldn't have passed. And if a later Congress adds an unconstitutional part to an earlier law, like the zero-penalty mandate here, why should the whole earlier law fall?
The Trump administration is saying that requiring people to buy health insurance is unconstitutional and therefore, the whole law must be dismantled.
How can anyone declare that having health insurance is unconstitutional? Everyone at some time in their life is going to either get sick or have an accident of some type. It is for the common good that we have insurance.
Trump lives in a gold-plated world and never has had to worry about getting health insurance. He lacks the concept. “Because you are basically saying from the moment the insurance, you’re 21 years old, you start working and you’re paying $12 a year for insurance, and by the time you’re 70, you get a nice plan.” Nobody gets private health insurance for $12 a year.
He is a a caricature of out-of-touch wealth. As president he should have an understanding of the economic hardships faced by the people in this country. Republicans do not have a replacement plan and scream 'socialism' at the thought of Medicare for All, a plan that will cover everyone at a reasonable price.
16
If Republicans succeed in taking away the health insurance of millions of Trump voters, they may have done themselves in.
15
@lswonder
I thought that electing trump would have done them in. But they are still here,looking out for themselves.
Republicans know this lawsuit will fail, but it'll let them say they _tried_ to strike down the ACA, without having to actually come up with a replacement. So they'll get credit from the anti-ACA people without incurring the wrath of those who need the ACA. Brilliant.
2
It’s truly heartbreaking that some people would put their bottom-lines ahead of the health and wellness of living, breathing human beings.
It’s a failure of perspective. If any amount of money is worth more to you than a human life, I implore you to reconsider your ethics and morality.
12
It may be in the best interest of all if Obamacare (the pejorative term 'now' for the Affordable Care Act) were struck down.
That so many people didn't associate the two names as the same thing in the rural areas and poorer areas speaks to the type of people in need of some pressure.
Republicans want to get government completely out of healthcare. That is the plan of Republicans. And they say somehow the magic of the markets will lower prices. Wrong, we have monopolies that dictate prices; and prices will be set to the average most people CAN pay and then some.
Senator Alexander has been useless (but we will get a hardliner, Diane Black next in Tennessee).
So we actually need to just let this system fail! And then maybe people will be more open to "some" change. Your doctor will still be a doctor and your meds will still be there.
This is mess, and if we solve the cost problem with a real fix (I will not go into because it will be labeled the pejorative "Socialist.") we will solve a budget problem, too. What do you want, affordable healthcare or the freedom for the biggest to steamroll the weaker players including individuals and their freedoms!
5
Let them get rid of the ACA law.
Congratulations! Then let’s see what Trump and his supporters have to replace it.
6
Oh my achin' neck. Tired of watching our healthcare coverage lobbed back and forth across the aisle. We want an end to it. We want Enhanced Expanded Medicare for All.
11
America’s present health insurance/health care industry is about profit, from the medical device makers to the pharmaceutical industry to health care "providers", medical administrators to insurance companies.
Republicans (conservatives) do not have any interest in any form of health insurance/health care that 1) involves the federal government and 2) does not promise profit for private industry.
That America has seen that the free market over the last 70 years has not been a success in terms of either insurance or health care cost control is immaterial.
"Well, I'm not going to point any moral,
I'll leave that for yourself
Maybe you're still walking,
you're still talking
You'd like to keep your health.
But every time I read the papers
That old feeling comes on;
We're waist deep in the Big Muddy
And the big fool says to push on."
"Waist Deep in the Big Muddy"
Pete Seeger
9
We are being swindled daily by are own government
Dissent Develops Democracy
Civil disobedience is required.
6
The ACA is the best thing that ever happened to our family. Why do the Republicans want to kill my wife and kids? I mean, we could not get insurance for my child and my wife due to preexisting conditions. We don't make "Trump Money" so how would we pay huge medical bills without insurance? Bottom line, the Republicans want to less fortunate to just die, already!!
23
If you’re searching for the real ‘Enemy of the People,” look no further. It’s the Republican Party.
15
All Democrat Presidential candidates want to end Obamacare. Unfortunately they can’t agree on what the replacement will be and who will pay for it. Maybe a bad Court decision will get Democrats to work together.
1
Clever to do this through the courts. Republican lawmakers wont get dinged if this gets repealled. They can blame bipartisanship for a failure to come to an agreement on a new law.
I heard an interesting story on the radio. A small business owner who had long opposed ACA was diagnosed with cancer. He thought, no problem, i will just pay for the treatment. Turns out the facility would not treat him without insurance because of the cost of the treatment. He enrolled in ACA at the very next open enrollment period and was able to get treatment. He credited it with saving his life.
11
But will he keep voting republican?
As many readers have noted, the ACA is far from perfect, but at least it gives us the opportunity to acquire insurance. If it is jettisoned, then millions of us will be left in the cold. As someone with a pre-existing condition, I have no hope of securing insurance. Does anyone really think the Trump swamp creatures will propose a viable alternative. Yes, I want the ACA fixed, but why must it be abandoned?
13
Can anyone explain to me why employers, including large corporations, are not screaming for single-payer?
They could streamline their HR departments, rid themselves of annual open enrollment, and never have to do plan comparison analysis again.
They could submit one report with one payment each year to the feds, based on number of employees. Isn't that better than what they deal with now?
21
Many corporations would love to shed health plans. But they are largely staying out of the political fray publicly out of fear they will look anti employee. Many would still offer some plans as a recruiting tool for certain positions.
6
Can I stop paying car insurance because a mandate to have insurance is unconstitutional?
Is the mandate to have a driver's licence unconstitutional? What about the mandate to not run people over with a car?
We're a nation of laws for the public good. It's the basic principle of society.
19
Maybe you could provide some proof or strong evidence that our society is around for the public good.
I see little evidence of actions that support they contention.
Our society didn’t help me when I was dying of kidney failure and needed a transplant. And I didn’t expect it to. It was my problem not society’s.
Go ahead strike that baby down and watch how fast Trump loses.
15
I wish you would.
Then watch Sanders or Warren snatch the White House and the senate turn blue as as summer sky.
15
@New World:
Beautifully stated, New World.
Better yet, you are exactly right.
2
There very dark forces working in America.
10
@Charles Wesley
Have been for 40 years. H'come most never noticed till Trump?
4
Cue the Dem's response... Here it is:
Another demure speech by Chuck Schumer on the Senate floor. Tisk Tisk- shake the head, wag the finger ... and that's about it..
Where is the liberal outage..? Where is the protest march, drum circle and poetry slam? Where is the free Jay Z concert?
This is the most single important issue for the American voter and all the Democrats worry about is giving free insurance to illegal immigrants.
20 million Americans lose their insurance but we still need to find a way to cover illegal immigrants?
You guys are weird! And deserve to lose! I'm voting for Trump out of spite!
2
@Aaron:
Then say hello to denial of coverage for pre-existing conditions, solely on the grounds of some ridiculous and laughably false hyperbole.
Talk about "weird."
Good grief.
10
That isn’t why you’re voting for Trump.
10
There are five and one half people in the “rally” in the photo lead for this story.
If it is struck down, Donald and the republicans win and people will die.
Trump and company could care less.
Yet people continue to support this repulsive man.
9
Things in the USA are going to have to get worse before they can get better. Much worse I'm afraid. The millions who will lose their insurance will be out of sight out of mind in DC and there will have to be millions upon millions more lose theirs before the great mass of the American people stand up and say no more to the capitalist corruption and criminality of which US medical care is but one aspect.
Whether that happens before the failure and fall of the republic is the only open question.
6
Unaffordable and continuously threatened healthcare, massive student loans, massive rates of incarceration, haphazard gun control measures, minimal holiday provision, poor maternity leave (and virtually non-existent paternity) provisions, stagnant wages, accelerating inequality, unaffordable housing in several major urban areas, a skyrocketing federal deficit, increasingly unrestrained corporate greed, and a dysfunctional political system, awash with money, that seems incapable of addressing any of the above-listed issues in a coherent and effective manner... it is the sad truth that many young Americans would be much better off had they been born in one of a dozen other countries.
22
Does the GOP have anything - ANYTHING - to replace ACA with? Or are they good only for creating excuses for more tax cuts for the 1%?
14
@T3D
The GOP would love for you to have the best healthcare that one can buy so that they can profit from it. If you can’t afford the bill, then you are unamerican, a free loader, and/or lazy. If you can pay the bill, then their GOP kids get to go to Disneyland in Paris for a third or fourth time. By diverting money to the 1%, they are simply filling their future political war chests, to ensure that they have a lock on power for at least the next decade or two.
Just remember, having a healthcare system to look after you, your neighbor or a fellow countryman in their time of need is simply nasty socialism and thus makes you a member of the ruling Venezuelan party.
On the other hand, having a completely unregulated free market health system would allow the 1% access to the best healthcare the world can offer. Meanwhile, millions of the remaining 99% get to go without care, or go into financial ruin if they must get healthcare. But for the GOP this downtrodden whinging lot present a glorious opportunity for them to pull themselves up by their own proverbial bootstraps and personify the American dream itself. Fail to do so, then you were simply unworthy, unamerican, and a wanna bee socialist.
7
Because of some hard times I need health insurance so I looked to the ACA for help. I was told that I cant get insurance until the next application period in January unless I pay for it myself. Wow--what a wonderful program!
Guess I'm just going to have to try as hard as I can not to get sick and die before then.
3
First off, ALL medical insurances have an open enrollment period. Before or after that, you have to have what’s called “a qualifying life event,” to sign up, like you lost you job and insurance, or you got divorced, or your company dropped your coverage.
This is done so that insurers can plan and budget for the year.
You should call and talk to somebody directly and explain, or talk to your own employer’s HR department.
But I must say, if you were just skipping insurance altogether, what do you expect? It’s like waiting till you crash to insure your car...
I wish you the best, but this ain’t the ACA’s fault.
10
@Robert
I wasn't skipping insurance. I was self employed. There is no HR to turn to. I'm not blaming ACA but it strikes me as profoundly unfair that Americans who miss the open enrollment due to no fault of their own have to forgo health insurance so that health insurance companies can budget to insure profits at our expense.
Not being allowed access to ACA in times of difficulty or outside of one month window a year seems to me to completely contradict the entire premise of the ACA and that its in the best interest of health insurance companies budget and not Americans in need make it all the more absurd.
1
What happens if the ACA is overturned? Riots in the streets? Who knows. The repeal will hurt so many people of every stripe but it will keep his highness happy, and that's what our democracy is all about isn't it?
4
What is it about denial of coverage for pre-existing conditions, mountains of paperwork, and death by a thousand lack-of-insurance cuts that some Americans find so appealing?
The ACA is flawed, yes, but there's a cap on premiums, it includes mental health and wellness exams, and prevents bankruptcy due to catastrophic illness, for which it provides coverage.
Additionally, it pulled people off junk insurance and made them pay their own premiums. Good!
So where is our can-do spirit? Because it makes absolutely no sense to whine about the ACA while refusing to do anything to fix its flaws.
Then again, many who complain about Obamacare have no trouble with the Affordable Care Act. The willful stupidity writes itself. Sure explains our weird paralysis where addressing health insurance and health care is concerned.
10
Health care for those that can afford it is the center piece of republican policy just as legal issues are determined by how rich you are. The new royalty of America is being rich which allows you to have sex with anyone you want any time and like the game monopoly when you get to own everything you win end of game. Amazon has taken over every biz in the country and pays no taxes the rich do not pay taxes as they select the govt officials who decide who pays.
3
I'm a recipient of Medicare and the ACA California Medi-Cal expansion. Being disabled and low income, I receive assistance with vision and dental care and medications that are prohibitively expensive.
The threat of losing these benefits is not a small thing. In fact, it's difficult to imagine affording these benefits if I lose them.
For those of you who think we older Americans don't deserve to receive any assistance from our government, please know that I've been totally disabled for 32 years and have never used any government services until the economic downturn of 2008.
Medical coverage shouldn't be a political football to be bandied about depending upon which political party takes control of our country. This should be about people and their needs only.
14
Chief Justice Roberts was wrong in upholding the ACA in the first place. His rational is now gone. Strike it down regardless of the political outcome. Political considerations are not supposed to be considered when deciding cases in courts.
1
@Matthew This should not be a political or legal issue - it must and has to be a human right issue. Think about it. How health should be considered in any other way?
4
How do I KNOW you said the opposite lately?
1
@Robert I don't understand your comment. English is my second language so I might have expressed myself in the wrong way - but I can assure you that my belief is that health should and must be a human right issue. BTW - as well as education. Im' sorry.
3
At the same time that Republicans are planning another tax cut for the rich.
11
I've heard one too many ACA subsidy recipient voice their disappointment about the ACA, and also voice support for Donald Trump. I say give the voters what they want and let them reap their just rewards. Burn it down. Single payer or bust.
5
Trump has told the electorate that he has a beautiful plan, lower costs and choice of health care providers. It’s time to let President Trump deliver his solution. I’m certain Republican Congressmen are eager to promote Trump Care. It will ensure landslide victory for the presidency and Congress in 2020.
4
If Congress has the power to tax, then surely it has the power to remove a tax. But since the ACA was passed with the penalty tax, its constitutionality is unchanged. The only possible conclusion is that the removal of the tax is the unconstitutional action. Of course, this is logical, not legal, thinking.
2
A Republican victory in this case likely means the first votes from Congress in 2021 will be the passage of single payer.
9
Most that were FORCED to sign up for the Affordable Care did NOT want it and would have been penalized for passing it up. The programs offered were not all the hype given and in many cases were very limited. By far for those that want medical care and companies that offer it, to repeal the plan as it exists.
2
Just so you know, there is no such insurance plan as “the Affordable Care.” Nor are you “forced,” to sign up for it.
As originally passed, the PPACA mandated that everybody have health insurance. This could be done in about twenty different ways. You could have an ACA-compliant plan through an employer. You could be on Medicare or Tricare. You could buy a private plan. You could enrol in Medicaid.
Or, you could shop for a Plan on your state’s marketplace, and probably qualify for subsidies or tax breaks. The Exchange plans were, and are, private plans.
Whoop-de-do, horrors.
10
I have 360 days until I qualify for Medicare, I can hopefully make it without ACA. I think the only thing that will awaken republican voters of the pure stupidity of voting against their own interest is losing healthcare. I hope they strike down the ACA and wait for trump’s beautiful secret healthcare plan. They’ll be waiting forever.
17
Hopefully in a grave or a cremation vase.
8
The GOP is pro-healthcare -- until birth. Then you're on your own.
25
Do you love your insurance or your doctor?
Single payer eliminates the insurance and replaces it. We all pay in akin to a subscription. Single payer eliminates the for profit only insurance which socialized their losses by throwing our high risk population onto government insurance ages ago. They only want if you are healthy. They are worthless.
If you really love your insurance agent I’m sure you can send him or her a check.
Single payer eliminates insurance middle men. Why do people want them? This is what the media keeps getting wrong.
Time to change the debate!
20
Actually, it’s more time for lefties to learn what they’re talking about. “Hey PRESTO!” won’t cut it.
Kaiser Family, and this paper’s Margaret Sanger-Katz via “The Upshot,” offer really excellent primers on the PPACA, single-payer and other systems, and costs vs. benefits.
PLEASE read them.
2
The Republican Party, ever focused on rigging elections, no doubt believes only Democrats will die if the ACA goes down.
The Party may be in for a rude awakening.
15
Who's gonna pay for ALL the medical care of all those poor
people republicans forced to have babies?
4
@jahnay: No one. Once the baby is born, mother and child are on their own.
7
Republicans outta think twice about abolishing the ACA. If this were to happen, Medicare for All would be shoved through Congress, and signed by a Democratic president. While I believe we should keep the ACA's protections in place, we are probably on a path to some sort of single payer. Republicans once again find themselves on the wrong side of history...
12
At this rate, your country will never have decent health care for all. I'm sad for you.
8
If the ACA falls and the Democrats fail to get a universally accessible public insurance program passed, my family and I will become health insurance refugees fleeing to Canada or elsewhere.two adults with pre-existing conditions, a child with a heart defect? We will be uninsurable and with the cost of health care being what it is, that means no medicine for us.
15
@Caitlin
With the low unemployment rate, you can't find a job that provides insurance?
Pre-existing conditions do not apply to employee group plans.
2
@Ian-Many of The trump touted jobs are without benefits like health insurance. I’m surprised you were not aware of that .
8
You should consider Canada in any event. This country is steeped in violence both home and abroad.
3
Whatever the motivation, I hope the ACA is shut down. The law was written by insurance lobbyists. "Better than nothing" is not much of an argument for keeping it. As unappetizing as it sounds, if a year of chaos is what it takes to get to real, complete coverage for everyone, maybe that's the way to go. And when it happens, never mind fretting over "how you gonna pay for it." Give people cards that will let them see doctors or go to hospitals for free. Work out the details after the fact, instead of fretting over who's going to do what.
2
Private insurance sold in markets is the model insisted upon by most people until they become eligible for Social Security because a majority use health care provided as a benefit of employment. They think of this as free market funding and oppose the terrible inferior socialized model offered by Canada et al. But when they are affected by the limits of coverage needed to keep the private insurance business able to provide, they are very unhappy.
The ACA regulates the private insurance to make it serve individuals not covered by employee benefits and to provide far better coverage.
8
If you give people cards to go to the hospital or doctor for free those providers will want to know what they will be reimbursed for each individual procedure code. Who will be deciding that?
2
Every service charged or paid is coded right now. There are two major coding systems used generally by providers. There are many more reporting requirements required by insurers, too, and providers often must file multiple separate claims for the same set of services. This has been the standard operating procedure for many decades. It’s why our administrative costs are probably twice as much as they could be.
6
Two dozen Democrats running for President want to end Obamacare. Unfortunately they can’t agree on anything to replace it.
Biden doesn’t. Klobuchar doesn’t. Harris doesn’t. O’Rourke doesn’t. Buttigieg doesn’t. Bennett doesn’t. Others don’t.
And warren’s not stupid.
3
First you make everyone afraid of lots of different things, then you tell that you can save them from it all... one person in charge of it all... the apathetic's answer, "well, if it's our only choice to save us, go ahead and just take control".
3
It's worth noting that when Obama's administration reversed the Executive's course on DOMA, they did so to expand rights to Americans, whereas when Trump's administration did it with the ACA, their goal is to take away healthcare from sick people. Maybe that doesn't matter from a legal standpoint, but it does from a human standpoint. Does anyone in the Trump administration or in the GOP in general have any humaneness or compassion? Do they care at all about humanity?
13
ACA is a mess because the Republicans have invalidated or removed parts of it to make it a mess. In its originally configured form, it worked fine. Saying it is a mess and getting rid of it will leave millions without coverage. If any of those millions vote Republican, then nobody can protect them from themselves. We will eventually be filling their beggars cups with coins on the street corners when they get sick and cannot work.
8
The health care issue is a human right issue. It has a lot of sticky notes, like racism, politics, money, ideologies, religion, etc,.
But as long USA, the richest country there is, won’t accept the fact that health is a fundamental right of any society, politics and money will dominate the subject.
The NYT on a recent editorial “Sound, Fury and Prescription Drugs” offered 5 “solutions” to the problem. It’s a nice effort but – IMHO - sorry to say it- worthless.
I have many- too many- patients, who, with watery eyes tell me: “Doc- I work just to pay for my insulin and I still have to live with my parents”. If those statements don’t go to the guts of the Republicans – what will?
9
Wait, why are people still acting as if court decisions matter? If Donald Trump can ignore the Supreme Court on the census question issue, then surely the rest of us can just ignore the Supreme Court if and when Kavanaugh & Co. declare the ACA unconstitutional.
Brett, you're an illegitimate justice appointed by an illegitimate president. And now all of your strict constructionist Federalist Society propaganda nonsense can remain stuck inside your beer-sodden head rather than adversely impacting the lives of tens of millions of underprivileged Americans.
12
This should be the Times' top story, not the "squabble" between Nancy Pelosi and Alexandria Ocasio-Cortez.
Democrats, this is the issue you will win on. Let voters know what Trump and the GOP are up to. Trump supporters won't hear about this on Fox and conservative media.
13
Despite campaign promises of "better, less expensive healthcare for everyone," Trump is trying to kill ACA WITHOUT any replacement plan.
More Trump LIES...(!)
10
Would it help salvage ACA if the current insurance providers who provide healthcare to government employees (Fed, State, County, City...) lost that privilege unless they also provided affordable care nationally for non-government workers?
5
@Mari
I’ve had Blue Cross all my working life as a nongovernment worker and as a government worker. The premiums and other out-of-pocket costs were the same.
This legal action should wake up all Americans to the fact that the only way to assure the best health care for all Americans is some form of UNIVERSAL health care for ALL citizens regardless of where he/she works or lives or whether or not he/she has a pre-existing condition. The kind of health care available to every Congressman and Senator and even to Donald Trump himself. Obamacare was a poor compromise for what we really need. This court charade should be a wake up call for all Americans to vote for congressional candidates who support some form of "Medicare for all". No matter how much you like your current employer provided system you may lose your job and your healthcare tomorrow!
7
The claim is that the Democratic states and governors "don't have standing" to defend ACA. If so, how do the Republican states and governors "have standing" to even bring a lawsuit against it?
I guess I'm missing something here.
9
The penalty was never eliminated. The amount of the penalty is currently set at $0. The amount of the penalty being set at a value of $0 does not mean that the penalty was eliminated. What the penalty being set at $0 means is that the current government, when it voted, set the amount of the penalty. Additionally, by setting the amount to $0, then the current government acknowledges that the penalty still exists. A future elected government could change the amount of the penalty from $0 to $1,500 or $1,500,000 or some other amount. Additionally, a future government could remove the penalty, but that would require a revision of the law--which has not happened. So, it would seem that the crux of the argument fails to follow all the way through.
7
Yesterday Trump declared America's air and water to be the cleanest in the world, after spending two years dismantling environmental laws. If the ACA goes down, he will surely announce that we have the healthiest people in the world with the greatest healthcare system. Of course, with doctors willing to say he weighs 230 lbs, I guess anything is possible.
11
This is just mean-spirited & greedy full stop. The header for this ought to be ECONOMY, not HEALTH.
1
“A new study from academic researchers found that 66.5 percent of all bankruptcies were tied to medical issues —either because of high costs for care or time out of work. An estimated 530,000 families turn to bankruptcy each year because of medical issues and bills, the research found.”
Republicans are playing with fire and peoples lives. They have no plan, but vociferously stated (for political reasons) that pre-existing conditions would be covered, which essentially means that health insurers would cover it, but the premium will be so high you can’t afford it. Ironically, Trump voters might be the group hardest hit by an ACA demise. On the campaign trail, Trump said “you will have much better healthcare at much lower cost”. Once he even said, “at a tiny fraction of the cost”. The companion article to this, on the consequences of an ACA strikedown, shows the cold hard reality. I’m on Medicare and even I would face higher bills. How much longer must we put up with this presidential fraud and his GOP toadies.
12
The study’s probably wrong, which doesn’t mean medical costs are okay as they are.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5865642/
Time's up. Time to hold those accountable who are responsible for making sure millions of Americans have either very poor or no affordable health insurance and why coverage for pre-existing conditions should be trashed.
Somebody has to interview at length Trump, Mitch McConnell and the Koch Brothers (the $$ wizards behind curtain) who demand the repeal of the ACA and ask them why they are so against all Americans having affordable health care.
Trump, of course, will avoid answering the question and start bleating that he will give Americans the best health care ever (translation: a bill far worse than the ACA). But it might be fun to see how he handles the question and to get him on video and on record so we can play back his response at election time.
Mitch McConnell will taciturnly snap: "The American people don't want the ACA." So get him on film too for the record.
And it is about time the nefarious Koch wizards came out from behind their dark money curtains and tell us why they hate the idea of Americans having decent, affordable health care and have devoted a fortune and endless organizations to kill any and all government-supported health insurance in this country.
It could be quite simple: They hate to pay taxes as citizens to help other people. After all, they can easily afford to pay for their own medical care, so who cares?
Long term: We must have public financing of elections and get legalized bribery by the wealthy out of politics.
8
For those that don't understand what the mandate was intended to do, here's a quick, easy explanation: it is an attempt to make sure that some Americans don't free-ride off of their fellow Americans! It's that simple.
It's not the federal government "making you buy something." Rather, it's meant to make sure some don't free-ride off of other taxpayers (who will effectively be forced to pick up the ER bills when the free-riders (who don't contribute anything to their own insurance) inevitably end up in the ER.
Another way to think about it: check out your car insurance statement. Millions of Americans are "forced" to pay a line item fee every month as part of their monthly car insurance premium that covers the "uninsured," i.e., this little line item makes the car insurance business far more viable than it otherwise would be because it means that when an accident happens and one party to it does not have car insurance there is no "crisis" because millions of other hardworking Americans who play by the rules have already "covered" the uninsured party. (Were it not for those uninsured premiums, the auto insurers would make far less money than they do.)
What could be more American than making everyone pay their fair share? The mandate aims to do just that. Those that want to bring down the ACA on the basis of the mandate are ummmm....un-American!
8
Americans are absolutely not required to carry car insurance. It’s getting repetitive in these comments.
If you don’t drive a car as an able bodied person you don’t need insurance. If you have proof of financial responsibility you don’t need insurance.
If you’re disabled and can’t drive a car or have a license you don’t need car insurance.
And a huge chunk of what people call car insurance isn’t even required. Primarily just liability coverage. I don’t carry collision or comprehensive on my cars. Just uninsured and liability.
Please stop calling it “Obamacare” - it is the Affordable Care Act and calling it by it’s name makes it the bi-partisan legislation it is and NOT a partisan argument point. We ALL need affordable healthcare. Helping the government to make it a partisan issue dehumanizes the need for affordable care.
3
If this does get repealed millions will lose Insurance coverage including pre-existing conditions. A good portion of this pool will include Trump "die-hard" supporters. Maybe this will be the straw that breaks this blind support. You can have a good economy, a few extra bucks in your pocket but once you lose your Insurance it's a completely different situation. And this is the one area where Democrats can win "BIGLY".
3
Single payer, Medicare for All and we wouldn't be having this discussion. See any doctor you want. Go to any hospital you want. No co-pays. No ridiculous thousands of dollars in deductibles, The end of medical bankruptcies. And the American people save $2 trillion over the next ten years based on the Koch brother's funded study. The reason we don't have such a system is that members of both the Republican, and yes, the Democratic parties are legally bribed by the insurance companies and the pharmaceutical industry to vote against such a system.
6
@FXQ
I have Medicare, the monthly fee is taken out of my SS, as I requested. I also have a Supplemental Plan through United Health Care. The Supplemental only pays a certain amount after Medicare pays; if Medicare rejects the claim, the Supplemental pays nothing. It is not cheap; and, I am grateful to have one of the last pension benefits before Pension Plans were allowed to freeze new entrants. Insurance companies do not provide health services; they are used to handle claims, and to deny claims under investigation with decisions pending outcomes. If all were covered under Medicare, an efficient program, there would be no middle man overhead. Claims managers could apply for jobs with Medicare which would need more people to manage more claims. There would be little or no profit for private insurers, so they would market high end plans to executives in corporate venues. High end Plans would offer coverage beyond what Medicare offers, and they would be expensive. The ordinary employee, or small business owner, would not be offered those Plans.
What I think is funny is how liberals try to make the argument that everyone should buy private health insurance, because it’s the “responsible” thing to do. Liberals don’t care about personal responsibility. They don’t care that illegal immigrants at the border are costing the US taxpayers money. They don’t care if an undocumented immigrant comes into the country and receives uncompensated healthcare at an emergency room. They couldn’t care less. They want Americans with money to help pay their bills. It’s as simple as that. They don’t want Obamacare to fail, because it will mean they have to pay their own bills.
1
Look, it’s clear that there are certain ‘kinds’ of people that believe what you believe & they have every right to make their opinions known. But it’s been 30 or so years now since bi-partisanship has gone the way of the dodo bird & nothing good has come of it other than the rich have gotten filthy rich & corporate welfare continues to be extended while wages, benefits for the working & middle class have not kept up & the domestic standard of living for the majority of the country is no longer rising. Our nation’s social contract has collapsed & a sort of de-evolution is taking place. And since Republicans & people that embrace pay to play - no exceptions ideologies have also bought into the us against them mentality which is the root cause of America’s total cultural, societal stagnation it’s no wonder we’re in decline.
2
I sincerely hope that you don't have a catastrophic illness in your family and not be able to pay your bills. If we share the cost and get rid of the middle men costs should go down. Denying people affordable health care is cruel and shouldn't happen in a civilized country.
3
Republicans have absolutely no plan to provide any type of real health insurance for Americans. They never did have a plan and they never will, period.
6
I pine for the days when Americans did not believe they were entitled to have government and taxpayers take care of them.
2
@Dr. John when our taxes paid for wars for corporate profits and politicians who raise money to stay in power? don't worry, we're still in those days.
6
So I guess you want to eliminate Medicaire & Social Security. If you’re 65 let you be the first one to send back you’re Social Security checks. And pay for all your medical costs out of pocket.
4
@Dr. John
Not really a matter of entitlement sir. Is it an entitlement to have affordable Insurance covering pre-existing conditions?
3
It would be interesting to know how many of the commenters passionately defending the Affordable Care Act (and passing judgment on those who have fallen through the gap in this very flawed, Republican think tank-designed, "free" market boondoggle) are actually covered by employer insurance and/or Medicare.
I personally would not be averse to paying a tax to support the availability of health care for all -- a tax levied at the same *percentage of income* for myself and my spouse (who have been forced to go without insurance since our premiums more than doubled in 2014, while paying a usurious fine for our "noncompliance") as or those far wealthier than us (for whom a $12,800 annual premium is merely a drop in the bucket).
If the Democratic Party really wants to win back middle and working-class Obama-to-Trump voters in the Rust Belt states in 2020, reinstating the Obamacare mandate penalty would be a colossally stupid move. If your big donors won't allow you to provide a true national health insurance plan like our allies do for their citizens, then at least fix the mess you made with the ACA and make it truly fair and affordable for all.
2
@Frank F I agree that the ACA has gone off the rails to a degree. However, we have no one to blame but the Republicans who has sabotaged the ACA from Day 1. Not only did the Repubs force a no vote on Public Option, but have chipped away at the good parts of the plan and are unbolting the wings, mid-flight.
2
@Frank F
My husband and I found ourselves (barely) over the income cliff, in the Medicare 'gap' (early 60's) and
holding a cancelled 'catastrophic' policy which under
ACA mandates was not 'good enough for us'. It actually was perfectly good for us and functioned as insurance
is intended to -- protecting us from catastrophic medical expenses while we were responsible for more modest expenses. After reading through thousands of comments, I came across a recommendation to look into Liberty Health Share, a health care sharing cooperative. We enrolled and instead of paying premiums of over $3000 / month for the most 'affordable' Bronze ACA plan (with a $13,500 deductible), we make a 'contribution' of about $350 / month. As a bonus, becoming members qualified to exempt us from the ACA non-enrollment penalty.
Health Care Sharing Cooperatives are a potentially very powerful alternative pathway, but good luck finding any information about them if you don't already know they exist !
1
@irene
$350/mo. is a lot of money to millions of working people whose income would not support that payment. If you can afford that, I assume you can also afford to pay for services not written into your cooperative. If I were you, I would read the fine print. Advice from one who worked in Pension and Health benefits for 22 yrs. If it is not in writing, do not assume coverage.
From where I sit, it's democrats who're the ones trying to "undo" everything Trump does. They've fought him politically and legally every step of the way. Their leftwing demands they fight, fight, fight. And they're whining about "undoing" Obama's actions?
1
@AACNY
Whining?
More like LAUGHING at the utter INCOMPETENCE of the Republicans.
Over 60 failed attempts to repeal the ACA by the Republicans when they controlled the House from 2011 to 2019.
The FAILURE of trump's attempt to get a "skinny repeal" passed in 2017.
Now, no matter how this court case (Texas et al v US et al.) ends, the Republicans LOSE.
If the ACA is found unconstitutional BECAUSE of the 2017 TAX BILL, the Republicans OWN that outcome, and they have nothing to pass to replace the ACA.
If the courts overturn the summary judgment opinion by Judge O'Connor that the ACA is unconstitutional, then the Republicans LOSE again in their attempt to kill the ACA.
This is all based on Republican miscalculation, and no matter how it ends, the Republicans get a political black eye.
They may actually succeed in dumping millions off their health care, which would be unconscionable, but they clearly do not care about that possible inequitable outcome.
It is very funny from where I sit to watch Republicans do themselves in, in public, with nowhere to hide, and no one to blame but themselves. Good riddance.
9
This is the question to ask:
Did fewer people die and get sick since ObamaCare was enacted?
No. It was just a transfer of money from taxpayers to insurance companies.
In reality, since co-pays went up so high, people have been deferring going to doctors. And getting sick and dying.
1
@George Orwell
You need to post some statistics to prove your point, if you can, but I bet you cannot find them.
In Kentucky (yeah, Mitch McConnell's Kentucky, for God sakes) many thousands (I think it is about half a million people) have health care FOR THE FIRST TIME IN THEIR LIVES under Kynect (Kentucky's version of the Medicaid expansion authorized by the ACA).
I have to wonder how many of those people will be voting FOR Mitch on November 3, 2020 if this decision by Judge O'Connor that the ACA is unconstitutional is upheld, and they LOSE THEIR MEDICAID.
THAT would be funny. Payback for Mitch. Very funny.
5
@George Orwell
I was mistaken. Sorry, I apologize.
I said that I thought about half a million people were covered.
WRONG!
I just checked the website https://www.healthinsurance.org/kentucky-medicaid/
Actually it says that:
1,241,612 people are covered by the Medicaid/Chip programs in Kentucky as of April 2019.
It says that:
643,807 people have been added to Medicaid/Chip coverage from fall 2013 to July 2018.
As I was saying:
I have to wonder how many of those people will be voting FOR Mitch on November 3, 2020 if this decision by Judge O'Connor that the ACA is unconstitutional is upheld, and they LOSE THEIR MEDICAID.
Again, I apologize for my error.
2
Far too many Americans seem to believe The Affordable Care Act helps only low income individuals qualify for expanded Medicaid. If "Obamacare" ends- millions of workers receiving health insurance through their employers will be in for a major shock:
No longer have to cover pre-existing conditions; no longer have to provide subsidies if your employer-provided health insurance is priced above plans on the Exchange. No longer allow your struggling 26-and-under adult children access to your insurance: In fact- your employer won't be required to provide health insurance.
Digest some of that.
7
This disgraceful stance by Trump's Justice department is just more proof that Trump will do anything he can to undo whatever Obama achieved during his presidency, even if it means threatening to take away life-saving health insurance and pre-existing condition laws for tens of millions of Americans.
Trump's mantra is that the Affordable Care Act should be repealed and replaced by something "better". By now we all know that he has no alternative plan, never did, and doesn't care. He and his wealthy Republican enablers don't have to personally worry about affordable medical care.
4
Despite all the flaws of ACA, many did get coverage they need with it. So what is the Christian right's response to take ACA off with no better replacement? Is that a Christian thing to do?
Yes, ACA has its problems. How about work to fix those problems and not throw the baby out with the bath water?
4
The negative results of losing the ACA would be devastating for national healthcare. With no options in place to ameliorate this massive loss of health services and the GOP without a clue or care regarding replacing Obamacare, thousands will suffer and perhaps die due to the neglect of not having a useful public health option. The GOP will almost surely lose nationally in 2020.
118
@DENOTE MORDANT the GOP will not lose. Only the American people will lose.
10
@DENOTE MORDANT
Do you know anyone on the plan. Most that were FORCED to sign up for the Affordable Care did NOT want it and would have been penalized for passing it up. The programs offered were not all the hype given and in many cases were very limited. By far for those that want medical care and companies that offer it, to repeal the plan as it exists.
1
@The Man
I'm on it. I've been on it since it began. I also know people who refused to purchase a plan even when it became the law to do so and not one of them was forced to sign-up anyway. If they in fact did get penalized on their tax returns, they hardly noticed. Believe me, if they did they they would have been the first to complain.
16
What does Republican Party hope to accomplish at this point with revoking the ACA? The ACA provided health insurance to Americans that did not have it and of equal operational significance gave the private health insurance industry control of health care delivery in America. We've heard opinions from all sides on this issue but nothing from corporate health insurance interests. Unless the insurance interests get a better deal offered to them out of what comprises the Republican totalitarian, inhumane agenda they're not going to like it.
3
Trump has tried to dismantle everything that Obama has accomplished regardless of the merits. You need to have car insurance in order to drive a car. There is no reason why you should not be required to carry health insurance. After all, if someone without health insurance shows up in an emergency room, they will get care. You and I will pay for that care in one way or another. The whole idea of insurance is to spread the risk among many people so that those who have need can be cared for. When young healthy people get older, they will be very happy to receive the health benefits that are provided by requiring their children and grandchildren to have coverage. The Republicans have no plans whatsoever to provide insurance to all those people who lose it if the affordable care act is struck down.
7
The core of Republican belief is that government is always a bad thing (excluding the military). They simply can't wrap their heads around the idea of a policy that actually helps people. If destroying ACA causes a few hiccups, like premature death or bankruptcy for a few million of us, well that's a small price for achieving smaller govt.
I retired early and purchased insurance thanks to ACA, without a subsidy. I have a pre-existing condition unrelated to lifestyle which would make me uninsurable absent the ACA. Too young for medicare. I am LIVID that the Republicans would recklessly gamble with my life and security with evidently no thought whatsoever about how to deal with the consequences.
If this goes through it will be the biggest pyrrhic victory of modern times, triggering tens of millions of furious enemies just prior to an election. Count me among the many who will work tirelessly and donate profusely to defeat them everywhere, at every level.
19
With this as a backdrop, Trump has directed Republicans to shelve replacing the ACA until after the 2020 elections. He lied the first time about replacing the ACA with beautiful affordable health care. Give him a second chance? No way.
13
Perhaps another reminder is necessary. Those executives and CEOs of healthcare companies have a fiduciary responsibility of maximizing profits for their companies and its shareholders. All other issues are irrelevant and whether it be pharmaceuticals, health insurance or any other items connected to the healthcare industry, they are just another group of companies like all others and that is the way they operate (and always have).
The ultimate question is, do Americans still believe it is OK that the healthcare industry in general continue to operate like any other business?
The problem with all of this is many countries throughout the world including ALL of the Western Industrialized Nations is that they determined decades ago, when lives are at stake and when it comes to the health, well being and even the economy of the nation, the American model is neither fiscally nor morally sustainable.
2020 is quickly coming upon you America and a choice will have to be made. With a little education on the subject, for a change, hopefully, it will be the correct one.
12
If you think that the legal decisions about this attack against the ACA do not affect you, then read the accompanying article about possible consequences of overturning the ACA. The protections and benefits offered by this legislation are not limited to the impoverished or unemployed; they are currently or potentially helping almost all of us.
8
I pine for the good ol'e days, back when I was rugged individualist, fighting the billionaire insurance company's lawyers standing on my own feet to file a claim for the health insurance, often sold door-to-door, in small storefront offices, or even in mobile RV offices. Frequently the premiums are paid in cash or even collected door-to-door.
Yes, I pine for the good ol'e days, where my health insurance often rejects every claim or most claims, saying they're not compensable or that they're due to a preexisting condition.
Essentially, ...fraudulent health insurance.
Ah yes, I remember the good ol'e days, like when mom paid for insurance but they said her cancer was a preexisting condition and refused to pay the hospital.
27
The anti-Trump, anti-Republican commercials write themselves.
Parents who can't cover their cancer afflicted children.
A prior pregnancy deemed a pre-existing condition and a reason to deny coverage.
Normal Americans where both parents work facing intense financial pain because no protection on out of pocket expenses.
Coverage running out on patients with chronic illness because they hit the lifetime cap on how much an insurance company will pay.
This will affect not only Obamacare covered people who buy their own coverage on the exchanges, but will also hit the majority of people who are covered by their employers.
The Obamacare protections have benefited everyone and everyone will suffer if they go away.
The protests against the Republicans will be astounding. Just look at how potent the issue was in the midterms.
The call, once and for all, for a national health plan - like Medicare - that is more humane than the private insurers will be front and center in people's minds.
Beware Trump.
Sometimes the dog catches the car and the car wins.
19
The U.S. Court of Appeals for the Fifth District has jurisdiction over the whole of Texas, most of Louisiana and Mississippi.
It asks whether 20 or so Democratic-led states have Standing in the case Yet has no problem deciding that 20 Republican-led states (outside of Texas) have standing in attaching themselves to a Texas law-suit challenging the legality of The Affordable Care Act.
I can hardly wait till millions of Trump voters who love The Affordable Care Act and HATE "Obamacare" start partying like it's 1999 because Obamacare is gone.
14
The creators and supporters of Obamacare decided it was fair & proper to force Americans to effectively subsidize drug costs for the national health programs of the rest of the world. They accepted (for the US gov't) an absurdly low payoff from Big Pharma in exchange for NOT negotiating lower drug prices for our national health program.
By what right did the authors of the Affordable Care Act decide that the American taxpayer would go on paying so much more for cures for diseases than any other people in the world?
The whole bill was a quick and dirty solution to a problem too complicated for them to solve in the absurdly few months they had to force the legislation through.
5
It was rewritten and adjusted so the Republican controlled Senate would pass it. The plan was to upgrade and make it stronger and better as time went on, but at least it was a start. The constant weakening of the ACA by the Trump Administration with no alternate plan in the works to be phased in has left health care in shambles for millions of people.
10
At the time the ACA was passed, the Senate was Democratic. And not every Democratic Senator supported the public option, or bargaining with Pharma.
3
@JB
I guess you didn't notice all the recent discussions about the insane rise in the cost of insulin and in order to stay alive and not ration what they have, how many Americans have to go outside of the country to purchase insulin in either Canada or Mexico which in many cases is "one-tenth" the cost of what is being charged in America.
While you get off your "high horse" about the sanctity of the American drug companies, you should be reminded that Insulin was discovered by the team headed by Dr. Frederick Banting at the University of Toronto, CANADA in the early 1920's and rather than patent the drug for his own profitable and selfish desires, decided to release it to the world to save lives, not line his pockets.
Three drug companies in America have taken this almost 100 yr. old "life saver" made a few minor alterations and proceeded to inflate its price to record levels, regardless of the repercussions of doing so and unlike its discoverer have chosen profits over saving lives.
American pharmaceutical companies charge the prices they do because they CAN, NOT because they have to.
8
An increasingly large part of me wishes Republicans would get exactly what they keep asking for and get rid of the ACA entirely. Maybe when insurance costs skyrocket, it'll be a wakeup call for the folks who keep voting against their own interests. Because, it's obvious Republicans have no ideas on healthcare - not after Paul Ryan's disastrous attempts back in 2017. Without the ACA, the fact is millions will be priced out the market and there will be a flood of horror stories like we used to have in the old days. Anybody remember that? Kids dying because their parents couldn't afford to take them to the hospital. Old folks going bankrupt because of medical bills. People forgoing cancer treatment because they knew it'd put their families into inescapable debt. It wasn't that long ago ...
14
@Mr. Adams
Hello ! Insurance costs HAVE skyrocketed. It's just that, for most people under the ACA, those costs are hidden by premium subsidies or the Medicaid Expansion. Ask those of us who have been priced out of the system and locked out of actual 'catastrophic' plans (which, regardless of the hyperventilation against them) were an excellent choice for us and
probably lots of other small business owners.
2
The problem with catastrophic plans is that when the catastrophe came along most Americans still did not have the resources to cover their costs. High deductibles and low lifetime limits meant that things like car accidents and cancer treatments, often running into the millions, weren’t covered and people were unable to pay.
1
The problem with Obamacare is that all those benefits are meaningless if you cannot afford to access them. Really tired of hearing people who are on Medicaid and/or being subsidized lecture everyone else on what's important.
Well, hear this. It's important that it is affordable. It's not right now. So spare us the lecturing on how great it is.
9
No, hear this.
The primary reason for the climbs in plans offered through the Exchanges is this: Republican sabotage.
You live in a Blue state that has expanded Medicaid, you’re better off.
And no, the free market would not solve all this, no matter how many myths you recite. Buying scross state lines? Already allowed, never been banned, insurers don’t want to do it. Allowing the import of foreign pharma? Where do you think it comes from now? Encouraging competition? Why do you think there are few insurers?
You also skipped the us sidies and tax breaks and caps on costs, but hey, par for the right-wing course.
3
@AACNY
Affordable is useless if it doesn't cover what you need.
3
@AACNY
Well, SOMEBODY has to pay for every insurance company CEO's 50 million dollar BONUS every year!
After all... those CEOs of those insurance companies are the best and the brightest!
And SOMEBODY has to pay for all the 20 million dollar BONUSES for all board members of every insurance company!
After all... those board members of those insurance companies are the best and the brightest!
And SOMEBODY has to pay for the dividends paid out to all the stockholders of those insurance companies!
After all... the stockholders of those insurance companies are all the best and the brightest!
Yes, YOU must PAY for all of those bonuses, and those dividends to all those stockholders in order to simply get healthcare, because YOU are the best and the brightest!
2
At the age of 21, attending a public university in Tennessee after the ACA, where you cannot get Medicaid if you're a full-time student, I was left without health insurance because my mother depended on public health insurance (which I didn't qualify for), and I had never been the dependent of my father (and therefore didn't qualify for his health insurance, despite being under 26).
I sliced my finger open one even while cooking, and needed seven stitches in my pointer finger. I could see my bone and the fat of my finger, and the ER was my only option.
It cost me $2,900. I was a full-time waitress, and a full-time student. I couldn't afford this whatsoever, and it devastated me for years.
Today, I live in Illinois, and I am lucky to have health insurance. I went to the doctor for a check-up for the first time since I was 17 (I'm 26) last month. This would take my health insurance away from me, and it scares me. I cannot go back to where I used to be, where it cost me nearly 3k for necessary stitches.
This is inhumane, and the Republicans should be ashamed of themselves.
34
Will this future ruling affect Medicaid expansion?
2
@Fred
Many are conflating Obamacare and Medicaid. As it turns out, some states are voting to keep their Medicaid expansion. This is a good thing. Medicaid and Obamacare should be decoupled. The latter is seriously flawed.
3
Funny, you don’t seem able to actually name any of the giant flaws. Also don’t seem to know that Red states generally block Medicaid expansion, and are trying to take it away.
2
It is now crystal clear that cruelty against the ordinary person is a central feature of the current administration and a plank in the GOP governing platform.
I guess as along as trump is hurting "the people that he needs to be hurting" it doesn't matter that his drones are hurting too.
Ain't America great? God bless us all.
9
The ACA is credited with all kinds of beneficial changes with little or no drawbacks. The message here is that no rational well-meaning individual would want to get rid of it unless it’s for single payer. The consistent message is that opponents of the ACA are essentially evil.
Next to nothing is written about policy differences when it comes to health care. But when you look at thoughtful conservative alternatives, you find that they tend to favor state control rather than federal control in order to promote choice. And they often favor funding by block grants.
Thoughtful conservative health care policy isn’t based on tendentious thinking. It is based on traditional Republican thinking. We aren’t told about the constructive debate between federal and state control because simplistic good and evil arguments are transcendent.
If you think there is no constructive conservative thought about health care you have been brainwashed.
4
@michjas Thoughts are not actions. There is no Republican healthcare policy even being discussed. So you can fool yourself in thinking differently, but it is another bubble. There is no policy via the conservatives in play to replace, correct, or improve what is currently in place.
4
@michjas Surely you know that the block grant approach will inevitably lead to diminished levels of support, no matter what the program might be. The ACA was designed to maintain a standard nationwide. Block grants effectively balkanize the "united states" by letting states treat American citizens health care differently. The consequences are predictable: poor health care on one side of a border, leading to increasing inequality. Flawed though the ACA is, I have not seen any evidence that there is SERIOUS Republican discussion of this issue. All that matters is eliminating the faltering efforts to establish nationwide standards. Fortunately for Republicans, they don't get the types of illnesses or have accident that lead to catastrophic expenses and bankruptcy. Or so I assume.
3
@michjas
Where is this rational, thoughtful Republican discussion of health care taking place? All we've seen is Trump's bragging, then walking it back with his inane comment about not knowing how hard it was, and then the constant braying for repealing the ACA.
So tell me, where is the rational, thoughtful Republican discussion?
2
According to the 2017 U.S. census, 56% of Americans had employer sponsored health insurance. Of those, many are unable or unmotivated to envision how tenuous life can be without health insurance.
Several of my acquaintances work in long term, secure government jobs. They say they don't want to subsidize other people's health insurance. My response is, "And we don't want to subsidize yours through our tax dollars." This results in blank stares or diverting to anchor babies or some other FOX news generated hot topic.
One person suggested that I obtain an affordable plan through AARP. Besides the fact AARP offers no such plan, I was age 49 at the time. He has worked for 30+ years in a protected bubble as a federal government employee.
The utter lack of knowledge of what life is like outside the protections of an employer plan is astounding. It isn't just corporate interests, it's also this 56% of our population. If they lost their benefits, the vast majority would be clamoring for Universal Healthcare like the rest of us.
14
Chief Justice Roberts has shown that he will not allow the ACA to be ended by partisan efforts. This a political issue that needs to be decided politically. Just as with partisan gerrymandering. The important issue is the census rebuke to Trump form the Supreme Court. Trump is trying to turn the census into a vehicle of vote suppression.
2
Let them kill obamacare and hurt Republican's chances in the next election, as it clears the way for Medicare for all. Best loss-turned-win-win ever.
10
The law is the law. If Texas wins then good bye Obamacare. Then comes politics and some combo of private public.
3
Trump's dream come true - Obama eradication completed - at the expense of people who need what little protection still exists under the ACA. Despicable.
8
What an insecure man we have in the Oval Office. He cares nothing for his fellow man and yet he pines for attention like a 2 year old from the media. It doesn’t really take much talent to destroy things, but building is a different story, a talent our president does not seem to possess.
7
All these years, all these threats and assaults on the affordable care act - and not s single “great” plan from the GOP or trump. A shameful thing.
9
No matter the outcome of this appeal-- one thing is certain:
The R's and Trump want to do repeal the ACA without an adequate replacement. No amount of lying or misleading information from Trump and the R's can mitigate this fact since they are the ones who are pursuing this case.
I certainly hope that they are successful since voters need to decide where they stand on this issue and vote accordingly. Sometimes we need to receive a jolt to be motivated to act. As the man said when he hit the donkey over the head with a bat to get it to move " First you have to get his attention".
4
I hope partisan judges overturn the ACA. It was not a good solution to begin with. Republicans turned it into a political football. If it’s overturned it’s going to be a liability for republicans. I say great! Anything that gets those greedy racists out of office is a win. We should follow the model of other nations and get real about health care. It’s a joke in it’s current state.
7
Why are the Republicans so lockstep against the protections of the ACA & why are they against Americans without health insurance coverage being able to obtain government- sponsored affordable insurance?
A Republican explanation:
Despite plenty of evidence to the contrary: "Republicans say it imposes too many costs and regulations on business, with many describing it as a 'job killer.'"
https://www.bbc.com/news/world-us-canada-24370967
Here is the major reason: Follow the money, especially the mighty Koch Brothers funding.
a. For the 2018 midterms "...the Koch network announced plans to spend up to $400 million in the 2018 cycle on policy objectives, including its two major legislative goals — repealing Obamacare and revising the tax code."
b. "For the Koch brothers’ byzantine network of largely anonymous donors, who spent umpteen millions to win a Republican-controlled Congress, it’s a blown investment."
c. Then as Doug Deason, "one of the few known donors in the Koch network’s fundraising rolodex, told GOP leaders 'Get Obamacare repealed and replaced, get tax reform passed.... You control the Senate. You control the House. You have the presidency. There’s no reason you can’t get this done.'”
https://www.opensecrets.org/news/2017/09/koch-networks-failing-investment-in-aca-repeal/
Yet, despite all the legal challenges to the ACA, in 2012 the US Supreme Court declared it constitutional.
For 2020, Democrats must stay focused on GOP health care repeal. Fear works
4
Where's that "trump"/republican "great" healthcare plan?? Hello? Anyone??
Oh, I know, "trump" will dangle that out all the way till he gets "elected" in 2020 and then drop it once and for all. It's just funny the timing here: hasn't he gotten on the phone to these judges to drag out the killing of the ACA until the day after the 2020 "election"?? Isn't the very last thing he wants is to kick a bunch of his base off the ACA and get them riled up? But who am I kidding... his base would jump off a cliff for him.. they will LOVE not having health coverage, cuz Obama.
7
Meanwhile, Democrat presidential candidates are talking about the green new deal, reparations fro slaves, illegal immigration protections, forgiving student loans, forced busing, equal pay, etc. Oh yeah, an trying to run out the clock in regards to impeaching Trump, so they can hope to win back the White House, keep the House and get the Senate.
Health care is the number one priority. It has been a number one priority for year. The ACA, never fixed the underlying problems; but, at least most people are more or less covered. And, if predictions come true, by the next election, the economy will be the next big issue.
The Supreme Court will again be asked to uphold or kill the ACA. The last time the Supreme Court decided it; it upheld the law and told Congress to fix it. The Democrats better hope they win in federal court, because the Supreme Court will pass on ruling and push back to the lower courts. With a 2 -1 conservative majority, at the federal level, it does not bode well.
It still amazes me that teh GOP keeps trying to kill the ACA, considering it was their idea in the first place. Force people to buy insurance, keep the health care gray train going, They did not reckon on the wealthy having to foot some of the bill, in higher taxes help help subsidize people to buy insurance.
By the way, my high deductible policy costs $150 a month with subsidies and $1200 without. I am 63. $1200 a month is a mortgage or rent payment. My out of pocket deductible? $6500.
5
A perfect example of how morally bankrupt the Republican Party has become.
Tear it all down out of out of spite, then lie about having a better idea.
Where’s Trump’s “big, beautiful healthcare plan”? Oh Trump will get back to you. Not
Vote my friend these bought and paid for con artists have got to go.
9
At this point, I think it's fair to say that the GOP healthcare plan is to take away healthcare from poor and sick people.
6
Boy Republicans are a confusing lot! On the one hand, they lambaste the idea of Medicare for all because it would strip people of their private healthcare. At the same time, they relentlessly look to blow up the ACA, which would...strip millions of people of their healthcare. Geez, it’s almost like they’re acting in bad faith!
6
Lose this case and win the election
1
Dems should play dead and let the courts act decisively. Let healthcare be ripped asunder. The people will then force our legislators to finally work together on this, when it starts to hurt.
4
Boy, I hope the 5th Circuit affirms, and it makes its way to the Supreme Court, which will either deny cert or hear the case and . . . . ? Great news all around for Democrats. Add an abortion case or two . . . great news for Democrats.
3
Many people forget that Obamacare was not bipartisan, which is causing many of the problem we see in politics today. There was a backdoor agreement with Senator Specter before the Democrats could force the bill to be approved by the Senate. Harry Reid got Senator Arlen Specter to change parties if he would vote for Obamacare and also promised Specter that he would retain his 28 years of seniority accrued. In other words, win at all costs, which is what we see today. Laws dealing with the social contract with Americans need to be agreed on a bipartisan basis if we expect them to stick. Both Republicans and Democrats need to understand that principle.
5
Obamacare is not prefect, but has SAVED countless American lives! Question for the Republicans what has your party done to help with healthcare, other than dismantle it, refuse to fund the ACÁ?!
Number one issue for Americans IS healthcare, number one! Why?! It’s about their lives and the lives of loved ones!
Healthcare is a human right, CUT THE BLOATED Military budget and fund healthcare for all.....and keep private insurance for those who want it!
Vote Blue YOUR life depends on it!
10
Why do the Republicans so hate the average everyday person.
6
Donald Trump is the worst president in the history of the USA.
William Barr is the worst AG in the history of the USA.
This GOP is the worst political party in the history of the USA.
They have all come together at the same time, to wreck their havoc on the American people.
They are destroying our healthcare, the environment, international free trade and global peace. They are doing nothing to solve our infrastructure problems.
They are doing the bidding of this country's plutocrats and oligarchs. They are owned by them. They seek to divide us by color, religion and class standing.
Stand strong, America. We are far better than Trump, his henchmen and the GOP of today.
Vote them all out in 2020!
11
So ObamaRomneyHeritageCare was supposedly unconstitutional solely because of the mandate. So now that the mandate is gone, it's still unconstitutional?
What a piece of logical garbage!
4
Many of my (ex)colleague physicians clamor that the ACA has ruined healthcare in the USA but I have yet to see cogent, well supported arguments why this is so due to the ACA, and in contrast to the system prior to the ACA, or even more telling in contrast to the government getting out of health care completely and letting the free market reign, an admittedly very hollow strawman. Ruined? Really? I think this relies on the old saw that if one repeats something frequently there will be believers.
7
@Nature Lover I do not participate in ObamaCare because I cannot afford $5,000 per month for very minimal coverage. Rather, it is much cheaper to use foreign health care, just as one buys foreign goods and services because they have a much better cost/benefit ratio compared to American products. American health care, for example, is astronomically expensive due to government mandated uncompetitive costs such as allowing absurd malpractice suit recoveries, resulting malpractice insurance charges, insane monopolistic drug prices and turf guarding by the American Medical Association. Mad at the ACA, or lack of ACA? A ticket to Bangkok, Singapore or Malaysia for first class healthcare is about $1,000, or about the cost of 2 hours in your local US hospital.
1
@Nature Lover did you ask them how many more hours they spend on additional paperwork or staffing vs treating patients. That's a good start. Ask them directly.
2
@Location01, Mr Bowman:
1. You missed the part where I was a recently retired MD. I did that paperwork. I had numerous patients with illnesses not caused by their choices, no insurance, who suddenly had it. SLE, rheumatoid, psoriatic arthritis patients suddenly had treatment options other than to marry a rich guy. (Women get more of most autoimmune illnesses)
2. Bureaucratic tangles preceded the ACA (Rep./Bush intiatives) and may have been worsened by it, no argument, but ruining health care from the ACA alone? I often spent more of my day fighting with insurance companies to get procedure or treatment approval, never medicare.
3.I never once did a peer to peer discussion with a gov't retired Ob-Gyn to get my rheumatoid a 'standard of care' treatment not approved by the FDA. I did with Aetna. 20 min. wasted after a scheduled phone meeting.
4. I never once got an approval reversed by any entity but private insurance-"We changed our mind upon review-denied"
5. $5000 monthly? Really? I wished to retire early with diabetes and heart disease and checked local ins. choices after COBRA ran out in '13. Not as good as my employer but $1300 monthly without subsidy for the gold family plan. My employer and my costs were $17000 then.
6. I will not argue that American Health care is not more expensive than foreign but that preceded the ACA since forever. That situation has little to do with the ACA. My understanding is that most cost issues had to be discarded in the negotiations.
1
republican health care: Quit your bellyaching, get sick and
die (go bankrupt in the process.)
8
this is more exciting than waiting for the OJ trial outcome!!!
1
@Bruce Rozenblit
I disagree with one part of your argument: the people who don’t support Medicare for All are, I suspect, wealthy not poor and healthy not sick.
You write that you don’t want to pay out $900 a month because of your age; neither do we. Our plan gets us to just shy of that amount and with only 18K annual out of pocket, and that amount isn’t accurate either.
We pay cash for two of the three medications I require monthly because that is most affordable, which seems ironic. One med is $60 at the pharmacy we use, but my insurance requires a preferred pharmacy, which charges $245. I can find it for $25, but that would require toting the script monthly to whichever pharmacy has a coupon. Here’s the biggest joke: I recently read a post by a credible source that stated the actual cost should be closer to $15.
All of that is a conversation we are worlds away from if we’re still arguing about whether people should have a path to affordable healthcare, which is what this debate about the ACA is.
2
Once again extremists hold the nation hostage. The extreme right thinks people should just drop dead if they can't afford coverage. The extreme left wants to hand out free coverage to people who don't contribute anything. Both ignore those in the middle.
2
@Hellen
The right to life is universal, regardless of whether you "contribute". We dont live in a jungle anymore. SO yes, healthcare is therefore a right, not a privilege.
1
@TimeToImpeach
Then you pay for everyone.
@Hellen
What would be the cost of an epidemic impacting a large part of the population? Those with insurance would be required to use it before Medicare or Medicaid. Those without insurance would be treated in public hospitals and community clinics where they existed. Finally, public health services would provide for all, because an uncontrolled plague would be worse, e.g. SARS, Ebola, viral pneumonia, Smallpox, etc. That is why on a basic level we pay now for everyone to keep people healthy, rather than later when thousands fall ill.
1
Perhaps we should just make medical insurance illegal. If you cannot pay (up front) you are simply left to die.
It's been done before. Look at our history. Unfortunately in a purely Capitalistic Society this phrase rings true:
No Bucks = No Bueno
1
@James Thurber
If insurance actually did what it is meant to do, then it would all work. The way to do it? Force everyone to have insurance, like car insurance, and make all insurance non-profit, so as to reduce the incentives to deny coverage, and keep CEOs from taking millions of dollars away from the pool of money people contribute to.
8
@TimeToImpeach
You will have a problem with your idea. In terms of dollars "contributed", the healthcare industry is now the NUMBER ONE lobbyist in Washington.
@Deus
Lobbying ends when profit is gone. Lobbyists are paid big bucks to write legislation, and to use their Hill connections to get it passed. The staff who actually write legislation will remain, both those who work for Congress and those who will apply for job openings will remain.
Maybe there are a couple of people in those 63 million who voted for trump who are mentally stable enough to realize a vendetta (against a smarter more empathetic person) isn't a reason to go after all his policies. We have a mentally damaged president folks.
6
If states can require vehicles to have insurance, why can't the federal government require people to have health insurance?
4
Not only is this about repealing anything Obama did, but, once again, the Republicans want to punish the bottom fifty percent, especially blacks and Hispanics.
These are the people Trump and the hard right hate.
Brown people.
That's why they deny them access to health care, education. food, and decent places to live.
Remember, Trump said he would mind people immigrating here from Norway. Tall, white, blond people.
As soon as the planet realizes that health care is a human right, the better off we will all be.
8
Am I my brother's keeper? For Republicans, that answer is no. For Republicans, it is a case of don't look for the government to solve your problems. Cold and sad. Beware of what you wish for my dear dark Republicans, you just might get it!
4
Judge Reed O'Connor, a well-know far right conservative, struck the ACA law down as unconstitutional on summary judgment, meaning he thinks this case (Texas et al v USA et al, NDTX 4:18-cv-00167) comes out in favor of the states trying to kill the ACA, based on the assertion that "there is no genuine dispute as to any material fact and that the movant is entitled to judgment as a matter of law." Basically, he is saying that if the case were to be tried to a jury, any jury would find for the plaintiffs, and the case has to come out the way he ruled.
Many attorneys think Judge O'Connor's opinion was very thin, and is not a well reasoned ruling.
If this ruling stands, the REPUBLICANS will lose. They will be tarred with finally killing the ACA, and having nothing to take its place. Millions will lose medical insurance coverage.
If this ruling is knocked down, the Republicans lose, because it will be one more attempt to kill the ACA which has failed.
There is no way the Republicans win this one.
Way to go, Republicans, another "very stable genius" move on your part.
7
While every member of Congress and Donald Trump have virtually free medical care at the expense of the tax payers. too many Americans don't now have adequate reasonably priced medical care and more will lose it while the Trump administration fights Obamacare's last vestiges in court. What kind of government do we have in this country? Why do so many Republicans fight universal single payer health care that has been so successful for most of the civilized world? How many Canadians would switch their health system for the mess we have in the U.S.? Wake Up America!
5
I confess I understood absolutely nothing of what I just read. ACA has become such a horrible legal mess of a giveaway to private insurance companies that the only one getting healthy from it are lawyers.
2
Perhaps all those who voted for Trump but got health care because of Obama may just learn a lesson the hard way. It was just recently (May 2019) that once again Trump claimed that McCain "killed health care". Considering the fact that McCain's vote actually saved it, you have to wonder how smart people can be so dumb to fall for such a ruse! Certainly it was billed as Repeal and Replace. But there was never, ever a replace component. I won't say that those people who WILL loose their insurance if the ACA is overturned deserve it. But I will say they have no one to blame but themselves. Not that that will happen! They will simply find a way to blame others. Perhaps another hearing on Benghazi!
3
Dear Republicans,
Please make sure millions of people get thrown off their health insurance while you have no replacement ready to go. It will be the best way to demonstrate how well your party governs
4
If trump and the Republicans put half the energy that they are using to destroy the Affordable Care Act into creating something better, maybe we could get somewhere.
Their blond hatred is much stronger than their creativity.
4
The Democratic states don't have standing to pursue the appeal, but the Republican states attacking it did have standing to bring the case in the first place.
That would be a truly rich result, and wholly in keeping with our right-wing judicial system.
2
As much as I hate to say it, I hope the courts do invalidate ACA, not because I am against it (I am not), but rather because maybe, just maybe, this will wake up the Trump nation types who believe Trump is going to replace ACA with some kind of health insurance that (of course) will supply gold plated health care to 'real americans' ie the white, working class, rural and rust belt types for low or no cost while denying it to 'those' people who today under ACA are getting 'great' health insurance for 'nothing' (needless to say, the those of course are illegal immigrants and poor minorities living in big cities, in their view). It is about time that Trump nation is forced to wake up and realize reality, that the GOP and Trump are not gonna give them great health insurance, if ACA goes away they likely would have no insurance..and then because of the pre existing conditions clause, many of them will find they can't get insurance or their employer insurance won't cover treatment (given how obese a lot of middle america is, how many of them still smoke, it is likely their diabetes, kidney disease, heart disease, etc will fall under this). As someone said, often nothing happens until people feel the pain, most people in the 1920's supported the 'glorious' economy that was helping only the rich, voted for the GOP conservatives, until it all collapsed.
5
I don't understand how the party that touts itself as champions of the "right to life" can care so little about the health of the already-born by their constant attempts to overturn the ACA and refusing Medicaid expansion in poor states. It's an abomination that the richest country in the world is so stingy when it comes to the very survival of the sickest.
4
Healthcare and health insurance are 2 different subjects. The AFA provided for more people to acquire health insurance; but, it came with a cost. And, that cost is being paid (mostly) be the already over-burdened middle class, who have saw premiums jump and deductibles/out-of-pocket maximums skyrocket.
In the past year, premiums have started to drop; but, actual health care is now often not affordable to those (middle-class) who are being burdened with the mistakes in the AFA.
Congress (and the President) should have addressed this years ago - through recognition of problems and application of root cause analysis to develop and implement meaningful change. They both failed. Now the system is so bad, the only viable option is to start over.
Do not quickly dismiss the Republican proposals, they are pretty reasonable. But, what we NEED is a bipartisan effort to address the problem. IMO - one item totally ignored, but adding greatly to health care costs, is the need for real tort reform.
1
@Steve - WHAT Republican proposals? Even when they had total control of Congress and the WH, they couldn't come up with anything that would pass. Do share with us what plans Republicans have to replace the ACA.
4
We are not yelling loud enough. You stand to lose your insurance including preconditions . The Republicans have no intention of offering an alternative. In fact, they would just as soon go back to the private insurance days before Obama. If this has yet to sink in, it won't be long now. Where is the outrage we showed the last time they threatened our health insurance. Trump knows they can destroy health insurance slowly; a little bit at a time. Well the time is now.
277
@Paul Raffeld They GOP offered solid plans to cover preconditions and try to drive down costs but they barely were not able to pass it.
The GOP has the same goals on healthcare but different methods of working towards those goals. They want to push more towards the states and allows more flexibility in general, get away from a one size fits all solution.
And they for sure recognize that most folks like their private insurance and do NOT want to trade it in for any kind of federally run program.
The grand bargain here may be to allow some folks to buy into Medicare early, but it will need to be at a fair rate, not a rate that undercuts private insurance like Medicare does right now by paying less than market prices.
@Marvin, every single GOP plan would have resulted in millions more people without insurance.
9
Getting group health insurance for people who don't belong to a "group" as defined for insurance purposes can be done by fixes to the Affordable Care Act. President Trump, however, has been intent on erasing what his party nicknamed "Obamacare" and promised that, if it was repealed, he'd replace it with "something great." The president has never given any specifics about his replacement plan. I wonder how many believe that he will replace the ACA with "something great" or anything at all. Meanwhile, the people without group health insurance know that being driven into bankruptcy by a hospitalization is not a matter of if but when. Leaving them in this situation is not only cruel to the individuals, but makes no fiscal sense because they will be forced onto Medicaid that is fully funded by the taxpayer.
2
@eduKate - The thing is that the 14 or so red states that still refuse to allow expanded Medicaid leave millions of people uninsured at all. Do you know how little you have to earn to qualify for traditional Medicaid in some of these red states? If you live in MO, you make "too much" for Medicaid if you make more than 18% of poverty. I think in KS it's 36%. Many of the southern states have exceedingly low limits like that, leaving many people without any insurance whatsoever.
3
Whatever President Obama accomplished during his presidency, Trump has sought to destroy, no matter the consequences. He pulled us out of the 2015 accord with Iran, and now they have begun enriching uranium beyond the limit set by that accord amidst rising tension between that country and ours. If the ACA is overturned millions will be adversely affected and some will lose their very lives as a result, which matters not one whit to Trump nor his fellow Republicans. Somehow the Republicans have succeeded in convincing their core base that providing access to affordable health care is not in their best interest.
The Republicans have never been in favor of anything that personally benefits the American public - especially the poor. They didn't want Social Security nor Medicare nor Medicaid, they have voted against food stamps, they have voted against helping our veterans, stabbing them in the back while looking all teary eyed when veterans have been brought before Congress for special recognition. They have been silent about the horror at the border, and they will applaud if the ACA is struck down.
If the ruling by the judge in Texas is upheld, all bets are off as to how SCOTUS would rule given that conservatives Justices are now in the majority. What then Republicans? What is your plan? What will you tell the person who will stop receiving treatment for cancer because he or she can no longer afford insurance? Too bad?
The consequences of the 2016 election have been dire.
10
Oops! The amoral characters behind this scheme probably didn’t plan on this playing out so close to the election.
Might be time for Mr. Trump to make a speech declaring how great a job he is doing on health care. Just like his advocacy for the environment.
Sad
4
A large fraction of those people in red states who rely on the ACA the most are people who do not vote. That’s a big problem.
1
One more way to destroy American society and democracy and strengthen the top 0.1% (and increasingly smaller) rich folks and big companies.
American elites, politicians included, are not much different than many kings and royal families in many countries around the world- be it in terms of buying degrees from "prestigious" and rich institutions like MIT & Harvard (less of an institution and more of a club), dominated by hereditary rich and powerful people from not just USA but around the World who are destined to occupy influential positions in either private or Govt organizations- irrespective of their talent or leadership quality; or buying justice at will. And that "aristocracy" and sense of entitlement for privileged class also trickles down and pollute other places like less prestigious institutions, and private companies.
This works on the same mentality and towards the same social engineering for which the Republican party and most American companies are so fond of trickle down economic models that ensures more wealth and more power for fewer and fewer people at the top. No wonder, even in this 2019, we are fighting to even ensure a $15 minimum wage while number of billionaires are exploding in the same country (all time high in its history.), so negligible tax for super-rich people that many such people (like Warren Buffet and many more) are now openly feeling ashamed and/or worried about its consequences.
3
What you resist persists. Until Obamacare supporters start acknowledging Obamacare has been a disaster for many Americans, they will be yelling in an echo chamber, convincing themselves that this will be the GOP's downfall and getting it completely wrong.
5
@AACNY
NY provides reasonable coverage; I know because I administered benefits in every State where my corporate employers had employees. NYC was very generous with benefits. The answer to ACA problems is the same remedy Congress uses to amend and improve legislation already passed. There is a lot of hysteria, hyperbole and propaganda running through Times comments. The GOP won't 'fall' if it actually succeeds in repealing the ACA, (not likely). The GOP is a Minority Party using all the tools it has, none of which will succeed legal challenges in Court. It might scrounge a few more votes; it will remain a Minority Party. We are witnessing the last gasps of old GOP Party hacks.
1
I will never understand why people want to refuse health care from others. How does it negatively effect someone with insurance when their neighbor, friend, or family member has health care from the ACA? Why refuse someone health care? This is just mean!!!
2
There’s no problem if someone else is paying for it. For example, I will never suffer damages from a hurricane so I believe that every building in areas that may be affected, should be insured by the government, at an appropriate cost so that the government doesn’t lose money. But those living in the affected areas want someone else to subsidize their insurance coverage.
@Richard Winchester
How about drought and flooding which impact Iowa? Hurricanes are much rarer than the above. Are we one country with a Central Federal Government or not? Do we rely on the Government when major catastrophes strike? Yes, we do, because no single State has the resources to cover them. It is better to subsidize needed insurance than to have individual taxpayers support all those who have suffered a major economic loss. I think we call it The Social Contract; it has stood the test of time. The Government is not a for profit business; it serves all of us, even those whose income is too low to be taxed.
1
This is the number ONE issue why I have had it with republicans. When, as a political party, you want to take away health care from Americans, that party will be responsible for the death of those people when they die as a result of that. Obamacare saves about 40 thousand people a year according to the statistics, people who otherwise would have died without access to health care. So wanting to take that away makes you a killer. Plain and simple. Health care is a basic human right. Over the last years, I have ditched ALL my "friends" who vote GOP. ALL of them. And mainly for THIS reason: Their desire to get rid of the ACA (Obamacare). I don't want anything to do any more with people who favor tax cuts for the wealthy over saving American lives. Or want to ditch it only because it was Obama's greatest accomplishment. DONE with them.
8
O'Connor was a hero in this area but a vital part of the corruption in the Northern District court in Texas. Nearly 30,000 innocent investors had their assets stolen in a sham SEC action to drive a successful and compliant investment company out of business. This, after 3 separate jury trials resulted in an innocent verdict for the company and its CEO. The judges like Reed O'Connor and Russell Nelms "have blood on their hands" and were instrumental in these crimes against American citizens!
1
SCOTUS, without term limits, underscores why the Senate should change hands:
Repeal and Redistrict
...against the will of the people. Because Corporations should have "free speech".
1
What is it with Trump and Obama Care? Leave it alone. What a farce--Trump tears down everything good and has no solutions. This is policy? The WP last week reported that 45 percent think Trump is doing a good job. Based on what?
4
And yet we have two dozen Democrats running for President that want to eliminate Obamacare and replace it with something they can’t agree on.
1
This from the president whose foreign-born wife spent nearly a week in a private hospital at taxpayer's expense for a "routine kidney issue" while any of us would have been sent home the next day.
One can only hope the first casualty in the destruction of health care for Americans is the death of the Republican party.
7
The Texas judge was right. Obamacare is unconstitutional and the people with a gripe didn’t suffer any damages. They’re just disappointed that Obama’s signature achievement is going away.
1
@Mark
All this hysteria is unwarranted. Over 15 million Obamacare enrollees are on Medicaid, which will not be affected. The subsidies are another matter. They were essentially a magically created $7 billion subsidy to insurers absent a Congressional appropriation.
If you have anyone to blame it's Obama who clearly didn't care what happened after he got his "big win". Obamacare was essentially a house of cards.
1
@AACNY - IF the ACA is repealed, every single piece of it goes away, including the Medicaid expansion. It also means that people can once again be denied coverage if they have a pre-existing condition, that insurance companies can drop you if you get too expensive (recission), that there'll be lifetime limits so that you can be dropped in the middle of your cancer treatment and a severely handicapped infant will run out of insurance before he's a year old. And that's just the start. Every single insurance policy in the country is affected by the ACA in many ways that most people have no clue about. They'd better hope they never have to find out.
6
@MegWright
Not if states vote to keep Medicaid, which they are doing. And as they should. Long overdue to decouple Medicaid and Obamacare.
1
This will effectively destroy many lives. The only upside is it will end the Republican party . When will this madness end ?
4
An actual repeal would spell doom for many Republicans. And I think they know it.
158
@jim hughes I agree. I'm betting trump privately hopes he is not successful in overturning the ACA; bad optics for 2020 when millions lose their health insurance.
13
If their voters are not mostly Republicans. Republicans voters will go broke paying for health care and still blame the ACA.
10
jim hughes,
The fact that the Republicans are TRYING to repeal the Affordable Care Act should (and hopefully will) spell doom for the Republicans.
They've been trying to repeal this since its inception. The only way to protect healthcare for all Americans is to vote out as many members of the Republican party at every level.
28
What a mess they will have if they win.
4
https://www.nytimes.com/interactive/2014/10/29/upshot/obamacare-who-was-helped-most.html
Found this 5 year old article that shows who benefits most from the ACA. I was really amazed that in '04, there were states where the uninsured rates topped 15%. Not so amazed at which states, but amazed nonetheless. Appears that the areas where people benefited most from the ACA were rural. Makes sense. Most people working in urban areas get insurance from their employer. OK, so Trump wants to kill the ACA. Who is he going to hurt worst ? Rural America. The same people who voted for the clown. Looks like the guy is riding on the horns of dilemma. Who does he hate worse ? Obama ? Or the 'uneducated' he claims to love so much.
6
@sheikyerbouti
Meant to write '14, not '04. Sorry.
Being myself 'on' Medicare, were I as selfish and mean as trump, I would hope that "barr, trump" (the 'law' office formerly known as The Dep't of Justice) wins its case 'against' the ACA … just for the schadenfreude'to come 'my way'' when the trump-republicans' replacement health-care 'plan' is revealed, once and for all, as no plan at all -- and 'the other half' of our country, realizing they've 'been 'had,' storm the administration's barricades (or at least demand impeachment of both trump and barr).
3
Thanks again, John McCain. The fight goes on. (I finally forgave you for putting a spotlight on Sarah Palin, after your ACA vote - never thought that would happen). Most sane Americans miss your courage, leadership, decency. Where are the rest of your like? I see no one, absolutely no one. I may have disagreed with you on some issues, but I would never question your motives. RIP, sir.
2
This country would be a lot better off if trump would spend more time learning how to be a president instead of always trying to get even with Obama's jokes about him at the White House Correspondents' Dinner in 2011.
6
Go ahead, Republicans. The sooner you show the entire country that there is no way you're ever going to relent on Obamacare, the sooner we can elect Bernie Sanders and force the system to move to Medicare for All. We need to convince more Americans, and there's nothing quite as compelling as the naked display of complete indifference to our health to make that happen.
3
This is one part of Trump's plan to "Make America Great Again."
2
Be careful what you wish for! Striking down Obamacare would be absolute political gold to the Democratic nominee, who can then run on reinstating coverage for tens of millions of Americans. A gift money can't buy!
2
We are just going to see the progress rolled back. Will I lose my insurance? Maybe. I’ve been uninsurable for two decades. People and politicians have such short memories about what things were like before ACA.
I will never understand why I am required to have auto insurance to legally drive. Or required to have homeowners insurance with a mortgage. But it’s a problem to be required to have health insurance.
644
@Elizabeth Prezio
You have to have auto insurance because your pockets are not deep enough to handle any number of claims against you if you get into a serious accident.
You have to have homeowners insurance because your pockets are not deep enough to pay back your mortgage if your home is totalled.
If you don't have health insurance then if you go to the hospital everyone else has to pay for you. If you have been uninsurable for two decades no one is going to insure you unless it's junk insurance.
Multiply any hospital bill by ten to see what you would pay without insurance. My super-simple ankle fracture for tripping on uneven pavement would have been roughly $160,000 without insurance. My insurance company paid about $16,000. I paid roughly $2,000.
17
@Elizabeth Prezio. I don’t believe it is required in any state to have car insurance, or mortgage insurance. In Ohio, simply posting a bond with the state that covers minimum liability is acceptable, you aren’t required to buy insurance. As for a home loan, or any other, banks require collateral to cover your loan. Put up collateral, and the banks could care less if you have home insurance. My nephew, an attorney, had catastrophic health insurance. His monthly payment was $70 with a $10,000 deductible. Under Obamacare, he is paying over $700 a month, with a $4500 deductible. Guess which is cheaper, under any medical circumstance?
2
@ms
So the real problem is why, without insurance, treatment for a 'super simple ankle fracture'
would cost $160,000 in the first place. The
problem with the ACA is that it deflects costs
by subsidizing premiums that still get paid for,
one way or another. Astronomical premiums
(had we enrolled, about $3000 / month for two healthy people in their early sixties, just barely over the 'income cliff') which are justified as necessary to cover the exorbitant and extortionist costs of medical care in the US. As my mother would say, we are 'robbing Peter to pay Paul' through these diversions
that hide the true cost of ACA policies while enriching the insurance companies.
7
Citizens are a country's most important and valuable asset. Doesn't it stand to reason that our politicians would want our most important asset to be strong and healthy to improve the country's competitive posture and overall well being? Evidently not to those in the republic party.
4
Assume the ACA is repealed in its entirety - in WHAT WORLD is this going to help Trump and Republicans? And how is this going to help the millions of people who will find themselves without healthcare, or the enormous shock to the economy?
This is what happens when you elect the guy at the end of the bar who has a simple solution for complex problems.
7
Most consumers of health care do not know how to accurately assess the quality of what they are getting even though they might think they do. That includes judges. It is those who administer and deliver health care who know who are receiving the so-called standard of care. It is alarming that health care has become a political, profit driven and now legal football. I feel badly for the millions whose well being is largely secondary.
6
I am not opposed to people having access to healthcare with “identical plans” to myself for an extremely “low monthly fee” if any cost at all. However I am opposed to myself paying a $900 automatic payroll deduction every month and then a $7,000 yearly out of pocket expense deductible before the insurance co starts paying 80% of fees and services. And yes I pay this much and believe it or not many people pay much higher than myself.
If there would be no liability to myself I would be happy to submit to the NYT or any news organization a 2019 employer medical plan fee schedule and the country outside of California or even in California would be shocked, yes shocked. Many working employees are unable to afford company plans.
One working segment of the population should NOT be subsidizing free healthcare for many.
4
@Duomo Calmo
What good is coverage for pre-existing conditions if you cannot even afford to use your health coverage? That's not access.
1
Well that’s not what’s happening. I get your point, and your out of pocket costs are high. My employer chooses to pay my entire premium and I have a reasonable deductible. My pay is probably less as a result. But the ACA plans are just as expensive and the deductibles every bit as high as your own. While Medicaid is financed a variety of ways, people with actual ACA plans aren’t being subsidised by you.
4
@Duomo Calmo - That is shocking.... but.... if the US had a true health care plan that works for everyone, you would take out the "middle" structure of the private insurance companies. These companies are making a profit from the health care plan you have. That is one of the reasons the ACA is too expensive for people like you.
But that is the compromise that was made to get any sort of health care plan even passed at all under the objections of the Republicans.
If you had a properly-functioning plan, and people paid for their health care through proportional taxes with the very wealthy paying proportionately more, your contribution would not be so high because no one would be making a profit out of basic health care.
Big Insurance companies and Big Pharma make mega contributions to politicians and, shockingly, they get to write the legislation, not the elected representatives.
Yes, jobs would be lost but many others would be created and not-rich people wouldn't have to fear medical bankruptcy.
But taking the profit out of people's misery and misfortune seems, to some, to be "un-American".
3
The single most important aspects of the ACA are protecting people from being denied treatment because of pre-existing conditions and no lifetime caps on treatment.
To anyone here who is cheering the end of the ACA, I ask you this, how do you feel about those two things?
If your answer is that Repblicans would come up with a plan, they won't and they haven't. In fact, the one attempt they made to create a pathway to protect people with pre-existing conditions (which is pretty much all of us), laughably had a loophole allowing insurers to....you guessed it, deny treatment for pre-existing conditions.
Every one of us should be angry about having to worry about this again and again and again.
This isn't party against party. This is them against us.
23
To all you “secretly hoping” that this goes through so that Trump’s base sees what they’re actually voting for:
This would affect people across political parties, across age, race, and socioeconomic lines.
As someone with preexisting conditions who’s highest monthly expense is healthcare (premiums medications) this could put me deeply into debt while taking me off of medications that I need to be functional.
For others, it could mean the difference between surviving or not.
That’s terrifying.
It’s nice to see this as a political game piece, but let’s get back to reality, please.
14
@Margaret Fox
Even if the ACA doesn't get struck down, your premiums will continue to increase. Premiums were low at first for the same reason mortgage payments before the financial crisis were low. It was to entice people to sign up because the cost would be borne in the future.
Unless the subsidies keep rolling in from the government, people's premiums will continue to rise. This was made very clear by the Society of Actuaries report on the ACA. Funny how no journalist manages to get a health actuary on record about any of this.
1
It seems to me that the response should be fair and even handed to all sides. Those who are in favor of the ACA (primarily Democrats) should continue benefiting from it. Those who are opposed to ACA (primarily Trump Republicans) should be removed from it. Because the Republicans have promised to replace ACA with a better plan, I am certain that those who choose to lose their ACA benefits will soon have them replaced by a much better plan soon to be passed by the Republicans and signed into law by the President. These people are entitled to get what they wish for. What's not to like?
7
I thought my liberal friends were in favor of activist judges overturning legislative laws ?
There are two problems here ,the first is forcing Americans to buy a particular product is obviously and infringement of our liberties and unconstitutional.
However perhaps the greater disaster is allowing partisan hack judges on either side to set them self up as judge jury and executioner and overturn legislative law.
The disaster of allowing any of 500 unelected partisan hack judges with delusions of power, to overturn any legislative law or executive action is already a prescription for chaos.
This needs to be changed and the Judiciary needs to be tamed and returned to its lawful position as interpreters and not makers of the law.
3
@Bummero - forcing Americans to buy a particular product is obviously and infringement of our liberties and unconstitutional.
You mean like forcing them to buy auto insurance if they choose to own a car? No, it's not different.
You mean like forcing hospitals to pay the for the care of those who cannot afford to pay regardless of citizenship or legal status as required by Reagan's Emergency Medical Treatment and Active Labor Act ? And by hospitals I mean we who pay their bills as individuals and insurance companies that we we pay premiums to.
If you believe it unconstitutional forcing Americans to buy health insurance to cover themselves (to take responsibility for themselves) than you must also repeal the Emergency Medical Treatment and Active Labor Act so that people will be left to die if they don't have any insurance. Else what is the incentive for people to buy it in the free market if the hospital has to take care of them?
11
So tell me what's different about being required to buy car insurance. Isn't that an infringement on our liberties? It clearly is for the benefit of the citizens as is requiring health insurance. We all benefit.
9
@Bummero Well no. Requiring people to buy something is not unconstitutional. Do you drive. Are you required to have insurance? Is that requirement legal? This is no different. No one has the right, imo, to not have insurance and then, in case of illness or accident, go to the emergency room & then not pay. The ACA makes sense - that's why the Republican governor of Massachusetts started it.
7
Looking at it from another angle, if Obamacare does get struck down, then maybe those Trump voters who were receiving subsidies and end up losing their coverage may be motivated to vote for the candidate supporting Medicare for All and this move becomes a slam dunk for the democrats by default.
Or, there could be a behind the scenes deal being made with insurance companies to offer low cost plans to cover those 20 million and then it's a slam dunk for the Republicans.
Just remember that having private medical insurance doesn't mean that medical care suddenly became affordable....
7
That’s all well and good, but I don’t actually want to go into debt to pay for my healthcare in the meantime....
1
@doc007 Do you really think the insurance companies will still give the same cost amount benefit that people are getting from subsidies? That's what they want to make people believe. The deductible would be infinity and the out-of-pocket would be beyond. Any GOP plan is rife with tricks and turns that ultimately will not be good for the well being of this country. Most "slam dunks" don't need a backboard, and the GOP team may get the slam dunk by cheating, but they will miss all the other shots at society's expense without a backboard.
2
When the ACA was enacted, the U.S. devoted eighteen percent of it’s GDP to health care. The nearest developed countries, nine to twelve percent. What was worse, that proportion was forecast to keep rising. Now while that means lots of money following into that part of the economy, it does not represent more wealth being created. The vast majority of it is wealth being used up. Health care is a cost not a profit maker for the whole country. As a whole the system as it was, was living on borrowed time. Eventually, it would become too expense to use, for all.
That is what Republicans simply are refusing to consider. They are playing with things about which they have not yet become aware.
3
@Casual Observer. It was 14 percent of GDP. Predictably, by artificially shifting the demand curve for insurance, the total cost—and share of GDP—have increased. We can expect to expend a greater share of GDP under universal health care or expanded Medicare approaches, unless there is significant rationing.
No, it was eighteen percent and projected to rise much higher, in all of the literature presented at that time. We already have rationing, it’s called do not seek care until it hurts or you are bleeding ER care. Health care contributes to most personal bankruptcies.
1
That healthcare has become so politically polarizing is both alarming and a shame. For all intents and purposes, millions have no voice in the matter, and are at the whim of politicians and the courts. In some future, ideal world, healthcare would become part of the Bill of Rights, its form and function would become universal and people would no longer have to fear potentially losing it.
14
Why not come right out and state the obvious.
The insurance companies are the ones behind fighting the law yet it's never directly mentioned, either in the articles or the comments section.
The insurance companies' bottom line is the only reason why ACA is being fought.
16
It isn’t mentioned because it isn’t true.
This is the GOP and Trump, all the way.
When someone has an emergency, they don't have time to shop around for the best deal on care. For this reason alone, health care is not an industry that can strictly be delivered by the free market without serious distortions in the marketplace. That's why Medicare for all works in every other advanced economy. It's about extending the right of health care, not the right of profit!
15
@Bosox rule Your argument is incomplete. It suggests that health insurance in this country is for catastrophic care only. When you and I am sure most reader know from personal experience that healthcare insurance is used much more broadly, from everything as minimal as a physical and flu shot to as extreme as cancer.
And by the nature of how we use health insurance, the minimal use case is far more current. How many time have you gone in for a check up or flu shot relative to life threatening treatment and care?
Most people do in fact have time to choose for the vast majority of health services incurred under health insurance.
You have as much time to shop around as with car insurance.
1
The interesting question is what position the ending of Obama care would put the major health insurers in. I suspect many fear that outcome.
3
I wonder how many who voted for trump in 2016 have benefited tangibly from some aspect of the ACA, whether by (1! the ban against pre-existing conditions exclusions, (2) the ban on benefits caps, or (3) the ability to purchase health care coverage at all?
15
“If the appeals court ultimately decides that neither the House nor the intervening Democratic states have standing and that the case has become moot, it could either let Judge O’Connor’s ruling stand or vacate it. In any event, the losing party will almost certainly appeal to the Supreme Court.”
Lawyer here - hard to see how the appellate court could vacate the lower court’s ruling if there is no standing for the appeal - the plaintiff wins if the Attorney General does not defend and no one else has standing. If the defendant defaults, the case is not moot.
@John Erickson
Millions will not lose their coverage. Insurance rates will go down and the Democrats and Obama do not want that.
Insurance rates will go down for healthy folks. Millions will lose their coverage due to being price out of the system, and, if they have preexisting medical conditions, will likely be kept out of the system.
4
''It was filed by a group of Republican governors and attorneys general against the federal government''
No.
It was filed against a bunch of really sick people who need affordable health care.
25
If Obamacare is struck down before the 2020 elections, Trump is toast and the Republicans can kiss the Senate goodbye.
25
Not likely. True American patriots NEVER get sick. If you are sick it just means that you have abandoned true American value, personal responsibility.
1
@Diane
A small upside given the suffering it will cause in the meantime.
@Diane
It isn't as popular with people in the middle who have to pay as you think. If Trump comes up with a better plan then democrats and their coverage for illegals are toast.
And the Republicans health care plan is fleshed out and ready to go in case the ACA is struck down, right?
33
@Jim, right, but it will be called the RPC: Republican Population Control plan.
3
THE SECRET ORIGINS OF THE TEA PARTY [TIME] How Big Oil and Big Tobacco Partnered with the Koch Brothers to take over the GOP
--“Over the years, Rich Fink, Charles Koch’s political adviser, and his various Koch protégés have occasionally talked publicly about what would be needed to take over one of the two national political parties from the outside and place Libertarian, free-market principles at its center.” The Kochs spent a billion dollars of dark money to purchase the republicans and put them into office. The republicans are a wholly owned subsidiary of Koch Industries.
Trump and the Koch Brothers Are Working in Concert They disagree about trade, tariffs and immigration, but don’t be fooled. Neither side can get what it really wants without help from the other. [NYTimes]
President Trump and the Koch brothers have made it clear that they don’t like each other. Politically speaking, they are in fundamental disagreement over trade, tariffs and immigration. Nonetheless, there is a functional Trump-Koch alliance, and the Republican Party has capitalized handsomely on it. Trump’s racially freighted, anti-immigrant rhetoric has been essential to persuading white voters to agree to Republicans’ long-sought tax and regulatory policies. These policies are inimical or irrelevant to the interests of low- and moderate-income Americans. They have been promulgated by the Trump administration and have been meticulously prepared and packaged by the Kochs’ massive political network
16
@Pray for Help
Here are just a few excerpts of the Libertarian Party platform that David Koch ran on in 1980: Then take a look at what the republicans are doing! The republicans are a wholly owned subsidiary of Koch Industries.
“Abolish the Environmental Protection Agency”
“Abolish Medicare and Medicaid”
“Abolish the Social Security system”
“Abolish welfare, relief projects, aid to children and ‘aid to the poor”
“Abolish government regulated schools and compulsory education”
“Abolish compulsory insurance/tax-supported health and abortion services”
“Abolish the regulation of the medical insurance industry”
“Abolish all taxation”
“Abolish minimum wage laws”
“Abolish the Postal Service”
“Abolish the Federal Aviation Administration”
“Abolish the Consumer Product Safety Commission”
“Abolish the Federal Election Commission”
“Abolish the Food and Drug Administration”
“Abolish the Department of Energy”
“Abolish the Department of Transportation”
“Abolish the Occupational Safety and Health Act”
“Abolish all public roads and national highways”
“Abolish requiring safety belts, air bags, or crash helmets”
“Privatization inland waterways and control of all water"
“Abolish all lending laws”
“Abolish all branches of the service except the Army”
2
@Pray for Help, indeed, pray for help. You nailed it! This and a multitude of other things are being done in the face of all American citizens and we have been to brainwashed to see it. I hate to say this, but the American people are to ignorant and cannot VOTE (citizens have the power) for their own best interest. The Republican party controls a large part of the population on single issues such as abortion, gun rights, extreme religious values and white peoples fear of others. Our country has lost it's own value of humanity, we are in very deep trouble. But all this is lost anyway since our Government can't even start to adapt to the implications of climate change. Talk about sad.
4
Along with Bernie Sanders, Tulsi Gabbard, Elizabeth Warren and other democratic progressive candidates AND the rest of the western industrialized world, the solution to America's healthcare problem is standing right in front of you and been there for decades, yet, continue to haggle about the small details and you have been haggling about all of this since Harry Truman was President "without" any resolution.
Is there any time before the very important next Presidential election that you are finally going to wake up from your deep "slumber' about this issue America, dispatch Republicans once and for all from office and FINALLY elect those whom are unencumbered by corporate dollars and are actually committed to do something about it??
You are running out of time.
13
@Deus Small details? Millions of people losing insurance coverage? End of protection for people with pre-existing conditions?
3
@Jack Toner, did you read the article?! Refusing to cover pre-existing conditions was common before the ACÁ, the Republicans want to help their donors in the private healthcare industry with that! Millions of Americans will lose their healthcare. YOU prove otherwise, we will wait for your answer!
2
@Jack Toner
When far too many Americans are worried about labels i.e "single-payer socialized medicine" rather than the actual policy and how it is to be implemented THAT is what I mean by the "small details" and the Republicans have been using that scare tactic for decades.
I will repeat, ignore the noise and elect those whom will actually do something about it!
2
If the GOP gets its chance now since they couldn't kill it over the years they tried, with the loss of care for millions, and ending the care for pre-existing conditions and unlimited costs, and unwarranted deaths which the GOP campaigned upon that it wouldn't happen, they will pay the price at the polls in 2020, including but not limited to the House, Senate and Trump!!!
7
Do the Republican never give up on getting rid of the ACA? They have spent all of their time trying to shove it to the people who most need Health Care without any way to get it except the ACA.
I hope some Judge can make sure that this lawsuit is not only worthless, but demands that the ACA is improved. Maybe, just maybe, a judge who never had healthcare when they were young, or who has a preexisting condition themselves.
10
I agree. It is a lot like the endless efforts to remove Trump from office. Imagine what Democrats could be doing instead.
@Richard Winchester
Trust me, the Democrats are doing a lot.
Not to mention they have a great slate of Candidates to run for the Presidency.
3
It's always, always about shoveling money uphill. Nothing else. It's not about race. It's not about class, not in any constructed manner. It is only greed and consolidation of wealth.
Republicans honestly do not care who you are or what your situation is. They only care if you stand in the way of shoveling money uphill. If you are someone with a pre-existing condition who can only be fixed through a government program? Drop dead. If you're a poor retiree, or a single mom struggling to make ends meet? Go hungry. Get out of the way. Money must move up.
A note to the millions of middle class Americans who vote Republican: you are not special, and you are not exempt. Your position is far more precarious than it feels, because you, too, are the beneficiary of public largess. It might seem ok now, because a bit of money is shoveled uphill to you en route to the top. But when life deals you hard times, and you impede the flow up, you'll be culled, too. The "conservative" philosophy does not care. Money must move up.
28
The photo of demonstrators that accompanies this article contains an interesting depiction. Look at the woman holding a sign on which she claims that ACA opponents are "killing me". She appears to me to be over age 65. As such, she would be on Medicare and therefore, preserving ACA would not affect her health, nor would ending ACA kill her.
Regardless of your preference regarding ACA or other alternatives, that woman appears to be using falsehood to advance her political agenda.
5
@Errol
Maybe she has children or other relatives. Maybe her sister is self-employed, or her children are currently unemployed. Maybe it's the right moral choice.
I have work issued insurance. I am over 65, so I will be able to buy Medicare when I retire.
I had an ACA policy for several years and it made a huge difference in my family's access to care. And I believe that maintaining it at the present is a moral choice.
12
@Errol
If the ACA was deemed invalid, though I am over 65, my current employer-provided health plan could have a lifetime cost limit, could demand cost-sharing for all charges and could skip paying for pre-existing conditions. Among other things.
7
@Errol, not really, if the Republicans successfully kill the ACA, their next targets will be Social Security and Medicare. She can see the future, you cannot.
PS, could you enlighten me to the "other alternatives"
4
Donald Trump and the GOP think only the rich should have access to healthcare. This is what is known as a FACT.
11
Most of Trump's executive actions have been aimed at destroying everything that Obama created. Without Obama's actions to guide him, I wonder what Trump would have been able to devise on his own? Since taking office, Trumo has not created one thing for the good of most of the American people (and, please, don't bring up the economy, a boom that enriches the wealthy & corporations & allows the rest of us to enjoy a meal at the table...until). The economy was a gift from Obama who did all the heavy lifting when it had been driven to its lowest point.
What good does it do to take away health care from people and, after decades, not have a plan in place to help people who cannot afford to pay for medical or dental expenses out of pocket? Why destroy it? Why not improve it instead? Because it's called Obamacare?
But these people who voted for him will continue to manipulate their less well off base to foam at the mouth about immigrants and to foment fear and hate, to believe that their racial superiority will be restored. And that is enough.
16
The US stands alone among every industrialized nation on Earth without medical insurance for all.
15
Republicans had two years of total control—the White House, plus majorities in the Senate, and House.
In that time, they developed/proposed absolutely nothing new in terms of health care.
Likely because Ryan and McConnell knew voters would not be happy about losing the law’s popular provisions, and many people would lose their healthcare entirely.
ACA has been law of the land for almost 10 years. I have no problem with making whatever policy changes would make it better, but it seems like the worst sort of foolishness to eliminate it, when there’s literally nothing to replace it.
15
Whenever I read a frightening major story like this -- cancelling the ACA with no replacement -- I slip into magical thinking: AT LAST conservatives will wake up and reject their leaders who are trying to take away healthcare. And then I flip over to the Fox news website and guess what? This issue is not even a topic. Not worthy of one iota of digital ink.
When the demise of the ACA occurs, a good chunk of the country won't even know it happened.
16
The "The Industrial Medical Complex" will not let Obama Care fail.
Obama Care insures their continued existence.
If Obama Care is struck down the cry for single payer will be deafening.
5
@Richard Fried, I think "The Industrial Medical Complex" is the driving force (along with the insurance industry) behind the death of the ACA. They are counting on their inestimable wealth and politician's greed to prevent single payer.
1
This is why the trump party "wins" (and the country loses): nothing stops them, not even the Supreme Court. Laws, truth, court rulings, decency (ha!), morals (ha ha!), are mere gnats. If they want an election, they steal it; if they want a war, they invade; if they want to target a specific ethnic group for dehumanization, nothing holds them back, certainly not the American citizenship of millions in that group. What do the Democrats do? Be patient, walk slow, move on. While we are accelerating toward irreversable climate change with no preparation, the trump party takes everything they want--land and money for the .01%--and the Democrats shuffle paper and feign outrage. While we accelerate toward authoritarianism and one-party rule, Nancy Pelosi plays villain on TV and pretends to have an "agenda" she's protecting.
Striking down the ACA is yet another move toward a Social Darwinist society with no protections for health, environment, workers' rights and safeties, education, consumer protections. Hate your neighbor is they're not like you, and every man for himself.
9
Natural selection does not favor magical thinking. It likes imagination, but thinking of reality without the unpleasantries is high risk.
I think we have to go back to the design of the ACA. The individual mandate was passed as a tax; it was Obama's only option to have the ACA signed into law and it was Justice Robert's interpretation that allowed this passage. As a self described constitutional law professor, Obama should have seen the weak footing of this bill; it's only law because of Justice Roberts. When you look at it in totality, Obama and the Democrats are partially to blame for not providing a more solid constitutional argument for the tax/penalty/bill. The Republicans are mostly to blame for their antipathy towards the sick.
4
@I Heart
Obama could now be a case study in how to do big things that don't survive his presidency.
@AACNY Hmm. And Trump could be a study on how to promise big things and never follow through.
At least many of Obama's initiatives did come to fruition.
3
@AACNY
Trump is a case study in lying about big things never accomplished; a case study in bragging, conceit, lying, incompetence, and the complete lack of any governing skills. He uses AF One as car service to his private Club in FL, a chartered plane following with SS agents, cost estimated at 1M per trip. We pay for his golf carts; we pay for Melania to fly back and forth to NYC. We paid for his trips to England and Scotland. The question regarding Trump is will we survive His Presidency. We survived Obama just fine; his legacy will be decency and honesty.
Leaving the US, to live overseas, twenty years ago now seems prescient and wise.
I have affordable healthcare now – what will the rest of America do, I wonder?
9
This has little to nothing to do with economics or improving the lives of citizens. Trump is still getting even for Obama's comments about him at the White House Correspondence Dinner so he is still targeting anything passed by Obama for revenge. The GOP is still afraid of Trump, has never had an interest in a national healthcare program any more than they have had for Medicare or Social Security. And McConnell is all about maintaining his power on all things.
Just my opinion.
8
Although I agreed with Nancy Pelosi’s stance on impeachment until now, I would favor impeachment if this lower court ruling is upheld. I know that policy is not grounds for impeachment, but it’s clear that there are other grounds to do so. Every day this administration is in office is dangerous to the health and well being of Americans. Democrats paid a terrible price for passing the ACA, because of Republican lies about death panels, and more. The ACA has helped so many people, and is now popular for that reason in spite of Republican lies. I think the divisiveness of repealing the ACA would cancel out the divisiveness of impeachment, even without the possibility of conviction in Mitch McConnell’s Senste.
9
While I greatly appreciate the Dems' attempt to expand healthcare to more people, I can't deny that Obamacare has been a total nightmare for me and my husband. We are self-employed and our coverage through the ACA was awful. Very high premiums but very little coverage. A total waste of money.
The one thing that helped us was getting rid of the individual mandate. It finally allowed us to get decent coverage and not be penalized for buying insurance 6 months at a time.
I was SO disappointed to hear Joe Biden recently say he'd bring back the individual mandate. The ACA as originally created does NOT work for many, many hard-working Americans. The Dems need to find a better alternative instead of going backwards.
5
@shstl
It sounds like your family could use the "public option" and therefore stop paying insurance company profits.
Blame the insurance companies for offering poor plans not the government for failing to make them do better.
7
Just make sure you don't get sick. You will find that the insurance you purchased via Trumps "exception" will be problematic. And, if you develop a pre-existing condition and ACA is annulled, you will find that you won't be able to get coverage. Then, you will be begging for the "disaster" called ACA.
8
@shstl there are insurance plans for self employed people that are not part of the ACA you may want to look into. The mandate would not have penalized you. You were not required to buy ACA insurance if you had documentation of other insurance and that insurance met the minimum standards. You are complaining that the sub-standard insurance you purchased would have gotten you penalized but that the ACA insurance coverage was awful - that does not add up. It just sounds like you just want cheap insurance regardless of what is covered.
7
As an American expat living in a social democracy I am struck by my neighbors shock at the United States government.
They can’t understand why a wealthy developed democracy would not consider low cost health care and education as a right of all citizens.
They are sorrowful at the selfishness of the American government denying these services to tax paying citizens.
26
@Michael Kittle Maybe you're being disingenuous in your comment, but I'll bite. It isn't the government's selfishness, it's the people who vote for the people in the government.
@Sidney Rumsfeld
You are correct, ultimately, it is the voter that elects those that make policy. The only problem is, America has the unfortunate distinction of money and lobbyists being so powerful that the politicians serve strictly the interest of their donors at the expense of the wishes of their constituents. Poll after poll confirms 70% of Americans want a single payer system, yet, they are ignored by the majority of their reps.
Pick the representatives unencumbered by lobbyists and you will get that change you are looking for.
2
The outcry about insulin being unaffordable will quickly become a lot of deaths when everyone on an ACA plan starts having to pay $1500-$2000 a month for their meds.
Back before the ACA (2008-2009), my husband and I were unable to get insurance and the months we had to cover our expenses racked up an easy $1800 a month for Type 1 diabetic meds and supplies.
The cost of medications is just barely being controlled by the ACA, and without it lots of people will simply slide down the hill, rationing their meds and compromising their lives and health: because they don't have the money to pay the extortionate prices.
I guess that is one way to get rid of the Type 1 diabetes problem: refuse them drugs and treatment they can afford.
17
@Betsy B: It was the REpublicans who made medications so expensive under the ACA. Rmember that when you vote.
4
I'm still trying to comprehend the Republican rationale for killing the ACA. It's been with us for nearly a decade, and while decidedly imperfect it's supplying much needed basic insurance to millions of people who didn't have coverage before. Moreover, if Republicans really cared about providing an improved package, they could easily have supplied one. Only conclusion to be drawn, is a kind of mean spiritedness. Why they would tar themselves with such a brush is mind boggling. But that's the story they're letting be told, and it will eventually kill the party--one can only hope.
22
@Dwight
Millions of Americans don't appreciate being forced to buy something so expensive that they can no longer afford to use their health insurance. Their access has actually diminished.
In other words, democrats didn't solve these problems, they just shifted them onto different Americans' shoulders. These Americans are not happy, are entitled to have their concerns addressed, and they vote too.
1
@AACNY It wasn't meant to be expensive. Blame that on the insurers. Obama did what he could but he was hamstrung in many ways by the GOP.
5
@AACNY
The only option insurers gave Obama when he wanted to expand coverage to millions of uninsured was to allow insurers to set the Premiums. The insurers raised Premiums, and will continue to do so, at will. Employers have dropped broad health insurance coverage, including some large corporations, unless mandated in certain States. Insurance lobbyists dominate some members of Congress through campaign contributions. Publicly financed elections would get rid of that; insurers would lose the power they now have, because those committed to public Plans could be elected. Professional claims managers whose jobs would not be to make a profit for a private business could be hired.
Republicans and conservative think tanks offered up the ‘mandate’ to avoid a single payer government system for funding universal health proposed by the Clinton Administration. The ‘mandate’ was implemented in Massachusetts. It assures that the health insurance market retains a broad and huge population of enrollees that keeps the system from becoming unaffordable as healthy people drop out.
Health care is necessary for people to live out their lives in optimal health, it’s not optional when it is sought and providing it is mostly not optional, either. There is no such thing as a free market when it comes to health care, and any realistic person knows this. Pretending that people are free to choose when they are not is lame.
By outlawing the ‘mandate’, the Republicans and conservatives are making controlling the costs of the ACA a problem but this assertion that the whole law is unconstitutional because the ‘mandate’ is not enforceable is kind of a stretch, logically. It’s more of a Trumpian sort of display of childishness, “you can’t make me”, by Republican elected officials act. The point being that the law offers people affordable insurance which the private markets just cannot by imposing regulations upon a portion of that market. By ending it, it leaves society with two choices, health care that covers everyone but at unaffordable costs or a single payer system which completely controls health care funding of all non-elective health care.
12
The AHCA certainly resonates with voters and others that believe health care is a right. In this regard, UChicago economist and Hoover Institution Fellow Thomas Sowell (Obama's enlightened counterpart) has framed the problem intelligently. Unfortunately, Obama was advised by those less capable in economics and policy. As a piece of legislation (2,000-plus pages, never even read, let alone deliberated) it is utterly flawed--if you actually read it. It is not about health, health care, health costs, science and technology, or any relevant issue related to human biology, except a rather mendacious targeting of cognition (such that it is) and apperception motivated by class agitation, taxation and party registration. It is not a public policy framework. The AHCA, or "Obama Care" will be repealed and replaced. It is an inevitability if only in economic terms, as it was not not thought through financially, on either the demand or especially, the supply side. As Sowell said, being intelligent is fine, but you still have to stop and think. See his book "Intellectuals and Society." That is the provenance of the AHCA.
I believe they were aware of these limitations but politically had no other alternative. They did not have a willing partner at any step of the way, so the Obama administration took the only path available.
13
@Matt Andersson "The AHCA, or "Obama Care" will be repealed and replaced" except there are no plans to replace only repeal.
7
@Matt Andersson
https://www.nytimes.com/2015/12/10/us/politics/marco-rubio-obamacare-affordable-care-act.html
It would have been nice to see the ACA work as designed. You can thank Marco Rubio and the Republicans for making sure that we didn't get that chance.
11
This is classic example of why conservatives vote against their best interests. The "threat sensitive" brain prioritizes their fears over everything else. In the case of the ACA, hatred of someone who doesn't look like you (Obama) and Government are two manifestations of the sense that everyone is out to get you, the most common symptom of paranoia. Thus, ridding themselves of those fears takes precedence over keeping their health insurance. Few people seem to grasp this root cause of why they think the way they do. The fear is a remnant of evolution, useful during the first 50,000 generations of humans, but not the last 500.
17
@Gery Katona
This fear has been stoked and manipulated by Republicans. It’s the same fear that makes so many of us think we need guns to defend ourselves against some unknown menace in our fellow citizens. I’m old enough to remember that fear wasn’t there years ago, when I grew up in NYC, and depended on the police to protect me, rather than gun ownership. I still do, and BTW, nobody has ever shot at or near me.
4
"[Kaiser] has estimated that 52 million adults from 18 to 64, or 27 percent of that population, would be rejected for individual market coverage under the practices that were in effect in most states before the Affordable Care Act."
Despicable.
23
@S.
I was rejected, not because of MY pre-existing condition, but because my FATHER had colon polyps. I applied with three different large providers. Nixed by all.
You do not have to be ill, just a first degree relative.
14
@Betsy B I wonder how an insurer (even pre-ACA) could ask an applicant about someone else's history.
@swampwiz
Common insurance practice to access medical history of immediate family members. Some medical problems are deemed to be genetic, inherited. How that plays out depends on the State in which you apply. You might have minimum coverage okay in one State, but not accepted in a different State.
Impossible as it seems, this Trump administration just gets worse daily. Who knew the militia took over the airports in 1776! And Trump’s AMAZING record on climate control and environment! That was news to me as well.
10
IF YOU VALUE YOUR MEDICAL CARE, Trump's effort to destroy Obamacare in court without any plan to replace it, may get legs and walk slowly to the Supreme Court just in time to place the healthcare of millions of people--including of many of Trump's supporters, to be a major issue during the 2020 election. He's made other claims of having "terrific" plans without producing them. In fact, one time it seemed like he took an envelope out of his suit pocket that appeared to have a blank piece of paper in it. Some plan! But you'd better believe that Trump's tax rip-off of the 99% was written out in full! He's only interested in what will benefit him financially--him and all of his rich cronies!
15
The Republicans want to lower the cost of health insurance. What better way than to only sell it to people who aren't sick.
Surprising that when it comes to health care the religious right has completely rejected intelligent design for natural selection.
13
Absolutely disgusting that in 2019 we are discussing reversing the marginal protections afforded by the ACA. What's needed is a shift to abolish the dreadful privat3 health insurance industry. Notably, I have argued in the past that this wasn't feasible given US politics. Now, I'm arguing it is necessary given US politics. The private sector is not a place for health insurance. Single payer, universal coverage is the only answer.
8
@Tony Robert Cochran
Agreed, but if you don’t give people the option to keep their employer-based coverage, you’ll lay yourself open to more Republican lies about “Death Panels,” and you will lose the election. People want to choose, not be coerced. Single payer coverage such as the Medicare with Gap coverage (NOT Medicare Advantage) is what I have now. It is better and easier to have than even the excellent employer based coverage I had while working. But the market will work that out, believe me. Just don’t impose the choice.
1
@FreeDem I can agree with that. Eliminate it by squeeze.
Social Security wasn’t perfect. Medicare wasn’t perfect. They were never intended to remain as they were when they were introduced. It took years and modifications to make both programs successful.
The ACA...same deal. It was introduced to get medical care for all moving. That’s all it was. There were design flaws but that wasn’t unexpected. The ACA was a start.
Republicans have been after Social Security and Medicare for years. Because it wasn’t their idea? Because it would benefit all those takers who also are a large part of the Republican base? Could never understand why older voters don’t understand this.
So now Trump want’s to eliminate coverage for 22 million Americans because, somewhere out there floats his better idea?
The ACA needs fixing. The framework is sound but wobbly, however, at least there is a framework to work with. Democrats, as with SS and Medicare, (and without republicans), could take what’s there and do some patch work. Then in the battle of, “you’ve seen ours, now where’s yours”, it would be a winning issue.
I like my Medicare and the government can keep it’s filthy hands on it forever. The ACA can be in the same category, but you need to get to tweeting.
19
Trump will oppose anything that stands to benefits the public with no regard to its dire implications. It is more about manifesting the power his position allows, thus, defying any adventegous ruling the former administration accomplished. Altogether, the president continuous to choose a harmful trajectory the kind that would benefit us all when stopped.
9
This article does not bring out the absurdity in the pliantiff's position. What is being claimed is that the Congress did not intend to have the law survive the elimination of the mandate even though that is exactly what it did. There would be no reason to worry if we still had a judiciary that is anything more than an arm of the Trump dictatorship, but we do not. Thus I who have a pre-existing condition of congestive heart failure and would die in months without the ACA will be leaving the home I own and the family I love to work and live in Asia where I will be provided health care. I am a refugee of the Trump dictatorship. I feel great concern for all of those who will die because they have no where to run. Trump will go down in history both as the executioner of the Constitution and as the greatest mass murderer in American history.
22
The amicus brief on severability is compelling. Its rationale should be adopted by the Fifth Circuit, preserving the bulk of the ACA statute, if it accepts, as it should, the standing of the intervenor states.
2
Undoing the hundreds of man-years worth of work required to bring ACA into fruition - without a clue of what, if anything, would replace it - is bad enough.
Undoing the legislation without even understanding the contents of it is inexcusable.
Unwinding healthcare for 20 million people to satisfy ideologues is to commit a certain number of those to a needless death. How far does the GOP bloodlust go?
27
Further, we have to look at the reason we have so many sick people in this country. Big Food - our corporate food and agriculture system - plays a large role in this. The way in which we produce conventional "food" in this country is toxic for people living near conventional farms and those eating the food products concocted from them. High fructose corn syrup plays a big role in obesity, and meats from factory farms contain much higher levels of Omega 6 fatty acids (and lower Omega 3's) and can lead to a host of inflammatory diseases.
Supermarket aisles are filled with processed foods that do little more for health than appease taste buds and fill the stomach. Unless otherwise marked as pasture-based, assume any meat you buy in a supermarket comes from a factory farm where livestock are fed an appalling diet that may be laced with heavy metals, antibiotics, hormones, and more. More on that here: http://bit.ly/2YS3veY
This just skims the surface of this problem and even tackle health issues caused by other polluting industries.
The problem is complex and goes way beyond the ACA. Corporations rule the roost in the US and everything is valued according to its economic worth. We have lost the ability to value the health and well being of people and the environment above economic vitality. Ultimately, we will lose that economic vitality because of this short sighted thinking.
When we can start connecting the dots, we'll start to move towards becoming a healthier country.
11
It would be useful to ask why we've allowed hospitals to become (raveningly effective) for-profit ventures. At one time, hospitals were non-profit, and the difference that made to healthcare costs is measurable and can be documented historically. Asking why we don't move to a model in which the whole of the US healthcare market bargains for drug prices as one unified buyer is another worthwhile question.
Dorothy Day on capitalism:
"Our problems stem from our acceptance of this filthy, rotten system."
We can't even muster the political will or pool enough individual courage to insist upon meliorating its worst predations-- or make the most humane use of the asymmetrical power it presumes and sustains. The wealth gap widens, more people's lives are wasted in meaningless labor apportioned now over two or three jobs that offer no benefits and no prospect for development of the worker's real potential for creative activity or for the economic security that would support the pursuit of that activity outside work-- or make it possible for parents to spend meaningful time with their children (hard to fit in kids with those two or three never quite full-time jobs).
And that doesn't even begin to consider the healthcare crisis that is already one of the consequences of our failure to address climate change. That failure, too, is a consequence of our acceptance of this filthy, rotten system. Heaven forbid we sacrifice economic growth and profits to keep the planet healthy.
17
Can you imagine the mess we would be in if we didn't have the Republican Party's leadership as the moral conscience of the United States?
9
@HANK: You are joking aren't you? We are living it with useless wars in Iraq and Afghanistan, the attack on Government medical care, the attack on voters rights and the attack on the environment. All brought to us by Republicans.
2
@Jeff
Yes, I forgot the "Wink, wink." Which means anyone who is still supporting this president is in moral crisis, using faux morality as a cudgel. No such person could speak to me with any moral authority.
2
Excellent article—clear and to the point about what’s at stake. Everyone should reread the last few paragraphs about implications for keeping your kids 18-26 on your coverage and more.
12
@Big Ten Grad Reality Check making it possible to force parents to purchase health care for kids up to age of 26 made it possible Two things one in case of expenses there kid has accident an has no insurance an ends up in hospital with huge bill the parent who didnt insure kid is reasponsible for bill to age of 26. Dont be fooled into beleiving they doing for our benfit parents arnt off hook .
1
Sure its replacement will be the "most terrific health plan" in the history of the world.
6
@Mannley Trump promised that big beautiful plan just after he met with Fredrick Douglas and was debriefed about the Battle of Bowling Green-in other words, it was just alternative facts or blatant lies.
2
When are the American people, including the left, going to wake up and realize that the private health insurance industry is an even worse cancer on the American body politic than Donald Trump? Trump came and Trump will go (presumably) in 2020 or 2024. The private health insurance industry has been metastasizing for generations.
It may be tempting to support the kind of private/public insurance mix touted by the likes of Joe Biden, given the popularity of such programs in most other wealthy, democratic countries. But the U.S. is different. The private health insurance industry has been allowed to do too horrific a number on the American people for far too long. I don't think it's redeemable. Wait a couple of years and watch when it tries to kill any kind of "public option" or "Medicare for Those Who Want It" supported by Biden, Buttigieg, etc.
It's time to implement "Death Panels" all right - for the private health insurance industry.
13
@Steve Like many countries, we could have government sponsored universal health insurance (like Medicare) and heavily regulated private supplemental insurance (also like we have with Medicare). Thus, we could contain private insurance to a smaller role in health care. Losing their stranglehold on the main system, they could compete for profits in the secondary market.
1
Will R's come to feel like the dog that caught the car it was chasing? A key reason the R's lost the House in the midterms is because they were hammered on health care. How will this help them?
7
If any federal appeals panel thinks that this country can eliminate a program that has provided health insurance to 20 million high-needs Americans, and which has been the law of the land for a decade now, then I want whatever it is these judges might be smoking.
14
What I don't understand is why don't the GOP want us to have health insurance? Also why are the people who benefit most from the ACA in states that are suing to have it repealed?
16
Politicians are bought off by health industry donations. Corruption is the definition of the GOP.
4
Get ready for more Go-Fund-Me pleas, bake sales and carwashes to help support those in dire need to buy insulin, support chemotherapy, etc.
I am disgusted by what this country has become. Is it time to start separation discussions? We are so divided in philosophy on what we see the purpose of government and social safety net. Maybe it's time to actually divide.
20
The basis for the judge's ruling is, I gather, that it is unconstitutional to require a citizen to buy insurance?
But, in every state I have lived in, we were all required by law to buy a basic level of automobile insurance. Why isn't that unconstitutional?
And the irony here is that the requirement that everybody get insurance is the only way that universal coverage based on commercial insurance companies is economically viable.
If the Republican kill off the mandate then the *only* alternatives will be either millions of people without any coverage or a single payer health plan based on taxes (or have we decided taxes are unconstitutional too?)
24
@Engineer The argument will be that owning a car is a choice. Not agreeing, just giving the rationale.
And yes, it is ironic that in their bid to kill ACA, the country is more likely to move toward single payer type system, since the Republicans have abandoned the idea of a workable replacement.
5
@Engineer
1. States are different than Fed Govt.
2. No requirement for car insurance in NH.
3. The Fed Govt is only allowed to do the specific things the states have allowed it to do in the Constitution. The states allow it to tax. It did not allow it to force purchases. States can do that to its citizens, and we can leave states that do that. The Fed Govt has LIMITED powers.
4. I'm greatly disturbed at the lack of understanding of how our Great Country is set up to operate.
1
I love when they make this argument. We have a choice to buy a car, which in most states, especially red ones that don’t fund public transport, we don’t really even have that choice. I digress, this highlights the reason all the more everyone needs health access. We don’t have a choice to have body. We don’t have a choice to go to a hospital in most cases. We know we will go through the medical system at least twice: at birth and at death, we don’t have a choice in those. We cannot predict when or how kick medical care we will need. Hopefully very little, but maybe we get in a massive car accident and end up in the hospital for 30 days and bill in the 7 figures. Happens every days. These people are absurd.
6
It's astonishing that we are still having this discussion. Virtually every industrialized nation in the world has a single payer health insurance plan, paid for by taxation. These nations pay less for their health insurance, less for prescription drugs, and have better outcomes. There is variation in the national plans. Some run the hospitals, some don't. An intelligent plan for health insurance and care would combine the most successful aspects of other nations' systems and adapt them for an American plan. We've done that successfully since the beginnings of the Industrial Revolution.
The US system makes no sense from a business perspective, unless the businesses one cares about are the insurance companies, the medical equipment businesses, the drug businesses, etc.
It is bizarre that Americans think other nations' plans eliminate private insurance altogether. Almost none of them do. People with the means can purchase additional insurance for whatever they want. But there is a baseline insurance that protects everyone, often with no deductibles and co-pays.
The arguments offered by the supporters of the US systems--long waits for care, limited care, etc.--are mostly hogwash, based on no real evidence. This battle against universal health insurance is being waged by the lobbyists and the Congressmen and women financially supported by the medical industry in the US. This in part explains the high level of disinformation swirling about in this fight.
27
@Harvey Green
No, the battle is being waged by freedom-loving folk like me who recognize the LIMITED ROLE the fed govt has under our Constitution. Other countries are not the US. They wish they were as successful as us. This is about power and control. The left wants to control everything and have power over everyone, so they can stay in control.
@Tim Under your understanding of the feds limitations is Social Security constitutional?
4
Says the man with employer paid health insurance.
4
Standing is a procedural issue that is not uncommon. But virtually all standing cased involve the plaintiff’s right to sue. Here, the Appeals Court has questioned the defendants right to defend. That question almost never comes up. Defendant standing is an obscure legal technicality. Deciding the fate of the ACA based on this issue would be like deciding abortion rights based on some obscure medical study complex in 1875. If a court is going to take on a monumental issue it should not base its decision on how many angels can dance on the head of a pin.
5
For a moment consider what will happen to institutions that are providing healthcare, particularly for a lower income population who would be loosing any type of reimbursement without the ACA
Those that are struggling ( see Hahnemann in Philadelphia) will close and others who are just managing will cut back services
Patients without the ACA will increasingly use emergency rooms as their only care, and in case you haven’t had the pleasure to visit one recently they are already stretched beyond capacity and by the way the nurses are not sitting around playing cards.
I always find it perplexing that if someone is arrested they are entitled to legal representation even if they cannot afford it but access to healthcare to treat or prevent illness not so much
16
It is ironic to see the conservative Republican fighting Obamacare. Obamacare is Romneycare which was adopted when Romney was governor of Massachusetts. And Romneycare come from the Heritage Foundation a conservative think thank.
20
@Wilbray Thiffault
What the state does at its level is its business. The Conservative issue here is Limited Govt. The Federal Govt is only allowed the powers that the states gave it in the Constitution. The states gave it the power to tax. It did not give it the right to force people to buy a product they don't want.
Everyone pays something and stop with the penalties on people who can no longer afford the high costs. It was an unfair and growing burden on working people. There should be a sliding fee scale for everyone, not just some.
Deduct a portion from welfare and SSI checks and have people on Medicaid pay also. They can pay a fee dollars towards office visits and prescriptions. Why should they get free prescriptions, dental and vision coverage?The elderly who worked all their lives and the disabled who worked for many years all have to pay a monthly premium for Medicare and 20% of costs. Also a disabled worker has to wait two years for Medicare and must carry Cobra or private insurance in the meantime.
Obamacare has some good points such as covering pre-existing conditions but in return it was a cash cow for insurance companies. It forced people in the middle to be burdened with outlandish costs that could still bankrupt them due to a major illness or face high penalties. In the meantime Medicaid and free coverage for some expanded. A completely unbalanced system .
5
Medicaid is for people without the ability to pay for it. Quite simply, your requirement that they pay would mean that they cannot use it or give up food, clothing, or shelter.
5
ACA regulates private businesses, potentially making it unaffordable for those businesses, so it offers guarantees to assure profitability. It makes sense if one takes the whole in context. Universal coverage means covering all, not just the people who can be insured profitably. Remember that most people in financial trouble are so in part due to health care costs. The costs of an emergency room visit requiring tests like MRI or CAT scan or other procedures runs over $10,000. Without insurance that means big financial problems for most people.
4
@Hellen Republicans refused to bargain, negotiate or even come to the table. So this is what passed. Do you vote Republican? If it gets dismantled, look for a tidal wave and single payer to be implemented. Now that will be ironic.
6
Our US people would never accept the taxes required of other countries having universal care.
Everyone pays in those countries.
Meaning in our country the 60M on Medicaid would be required to contribute.
And anyone expecting timely access to care would have to carry supplemental insurance out of pocket.
4
@Dr. John
Exactly, a big problem in America is the continuing insistence that some people should get completely free coverage while others pay.
In a truly shared system everyone pays.
3
Um no. Because all other country’s spend significantly less than the US, the taxes necessary to finance those systems are substantially less than businesses in the US pay for employer plans. Also, not all countries have tax financed system. Many get to universal coverage in other ways. More importantly, in many such countries (Germany, Switzerland, France, Japan, to name a few) wait times are less than in the US and supplemental insurance is generally only used for things like private rooms or to eliminate deductibles and copay. You are generalising the 40 something democratic, wealthy nations with universal coverage when the reality is that no two of them arrive at universal coverage in the same way.
19
@Dr. John Many who are on Medicare do carry supplemental insurance for a couple of reasons-the co-pays and deductibles and to have medical coverage while out of the United States and its territories.
It has nothing to do with timely access. We are at the mercy of the provider.
8
The mantra that pervades and, is responsible for Obamacare is, HEALTH CARE IS A RIGHT for all Americans, and the law, though imperfect, goes a long way, to satisfy this "goal". The case brought by a number of "red" states that will be argued later today in New Orleans before the 5th Circuit is not only anathema to this philosophy, but is a result of some of the worst judicial analysis and writing by a federal judge I have seen in my 46 years as a health care lawyer. Superb scholars and lawyers agree per the friend-of-the-court briefs they have all written and submitted. The issues are set in a backdrop of politics, but when a case such as this one gets to court, there, hopefully, will be a different mndset than a politican chastising an opponent or the other political party. One element missing in the article is that---in complying with the court in its order mandating supplemental letter briefs to address the issue of standing, that is, do the states and the US House of Representatives that opposed the lower court's decision and even the case itself---it (article) failed to say that all parties agree that the opposing states DO have standing to challenge the present decision. It is the standing of the US House of Representatives that is problematic, but that is inconsequential if the court decides the case presents an actual case or controversy that the cout believes it has authority to decide. Regardless, the ACA needs to be on the books to preserve American's health!
11
Health care is not a right in almost every European nation. Offerings to illegal immigrants are far below those for citizens in almost all these nations. Why should highly skilled citizens pay $30,000 to $40,000 a year for single payer (taxes) while illegals contribute almost nothing — while both receive the same care? This issue alone and demand by almost all Democratic candidates has cost them my vote and pushed me to third party.
@DC c
Please tell us who is paying 30/40K per yr. for single payer. I do not believe your post, and I administered corp. benefits for 22 yrs. We paid approx. 1M for multiple States insurance coverage, as an aggregated entity.
I read this article and conclusions point towards Medicare for All as a solution.
22
Trump and McConnell will probably not be able to have the ACA overturned, but if they succeed, I assume that Blue states will implement some form of universal healthcare for their residents, and Red states will revert to the times before the ACA. Guess where employers and employees will move to? To the states where health insurance costs and drug prices will be kept in check. Guess where rural hospitals will close and doctors will close their offices? In the states where most of the residents cannot afford health insurance anymore and do not qualify for Medicaid. So let the Republicans have at the ACA, I have no doubt the Blue states have their contingency plans ready for their residents...
29
@Anna
And guess which states' residents will become even more resentful of those snooty liberal "elites" in places like California and New York with strong economies and healthy, well-educated populations, while their economies stagnate, their young people move away or succumb to opioid addictions, and their small towns wither and die? Yep, the same states whose Republican administrations are pushing this lawsuit because they think it's good politics. It should be obvious by now that ginning up anger and resentment is precisely the point of much Republican policy, not an unintended consequence.
10
@Anna
A state-by-state solution is perfectly within the realm of the authority of each state. The Federal Govt has not been given the right to force people to purchase something. It is an Unconstitutional law. But because it's healthcare, no one cares about what is Constitutional.
@Tim: No, but the Federal Govt can levy taxes. That's how the individual mandate is designed. And the EMTALA is federal law too, and an unfunded mandate, which means you and I pay extra in insurance premiums to offset the costs for hospitals and doctors. Those costs would probably a lot less if everybody was mandated to have insurance and if not, would be required to pay a fine in the form of a tax as is required in the original ACA, so that those with insurance would not be saddled with the bill for someone else's shortsightedness.
2
Almost eleven months of the year, if one loses their job, their only choice is Cobra (averaging $700 a month per adult) or short-term indemnity plans offering almost no real coverage and costing $100 to $400 a month. Most indemnity plans are capped at close to $10,000 and cover only a small fraction of that during emergencies, except for accidents. Our short-term plan covered $150 and negotiated away $1500 of a $10,000 hospital visit (ER). As long as no decent options exist in the eleven month period for those losing jobs, the courts have an obligation to not support the ACA in any way. The only real alternatives involve (a) single payer (Germany, Canada, ...), (b) universal with a strong mandate and affordable quality year-round purchase options (Switzerland), (c) or what we had before (tens of millions without insurance or paying through the roof for conditions). Millions will suffer with a (sky high taxes) or c (sky high health care costs). The best option for the majority in a nation like ours would be a system like that in Switzerland.
6
@DC c Just to be clear, while I agree with the spirit of your comment, Germany does not have single payer. They have something more akin to the Swiss system, mandate and private non-profit insurance plans, but certainly nothing like Canada.
8
You should not have to wait for open enrollment in this situation. If you lose your job and subsequently, your health insurance, you are eligible for a Special Enrollment Period through the Marketplace. This is because losing your employer based health insurance is a qualifying event, triggering the Special Enrollment Period.
4
Losing insurance for reasons such as job loss, death of spouse, etc are exceptions that enable someone to purchase of insurance through ACA outside of the annual enrollment period. COBRA is also an option if the insurance was through an employer.
4
I fail to understand why so many vocal Republicans have an almost uncontrollable desire to take health care insurance away from people and replace existing plans (as flawed as they are) with nothing at all. It is unfathomably cruel to withhold health care from anyone in need. If you don't like the Affordable Health Care Act then replace it with something better instead of raging against it. In other words, grow up and accept the responsibility that We the People have for one another.
96
@dhb
Read the Constitution. "We the People" came together to form a "more perfect union" by voluntarily giving this new entity - the federal govt - some powers that it doesn't have on its own. The Fed Govt's power is derived from the power we chose to give it. We gave it the power to tax. We did not give it the power to force us to purchase something we don't want. Case closed. Don't like it? Amend the Constitution. Won't work? Yeah, because "we the people" don't want your style of govt. Go to a lib state and get all the socialism you want.
As long as healthcare can be influenced by private insurance and political pressure (from Republicans, mostly) it will never work. Piecemeal arrangements like ACA/public option will not solve the problem. That's why Ken Arrow thought that a federal single-payer is the best among all other options.
6
It's a shame that the Times feels the need to point out who appointed each of the judges on the appeals panel. Judges are judges (at least in theory); they're not supposed to be Republican or Democratic judges.
However, this issue is so deeply political that I will be outright astonished if this panel comes up with any decision other than 2-1 against the ACA, split exactly along appointer-partisan lines. Because here in the real world, there absolutely are Republican and Democratic judges, and it's easy to figure out which is which.
23
Your comment after the first sentence points out the need for the NYT to point out who appointed the judges. The courts in the USA, largely due to GOP packing over the past three decades, are now largely yet another arm of the conservative destructor of democracy.
2
You answered your own question by using words like "in theory" and "supposed".
1
@Jay schneider
Oh, I know. You'll note I said "it's a shame the Times [needs] to point it out", not "it's a shame the Times pointed it out". The fact that the appointer of a judge totally does make a difference is not really in dispute, at least here in the real world. It should be... but it isn't.
In theory, theory and practice are the same thing, but in practice, they aren't.
1
Almost every Democrat Presidential candidate wants to get rid of Obamacare. It seems a lot like the failed and disliked Republican effort to repeal and replace Obamacare. I wonder if Democrats will tell us that we can keep our doctors, that our costs will drop, and agree with the Republican plan to cover preexisting conditions. This Court decision could accelerate the interest by both political parties to make changes that we can believe in.
@Richard Winchester
As long as people in both parties insist that healthcare should remain a source of profit for giants in the industry, costs for consumers will continue to rise.
13
@Richard Winchester false equivalence.
1
‘’Republican plan to cover preexisting conditions” Huh? Did I miss something?
2
What is amazing is how these governors and implicated on the controversy (including the Trump administration) do not have an option for healthcare to cover the thousands of people in their states that will lose coverage and that will hurt the states economy. This is not only lack of empathy, but complete lack of governing , leadership and initiative. They lost the House on this issue. Lets see how it will run on 2020.
20
I had to drop the ACA and get on my partners plan in order to get coverage for Sloan Kettering so I wish you’d cover this honestly. I personally know 4 people that are in limbo because the ACA pays out so little no one wants to take it. When you are in between jobs with cancer this is no joking matter. The ACA either needs to be strengthened or completely taken apart (keep its cap and pre existing clause). The plans are not taken at many tear 1 cancer hospitals and the out of pockets are ridiculous. I support a buy in to our gvt plan but I also know the ACA and Medicaid payments will NOT sustain hospitals. We will end up bailing all of them out. none of these politicians know how to fix healthcare it’s going to be trail and error. universal will further break this system and more doctors will do conceriage care or won’t take insurance. We should have insurance companies fight for every single one of us as a business and across state lines. Turn the whole industry into a massive competition for our business. No more cushy corporate contracts. What’s sold to one should be sold to all. The ACA traps us into high deductible plans. The #1 issue though is type 2 diabetes which in many cases is fully preventable/ reversible. obesity is draining our gvt healthcare system. We are going to run out of money. This discussion won’t even matter if we cannot get chronic illnesses under control or fully prevent them. Our country has sick care not healthcare and it’s bankrupting us.
11
@Location01. Unfortunately this is a consequence of a relatively unregulated insurance market in general (unregulated compared to health insurance markets internationally). The reimbursement issue for ACA plans is a problem in some parts of the country and Not so much in others, but regardless of whether it’s an ACA plan or employer sponsored plan, the insurers negotiate reimbursement in private, do not share that information, and develop provider networks of their choosing. Luckily your partners plans provides what you need but for many with employer coverage there are few options, a severe lack of choice, and limited provider networks as well.
11
@Location01 I guess it varies by state. I was on the ACA for 2 years and it was the best, most comprehensive insurance I've ever had. They have Gold, Silver and Bronze programs. Are you suggesting the Gold covered next to nothing? That's pretty hard to believe, especially in NYC.
8
@Location01
The ACA isn't an insurance plan. It's a law that regulates aspects of the healthcare industry from the rules about how insurers can select clients to mandatory calorie listings on menus. But is isn't a health care plan.
How were you ever on ACA? And how did you drop it? And what doctors were telling you that they did "take" ACA?
I don't want to assume anything, but I think the problem was that you were telling doctors that you were on an imaginary healthcare plan and they were telling you that they wouldn't take your imaginary plan for real coverage. One of the weakness of Obamacare is that patients still needed real coverage in the real world to get real care. Pretend coverage still wasn't good enough.
7
The argument is that the repeal of the mandate made the ACA unconstitutional. But Congress can’t enact an unconstitutional law. I would think that the court should therefore void the mandate repeal. After all, courts regularly void unconstitutional laws like the census question and all kinds of improper abortion restrictions and laws against gay marriage.
6
@michjas
Though, technically, it's not unconstitutional for Congress to repeal what is considered to be a tax. Article I Section 8 enumerates that Congress has the power to legislate regarding taxes at their discretion. Thus they can repeal a tax as they please. It's quite cut and dry, and in this respect by calling it a tax the Supreme Court may have inadvertently made a huge blunder.
1
@Bill. I didn’t think I would ever hear anyone call our tax laws cut and dry.
Maybe this should happen so more people will take a look at their congressional leaders and demand they act on health care. Maybe more voters will demand democratic candidates raise their hands and promise to fix health care for American citizens. Maybe this should happen and shut down rampant Medicaid where people who pay nothing never bother to think about costs. This may not be the change people wanted and no doubt some will suffer but the country is long past due a true shock to the system over healthcare. This will be a major issue in 2020 but it will be over the healthcare of Americans, not illegal immigrants.
10
@Hellen
If being poor enough to qualify for Medicaid is something you would like to try, go right ahead. My guess is if you were making less than 17k a year you wouldn’t be to happy.
1
@Corbin
So sharing the responsibility for healthcare for all should only be borne by some? Everyone needs to contribute.
If the entire ACA is overturned, I'd predict that the resulting blow back would be so great that Congress would very quickly reinstate a token tax penalty, which theoretically would put the entire law back on the books.
14
@Phil And you really think McConnell would allow a vote? Really?
@Phil Many will cheer the demise of "Obamacare" ignorant of the fact that ACA is "Obamacare".
Those persons will not realize what has happened immediately and Trump will gaslight them and nothing further will be said.
I lean libertarian, and generally oppose government intervention, but I don't see how dismantling pre-existing condition coverage can work. Preexisting condition coverage is one of the most popular parts of the ACA, in part because insurance companies abused the it in order to deny coverage. I worked in the health insurance technology for a number of years, and saw how insureres erred on the side of denying claims whenever possible. But providing coverage for preexisting conditions doesn't work if people only buy insurance after they need it. Consequently, buying coverage is a requirement, and there is a penalty for not being covered. How exactly will Republicans address this problem?
39
@Janet Janet pre existing conditions was exactly what made possible to make manditory to have health care.
4
@Janet trump has said many times he’s keeping preexisting conditions I wish news outlets directly interviewed in depth their thoughts on how to fix healthcare then the public can decide what’s best. I’m inclined to think we should do something extremely drastic like no longer provide corporate contracts to insurance companies and let all of us have the ability to outright buy any plan we like. Our gvt should pass a separate preexisting and cap law then let the insurance companies seriously sweat fighting for our business. Make it across state lines. Keep gvt programs for poor and elderly and offer tax credits to those needing them to buy plans. I don’t see universal working in the us without completely hacking deeply into union wages.
1
Pre-existing coverage is a total failure without a strong mandate. That should be pretty clear from the mess almost from the beginning of the ACA. Our mandate was always weak and now it no longer exists.
5
Taking away the ACA will result in those millions of people going to ERs for their health care. Emergency room care is *the* most expensive front-line care because it requires highly-trained medical people and high-tech equipment - far above the cost of seeing a family doctor which is where most health problems can be handled. Forcing people to go to an ER because they can't afford to pay for a visit to a family doctor will increase the cost of health care exponentially.
The US already has the highest health care cost per capita in the world according to the OECD and the internationally respected journal, The Lancet and many other sources.
The result is that the US will end up spending billions more on a less-effective health care system.
And why would a country choose to do that? Is that one of those famous American freedoms we hear so much about?
35
@MJM: Profits. Follow the money. Politicians who are bought and paid for and who will do what they are paid to do, which is most often not in the interests of their voters.
16
There is no constitutional argument here. The Supreme Court in its 2012 ACA decision said that the individual mandate was an unconsitutional violation of the Commerce Clause (leading to breathless cries of CNN and Fox that the law was dead within 15 minutes of the decision's release), but was a constitutional exercise of Congress' right to tax (leading to red-faced media retractions).
The real issue is a practical one. The ACA is premised on the three-legged stool of the individual mandate, universal coverage, and subsidized premiums. Take away any one of these, and the law becomes fiscally unstable. We know this from failed pre-ACA two-legged experiments in states. But that's an economic argument, not a constitutional one.
9
We just heard that India is embarking on implementing a health care plan for 500 million people. They cover up to $7000/year of expenses. It might not sound as much here but it is substantial in India and would cover many aspects of basic medical care.
We are the largest economy in the world, it is a shame that we are unwilling to cover 60 million uninsured.
15
The Republican Party does not represent working class Americans. They represent their allies and constituents in big business and the mega rich. Throwing millions off health care and potentially leading to millions more being denied coverage for preexisting conditions is not in the best interest of most Americans today, and yet the GOP continues fighting it anyway. I hope that voters remember this and ignore the nonsense about socialism they will hear from the GOP in this coming election cycle.
18
Let's suppose that removing the tax-penalty for the mandate is enough to leave federal law in an unconstitutional state.
What I sincerely do not understand about the lower courts ruling is how it is that the ACA---not the legislation that broke it---is deemed unconstitutional. If Congress makes a change that violates the Constitution, that change is what ought to be reverted! If Congress wants to change the law, it's their job to figure out how to do it constitutionally. Matters of standing should be irrelevant when appealing such blatantly mistaken judicial decisions.
10
While Donald Trump and some who call themselves "conservatives" might prefer that sick and disabled citizens who can't fully pay their way just vanish to pay for the tax cut of the Republican Party financiers, that is not what happens.
Without good health insurance, ill and injured working Americans often become poor and unemployed Americans. They stop paying taxes, families lose breadwinners and society picks up the cost of both healthcare and welfare for them and their dependents. .
There is no doubt that giving all Americans good healthcare, would extend their ability to work; make them more productive; Keep families together; Avoid bankruptcies, and actually do more to make America great than slogans on hats. The ACA, (Obamacare), should have been named the keep Americans Working Act, because that is exactly what it accomplishes in the long run.
71
Why are Republicans so against their fellow Americans having healthcare? Republicans are heartless. So much for their so called evangelical Christian beliefs. Stripping Americans of their healthcare goes along with their approval of the persecution of immigrants at the border. Who are these people?
113
This has always stymied me as well. Democrats are not the only citizens that need healthcare.
11
@Mary Yeah you are right. We will be the new immigrants in the shake of a lamb's tail. We are becoming the other. I don't understand if the evil oligarchs get their way and kill most of us and enslave the rest of us how they think that will solve all the problems. I guess they have to keep enough of us barely alive to serve them. But the fun will have gone out of it. Then they will turn on each other for sport.
I am glad there are billionaires who have joined together and are demanding higher taxes for the ultra wealthy. Not only are they humane, but see the disaster of oligarchy and want no part of it. Really we are headed for even more slavery if the masters are not stopped. And for their own good too. Don't count on Nancy she is no field hand and does not consider herself even a house slave, though she should, being as she is old and a woman to boot. Maybe she should consider what will happen to her if the male slave masters get their way. It won't be pretty Nancy. The masters are applauding you now you now because you will not hold Trump accountable.
1
#Trump2020 campaign strategy is to take folks healthcare away... brilliant.
25
@Wendi I don't even think anyone even says "repeal and replace" anymore, now that it is clear there is not and has never been a replacement. It's just "repeal and each man (and woman and child) for himself".
1
We rarely read in the NYT about the number of people whose insurance was decimated by Obamacare and who cannot now afford the most basic access to medical care. Perhaps this explains why so many NYT readers are unaware of how negatively Obamacare has effected Americans. They conjure up narratives about evil republicans when it's really just about Americans being disadvantaged by Obamacare. Their ignorance is understandable, perhaps, but inexcusable from people who profess to care about health care "for all."
2
@AACNY
Go back and have a second look at the original plan. For people in need there were all sorts of exceptions. No one should have had her healthcare decimated by the ACA. The Republicans of course had a vastly superior plan which would have gone into effect the second an Obamacare destitution passed Congress, but that's another story for another day...
3
@AACNY
According to the NHIS, the percentage of uncovered adults dropped from 22% to 12% because of Obama care. That's about 20 million people who gained coverage. By contrast, under Obamacare, there were between 2 and 4 million insurance coverage cancellations. Most of these cancellations occurred because the policies didn't meet the minimum coverage requirements set down in Obamacare, which is a nice way of saying that the were cheap policies that basically didn't really cover much. However, out of these cancellations, most folks were offered an alternative policy or received government assistance to get a new one. There is no data on how many people had their policy cancelled, but easily picked up a new one. It is worth noting that even if every person who had their policy cancelled picked up a new on, we'd still have 16 to 18 million people covered who were never covered before.
If leaving Americans uninsured is evil, then the numbers clearly show that repealing Obamacare, with no more robust plan in place, would be the greater of two evils.
Believe me, I send my hopes and prayers out to anybody who lost their good coverage and remains uninsured. But if you solution is to save the spotty coverage of 2 to 4 million people by sacrificing the coverage of 16 to 18 million, you'll have to forgive me for assuming your goal isn't really to get good coverage to more Americans.
12
@AACNY
Because these are Republican lies. It is your red state’s fault for sabotaging the expansion of Medicaid and blocking funds.
6
If the ACA is struck down, won't the biggest losers be the majority of Trump's base?
38
@R Thomas BERNER But, their cognitive dissonance will prevent them from understanding that enough to change their votes.
7
@R Thomas BERNER - Yes, once they realize the ACA is actually Obamacare.
4
This administration, day after day, has shown all its incapacity, negligence and selfishness to serve the country.
Trump is well able to destroy anything on his path. It’s very easy to do.
Unfortunately his incompetence to reform and improve anything is beyond his intelligence.
17
It's incredible that an Administration so gravely discredited and despised, could still be sticking it's nasty fingers into this long awaited and bravely won pieces of legislation in such a transparently petulant and childish way. And this out of pure spite. Donald Trump, probable criminal, jealous of Obama's inauguration crowd, treats the country he became president of through malfeasance and subterfuge as if it were a pawn in his re-election campaign. Lordy, Lordy.
27
Just three of Trump's lies:
- Global Warming is a Chinese hoax. It's a hoax. It ain't happening."
- "Tariffs are making America rich!"
- "We are going to create the best healthcare ever. Ever! It'll be terrific!"
36
@Clearwater
He also said you can get the best healthcare for just $12. He actually said that.
I'm still waiting.
16
Trump's a populist who wants to take away people's health insurance. Got it!
11
This is 2019, by now healthcare should have been a birthright. It is pure evil to take healthcare away from people. Anyone with good health today may have some major health concerns tomorrow. Vote
13
If Obamacare is so wonderful, why do Democrat’s want to replace it with Medicaid (a 100X more accurate term than “Medicare”) for all?
1
@Dr. John What do you think? Maybe just moving a little closer to the healthcare policies of more advanced countries. Obamacare was brilliant as a first step, but not half the system we need in order to enter into the excellent sisterhood of nations whose voters know that it's cheaper for everyone if healthcare is universal. So easy for me to understand, Dr. John, and I'm not even a Dr.
13
@Dr. John
Dr. John, the vast majority of Democrats don't, just a handful of loudmouths with twitter.
It is a good talking point for Republicans who don't care about the truth and want to distort issues for political gain, though.
2
Perhaps because it provides even more protection for people? Beats the GOP plan that is nonexistent.
4
The Second American Civil War is upon us. The first, a bloody conflict pursued and begun by 19th Century plutocrats seeking social and racial segmentation and engineering; the second—to come—pursued by 21st Century plutocrats; the spiritual progeniture and descendants of the former, seeking the same ends. The roles of the Republican party having reversed from one end of the moral/political spectrum to the other.
13
Let Obamacare burn. It has been one of Republicans top five objectives, along with entrenching power by systematically dismantling our democracy, caging children, trashing the environment, while protecting blobs of cells. The rubes who vote Republican won’t change their ways until they feel literal pain — and get turned away at the hospital door.
14
The Republican party has been striking down affordable care ever since the negotiations began. The initial proposal had a public option. And it took over a year's worth of haggling with the Republicans who were acting in bad faith all along to turn it into Romneycare.
Then when they had a complete majority, the only thing they really worked on was dismantling every component that would make it affordable.
I'm sick of these people in office who are not only tearing healthcare reform down, but tearing our country down.
If they want to destroy their own party (and they have) that's fine with me. But to the Republicans who are just an inept autocratic fraud's court jesters, I have only one thing to say to you.
You're fired.
13
Who is surprised? Trump gives to the wealthy and sticks to the poor and middle class.
15
I have been to Denmark and lived in Europe. I would never live in Denmark where the government intrudes and regulate so much of everyone’s lives and taxes are astronomical. The government funds healthcare but also dictates the healthcare. The doctor is an agent of the government and the patient has no input in healthcare decisions.
4
@Qcell And here in the U.S., the task of allocating healthcare resources is in the hands of my company's CEO, or the accountants at the insurance company he has hired.
Am I crazy about the government making healthcare decisions for me? Not really. But do I trust that the government will do so more fairly than a for-profit corporation? Absolutely.
21
@Qcell
How long did you live there - 2 minutes?
If it had been any longer than that, you'd have realized that (a) you're wrong; and (b) you could purchase private health insurance, it's an option. Just like we have it when we're on Medicare here in this country.
Take it from me - a Type 1 Diabetic - in light of the fact that my insulin would cost $1,098 without insurance, and with my insurance, the claims adjuster fights my endocrinologist every step of the way about the care I need, your claims are not only offensive but dangerous to me.
Because your claim does not sound at all knowledgeable about what's actually occurring in other country in terms of the healthcare they provide.
And by the way, why on earth would you even think we would even become Denmark two years from now. Good grief. If only.
7
@Qcell In the United States, health care is rationed by for-profit insurance companies. Patients have no input in decisions made by Aetna & Co. Ask any woman who experienced a “drive by delivery” I.e. giving birth to a baby and then getting kicked out of the hospital ASAP.
4
Trump, still seeking revenge for his humiliatiion at that White House Correspondents Dinner so long ago, is determined to destroy everything Obama ever accomplished, even if it means depriving millions of Americans of their health care. It will cost him and the GOP dearly. He may get away with shooting someone on Fifth Avenue but he will never get away with destroying the ACA.
66
The U.S. is approaching the apogee of health care folly. If the ACA is killed, chaos will rule because the Republican president has no better plan (for this, or for that matter, for anything else). This will likely throw the 2020 election to the Democrats, who can then institute a serious full-coverage healthcare plan like we have here in Canada.
53
Spilled milk. By not coming to vote, or casting a protest vote for a third party candidate.
I am pretty sure said milk will be spilled again. Because now there are plenty of contenders among democrats, each of them offering a new way of making life risk and cost free. The infighting has started; democrats will show us up again by not voting.
I am surprised anything good happens in America anymore; people who are hurt the most do the most to shoot themselves in the foot. Like the geniuses awarding a rock star status to Trump, every single one of them on some form of massive government handout or subsidy.
So all the people concerned about losing their healthcare now, where were you in 2016 November, on that Tuesday, that pretty much changed the trajectory of this country toward some dystopian end? If you voted for Hillary, god bless you. But if you didn't, please take your placard and go home. You deserve NOTHING.
25
The "crisis" of health care is just another manufactured political button to get people riled up and waiving signs. Americans are born with a gold brick in their pockets and have no trouble accessing extremely good health care. Obamacare has done nothing but drive up costs and drive physicians out of the practice. Everything our bloated government touches gets ruined - look what happened with student loans and access to education. Our government took over and created indentured servitude of the working class. They will do the same thing with healthcare. They will hit the working class with the biggest tax increase of the modern era. If you have a steady job, you should be afraid of the lefties.
4
@DecliningSociety
The article states that 65 million people will no longer have health insurance. People with pre-existing conditions will not have health insurance. But in your mind, Obamacare is the problem? I live in MA, and Romneycare was the model for Obamacare. Our state has only 2.5 percent of people uninsured, vs. MD has 11 percent uninsured.
7
Your notions are conservative lies. Read the article to see how GOP attacks on the ACA will KILL people. Death panels, anyone? The conservative Republican party is one big death panel. Its adherents are murderers. Killers of REAL, living Americans, not lumps of insentient cells.
3
Obamacare proved the federal government could help the average citizen and their family, and not just serve the rich. Republicans campaign every election on the principle that the government can do nothing but keep you armed with battlefield weapons, and women without prenatal health care, birth control or family planning. As a result, Obamacare benefits were, and still are, the GOP's worst nightmare.
21
Dozens of other countries get BETTER care for HALF of what the U.S. spends per person, by making health care decisions using Best Practices as determined by researchers, doctors, nurses, and patients, instead of corporate profits.
The investment in the transition to such a system would pay for itself quickly and for a long time.
There is no reason to take away anyone's private healthcare plan. Just raise taxes on billionaires a little and offer people's plans with far lower premiums.
Article I of the Constitution gives Congress the power and responsibility to tax and spend. Taxing and spending is what governments, including democracies, do. (Republicans borrow, spend, and blame.)
A simple law that says we raise this tax and pay for healthcare is, by definition, Constitutional. Medicare for All could not be sued in the Supreme Court or ignored in the states. It would not be based on novel legislation.
Obama Care is a Frankenstein designed to avoid the obvious. That is why it can be challanged in the Supreme Court.
Most of the things it wants to do are good, except except having corporate health insurance companies making healthcare decisions. The way it was designed is convoluted, however, because corporate Democrats refuse to just follow the Constitution and tax to invest in our own country, instead of throwing cash at global banks that invest somewhere else.
Medicare four All would save the country money and give us better care, without Supreme Court Cases.
6
Still waiting to see the Trump Administration's "Terrific, cheaper" healthcare plan. Won't hold my breath... Just remember that it is the Republicans who over and over and over have tried to limit your health care access and roll back any protections for coverage. Over and over again. "Family values"... HA!
28
Sure - let’s just get rid of all insurance requirements while we’re at it: health, flood, automobile....is there any difference in constitutionality between one or the other?
21
People just don't get it. Everyone's health affects all of us. Look at the measles breakout. Without coverage, that will sweep through the country. Healthy citizens are productive citizens. Unhealthy citizens are costly. Why so selfish?
38
@KAL
Because the GOP's theory of life is bad things happen to the "other" guy who obviously deserved it. Never to them.
But when it "happens" to them or their family, then they expect the Feds to help them.
3
@KAL And, we end up paying for their health care eventually anyway, when they end up in ERs and hospitals, as we are not (and should not be) in the business of turning sick people onto the street.
5
@KAL
Greed!
The wealthy got a huge tax break and if you want to see how that money is spent, read the stories about Epstein!
Has anybody noted that the scutwork behind the 2017 tax law which stopped the individual penalty for not buying insurance, and the Texas lawsuit, could have been funded by the same right-wing "legal defense" organization?
Considering the negative repercussions, both for the health of individuals dependent on private insurance bought under the ACA, and public-health ramifications, one should see this as what it really is, genocide by malign neglect, with income levels being th determinant rather than race, religion, or sexual orientation.
It's cheaper than the Final Solution, but just as deadly.
9
The Affordable Care Act, and its viability, is just another issue Democrats can't seem to effectively communicate to more Americans.
9
@Tom
Is it really just a "communication" problem? How can this be when millions of Americans can see with their own two eyes how their individual health insurance situations have changed? If the message isn't resonating perhaps because it's not acknowledging the problem?
6
@Tom I agree that the Democrats have a huge communications problem, on this and other issues. It worries me a lot regarding upcoming elections and our future.
2
@AACNY Yes, it is. Even you consider only one point--that Americans think they would not be able to buy extra insurance if they want and can afford it--you can see that there is a communication problem. Beats me why the Dems don't attack that canard.
1
Unless it’s changed through amendment, we’re struck with the Constitution. What’s playing out presently with ACA by Republican initiative to challenge its legality is rooted in sloppy legal formulation of ACA in the first place ... not to mention strong-arm maneuvering to have that become, when it did, “law.” One cannot reasonably complain about Trump’s threat to democracy, which in my view is very real, and then turn around, basically on the Constitution, and complain about what it, the Constitution, mandates to uphold democracy. If only there was a way to “get along” to seek the common good; but it’s now a polarized political street-fight of “us” (who are the righteous) vs. “them” (who are always wrong ... if not demonized). Perhaps we might begin with a national referendum of whether or not universal health care is wanted, if that were somehow possible even to agree about and implement.
4
@wak
Do you really need a referendum? It appears that there is a substantial group of Americans who are opposed to allowing the government to have total control over their health care. This is evidenced by the drop in support once the consequences are introduced into the survey questions.
2
@AACNY I am a beneficiary of Medicare, VA and military healthcare, you know, socialized medicine run by the government, for many years.
During those years not once has some government employee denied me care from any of those providers I have cited.
The control I see is contained within the handbooks provided by the providers I have listed and contain much of what one would see from the public sector insurance companies.
So, please, explain the total control of the government over our healthcare. Or, did you just make that up to see what sticks?
13
@wak
While I appreciate the "Democratic" concept of the referendum, unfortunately you can't count on people voting with their own best interest in mind (or even showing up to vote).
How many 'people' have you seen ranting about "Obamacare" then screeching "Hands off my Medicare!"?
Then they put a Governor in place who doesn't expand or rolls back.
Referendums are too much like Russian Roulette, as proven by the Brexit wreck where too many decided being in the EU was a sure thing, got lazy and chose not to bother voting against withdrawal, now they're stuck with the crazy Right Brexiteers trying to crash the plane into the mountain.
Better we take the Senate, remove that obstructionist liar Mitch, and put Healthcare to bed, restoring and improving the ACA and developing a course toward single payer like other "Civilized Societies" have.
2
I'm a 68 year old retired teacher now on Medicare. I had private insurance all my working life. If Trump manages to take apart the ACA, then what? Most Americans--at least 50% of us--know that the Trump and the GOP do not have another plan ready to go. We've already been to that rodeo. So basically, we will have no health insurance system and the private insurers will be calling the shots again. At my age, I have a couple of pre-existing conditions. Although I'm on Medicare, I know that the GOP is itching to get its hands on this very good healthcare system and take it apart. If the ACA is dismantled, it is just a matter of time until Medicaid and Medicare are chopped up and handed to private insurers to do as they will. And that won't be in the best interest of any American. There is a lot at stake here for all of us. I am so tired of living in Trump's America.
167
Should the ACA be overturned due to the tax being zero, will Democrats (or anyone else) introduce legislation to set the tax penalty at one dollar?
If so, it will be interesting to see who would support or oppose such a proposal.
6
I am on Medicare. My daughter is 26 and earns < poverty level and has a chronic condition that means without pre-existing protections, she cannot get (even if it were affordable) health insurance. I have asked this before but get no answers: what is the appropriate response to a government that tries to kill your child through removal of health insurance? Without Obamacare she has no coverage and can’t get it. So to the courts I say-please don’t remove the only insurance millions of people have. The damage could be the end of the lives of many of these people.
118
We are forced to buy insurance for so many things, but namely our cars and our homes (if we so choose and have the ability to drive or own, respectively). I understand that cars and homes are mostly choices, but most people I know don't think twice about paying the insurance for the privilege to have such things. If we don't bat an eye insuring our car, I don't understand why people are so against insuring their own health and well being. It's broken system, yes, but it's what we have and it's better than nothing.
29
@Mike
...and if we can't afford to run a car we just call an Uber, yeah?
1
@Ray Chatham
Or if regarding you have no medical coverage, you show up at the ER and get hundreds of thousands of dollars in bills for service and everyone pays for it anyway.
Double dipping by the Insurance and Pharmco's. They like that.
Yeah?
1
The.problem is not the GOP, but it is those among us that they leverage through the use of hate, greed and fear to support the policies that are counter productive to their own interests.
15
That accurately describes the current GOO. They are not benign.
2
Since when is the Urban Institute, self-described as a non-partisan research organization (and it is) a "left-leaning research institute"? Who gets to make these designations? Heavens, how significantly the center of thought has shifted to the right since the 1970s to provide that designation.
23
I have always been fortunate to have health coverage thru my employer, they paid most of the premium and I paid some. I find it sad though that the federal government still wants to take the ACA away from millions when they have NO replacement. My own state Texas is involved in the law suit today, to have the entire law thrown out, leaving many Texans with out any coverage, again with NO replacement to offer. Sorry but how can any one support these actions, even if your like me have coverage, its still not fair. The truth the more people without coverage have to use the ER, and don't expect many of them to pay there bills. Health care is expensive, even with insurance. If more folks are with out health care insurance the unpaid medical costs will be passed onto those of us who have insurance. I hope the judge(s) say no to those trying to take the ACA away at least until there is a good plan waiting to replace it.
33
@Ricky
You are mistaken. Judges are shooting down replacements. Republicans are trying but obstinance on Obamacare's requirements has made it almost impossible to get any reasonable alternatives through.
3
@AACNY
Why haven't we seen any of these "replacements" offered by the GOP? They have been at it for over 12 years now with no documents to compare or ideas to share.
Are they doing it all in secret meetings held in dark rooms, with passwords and special handshakes to enter?
While the dreaded "Mainstream Media" may be able to bury a story, I'm afraid they're not that good.
Alternate voices would be heard, if only there was anything ever offered.
5
@AACNY
If by "replacement," you mean "removal", then you're correct. Apparently you didn't understand this article. Please provide a citation to ANY healthcare replacement legislation for ACA that republicans have introduced in the last five years.
5
So it comes down to this, really? Talk about an activist judge. For ACA to be dismantled so summarily with two (?) court cases from conservative districts shows the fragility of our system. It really is based on a social compact, trust, and a shared sense of norms among the governed. The barbarians have always been at the gates, and while the modern GOP would open them up every once in a while, Trump has completely dynamited them.
43
Saw a story on the news the other night of Diabetics driving to Canada, in a bus, to get their insulin (where it was originally patented, patent sold for a $1 so it could be produced, and costs 1/10 of the USA prices). I'm thinking to myself, why can't Drs electronically send most scripts over the border, and we set up some sort of pickup or delivery service, with strict ID controls, to bypass the greedy drug companies here in the USA. Citizens taking it to the drug companies, directly. Congress isn't going to do anything. I'm sure Canada would love the extra business, and they clearly have no intent on gouging us like our own government and medical industry. I'm really serious. There's probably a legal, convenient, compliant way to do this if one can just drive over the border and provide a script. Canada, if you're listening?
24
@Character Counts Sounds like a good idea to me. But I believe the U.S. has to do something to fix their own system which allows the pharmaceutical companies to gouge people down there for medications No reason why the same medication should cost so much more in the U.S. than it does here. I have no problem with Americans coming over here to buy insulin as long as it doesn't deplete the supply here in Canada. My other concern, although it may be far fetched, is that the pharmaceutical companies may decide to protect their profits by raising the prices for us here in Canada, to counter any effort by Americans to get their drugs either in person or via mail from Canada.
7
@Ann - Oh, I understand your concerns. It's one of the first things that came to my mind after posting that comment. You could even charge Americans a surcharge to jump start larger production (if necessary). But, assuming Canada gets some profit, it's a win win for everyone. I don't claim to understand Canada's drug pricing policies, but it would need to be designed to protect Canadian citizens from any negative impact. Thanks for your comment.
@Ann You have many valid points. Canada, as the United States does, must protect the interest of the people.
A major issue I have with so-called conservatives is other than giving tax breaks to the wealthy they are simply consumed with taking things away from people, especially the less fortunate among us.
88
@Fred let me help you a little. Right now I lean conservative because of the desire to promote regulated capitalism and the merit based reward system. The "taking" you refer to can and should be more accurately ascribed to taxes. The "wealthy" you refer to increasingly means anyone with a steady job and a savings account.
2
@DecliningSociety Actually, you are wrong in your definition of "wealth" in terms of the tax system. The tax system systematically rewards those with significant acquired wealth, and the changes to recent tax law exemplify that.
9
@Fred
Well put Fred.
They believe anything someone else has, they want.
(Except a "Pre-Existing Condition", of course).
2
I love how Trump, all these attorneys general, governors and federal judges who are angling to deny affordable healthcare to millions of their federal citizens also enjoy Cadillac healthcare plans subsidized by those same citizens.
145
@Jake Reeves - The rationale is that, since they don't have to worry about their own health care, they can be objective and impartial in ruling on others' health care.
1
I have no horse in this race so take this suggestion as well intended. In the matter of trade the R's mantra is short term pain for long term gain. Now say the D's play the same game. If the Fed Appeals Court rules against the ACA, the Dem's accept the ruling and do not no appeal to the SC. However, they run in the next election promising universal health care and that can only be achieved by electing Dem's across the board. That throws the lead up to 2020 in complete chaos but it might be worth it. Just a suggestion.
12
Progressives have to think incrementally. Half the country is HOSTILE to just the modest requirements of the ACA.
Personally, I think several Democratic states should band together and create their own programs. Democrats should focus on keeping ACA and giving states the leeway to experiment with their own individual or regional health care programs.
You can’t save the Conservative states from themselves. They have to learn the hard way.
25
@Practical Thoughts I think that is happening. Didn't NY State already pass a law like that?
1
@Practical Thoughts A significant problem here is that red states enjoy inordinate, non-majoritarian power over policymaking and federal resource allocation. Hence, they force blue states to subsidize them with federal largesse. I think Democrats should also focus on cutting off the federal $$$ spigot to those rightwing moocher states, like Mississippi, Arkansas, Kentucky, Oklahoma, etc.
5
"Striking down the Affordable Care Act"
This is very simple. The Dems must think long and hard about who they nominate to oppose Trump in November 2020.
The Dems need to focus on protecting and shoring up what we have now - the ACA, Roe vs Wade etc - and put aside the lofty aspirations.
18
How’s that “greatest” Trump health care plan coming along that will cover more people at lower cost?
Only in America can one imagine the ruling party suing to remove health care coverage from its own constituents. We’re going to go back to 60 million uninsured? Being dropped for pre-existing conditions? Is this 2019 or 1819?
The GOP continues to wage war on the middle class and poor, in ways that don’t even make sense. The cruelty is the point. The only solution is to remove this noxious group from office.
180
Whether the ACA can be struck down or not, I believe, is beside the point, as it would disenfranchise millions from receiving health care, care otherwise 'forbidden' to them on the basis of economics. Besides, as it would be cruel beyond measure, why even try to disembowel what seems to be working for the people (the poor, the young, the elderly, for women, and children, for the disenfranchised)...before transitioning to a more universal system? Unless this democracy works for everybody, and not only for the rich corporate world, let's be honest and call ourselves a pluto-kleptocracy instead. This, to avoid being called hypocrites 'a la Trump'.
21
This is where we should be putting our energies-into protecting and defending the ACA. There seems to be a chasm between ideas of Medicare for all without insurance and of the idea of protecting and refining the ACA.
I could be wrong but I wish some of the progressive Democratic candidates would acknowledge the starting point for many states in giving people health care. We may get Medicare for all at some point. Some candidates have gotten stuff done in Congress (Elizabeth Warren and financial regulation is one example) . They may be work on Medicare for all after they get elected.
Could we concentrate for now on the reality of how health care is or is not covered-or whose coverage is threatened-for millions of people?
16
Fine...let the Republican politicians and their right wing judges destroy The Affordable Care Act. Their arrogance and stupidity are breathtaking. This would result in what Lincoln said: “You can’t fool all the people all the time”. And an opening for a “Medicare for all “ candidate like Elizabeth Warren.
27
@Mary Beth
"“You can’t fool all the people all the time”. "
But "you can fool some of the people all of the time", so far just enough to win control of the Senate and the Electoral College
4
I am sorry to see the Times continuing to try to politicize people’s thinking about the judicial system, following the lead of President Trump. It does so by always tagging judges with the president who appointed them, implying that they are somehow biased for that reason. I practiced in federal court for nearly 45 years, and virtually without exception I found federal judges focused on applying the law to the cases without regard to political beliefs. Certainly some were personally liberal and others conservative, but they tried their best to call balls and strikes.
An independent judiciary is too important to our system of government to impugn with guilt by association.
11
@Brian Greig
Unfortunately, after your 45 years, Republican McConnell came along with the clearly stated goal of taking control of the Judiciary for Republicans.
As you know, he blocked Obama appointees, most famously not even allowing a hearing for Garland, then busily started filling empty spaces once 306 party-over-country Electors handed Trump the Presidency.
So, while your concern re the unfair implication of identifying people as "Carter-appointed" implying partisanship may be true, any "Trump judge" is by specific intent a partisan player, In fact, it is reassuring to know that there is a "Carter" appointed judge involved who would do what you expect and is the job of the judge: apply the law
If a Trump judge actually applies the law, well, they are not doing what McConnell intended when he appointed them.
31
Brian, other than one sentence identifying the judges in this case, this article doesn’t even remotely have anything to do with what you’re stating. It is about our government taking health insurance away from it’s citizens, a heartlessness some of us have trouble understanding.
6
Maybe because we watched the GOP deny Obama his constitutional pick. We have watch the GOP politicize the courts. Maybe it is not the same as when you were there.
6
That millions of Americans will be left uninsured if the ACA is struck down is secondary to dismantling Obama's signature legislation. Trump will have the satisfaction of knowing that he bested Obama, and can claim a "win." If he was concerned with the American people's interests he would have a far superior healthcare plan ready to replace Obamacare. But, he has nothing. As usual, this has nothing to do with anything except Trump's ego.
33
The ACA never did make healthcare affordable. The lie is in the title, just like Bush’s Clean Air Act that was a polluters charter.
The ACA cannot stand on its own. It’s inherently unstable. It can only be a stepping stone to full single payer.
5
It expanded Medicaid and covered pre existing conditions.
12
@Tullymd
Yes, it expanded Medicaid. That's all it did. Why did the entire insurance market have to be destroyed in the process?
2
The ACA also removed lifetime caps
4
The Republican Party has contracted a virulent disease of fascism manifesting itself through greed, hate, and hostility to the Constitution and the well-being of the American people. This disease is metastasizing throughout the party and appears terminal without hope of any recovery. In some isolated cases, party members have been able to recover by turning toward a path of genuine concern for fellow human beings and the planet.
14
Exactly. Not many people are in touch with this truth.
4
The GOP/Trump are anti life . They get us into more wars which kill women and kids, are destroying our planet with coal use and fossil fuels. Now want to take away the AFC. Our churches all side with them over abortion which is wrong but God will deal with those people doing that. The GOP ideology is less government and every thing money goes to the rich. The churches are cults for supporting the GOP and with their women and child abusing men should be closed down. Shame on them for supporting these anti life GOP and coal use . Instead of building Mexican wall you need to put money out for a long sea wall on both coasts to protect us from sea level rise. Very sad if this fails now.
16
Of course, this makes sense if you are a republican governor.
Why not tear healthcare protections away from all Americans. It's not like they think that their constituents matter. The very sick and the diseased of mind are running this country. Their sickness is greed and cruelty is their operating system.
14
The GOP is whacked. First off, who needs health insurance the most? Those with illnesses. Second, I believe in some program, policy etc. that has all Americans covered. Third, if it must be this way, then those making the stink, don't buy health insurance, but come with cash if you need treatment, no cash no treatment. Uninsured, can't use the system as free-riders, I have empathy but I am not a chump either, I am not paying for those who don't want to participate. I'd prefer to not pay for auto insurance, it is expensive and I hardly use it, but the law requires it. Finally, why don't these GOP members reject the health insurance we pay for. Live by their own words. Instead they have cushy coverage and they want to take a minimum plan away from the rest of us. Who are these GOP members....they are not human.
20
If he could, the president would take everything away from everyone and take it for himself.
20
If you don't think healthcare is a right, then you think your life, your wife's life, your child's life, is more important than the next person, their spouse, their family. It's really that simple. And if you feel that way, I feel really sorry for you.
20
With the 50 year anniversary of the Moon Landing coming up, I am cynical about what this country can even do anymore. The 1960s broke our fragile unity because of idiotic racism, and America is still struggling with old problems that other advanced economies solved decades ago.
2009's Affordable Care Act was the Republican plan and supposed to be a gradual step towards Medicare for All -- with the option of additional private insurance for those who could afford it.
With the Republicans and 40% of the country staunchly with Trump, we can't progress as a country to solve domestic let alone global problems e.g. infrastructure, Green New Deal, etc. 2018 voter turnout was only 49%... 2016 voter turnout was only 60%.
17
@John W It was NOT a repub plan at all. Some parts were but the Dems changed it so much not ONE repub could vote for it, scrub it now!! Make the Dems and Repubs sit in a room and come up with a better plan.
I was looking at a drug I take on wikipedia last night, and the global average price is one penny per dose, while the U.S. cost is 50 cents. Now, this is a normal staple drug, still cheap in absolute terms in the Us, BUT 50x more expensive? Really? Absolutely ridiculous. This is what Congress should have been focusing on, and pricing transparency. Instead, they are just constantly trying to pick political battles to rile up their base. If Trump manages to kill Obamacare before the 2020 election, that will be the end of his reelection. Not sure why he doesn't realize that. I must admit, I'd be willing to sacrifice Obamacare (in the short term) to get rid of the evil that is Trump, IF I were forced to make the choice. That's how much damage he is doing to our country.
17
And again this being reported as if there are valid legal arguments on both sides. There aren’t. If this absurd lower court decision as any chance of being upheld, it is not because of legal argument - it’s because of naked power, grabbed by Republicans by patiently infiltrating the federal judiciary with political operatives over decades.
22
The silver lining in this cloud is that this terrible development lays bare the fact that the GOP could not care less about health care, whereas the Democratic Party champions the cause. It's pretty black-and-white (which of course means nothing at all in trumplandia). Now all that is needed for a strong Democratic showing in Nov 2020 is for American voters to use their thinking caps...
17
I resent politicians playing games with people's lives
2 years ago, a family member was diagnosed with M.S. Without the drugs and doctors paid for by his Obamacare coverage, he will die. This is a neuro-degenerative disease and a pre-existing condition. Trump plays to his base, Republicans are complicit and good people die because of politics.
Reprehensible.
48
Just as immigration is a winning argument for Trump, health care is a winning argument for the dems.
8
The lower court's reasoning is that the entire ACA became unconstitutional after Congress removed the Individual Mandate from ACA. The ruling is being appealed.
The lower court's line of reasoning goes like this: You go out in the morning to discover that your car has developed a flat tire overnight, rendering your car nonfunctional. You must immediately call a towing company and have it towed to the junkyard because with only three functional tires your car is no longer a car.
11
Maybe it's best if the ACA final falls apart - legally, but only when a suitable replacement is ready. It was a written poorly, functioned poorly, and has been circling the drain since day one. A boondoggle for insurance companies, not much more.
2
@Midwest Josh You will not find anything from the GOP that would replace it. The ACA fell apart because the GOP sabotaged it from the get go, since day one. Joe Lieberman also was not very helpful in making the ACA what it could have been. This is why we need a Democrat with a healthcare backbone in office. This country is due. I highly doubt that the GOP would instill any plan before the election because they know it would be unpopular. No, they would wait until after because all this would take time anyway. It would be like a reelection of Reagan ---when much of his constituency finally realized that he was not for them. Please vote Democrat in 2020.
7
@Midwest Josh
Unfortunately, the defense of Obamacare has reached the level of religious fervor. It was a disaster for many Americans. They vote too (hence GOP's actions). Its supporters have always bee in denial about its weaknesses and how badly many Americans feel about it.
1
Unless Trump's GOP seeks to repeal Reagan's Emergency Medical Treatment and Active Labor Act passed in 1986 everything they say and do about the ACA is a scam. A lie.
That act requires any hospital that takes Medicare to treat patients for emergencies regardless of their ability to pay, their citizenship or legal status.
If they are not willing to see patients literally left to die on the streets and hospital doorsteps as an incentive to buy health insurance than all their objections about the requirement for people to buy insurance are a fiction.
Either people are required to have health care coverage or they aren't. And if they aren't than they don't get service if they can't pay or its meaningless.
6
Well, the Republican Party is moving closer and closer to one of its ultimate dreams - making health care insurance unaffordable for tens of millions of Americans. How proud they will feel when the loaded Supreme Court finally rules in their favor.
21
We'll learn a lot about how the Court is going to operate from this. If mandates cannot be included in programs for universal medieval coverage and health care, I don;t see how we can ever get to being a civilized Western country.
Part of me thinks: let it go. It was a mess, because it was so constrained as to how insurance could be provided, funded and controlled.
Let the people who have been using it start screaming at the GOP and Trump: where is your wonderful plan? Let McConnell supporters see what their man is willing to do for them.
And let the Democrats pursue the GOP tooth and nail. Even now, they should never let up reminding people how long it has been since Trump promised his wonderful plan... better than anything they've ever seen . .
14
So, where is the grand Trump healthcare plan that will replace the ACA should it fall? Appears his plan all along was to have the ACA repealed and have his adoring supporters believe the Democrats were at fault (that tactic still works on those who are easily hoodwinked).
Also, if "Obamacare" should be ruled unconstitutional will the ACA remain? No, not being ignorant, however, many believe the ACA and "Obamacare" are two different plans.
So, how many reading the piece have that belief, rely on Obamacare and/or the Medicaid expansion that will be adversely affected should Obamacare be dashed away along with the ACA?
17
One of the wonderful things about being an American expat in France is that every issue is not personal, political or racist oriented.
Health care is treated as common sense. Good, inexpensive education is also common sense. Abortion, religion, and politics are your personal business and no one else’s.
Gun control is treated like a right to survive for all French citizens. There is no right to shoot somebody except in the rarest of circumstances.
The most emotional issue for the country is whether the government is doing its job in caring for its citizens!
202
Oh my, how are your taxes or have you been able to avoid true French society and not pay them? The services come with a cost. And equality is not real. Rich and privileged attend Grand Ecole and family names still run companies. France is not the panacea you suggest.
@Michael Kittle,
If America has ever been the envy of the world, under this presidency and administration, it is now viewed as the scandal of leading democracies.
13
@George she does pay more in taxes but she is not paying deductibles, premiums and a plethora of other costs that come out of your pocket. They also have a higher quality of life. I suggest that we open our eyes to options that improve our overall quality of life. If I pay more in taxes but save my premium cost and deductibles. I would be able to support our economy more with more buying power.
34
When trump was elected, most of us felt sick. Now we may not even have Obamacare. There is truth to the fact that many people steadily became unhealthy after the election. Yes GOP, there are still some people who absorb the pain of others. The GOP has to be stopped. There is not much we can do about the stacked Supreme Court, so we will need a respectable, far reaching plan for all of us because we may have plenty of ills in the future. And if a Republican wants to use it, well, that's fine with us. This just gets worse by the minute----but we still have to fight for what's right. 2020---Let's get the White House and the Senate back and maintain the House and do some stacking of our own.
15
Under Obamacare people who able, but refuse to work are receiving free care.
While people who do work are unable to afford the policies and their deductibles, and are without any care.
How is that fair and effective?
4
@Dr. John: With an unemployment rate of 3.5%, there is a negligible number of able people who refuse to work. And if one of those “able refusers” contracts a serious infectious disease such as TBC or Ebola, would you want him to go without medical treatment?
11
@Dr. John
How is that true?
8
@Dr. John: So we can assume that you strongly favor a universal health care plan? That would be the really fair and effective solution. Everyone is covered.
14
I know the NYTimes has written about the costs of injuries from gun violence but I just wish someone could do some good research and find the costs of care that Rep. Scalise received (and most likely still receives) after he was attacked by a shooter in DC and the cost of care for one victim with similar injuries after the Las Vegas shooting. I, for one, would like to know how much “out of pocket” medical expense each is paying. We know that Scalise’s injuries have changed his life physically. Have they changed his financial well-being as well. Perhaps that
might show the disparity not only in our healthcare coverage but also the long term financial impact from which some are never able to recover. Practicing for a baseball game, listening to a concert - equally innocent behaviors, but what about the long term outcomes.
24
@Pmalex Under the current ACA law House and Senate members, along with their staff employees, to obtain their coverage from the ACA marketplace.
Now, that coverage is in all likelihood "gold plated".
However, the big question looms-what will those people, Senators, Congress persons and the staffers do if the ACA is struck down?
Oh, I know, as usual they will feather their nests at our expense.
5
In my household, the biggest financial challenge is the continual rise of drug prices.
A person may see the doctor periodically and that costs some bucks. But having to take prescription medicines every single day while those prices continue to skyrocket and go unchecked and unnoticed by most law makers - now THAT's one of the biggest burdens most Americans feel in their pocket book.
No American should have to decide on a daily basis - do I take my medication or do I eat today because they don't have enough money to cover both adequately.
I don't see either party addressing THAT behemoth of a nightmare.
22
@Marge Keller
Or how about... do I pay my insurance or eat this month?
2
I was at the hospital with our 24 year old daughter as she was being admitted after being diagnosed with cancer. In a panic, I called my employer HR department to ask whether she would still to be covered under my health insurance and it was with enormous relief to learn that her care would be covered through age 25 because of this provision of the ACA, which went into effect that very day.
When faced with devastating medical diagnoses in the US, the trauma includes facing the possibility of the tremendous costs of treatment.
57
@EW
Hi, I can't imagine that added anguish above that of your daughter's illness.
As a Canadian I don't ever worry about anything like that.
2 years ago my daughter was hospitalized for 4 months and had 2 emergency surgeries. She has had 2 more surgeries since then to return to normal.
Never once did we have to worry about cost as it's all covered by our universal healthcare.
Hopefully Americans will soon be able to enjoy that as well.
13
@EW
My wife was diagnosed with uterine cancer last year and I had the exact same reaction so I understand exactly your panic. The first thing I did was go online and look at our coverage to see what would be covered. I realized that the ACA gave cancer patients specific rights (there cannot be caps on coverage, no denial for pre-existing conditions, limits on out of pocket expenses, etc.) My wife required an emergency full hysterectomy, 29 sessions of radiotherapy and six cycles of chemo even though she was stage 1A because she had MMMT, a rare carcino sarcoma which is an aggressive form of cancer. As an example, a single cycle of chemo costs about $30,000 for the drugs, supplies, hospital fees, etc.
So to the idiots saying that if they get sick “they will go to the emergency room” good luck with that one. Pray you never get sick because even with a top level insurance plan and the ACA in place we’ve spent months fighting the insurance company who deny everything they can.
My wife completed treatment in March and now we have to monitor her every sixty days. I live in terror that this evil disease will come back and now have the added fear that for reasons I fail to understand, evil stupid Republicans will take away the means to keep the love of my life alive.
I am furious and terrified.
17
@Marie I will be thinking of you and your dear wife. I hope that she is getting the best care and you do not have to worry about the bills.
3
I, for one, hope the courts knock down the ACA at the behest of the Republicans. 2020 will become a 'one issue' election, healthcare coverage. The actions of the courts to eliminate the ACA would probably all but guarantee a big win for Democrats. Go for it, Republicans (and good luck with that)!
12
@Jimmy and yet the republicans have no answer on how to give people coverage. All they know how to do is tear down and tell people to go to ERs.
10
@Mark H Yes, but President Trump has a plan he will reveal as soon as he gets us out of Vietnam.
4
If the ACA is declared illegal will all of the people who did not have it and were assessed fines on their income tax returns for not having it get back what they paid as fines ?
4
@MIKEinNYC
If a property tax is eliminated, do you automatically get back all those property taxes you paid?
Further IRS/congressional action would be required, imho.
BTW, those who opted to pay the tax penalty instead of paying insurance premiums made a bet that they'd keep more $$$. I expect some have come to regret that wager - and that has cost us all.
2
@Uncle Jim
In response to your first question, if property tax is ruled illegal then yes, people should gat back what was assessed and taken from them illegally.
1
I dare say there are few Trump supports reading the NYT. However if there are, please tell me why, if the mandate to purchase is removed, the tax has already been removed why in the name of decency is this OK:
From the article "If Judge O’Connor’s decision stands, the number of uninsured people in America would increase by almost 20 million, or 65 percent, according to the Urban Institute, a left-leaning research organization. That includes millions who gained coverage through the law’s expansion of Medicaid, and millions more who receive subsidized private insurance through the law’s online marketplaces.
Insurers would also no longer have to cover young adults up to age 26 under their parents’ plans; annual and lifetime limits on coverage would again be permitted; and there would be no cap on out-of-pocket medical costs people have to pay.
Also gone would be the law’s popular protections for people with pre-existing conditions"
18
The Republicans who want to take health care away and most particularly disallow any centralized government support have long been on the losing side of these arguments. Even if they create incessant road-blocks to coverage, the vast majority of citizens favor some form of national and universal access and care.
None of this matters to those Republicans who would dismantle Medicare if they could. They would give the financial "windfall" to the most affluent among us. This is very old behavior.
We can hope that our SCOTUS continues to stand fast in majority support of affordable health care for all. Let us hope they do not abdicate to the unrealistic expectation that the current Congress would handle this in a sensible way. Spare us all the arguments that the market will just take care of this.
23
God bless Barack Obama for finally ramming through a "sort of" national health plan, but he took his eye off the ball, merely happy that the legislation is nicknamed after him. It's a poor mishmash of a health law, combining the same rapacious insurance companies with government. It should be one. Or the other. Either a highly competitive market among insurance companies alone, regulated like the utility it would resemble, that allows them to cross state borders to enroll participants (Obamacare, thanks to the insurance lobbyists, does not. It was a primary reason that not one Republican voted for the legislation.), or a similar trans-border, single-payer plan, run by the Federal government. Personally, I think it's time we join the rest of the First World and have that single-payer plan for almost all medical procedures.
11
@CM
I think it's pretty fair to say that all that is weak with Obamacare is due to Obama's attempt to get bipartisan support for the bill, diluting it to gain some degree of GOP support. How naive was he to imagine that such a thing was still possible in the 21st century!
31
@CM some revisionist history here, Obama sought bipartisan support with Republican ideas (Heritage Foundation/Romney Care) and was abandoned by Republicans who were against everything Obama (see Mitch McConnell)
21
@RickyDick - "Obama's attempt to get bipartisan support for the bill.."
Getting bipartisan support starts with bipartisan crafting of a bill. If memory serves, the Repubs were literally locked out of the room.
Go to your medicine cabinet, open it up, in it is the totality of the Republican Health Care Plan. Good luck.
22
On the one hand, the ACA provides a guaranteed and subsidized level of health insurance to millions of people who would be otherwise uninsured.
On the other hand, trump tells them everyday that Obamacare is awful and his plan for no care health insurance would be so much better.
Whatever is a deplorable to do?
20
Where is Obama? Why isn't he out front defending his major legislation?
11
@David Henry, the majority of people who like the coverage do it for him every day!
5
@David Henry
He did for 8 years.
Why aren’t the American people out demonstrating and demanding decent health care
14
@David Henry
He is where he always was: off somewhere being classy and wise, above the dirty fray of American politics, compassionate and caring for all his flock from a dignified distance.
That man was a symbol and a source of hope and self respect. He was not a politician; never a leader.
Which is too bad, and so sad for those who caught a glimpse of what might have been.
I wouldn't plan on seeing him in this or any other political or legislative arena anytime soon.
2
Obamacare is a total disaster for working class Americans. My family premiums doubled to $2750 a month and the deductible soared to $7500 year. Congress in essence added another family to my account without my permission.
If I have chest pains later today, do I just hope it’s heartburn or do I risk a $3500 unpaid ER bill? Why should I be charged more than Medicare pays for the same ER visit? This is not what I deserved after paying for 30 years of healthcare with hardly a claim.
11
@Conservative Democrat
There was a reason Obama went from touting "access" to touting "enrolled" as a measure of Obamacare's success. He could then count Medicaid enrollees, which accounted for about 80% of its initial enrollees.
4
@Conservative Democrat
As a sole proprietor over 50 I was paying $1,200/month with no pre existing conditions for health insurance. And at 60 you dare not go without. Under the ACA is went down to $300/month. One hospital non admitted hospital visit bill was $9,000 in Boston.
Your problem is that you live in WV which tried to undercut the ACA.
25
@Conservative Democrat You can thank republicans for that out-of-balance ridiculousness. republicans never intended to help Democrats provide healthcare for Americans. Obama in his belief that the “good ole” boys in the Senate would work with him, was blind sided by their hate and racism, and their utterly pathetic resistance to help with healthcare legislation. republicans are guilty of everything that is wrong with the ACA, not Obama, he tried, but republicans made sure his attempt at bipartisanship was halted, and providing real healthcare for Americans almost died.
5
Dictators, elected or not, all professing the purest of motives, are pleased to issue what are really tendentious partisan edicts, maintained via appointed “agencies”, and to dub them ‘laws.” They bridle at confrontation with real laws. Such is the case with what has been called “Obamacare.”
President Obama, so far as can be determined, had no training or experience in any aspect of medical care, and minimal experience in Federal legislation. The result, pushed by him unabashed without consensus, is now, appropriately, though delayed, being questioned, after having been enforced with the idea of establishing its pseudo normality.
There are those who stood to profit by the changes produced by this means, who are now chagrined to be brought to realize that there is a judicial branch in Federal government, to which all “laws” are subject.
They are free in our society, at least at present, to defend their presumption in true courts of law.
Let us see what justification they offer to those, in an open society, who really provide medical care, and to those who receive it.
1
@Arthur Taub MD PhD One does not need medical experience in order to come up with a system of insurance options. Health insurance is a business. It is not health *care.* Following your logic, Trump would need to be a doctor to dismantle it.
10
@Arthur Taub MD PhD Do you find a solid proposal anywhere as an alternative to the ACA? I'm looking around. So far, people have talked a lot, but not done much of anything. I firmly believe that the best alternative to the flawed Obamacare (flawed in one way at least, because each state has the option to refuse the Federal funding which makes it work) is what all our major allies have, a National Health system. Things were bad before ACA, and in some cases bad with ACA (although in New York, I've seen a great improvement in my options, with the full version of Obamacare and the state's own expansions of publicly funded care).
8
@Arthur Taub MD PhD
Obama got it dramatically wrong, and not just with his "Keep your doctor" claim. He didn't understand the dynamic between hospitals and pharmaceutical companies, confusing which was really driving costs. He didn't understand what drove ER visits.
He actually believed "folks wouldn't mind paying a little bit more" for insurance benefits (ex., pediatric dental) they didn't need. Either he was in denial about the adverse effects (ex., skyrocketing out-of-pockets) or he was just completely ignorant.
1
Whatever legal Ju-Jitsu the courts perform on this, the right thing to do is still to make affordable health care available to American citizens. If the court decides that’s unconstitutional, there is a problem with either the court or the constitution.
19
@Peter
Wrong. Our constitution protects us from “affordable” healthcare when it means I pay for you even though you can work and pay for yourself.
1
@Conservative Democrat
Then why doesn't it protect us from "affordable" postage at the Socialist U.S. Post Office? Why should I pay for your postage, even though you can pay for FedEx?
You are completely wrong about the constitution protecting you from such things. Public schools, roads, bridges... take a moment to look up all the socialized services in the U.S. You personally benefit from many things my taxes help pay for.
If requiring all to have medical insurance is unconstitutional then so is the requirement for auto insurance.
Unintended consequences, Trump.
20
Ever since the Affordable Care Act was signed into law on March 23, 2010, the Republicans have been gunning for its dismantle and destruction.
The fact that this administration continues to swell with power and now especially with the latest justices added to the Supreme Court bench, the Republicans seem to be on one continuous roll of revenge. They don't have a better plan or even a different plan to replace the ACA, they just want it gone and could get their way.
The Democrats always knew that the ACA was not perfect and that it had problems. I was always worried that these health hiccups were never really addressed or fixed and now it seems the GOP judgment day is lurking in the background.
It has been 9 years and the same questions and problems which plagued the ACA then still do. I honestly don't know what the Democrats can do in the next 483 days that can keep the ACA intact, if not safe from those ravishing and villainous destroyers of democracy and human decency.
If the loss of the Affordable Care Act actually becomes a reality, the second biggest loser besides the American people who need and depend upon it will be which party in November 2020 - the Democrats or the Republicans?
7
Leave Obamacare alone.
Repeal & replace Trump!
218
@Dro,
Thank you. And politics aside, such action would redress and benefit the enduring principles of Americans who maintain allegiance to them.
10
Every Progressive campaigning for “Medicare for All” basically is admitting Obamacare didn’t work. The ACA was meant as a stick of dynamite to blow the entire situation up. Trying to ruin medical coverage for 180 million Americans to insure 10 million free is insane. This is a losing issue for the left. I was happy with my healthcare pre Obama.
6
@JOSEPH
And most calling for "Medicare for All" have no idea how it's run. They want to do away with private insurance yet fail to realize private insurers run Medicare for the federal government.
3
@joseph, elaborate please, under the ACA how did your coverage become worse. Mine got better, preventative was covered, increase premiums slowed down. Yes, ACA is a plan that needs work, but it was tweaked by the GOP as a compromise. At least Obama cared.
13
@JOSEPH
Insane describes your argument. The ACA afforded insurance for 40 million uninsured and it wasn't free.
You forget the ACA was based on a successful republican plan, adopted by Obama then severely watered down by republicans in Congress.
Any failure is due to the continual weakening of the law by litigious republicans.
Healthcare increases were out of control for all, including employer based plans, before the ACA was enacted. Had the law been left intact it would have addressed most of the inflation issues, but republicans were hell bent on dismantling a democrat's efforts to ensure affordable medical insurance for all.
The ACA is imperfect, but until we have a single-payer system, it's the best we have. Medical care is a right, not a privilege. You'll find that out when your beloved employer plan continues to lower coverage while raising premiums (as millions already know).
7
Gee. Maybe Americans don't like Obamacare.
Defending something that many Americans despise and refusing to acknowledge the killer flaws in it is how democrats received that midterm shellacking. Defenders claimed Obama and democrats didn't promote Obamacare enough. They didn't realize that republicans were running against it because so many Americans hated it. And still do.
4
@AACNY How are you able to determine that from the piece?
Please provide a citation that supports your assertion that supports the statement about all of those Americans that hate it.
Grasping at straws as usual.
20
@AACNY I agree with Dan's comment. We can't go around making sweeping statements without backing them up. Anyone who's ever done a decent debate class knows this. This is what the internet and the lack of the Fariness Doctrine for TV news has brought. We make accusations like this without solid fact. I do agree ACA has some horrible loopholes, but this is what they were able to pass at the time.
11
@Dan
It's not rocket science. Republicans are responding to their constituents' unhappiness with Obamacare. Why is it so hard to acknowledge that many Americans are worse off with Obamacare?
1
Hello 2020! The dems need to ring this bell the whole campaign season. It’s been years now and most Americans want this to stay.
15
The perception is that Roberts was a good guy on the ACA. Maybe, but it sure seems he's a smart enough lawyer to know the language he used in his ruling gave the Republicans a way to kill the ACA. It's similar to his opinion in the recent census case. While it seemed to shut the door on the Trump Administration it gave the chance to give it another shot.
7
I hope I don’t lose my insurance today, again.
13
Please people, let's stay focused! When the debates/media start asking about which candidates would cover "illegal " immigrants we need to flip the script and remind Americans of this: Democrats, most of all, want to help AMERICANS have decent and affordable healthcare. Period.
Don't get sidetracked by the media's quest for partisan ratings...keep hammering home this fact: no real alternative healthcare yet has been offered by the Republicans--they just do not care.
41
@Elle J. Right on! Democrats, listen up!!
If the ACA goes down, the real battle will be convincing the public why and who is responsible. Trump will blame the Democrats. His explanations will not make sense, but then nothing he says makes sense. He will blatantly lie about the facts of the matter, but then he blatantly lies about facts all the time.
The Democrats will see this as an opening for Medicare for all, which most Americans do not want, and then tear each other apart about something said or done decades ago, all under the banner of race or gender equality.
The Republicans will be unable to come up with a plan of their own because they can't and will refuse to compromise and work with Democrats because Trump won't let them.
Trump supporters will be hurt the most, but believe everything Trump says.
This is armageddon. If the ACA goes down, nearly 50 million will lose their coverage or be unable to get covered. There is no way to just revert back to the old system without blowing everything up. Actually, there is no old system anymore.
Personally, I will lose my insurance and cannot afford to pay $900 a month because of my age.
Elections have consequences. You may love to hold that rifle and enjoy unlimited access to guns and ammo, but that won't fix you or your kids if they get sick. That won't get you insulin or remove that tumor. That won't keep your small rural hospital open. That won't prevent your wife from dying in childbirth. And that's your right and our loss.
130
@Bruce Rozenblit I keep coming back to opening Medicare to those ages 55 to 65. Medicare premiums are adjusted for income through the IRMA which is is a monthly add on to the basic, extremely low, monthly premium. Most people don’t know about IRMA until they sign up for Medicare at age 65.
Opening up Medicare to ages 55 -65 would take pressure off those aging out of jobs and losing employment based insurance. It would provide some buffer to raise Medicare reimbursement rates to provides because more IRMA premiums would be collected.
What is Trump’s plan? Basically back to square one with millions uninsured or bankrupted by medical bills. No thanks.
12
Reading about the likely ramifications should Obamacare be ruled unconstitutional made me feel like someone just about to pull himself out of a pit, only to be thrown back into it: Millions of people, many of them already struggling financially, losing health coverage. Those with pre-existing conditions able to be denied coverage by insurance-company dictum (I was one of them — borderline high blood pressure). Limits on permitted coverage, after which, you’re on your own.
Do we really want to force people to choose between caring for a loved one, or being able to buy food and other essentials for their families? Making for-profit insurance companies the arbiters of life and death? How can Mr. Trump and Republicans — who have utterly failed in their promise to come up with an alternative that’s better, cheaper and covers everyone —see this as winning? See this as a victory?
If this is capitalism, then give me socialism.
25
@Alan
It's not a choice between Capitalism and Socialism, I live in a capitalist country with universal healthcare.
It's a choice between a more expensive program with worse outcomes (American system) or a less expensive program with better outcomes (All other western countries).
Honestly, everyone else in western countries can't understand how Americans can be so dense on this issue.
8
Do wonder how Trump's base will react when he tells them he made America Great Again by taking away their health insurance--knowing Trump's base---not a problem.
28
@Amanda Jones How many in that base don't realize that the ACA and "Obamacare" are the same thing so if "Obamacare" is sent to the scrap heap they will still believe they have healthcare?
5
We have pundits and Republicans running around screaming that Medicare-for-All Democrats want to abolish private (i.e., for profit) health insurance. They don’t mention that their very concrete plan is to replace it with a public system that is more efficient and more effective and less expensive. And here, in contrast, are Republicans spending years actively and recklessly seeking to take affordable health care away from millions, getting a little closer each time. This is insanity, this is evil, and this is wrong.
12
I like the changes brought on by the ACA, but it is certainly time to move to the next level. Republicans are just making it easier to propose more aggressive legislation.
The insurance companies are unnecessary. I don’t need a broker for my health care. It just makes it more expensive. Wake up moderates and swing voters. Let’s move forward!
35
Two words. Single Payer. Let's get with the rest of civilization.
66
Face it. The ACA, ("ObamaCare"), stinks.
The non-existent Republican plan will stink if if it ever materializes.
Here is MikeCare. It almost doesn't stink.
You know how the government pays to provide us with universal necessities like cops, education, libraries, road construction and repair, fire departments, snow removal, defense, garbage removal and the like? That's what we need in regard to medical care to make sure that everyone in the country, regardless of wealth or income, is covered. Just like with the other services medical services should be paid for using the taxes which we pay.
You go to whatever doctor you want, you pay a deductible to discourage frivolous medical visits, and the medical providers get paid according to a reasonable government schedule that is tailored to region. Medical providers who do not want to accept what the government is paying can do so by posting a notice in their offices to that effect. You either pay the difference or go elsewhere. In any event you get the best possible care which is what we all deserve.
What is the argument in favor of letting people get sick and die just because they are financially distressed? And that's the end of it. Welcome to the 21st Century! If it makes the prez feel any better call it "TrumpCare".
The government is not equipped to run what in essence is a medical insurance company of this magnitude so job it out to private companies with experience to run it, like FEMA does with flood insurance.
2
@MIKEinNYC The government is well-equipped to run such a program. It's called Medicare. We do not need another proxy to run it. That just increases the cost, encourages fraud and waste, and you bet it will be the insured person who pays it. BTW, that "deductible" to discourage frivolous medical visits is easily covered by a supplemental policy bought from an insurance company. It's what many of us seniors buy. Problem solved. Now let's move on to the obscene pharmaceutical industry.
22
@Karen K
Medicare is not actually managed by the federal government. Cigna and Blue Cross manage it in most places.
The problem with people advocating for a "for all" system is they really know very little about those systems.
2
@Karen K Many, most of whom are not on Medicare, claim that we face "death panels" and the government is always denying coverage on some illness, disease or ailment. That belief was born somewhere.
Or, many will state, we don't need socialized medicine as they attempt to be approved for Medicaid, VA healthcare or are military members.
I am a beneficiary of Medicare, VA and Tricare, all socialized programs. And have never been denied care or faced a "death panel".
Now, as for the prescription medicine issue, I use social programs for that also. Can't beat that $7.00 copay for a 90 day supply.
7
Republicans like to say that Democrats in Congress "forced" Obamacare into law without sufficient input from the opposition, which is nonsense. Or that, in any case, the Obama administration overreached in making the law mandatory. What is too often forgotten is that two years after Obamacare became law, the American people vote by a substantial majority to re-elect President Obama - an implicit approval of the healthcare law. Oops, I forgot that the Republican party does not believe in majority rule.
19
@Charles Michener
Democrats also suffered a blood bath in that midterm when republicans ran against Obamacare.
The states have standing for the same reason Republican states had standing to attack the ACA and DACA. But since Republican-appointed judges do what the Republican National Committee wants them to do, don't expect that logic and precedent to have any effect. And don't expect the Supreme Court, and maybe the Fifth Circuit, to rule on the issue, or overrule Roe vs. Wade, before the 2020 election. The RNC wants the Supreme Court to rule on these issues AFTER the election -- for obvious reasons.
6
@Bob
How dare any liberal complain about “Republican judges,” while Obama appointed judges won’t even allow this president to reverse a simple executive order (not a law passed by Congress) of his predecessor president.
1
Obamacare may not be perfect, but rolling back its existence to the days of people going to the emergency room for everything & going bankrupt...is that really what Trump & the Republicans want? If so, how can they in any way shape or form be considered moral human beings?
19
@John if you are still asking that last question after all the events of the past three years, you simply haven't been paying attention.
11
@John. Some of us have been aware for quite some time that the Republican leadership is morally bankrupt. (Maybe it's because I live in Texas, which is dominated by morally reprehensible Republicans, including our criminally indicted AG who is one of the parties challenging the ACA.) I never consider that the GOP might "do the right thing" any more...quite the opposite...and it doesn't matter if we're talking about healthcare, the environment, or children in cages. The one thing I still haven't wrapped my head around is the support they receive from the "Christian" fundamentalists.
4
This country, under this administration led by the rabble of the Republican party, has become what I believe it as become... Mediocre! What governments, in the 21st century, work to DENY the general welfare of its own citizens?
29
This type of brinksmanship calls into question the very purpose of the three branches of government. A Democratic Congress passed the ACA. A Republican Congress has been unable to repeal or amend it via the legislative process -the process elected officials are supposed to use in order to “govern” our country. So the ACA should stand, unaltered.
...But instead it’s chipped away at by Executive Orders and little nit-picky court rulings. It seems like it’s just a matter of time before the conservative block on the Supreme Court will be a position to go “full Barr” and we will find ourselves with no ACA, no abortion rights and few voting rights...but a gun for every lunchbox is ok because the framers mentioned the word “militia”.
20
@Dudesworth It's past time to reign in the power of the Executive branch, particularly "executive orders," which by the way, I don't remember studying in school when we studied the constitution. Would love to know the history on that practice.
1
I think it is a very strange part of America’s world view when so many of you have a problem with the idea of sharing the cost of your fellow citizen’s medical care. Seriously, what is up with that? Can these people not think 2cm ahead of their nose?
And when some people use contorted ‘constitutional’ arguments for taking it away, and others say ‘fair enough, that’s a valid reason.’
This is healthcare we’re talking about, guys. Can’t you see what’s wrong with this picture?
1092
@Jens Jensen Wery strange indeed. Many of us don't know what we want, don't know the truth when we see it.
48
@Jens Jensen
Americans already do share the cost of medical care. Emergency room visits, which the uninsured use as healthcare, pass those costs along to all of us through higher premiums and taxes. Americans just like to have a two tiered system of haves and have nots. That makes us feel superior, like we are somehow very charitable people who "take care of" people who show up at emergency rooms because they are "worthy" of our help but we don't give preventative healthcare to the "unworthy".
163
@Jens, a lot of us hear you. I, for one, advocate government-sponsored healthcare because that is the only entity big enough to negotiate with our big-Pharma, a hugely powerful organization.
Big business has gutted our poor and especially our Middle Class. We’re deathly afraid of anything new. Well, most of us. Plus the fact that Republicans want to enslave every man, woman, and child to an 80 hour workweek.
I’ve been to Denmark. An absolutely wonderful country. If Americans, especially older and those with frailties were to visit for one year, they’d be convinced and they would never accept any other type of healthcare.
Plus, as a whole, Americans are not as progressive. Most of us live in constant fear of big business. They control so much of our lives because our leaders constantly sell us out at every turn.
And then you have Trumps Base. They’re not called Deplorable for nothing.
261
With 52 million people in the "insurance pool" signed up with no mandatory demands I would think you'd have an insured "critical mass".
So why is this law suit even necessary?
1
@Peter B
Because it's "Obamacare."
We should have renamed it "Trumpcare" and the Republicans would eagerly rally behind it.
7
@lgalb Indeed. The Republicans many times will put lipstick on a pig and the supporters cheer.
3
I walked the hospital hallway trenches as an RN Case Manager during the recession, hearing story after story from patients who had no healthcare insurance anymore through no fault of their own. I also know what it is to try to obtain healthcare insurance with a pre-existing condition because I worked for a healthcare insurance company where denials were the words of the day hour, minute. I also am glad I am personally on Medicare now because I have a health condition that were I younger, my life would literally be threatened if I could not obtain healthcare insurance.
The Affordable Care Act has saved lives. The Affordable Care Act has saved millions of lives. The Affordable Care Act has served citizens of this country, millions of them.
Republicans have no alternative plan. It makes me wonder what is their motive? Mitch McConnell’s Kentucky constituents are among many who have been saved by the ACA. I spoke out personally in a town hall, a big town hall, pleading with Paul Ryan over the ACA potentials while he wanted his own ridiculous plan for Wisconsinites and everyone. Melania Trump stayed a week in the hospital over an outpatient procedure, a First Lady taking advantage over what an average citizen could never have done.
Yet they want to literally send millions of Americans on their way to graves? And yes, that is what would happen.
Bankrupt, sick, dead. That is what Republicans would rather want for Americans than the ACA.
Our country? Sad. Shame.
118
@MIMA
"Republicans have no alternative plan." That says it all.
15
@MIMA
Sadly, many of the beneficiaries of the KYnect health insurance plan in Kentucky do not realize that it is part of the ACA. I can't find the source article, but when the Republicans were trying to "repeal and replace" the ACA (really just repeal, they had no replacement), they interviewed a woman in Kentucky and she said that she didn't need the ACA/Obamacare because she was covered under KYnect. And yet, they keep sending Mitch McConnell back to the Senate.
17
@MIMA
This issue keeps me up at night and is harming my health.
5
Ok you far out identity obsessed, social engineering Hillary supporters this is the issue you can beat the ego maniac demagogue Trump on, not the former.
If you stress this, ie an affordable, universal, quality health plan than almost all of our peer countries have and a majority of Americans want and other issues that Trump demagogued, it your ticket to the White House not identity obsession and social engineering.
Obama broke the code, ie give the people what they need, Hillary didn't. He served two terms, Hillary none. Ok let's here it from the enablers and co dependents of Hillary, ie because she was a woman everybody jumped on her, Russia interfered, emails were hacked, they criticized her hairdo etc. etc.
No, look at the results, 80k total change of votes in PA, Wisc, Mich. could have put her in the WH if you addressed issues like blue collar job loses, immigration, trade etc., that Trump demagogued.
Learn from history or be condemned to repeat its worst mistakes.
5
@Paul
If only. I see no indication the DNC has learned anything from 2016. The Party isn’t unified behind a drive towards socialized medicine, the easiest path to victory anybody ever tried to hand them. The choice is (still) between the Party that feels your pain but won’t do anything about it, and the Party that doesn’t feel your pain but knows how to make money off it. Looks like Trump in 2020.
1
@Peter-Thank you for your reply. Interesting post.
1-Your last sentence pretty much sums is up, ie the dems obsessed about social engineering and identity obsession and forgot in the past things they achieved and all people needed like SS, Medicare, medicaid, Civil Rights, women's rights (not neo feminism) instead of the number one key people need today, a national health plan.
2-I differ from you on socialized medicine. I meant a universal, quality, affordable health plan with a mix of private enterprise but price regulated by gov't like Canada has. The word socialized would be a killer for most Americans.
1
@Paul
I sadly agree about the word "socialism," despite the long list of socialized programs we enjoy in America. You mentioned SS and Medicare, but don't forget the military, public schools, roads bridges, police, fire dept., FDA, FBI, CIA, FEMA, OSHA... Spreading the cost of basic services is socialism. When you send a letter, do you use the Socialist U.S. Post Office, or do you prefer to send everything by FedEx to the same place for 20x the cost? In America, there will always be better options for the wealthy, but taxes should pay for basic services - like decent medical care. We should be trying to provide better, more affordable, more universal, health care than they do in Canada. Instead, we (they) cling to our system because it is insanely profitable for the people who donate the most to political campaigns. The profit motive in health care is among the most deadly afflictions people suffer from in this country.
1
I suspect there are Congressional Republicans cowering under blankets praying that this court does NOT kill the ACA.
That would mean that, going into the 2020 elections they'd be exposed (again) for not having the "replace" plan they touted for years, and their leader would be exposed (again) for not having that 'beautiful' plan he bragged about in 2016. The Trump cult won't care, of course, but they're a minority of the voting population.
If this court kills the ACA, the Democrats must make good use of the gift, and the rest of us should do our best to stay healthy.
6
Why all the angst over repealing or striking down ACA? Just replace it with the plan the Trump had on day one of his presidency. The first couple of hours as I recall. Oh, wait, there was and is no plan. So Trump and his buddies in the Senate would rather 20 million Americans loose whatever healthcare they can get even if it is expensive.
No plan, no compassion, no interest. Well, at least it won't effect the healthcare of the people trying to get rid of it. They're covered thank god!
11
If the argument is that the Democratic state's attorneys general do not have standing to contest the law, how is it that Republican governors and state attorney general's have standing to bring the case in the 1st place?
3
The ACA is a sound public policy. Improvements are always available to make it more efficient, cover more people, and deliver more healthcare.
Since the law was passed, GOP politics has worked to dismantle the ACA. Their effort has nothing to do with a better public policy for healthcare in this country.
The GOP is motivated to prop up the failing health insurance industry and pharma's out of control pricing of medicine and devices by the cash members receive for their political campaigns.
One step forward for progress; two steps back under GOP leadership. We must get the vote out to remove the pay to play party at both state and national levels. We cannot continue to stagnate as a country if we want to have a future we can be proud of.
7
Parts of the Affordable Care Act that involve the paperwork and the regulatory requirements and the time frames for them should be reviewed and redeveloped. The algorithm platforms are very onerous, extremely time-consuming, and frequently dysfunctional. A common work theme in healthcare now is that the system crashes, the IT departments then sends the email that the system is down and all work stops. That can't be the intention.
The genesis of healthcare attached to employment started with unions pooling money and getting group funding for medical care retirement finds ( pensions). Now that unions are pretty much out of existence the burden has slipped over to the employer by default. If given the chance, Commerce probably would welcome the idea to release its obligation to insure its Workforce, by heathcare becoming a national good like roads, school, sanitation and rescue. I can personally say that the new healthcare paperwork requirements are so onerous that it leaves little time to do actual face-to-face work with my clientele. It's at least worth looking at, but not with a political eye, just a practical and humane one.
6
The Republicans are in a true no-win situation.
If they lose the case, then the ACA remains viable, and they will need to explain to their base (as Red Sox, '04, '07, '13, '18 so aptly says) why they were unable to deliver on what is clearly a racial issue.
If they "win" then the Democrats will have the opportunity to run the 2020 campaign on one, and only one, issue, and sweep the House, the Senate, and the Presidency.
And, whatever the Fifth Circuit may do, this case will head to the Supreme Court with a decision to come down probably in June 2020, just in time to heat up the campaign.
16
@John Graybeard Republicans are already allowing health insurance underwriters to offer up skinnier plans.
If Democrats insist on the mandate (I actually agree with a mandate provided the insurance is actually affordable), then they should lobby state legislatures across the country to pass state laws that mandate insurance coverage.
By a 7-2 Supreme Court Ruling, they declared this is a right reserved for states and NOT by the Federal Government..no matter how much linguistic gymnastics John Roberts throws at us.
Pre-existing conditions should be covered, but proof of continuous coverage should be required to get pre-existing conditions covered.
Here's a well kept secret .There is no Santa Claus.
Finally, Democrats could lead on this issue but they haven't offered up a single improvement to ObamaCare in 10 years.
What's that tell you?
Fact is, most of the D's hate ObamaCare, which is why they want to trash it and move to Nationalized Single Payer healthcare.
They couldn't get this through when they had 60 Senators in the Senate. How are they going to do it now that they only have 47 Senators?
There are components of ObamaCare which work well for everyone, but if you're a 60 year old couple buying on the exchange.you're looking at $18,000 a year premiums and $12,000 a year deductibles.
Affordable Care? I think not.
Lastly...let's put that 40% tax back in place for the Cadillac union plans rich health insurance policies.
3
@Erica Smythe Dear 60-year-old couple: If you were buying that insurance on the individual market, pre-ACA, you'd still be paying those kind of premiums and even higher deductibles PLUS you'd be uncharged for any medical condition you were unfortunate enough to acquire that requires continuous care, your premiums would increase with your age (much like my supplemental policy for Medicare does now), there'd be no free screening colonoscopy or mammogram. That's what the individual market for self-employed people was before the ACA. Wish people would quit comparing the ACA with employer-bestowed plans.
8
@Erica Smythe Why would you have to prove continuous coverage for pre-existing conditions? Do people not matter if they are too poor and/or too uneducated and/or too unhealthy to get coverage? (Yes, too unhealthy. Severe mental illness can incapacitate a person.) If someone were in recovery from drug addiction, e.g., this rule would make sustained recovery even more difficult to achieve than it already is. Rules need to be made with everyone in mind. We have to think about both the individual AND the community that is America.
3
Without a plan or proposed replacement, Americans will surely loose.
Bottom line, when people get sick, and have chosen not to pay into the system, someone will ultimately pay for these people. We must all pay into the system to support the Affordable Care Act, healthy and unhealthy. Without these mandates, those that do pay will ultimately pick up the tab for those that can't or won't.
While other countries all pay into a mandated system and cover their citizens, America won't or can't resolve this issue.
Healthcare costs will never ever decrease but eventually price us out, leaving only the wealthy with health insurance. Meanwhile, America sits, won't upset the apple cart to repair this huge social issue.
Shame on our government. Elect those that can and will resolve this issue.
554
@MW “leaving only the wealthy with health insurance”.
Isn’t that the GOP’s implicit plan for the home of the free and the brave? In their approach, only the wealthy merit clean air, clean water, medical insurance, economic bail outs, tax incentives, the finest education, social safety nets such as retirement accounts and judicial favor, and, towards that end, a government ruled by the wealthy, for the wealthy. While the rest of us should consider ourselves lucky to live in a country that grants us the “freedom” to lift ourselves up by our boot straps and the “liberty” to win or lose in that effort; “bravely” never having to ask what our country can do for us rather what we can do on our own.
32
Let's cut to the chase, shall we?
The Trump administration's lust to abolish the Affordable Care Act is a racial issue, not a healthcare issue. Judge Reed O'Connor's decision falls handily in line with the score-or-more of red state governors and attorneys general to have the black president's achievement fail. It's not any deeper than that. And their plea that the insurance mandate is unconstitutional is the merest ruse. A child could see through it.
Democrats, for their part, need to continue to hammer home that maintaining the ACA is a pocket book issue. Indeed, one wonders if the folks who routinely send people to Washington realize that they are the ones who will be chiefly hurt by a ruling that disenfranchises them from affordable health care.
It amazes me to think that there are millions of citizens who think that they will never take on an illness; that they will never become the unwitting victim of a traffic accident; that a child or a spouse or a parent will, on a day, suddenly turn up ill. There are some things in life that have no accounting.
If those who wish to see the ACA demolished could only have the sense to ask, "What will replace it?," perhaps Republicans might give pause to their zeal to destroy what has been working for so many.
Perhaps, but doubtful. The whole purpose of this lawsuit is to further deface the legacy and image of President Barack Obama. There's nothing here folks. This has nothing to do with your health. It's only hate that counts.
1210
@Red Sox, ‘04, ‘07, ‘13, ‘18
That's absolutely spot on!
109
@Red Sox, ‘04, ‘07, ‘13, ‘18
Might I also add to your closing sentence that these actions filed by that "group of Republican governors and attorneys general against the federal government" reflect a deep sense of prejudice against poor people, sick people, vulnerable people. Such a willingness to hurt and harm those most effected is beyond just plain wrong, it's mean, spiteful, and deliberate.
367
Many who use it don't know it. In Kentucky they loved Kentucky Connect (their state's name for the AC) but hated Obamacare.
540
The ACA though not perfect yet by far the best legislative measure to address the healthcare needs of the millions unable to afford costly private health insurance is now under clouds due to sustained personalised anti-Obama campaign from the first day. It will deprive millions of the insurance coberage if somehow the ACA becomes the target of the Republican instigated politico-judicial conspiracy.
10
Judge O’Connor has long been the go-to judge for conservative judicial activism. When his ruling came down last year it was widely mocked for its lawlessness, recklessness, and revision of history and congressional intent. The Fifth Circuit needs to do its job and reverse.
13
Hatred for Barack Obama, our first black president, has a long history in the GOP.
It was institutionalized by Mitch MCConnell in 2009 by his famous pledge to block everything that came out of the Obama WH even when the GOP agreed with it,
And of course stoking it on in the shadows was the hideous racist conspiracy theories put forward about Obama’s birth by a future President, Donald Trump.
All of this hatred coalesced around the ACA, Obamacare. It didn’t matter, doesn’t matter, that the act genuinely helps people, regardless of inevitable flaws in any human legislation. It didn’t matter that the GOP had nothing, has nothing, to replace it.
It came from Obama, therefore it is wrong; that was and is there brilliant logic.
If carried through this GOP Obama hatred will steal—yes steal—legitimate healthcare from millions of Americans.
Why would they do that? I think the answer is staring us right in the face.
They would rather millions of Americans LOSE their insurance, than our first black president WIN a legislative triumph, even years after he has left office,
It is racism. That is the reason.
254
The crazy thing is the ACA was actually invented by Mitt Romney, while governor of MA. But it was adopted by the Dems, so they hate on it. If it is repealed soon, after all this weakening, it will galvanize the electorate.
Trump might not want to kill off his own voters.
14
@Blue in Green
Trump doesn't think that far ahead - ever!
9
Republicans only need 12 to 68 more years to come up with a replacement to Obamacare.
Of course, Trump already has a great plan to cover everyone, even those with a pre-existing condition, a plan that will be better and cheaper than Obamacare. He's just waiting for the right time to unveil it.
And, pigs fly.
51
From repealing Obamacare, to denying climate change, to shoveling more wealth to the rich, the greatest threat facing America is the Republican Party.
519
@Larry Roth
Not just the Republican party but the entire human race. Somehow I think we all know that the human race will one day cease to exist. It could be in the distant future or it could be sooner than you think. The longer the Republicans and the minions or idiotic American zombie voters stays in control, the sooner than you think scenarios just keeps getting sooner and sooner.
18
Go ahead, GOP, get rid of it. The GOP has done, and will do, exactly nothing on healthcare, or less. Gut it, and leave all those impoverished rural communities twisting in the wind while you fatten yourselves on your pharma investments, and see what happens then. How antisocial can you possibly be?
20
In an effort to pass Affordable Care Act, pejoratively called by Republicans the Obamacare Act, all details were not thrashed out. Even Pepsi famously said that let us pass it first and we will figure it out later. if I remember, not many Republicans in Congress voted for it.
Despite its shortcomings, ACA was a laudable effort as it provides healthcare to millions of people. Perversely, I believe it should be deemed unconstitutional, Republicans should be voted out and all three political houses should be controlled by Democrats. Write the law properly this time, don't engage with lobbyists, make it iron tight, and make it single payer. Do it right the next time. Yes people will temporarily suffer, but we have suffered for more than 30 years under the tyranny of healthcare industry. So 3 years more we will suffer. Do this right, Democrats.
8
Here is the bomb Roberts planted when he failed to find the ACA constitutional under the Commerce Clause.
15
GOP has done nothing from the start to come up with better solutions, just to tear down a system that started to save money and lives
don the con promised such beautiful health care and has done nothing but tear down the ACA
meanwhile, the GOP/president* claim that they are pro life.
they are nothing but hypocrites
13
Until enough Americans suffer a financial problem due to a health issue, they will not support universal healthcare. They are too selfish. I feel incredibly lucky to live in France where healthcare is considered a right and guess what, I can chose any doctor I want, I am not limited to those in my health plan and the sicker I am the more help I get. Also should you ever fall sick in France, France will take care of you and won't immediately ask for your insurance or money. They believe in the Hippocratic oath. Shame on America.
96
@getGar
The same was true in Belgium when my daughter worked there. She was insured under a Levis plan; when she got sick and went to a clinic, her card was not needed. She was treated, no fee, with follow up care. We could have Medicare for all, financed through taxes, payroll deductions, and SS deductions, as mine is. GOP propaganda uses immigration and the unemployed as a weapon to deny coverage. We can afford to send troops all over the world to protect corporate interests; we give them medical care. We did not cover our own with basic care until the ACA. Those who used ER's were hounded with huge charges which could produce liens against earnings, no matter how small. This appears to be a historical by product of the Puritan need to control all things. Only men of property could vote. Now, we are looking at only people with earnings, property, or savings to attach deserve basic health care.
23
@getGar
As a Canadian I enjoy the benefits of universal healthcare.
I never have to worry about not being able to afford treatment, and the cost to provide universal healthcare is far lower than the American insurance model.
It's time for the USA to finally come into the twentieth century and provide universal healthcare.
17
@Linda Miilu
"Those who used ER's were hounded with huge charges which could produce liens against earnings, no matter how small."
This. People don't understand that the 'free' coverage by emergency rooms and hospitals were billed to the patient, and credit collectors sent after them. Then when they did have to file for bankruptcy any assets, including any retirement savings, had to be liquidated.
13
Let's strike down the Affordable Care Act, elect Elizabeth Warren or Kamala Harris (along with a Democratic Senate) - and then enact a single-payer system!
5
The GOP and Trump are just petty and mean, more concerned with undoing anything Obama than protecting people’s health care. The ACA is far from perfect but the GOP offered nothing to improve it in their 7 years in the majority. Outside the netherworld of Washington such behavior would be certified as crazy.
15
A few points:
- All people need access to health care for life, liberty and the pursuit of happiness.
- Every Republican senator voting for the tax bill that ended the individual mandate should be voted out of office.
18
I thought several weeks back Trump stated he would announce a new health care plan? Also an infrastructure plan, an agreement with N Korea, get the troops out of Afghanistan and finally build a wall with Mexico paying. I guess these are like the promises he has made to his former wives and business partners. Worthless. Will the voters realize we don’t have fake news, we have a fake President.
57
The healthcare universal coverage brouhaha snaps into focus what you think having a liberal democratic Nation is all about.
I am talking about existential things not some implementation issue.
There are many ways to skin a cat and all cogent ideas that align with the guiding concepts, principles, and ideals (objectives) should have place in the market.
No I am talking about essence! What is this Nation all about.
On the one hand you have the Ds that lean toward the very heart of liberal democracy.
Toward the notion that people form Nations for the GENERAL WELFARE.
That Nations should stay out of people's private lives mostly but that every citizen in some way must respect the need to enhance the GENERAL WELFARE.
That the more fortunate must share some of their good fortune with less fortunate for the GENERAL WELFARE.
That authoritarianism is verboten.
That equality, fraternity, and liberty should prevail over wealth, power, and association (religious, political, social, etc.).
That our children and all children to come will enjoy an incrementally better life; that they will have a clean and healthy environment and the most modern good version of supports, protections , and freedoms/opportunities.
On the other hand we have the GOP that is TRULY at war with modernity and liberal democratic concepts. Theocratic Plutocracy their aim!
I hope we choose liberal democracy 2020 in a big way!
20
Umm, they already charge more based on age even with the ACA, if you have to buy an individual plan from the "marketplaces." Four times as much for someone in his/her 50's versus 20-somethings. Can progressives get out in front of this issue and get us single payer, or at least a public option, before the ACA is butchered? Even the ACA is not affordable insurance for too many middle class people.
8
@mdieri
Obamacare is terrible for anyone earning over about $65,000. If your income is under this, you get Medicaid or subsidies. Above it you get high out of pockets and benefits you don't use.
Obamacare was essentially a giant expansion of Medicaid. Why did democrats have to disrupt everyone's insurance just to expand Medicaid?
2
@mdieri My son, who is 31, pays a small fortune for ACA here in NYC. As a freelancer, you may imagine how tight his budget is. We, who are retired city employees, have private insurance and Medicare. We love both and would not want to change. BUT, even living on our pension and social security, we give back: we contribute to the cost of his payments every month. This is in aid of his not purchasing the cheapest policy, but instead helping him to buy a better plan. ACA needs revision, not rescinding.
9
Why not just admit it: the Affordable Care Act was a very weak and inadequate measure, and a band-aid on a gaping wound.
Instead of continuing to call it Obamacare and worrying about someone’s legacy, let’s get going on a transition to single-payer universal health coverage.
A physician MD
15
@srwdm It was better than the NOTHING we had. How many of your patients will die while we transition to single payer? We democrats will never take over the senate (primarily because no one is running), and we could certainly lose to Trump. Single payer is not happening.
8
It seems like legalise is hiding the fact that should the ACA be found unconstitutional, it will be the Republican Party who bears the brunt of killing healthcare for millions of people.
Their vendetta against this law, in part based on hatred for Barack Obama and already found constitutional in 2012, has been attacked relentlessly in order to "bring the American People wonderful healthcare".
Just what that is is never explained. But if 27% of pre-Medicare age adults lose coverage and can't obtain replacement healthcare, it will trigger a health crisis the likes of which may bring unintended but roundly deserved consequences for the GOP.
15
@ChristineMcM. But Trump & GOP will blame Democrats — which is why Democrats should be focusing on this issue, rather than ‘support’ for illegal immigrants. Dump Trump should be the focus!
The 5th Circuit based in Louisiana has a long history of decisions that would please the Clarence Thomas’ of the world. They will find the ACA unconstitutional and only Justice Roberts will stand in the way of a catastrophe for millions. He will do the right thing but the turmoil can only help drive Trump from office. His vendetta against anything Obama will cost him the election.
7
This case doesn't raise any genuine issues, and the silly question of whether the temporary reduction of the penalty amounts to a legislative revocation of the mandate ranks up there with "why did the chicken cross the road?"
If the 5th Circuit strikes down Obamacare, then the case will hit the Supreme Court in the middle of the election campaign. That would certainly help pump up Trump's pep rallies. Perhaps that is the point.
3
@Sequel
People think Trump will be "punished" for ending Obamacare. On the contrary, he will be heralded by everyone who isn't on Medicaid and not receiving subsidies. That's a lot of Americans.
4
@AACNY Since the majority of Americans like Obamacare now, Trump has more to gain from losing this frivolous case, and more to lose by not having it in the middle of the campaign.
4
Our country is supposedly based upon the rule of law. But who’s law? And what prevents you or I from interpreting the law to suit my own beliefs or agenda. And with enough money and lawyers, I can bend the law to my will. So what makes, America the great democracy, so great? My individual right to interpret the laws as I see them and the right to buy as much of the law as I see fit. Tell me then how this is so much superior to a system of graft and bribery where you can use money, which is power, for much the same purpose. The answer is our social fabric. But every now and then our social fabric becomes torn and tattered. And our electorate. There are those who wish to purposefully tear our social fabric and those who wish to hobble our electorate. As chuck Schumer said, it’s settled law till it’s not.
@Robert
Of course, in a democracy, there can be no universal, apodictic, “settled” law, as law is governed by circumstance and, in a free society, by consensus.
Your idea that all law is bought and sold, that you, or in fact any demagogue, may interpret it at will, and your informed prejudice against lawyers, is misguided.
There are laws you would uphold, I imagine.
Without the ACA, individuals with any kind of disabilities are forced to limit income and qualify for medical assistance to access healthcare or go without, excluded from the market due to preexisting conditions. Employers need to carefully screen who they can and cannot afford to hire based on healthcare costs. Employees are infantalized into thinking healthcare is free, unaware their incomes are greatly limited due to employer health-care costs. Again. Welcome back to pre-Obama healthcare.
21
@Leigh
"Employees are infantalized into thinking healthcare is free, unaware their incomes are greatly limited due to employer health-care costs."
This why people are shocked at the cost of COBRA insurance if they lose their jobs. That huge monthly payment is just the total cost of the employer provided insurance, including the part the employer paid for.
2
Thank you Chief Justice Roberts. By using twisted logic to uphold the Affordable Care Act by labeling the penalty for non participation a”tax” he left the door open for a right wing judge to declare the entire law unconstitutional when the republicans eliminated it. Now he has done the same with the census question on citizenship by faulting the logic of the reasoning behind it rather than the intent. The door has been left open once again for the administration to continue to subvert the rule of law.
51
@Old Doc
Why not thank the party responsible for creating this unsustainable mess?
2
@AACNY
You must be referring to the republicans who refused to participate in making the program better rather than allowing improvements (such as a public option) to be made
11
This case will be the path for Trump to NOT get reelected. And other Republicans. Please continue and ruin your chances for reelection. Democrats, please continue to bring this issue to the forefront as it can only help you get elected or reelected.
101
@Chris I Even if a miracle occurs and Trump is not reelected, it won't save our democracy. As Mitch has gleefully noted, laws can be changed. But federal judges are appointed for life. Bret Kavanaugh will be passing judgment on women for the next 40 years. The Democratic House majority won't survive the continued GOP rewriting of the map, now fine with CJ Roberts.. Does anyone think that Republicans are going to stop walking all over the rule of law? Ask Stacy Abrams. Just the idea that the now Governor of Georgia, acting as Secretary of State, openly refused to process 50, 000 new voter registration forms specifically b/c they would benefit her, never mind conflict of interest etc. tells us all we need to know about our future as a Republic. Late night comedic insults only serve to infuriate the GOP, making their mirth all the richer when they grind the poor into dust. Nancy caved on the money for the border kids, letting us know that "liberal" House Dems are more concerned now about job security, realizing their control will be short-lived. The Federalist Society knows well who to recommend for judgeships: people who don't even care what the public thinks of them. And Roberts won't last long either if he supports the ACA again. Well, at least Pres. Obama is enjoying his life.
6
@Chris But what then? the ACA will still be gone. Congress will have to come together and pass comprehensive health care reform. Do you see that happening next term? Regardless of who is president? I'm hoping to retire early, before medicare age. Without the ACA or some sort of health care reform, I can't plan for retirement. I would have no way of figuring out my medical costs if insurance companies can dump me if (or when) I get a preexisting condition. I'm not afraid of high premiums and deductibles; I'm afraid of no insurance. That jumps the cost of everything up astronomically. Bypass surgery with a high deductible may mean $6000 or $10,000 out of pocket; bypass surgery with no insurance means $100,000.
1
The only losers in this deal are Americans who are forced through taxation to buy insurance. I have been in the finance arm of healthcare for over 30 years. Everyone regardless of their socioeconomic status gets healthcare. The differences in the health status of Americans is not who has and doesn't have insurance, it's the lifestyle that they lead. Those higher up on the food chain are generally more educated and live a healthy lifestyle which in turn ends in better health. Those at the lower end of the food chain are struggling to get by and do not have the knowledge of how to eat better and they probably can't afford to eat healthily. Lets stop kidding ourselves, we need to do more as a society to educate people about how lifestyle affects health
4
@Anthony
Your position appears to be ignorant of diseases from birth.
As someone who has a chronic illness from a very young age I can tell you that it is not only a matter of a healthy lifestyle
My illness without insurance for ongoing specialist visits, annual tests and medication would run over $10k per year.
I have been hospitalized numerous times and had major surgery on top of that
It is not simply an issue of lifestyle and financial status as you and the healthcare industry may like to claim.
237
Anthony in Austin: You make very valid arguments about healthy life style and income. I do not follow your argument that everyone has health care protection without Obamacare. Are you talking about Medicaid? Elizabeth Warren has shown that many people who file for bankruptcy do so because of health bills.
While we’re waiting for everyone to get a healthy life style, with or without an increase in income, what are we (society) to do about health care for everyone?
17
Yes, people get in car accidents because they don’t eat right. Everyone does not get health care. If you don’t like to contribute through taxes to the good of your country go somewhere without taxes and see how that works out for you.
30
Can this be more of a nightmare? Limits on coverage would be permitted but NO CAP on out-of-pocket costs? The perfect storm............I am in shock, I just can't accept this as normal.
162
@mary Suicide will be the only option for many, even the presumed wealthy (just not the uber wealthy). Again brought to you by the "Pro-Life" party.
22
A glimpse into the current and real-life ramifications can be found with so called "gap" insurance, such as United Healthcare's Golden Rule. An internet search of consumer complaints reveals that when a health crisis occurs, people quickly find out they don't have the coverage they thought they did.
There is the usual fine print and creative license in citing pre-existing conditions to deny coverage. ACA originally allowed up to 3 months on one of these risky plans. Under Trump, this is now up to 3 years.
In the early 80's, my mother worked briefly for a health insurance company in the claims department. She quit within a month because she had to automatically deny every claim. Haven't we learned?
14
@mary
Yes indeed, "the perfect storm".
Add to that ongoing assaults to helpful poverty and educational programs; "pro life" until birth, then Good Luck within the system; the new gig economy, contract labor with few/no benefits; decimated union voices that are needed to re-balance this lopsided economy; the intractable drug crisis; the high cost of lifetime veterans' healthcare; and of course ... the aging Boomers.
But, "we" did get a big tax break, yes?
And, we may be at war somewhere in the world, with all our new rockets and machinery?
Can hardly sleep at night ...
9
If "Trump’s Texas lawsuit" ends up in the lap of the Supreme Court and they side with him, then perhaps that 27% of the population who "would be rejected for individual market coverage under the practices that were in effect in most states before the Affordable Care Act" plus most other Democrats will garner enough votes to rid this monster in 2020.
It's been nine years since the Affordable Care Act has been passed, so I am hoping Speaker Pelosi finally found out what was in to so she and her fellow law makers can begin to make it better and more sound for their constituents should Trump get his way about this issue as well.
10
I am confused. Paragraph 6 begins "If the mandate is indeed unconstitutional...." but didn't the Supreme Court say that it was indeed constitutional in 2012? The previous paragraph says the Supreme Court upheld the mandate as it is considered a tax and Congress has the right to tax.
And then Congress decided to repeal the tax, and that is what makes the basis for the law become wobbly.
What am I missing?
13
@J.S.: John Roberts ruled that the Affordable Care Act was constitutional as a tax - and Republicans removed the tax part.
2
@J.S.
did you really buy the "health insurance is a tax" explanation?
As a mom-and-pop business owner, my experience with Obamacare was to be denied the small group coverage that I had been purchasing for decades. Obama made it unavailable to us. So we were shunted onto the individual market, which is still a royal mess. At one point we lost all our doctors and specialists.
Trump tried to change this but was shot down by the courts. I hope he prevails so we are not at the mercy of Obamacare, stuck buying what we don't want (ex., pediatric dental and maternity coverage) and can get back what we always had.
4
@AACNY
"back to what we always had." You mean that fun denial of care if you've ever been sick before" stuff? That wonderful time when people could just die and get out of your privileged way?
8
It very well may be that requiring people to pay a tax or a penalty for something would be unconstitutional, had it not been for the 16th Amendment to the Constitution. Surely, the "pay-as-you-go" supporters would support a national effort to repeal it. Why should I pay for my neighbor's ER visit? Why should I pay the fire department when I should just learn not to play with matches? What do I need roads for, with the Internet? And with a Smart Phone, what do I need with public education and libraries? And why am I paying Trump's salary when all he wants is for me to not pay the taxes that pay his salary?
Or... since sickness, injury, and old-age are "inalienable rights" of the body, don't we have a duty to protect ourselves with healthcare just like we have the duty to protect other rights by being sure the laws are faithfully executed? The Bill of Rights would not be worth anything if there weren't three branches of government to make sure they weren't being violated and to bring justice when they are. The body has rights, for without the body, of what use is the rest of the Constitution?
40
@Maxine and Max
I can't tell if you're argument is serious or not.
Example:Why should I pay the fire department when I should just learn not to play with matches? What do I need roads for, with the Internet? And with a Smart Phone, what do I need with public education and libraries?
5
@Rick Tornello
The pay-as-you-go crowd presume that it's a perfectly valid social contract to neither accept nor offer charity, loans, or anything that they didn't earn and get on their own. People, as a resource, count less and less in a world where we look to Youtube for answers, Angie's List for someone to help with the chores we can't do, and the Internet for all the education we need. Friends are a Facebook value. If our grandparents were once valued for the wisdom they earned, now they are just relics of a time when wisdom wasn't available to anyone with a Smart Phone. Heartbreaking but very very serious.
12
Will this open a Pandora's box? If a driver drives on a federally owned road (say, an interstate) and is required to have insurance in order to legally drive on said road, will that insurance then be considered a "tax" and challenged? It seems that Republican Governors (name them all please) are interested in more than simply making lots of people really sick. Will hapless Dems please concentrate on defeating these people? Can we please take our government back from these reactionaries?
80
Still waiting to see the Trump administrations alternative plan -- the one he claimed to have while campaigning in 2016.
649
@ACA
it's in the same bucket as the Pesos that will pay for the southern wall ....
72
Alternative plan? Years have come and gone waiting for the writing of a viable alternative plan.
32
@ACA
Alan Grayson, Representative of Florida summed up the GOP Health Care View:
The Republicans’ health care plan for America: "Don’t get sick"... If you have insurance, don’t get sick; if you don’t have insurance, don’t get sick; if you’re sick, don’t get sick...That’s ...the Republicans’ health care plan.
The Republicans have a backup plan, in case you do get sick. If you get sick in America, this is what the Republicans want you to do: "Die quickly."
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I wonder what Trump's prospects are for re-election if he strips away healthcare for 20 million voters nationally?
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@Adam Trump's prospects for re-election? He will win because those 20 million will still vote for him despite losing healthcare. This is the country we live in today.
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They will also vote for him because of the great work he’s doing to save the planet.
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@Sally
What "great work" would that be? The dismantling of over 80 environmental protections and pulling out of the Paris accord? His palling around with dictators? His giving our technical secrets to the Saudis so that they will now make our smart bombs? Maybe it's how cleverly he managed to make sure that Kim continues his nuclear work. Or is it how he locks little children up in cages after ripping them away from their mothers? Just what "great work" is this hero of your's doing that is saving the planet?
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If there is a question as to whether the Democratic states and House of Representatives even have the standing to appeal the judge’s decision, how is it that the Republican states had the standing to sue to overturn the ACA in the first place?
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They claim their citizens are wronged by the law and that their states pay taxes to cover that wrong. Hence they have standing.
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This could guarantee a Democratic Senate and White House in 2020!
To pull insurance from millions with no plan to replace it with anything would be devastating, but it just may be the issue that turns some GOP supporters off.
I do not want to see anyone suffer, but DJT followers have remained allergic to the truth for too long.
Maybe their time has come to feel the real life consequences of DJT and his GOP enablers.
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"This could guarantee a Democratic Senate and White House in 2020!"
And Court. Don't forget the soon-to-widen Court. The vile GOP will never walk a government hall again if they pull this. As someone in a galaxy far, far away might say, "If you strike ACA down, sanity shall become more powerful than you can possibly imagine."
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@Is_the_audit_over_yet I hate to say it, but I'm with you. Maybe with the dismantling of the ACA we could see bipartisan support of something much more progressive. It's a gamble and definitely jeopardizes the lives of many Americans who rely on the program now, but the payoff could end up being universal coverage.
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@Is_the_audit_over_yet Why would this guarantee a Democrat White House or Senate? Clinton ran against a candidate video taped bragging about sexual assault and that didn't guarantee a Democrat White House. California has 27 times the population of the Dakotas but they get twice the Senators.
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It amazes me that the republicans would not want their constituents to have healthcare; they would be complicit in the deaths of their own constituents. Folks, wake up - this is about you - your families, your children. Don't take for granted that your child under 26 is covered, this is a huge boon. Don't take for granted that if you lose your job, that you and your family can get healthcare coverage. Just 10 short years ago, this was a huge issue. Please follow your legislators' position on this and demand what is basically a human right. Of course, the Republicans have been bought and paid for on this issue, but you can VOTE them out!
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@Meighan Corbett
Well said. The ACA is far from perfect, but for millions it’s the best they’ve ever had. Especially those with pre-existing conditions
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@Meighan Corbett
You are all missing the point on the willingness to throw out Obamacare. Over half the housholds in the U.S. do not have $500.00 saved for an emergency, that’s a fact. These people live pay check to paycheck, there is nothing left over at the end of the month. If everyone made a middle class wage, of course they would welcome less expensive coverage. The budgets of half Americans dictates a choice between mandated health insurance and rent or a car payment. Now, we have the, "no brainer,” everyone talks about, because the community hospital down the street has to take you in and take care of you. Most people have no wealth to protect, they may have a car or a cell phone. The ACA boils down to one more bill to pay that tilts these housholds into insolvancy. So there is the choice, insolvancy or insurance they can’t afford. Now, throw in, the lower end of Obamacare and you get the, "Bronze Plan," with a ten K deductable. A day or two in the hospital and they are bankrupt anyway. So, please, let’s not all be in a bubble of prosperty, there are genuine reasons so many people are against the ACA. Obama, handed the Republicans a fulcrum to label the Democrats as a tax spend liberal cliche. The result was a legacy of complete Republican take over of elected government, and the Supreme Court.
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@Prant
I could be wrong, but I suspect there is a large cohort of individuals/families that are not covered by employee health plans (multiple part-time jobs, contractors, etc.) and earn too much to qualify for Medicaid but are burdened by the cost of insurance on the individual market, so would jump at the chance to opt out. And as you say, even if they can swing the premiums, the cost of actually using the coverage is cost prohibitive (deductibles and co-pays) so acts as a catastrophic plan. To get to MFA, next best step is a public option to compete with insurance companies, negotiated prescription drug pricing, and increased financial supports (subsidies) for ACA plans.
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Regardless of all the solid utilitarian arguments supporting Obamacare, if the law is unconstitutional it must fall. Then it's Congress' job to fix it. Just like all things that are 'legal' are not good, all things that are 'good' are not legal.
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@Mark Evans The law is not unconstitutional until and unless the Supreme Court says it is. There is a presumption that all laws passed by Congress are constitutional, and that presumption must be overcome in a court. Unfortunately, this Supreme Court has become the political tool of a deranged administration. It will take a generation or more to undo the damage currently being wrought.
Perhaps if your healthcare were on the line you might seek a more informed approach.
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@Mark Evans: Fat chance with McConnell blocking everything that comes from the House. I don't know what kind of healthcare coverage you have, Mark Evans, but to see those kind of numbers thrown back on the open market in the dog-eat-dog world of US healthcare, is incredible in a modern country. Just remember, you might be one of them some day.
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@Mark Evans if you read the article, you would see that if it is unconstitutional, it's because of the Republican Congress's sabotage to the bill. They were the ones who changed it in the hopes of destroying it, they are the ones whose change might be unconstitutional, and they are the ones that have no plan to replace it. So if it gets thrown out, none of this is on Obama. It's on the people who secretly hoped for this when they changed the law and refused to defend it.
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should this be supported, it will be very difficult to make needed changes to the health care system as the public will lose trust with the government who appear intent on undoing hte other parties work.
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