There is a lot of crazy stuff on the airwaves re: the Supreme Court's upholding of the Affordable Care Act.
The Inane "Is It a Tax?" Debate: Republicans are viciously attacking the ruling because it introduces a new "tax" on people who don't have coverage. As I and many others have stressed, this tax is a free-rider penalty. It is a PRF -- a personal responsibility fee -- for not saddling the rest of us with your health care costs, thereby imposing an implicit tax on the rest of us. And it hits 1-2% of the population.
You thought personal responsibility was supposed to be a conservative value? Not, apparently, when the dreaded tax word is invoked.
But, really, a pox on both houses here. Despite the fact that the Supreme Court ruling calls it a tax -- I mean, it doesn't just call it a tax, it says the reason we can do this is because Congress can tax -- Democrats are working overtime to not pronounce those dreaded three letters. Weirdly, they now have an ally in this Kabuki theater: Governor Romney!
I get it: silliness pervades in an election year... but really? Seriously?!? Taxes happen in societies -- according to a Supreme Court justice from a saner time, they're "the price we pay for a civilized society." And in this case, they're the price we pay to offset a negative externality by which the behavior of a small minority of citizens imposes a cost on everyone else.
To be ashamed to make that case is to cede the field to Norquist and co.
The Supreme Court Ruling's Impact on the Cost of the Affordable Care Act: Another unfortunate talking point evolved over the weekend that also makes no sense: based on changes to the law imposed by the SCOTUS, the ACA is now a "budget-buster." I heard Sen. Coburn make this argument on a Sunday show, and my conservative doppelganger Doug Holtz-Eakin made the point in a debate we had on Friday. Doug's argument was later picked up by the Washington Post... unfortunately because, as my CBPP colleague Paul Van de Water points out here, it's got to be wrong.
First, you should know that the CBO scored the ACA as slightly reducing the budget deficit in the first decade of its existence and reducing it a lot more in its second decade. So, what's changed in the SCOTUS ruling that would lead Republicans to make the claim that the law is no longer fully paid for?
The only change the SCOTUS made that has significant fiscal implications is making the Medicaid expansion optional for states. If no states take them up on that, the CBO cost estimate stands. But if states opt out, that means the law should cost less to implement, not more! This is a bad thing as I see it, because it means less coverage for the poor. But it saves money.
Clever Doug argues otherwise based on the following logic: It's true that people below 100% of poverty will now not benefit from the Medicaid extension in opt-out states. But those between 100-133% of poverty -- who would have been covered under the Medicaid expansion -- will now be eligible for the federal subsidies to buy insurance from the state exchanges, coverage which Paul Van de Water says "may be more costly than Medicaid."
The problem for Doug, Sen. Coburn and others who are making this case is that there are about four times more people potentially eligible for Medicaid below 100% than between 100 and 133%. As the figure below -- from some very timely Urban Institute research -- reveals, there are 22.3 million uninsured poor and near-poor people who would be eligible for coverage under the Medicaid expansion. But about 80% of them -- 17.8 million -- are below 100% of poverty and therefore not eligible for subsidies. It's implausible that a much smaller group getting subsidies would cost more than a much larger group not getting on the Medicaid rolls.
In this regard, based on the SCOTUS ruling, the CBO cost estimate should now be considered an upper bound. It's the cost of the ACA if no states reject the Medicaid expansion.
This post originally appeared at Jared Bernstein's On The Economy blog.
Follow Jared Bernstein on Twitter: www.twitter.com/@econjared
Cecilia Attias: Affordable Health Care Will Be Good for America
Eric Simpson: Universal Health Care Is a Moral Imperative
By the way, I worked for a major health insurer for 19 years, and although I'm grateful for the good benefits, I do wish we had some sort of universal health care.
Try to treatment for a catostrophic illness for free.
Government by freezing wages in WWII compelled employers to institute the employee based insurance system...which is NOT insurance...it is perk...part of your compensation.
To call it insurance, would be like having an auto policy that paid for your gas and oil changes.
Insurance is for catastrophic and financially devistating events...not a $75 trip to your family doctor....adn you e know what...insurance comapnies aren't even allowed to offer teh real insurance...again by government edict. If they were a policy would cost a fraction of what it does now.
Obamacare just further enshrined this stupid system that was created by a govenrment boneheaded move.
A quote attributed to Oliver Wendell Holmes, either in 1904 or 1927, or perhaps some other time prior to his death in 1932. But in any case, before the first of the New Deal entitlements. This is germane because it's the root cause of Conservative aversion to taxes.
Up through the early 1960's, our taxes went to the federal government to exercise federal enumerated powers and responsibilities. Under Eisenhower, 55% of the federal budget went to defense, less than 6% to social spending. People accepted the need for a 90% top income tax rate, it was clearly to benefit the nation ("the general welfare"). It was not transfer payments from those who work to those who won't (or other incendiary words to that effect, choose your poison).
The system of social safety net spending, including Social Security, Medicare/aid, and transfer payments to the states to support social welfare spending has become a monster, but for reasons that are not often noted.
The federal government has become the Sugar Daddy, so all federal politics has become personal. Who pays, and who plays. Issues of war and peace take back burner when personal entitlements and personal taxes are at issue. The Founders wrote the Tenth Amendment for a reason. We've repealed it without a vote, and now our federal government is in useless disarray.
Fools, this is just an attack on freedom and redistribution of wealth. Period. Every justification you have is made-up fluff and fear mongering. The reality is you are hurting people that are healthy and working, in order to partially offset the cost of supporting people who are not working. And I say partially, because the plan is still going to bankrupt an already struggling economy.
The Republicans are claiming to have a better health care plan but prior to the 2010 election the Republicans claimed they were going to create jobs . If a Republican's lips are moving they are lying . That may be why Mitch Mc doesn't move his lips .
Going back in time , the Republicans claimed corporation duty free importation of finished goods and materials (free trade) would create jobs and it did . Millions of them . And for each job they created they took one away from the American worker . And their justification and smoke screen has been a long campaign of vilification against American labor unions . And since then Americans have been living in a continually sinking standard of living with disappearing support programs .
Our healthcare insurance premiums have gone up SHARPLY since the passage of ACA. So much so that we've had to scale back to a less comprehensive policy than we formerly had. That is a simple fact.
I'm trying to figure this out. If health care is a positive economic right that government should provide, as progressives seem to think, then it falls into the same category as the "rights" to adequate food, shelter, education, etc.
If one shifts any of these "personal responsibility" costs from himself to the public, isn't he also a free-rider, who deserves to penalized? And then don't ALL individuals who impose such costs on taxpayers also deserve to be penalized as free-riders?
If this sort of penalty is a step to universal health care, then I suppose we should take similar "progressive" steps, like fining special education students for not having special insurance to cover their higher cost of education.
Those who can't afford adequate food can get Food Stamps.
Education in the United States is a right, and through high school it's free.
Homeless shelters exist for those who cannot afford a place to live.
Health care is a primary responsibility of society because it is a direct matter of life and death.
People who cannot afford health insurance will not be penalized.
how weird can you be ?