"Court decision calling penalty a tax sets off debate" by Matt Viser | Globe Staff, June 30, 2012
WASHINGTON — Is it a tax? Can it be called a penalty, maybe a fee or a fine? How about a penalty tax?
A rose, by any other name, still has thorns that tear your ass up when they are shoved inside.
Following the high-stakes Supreme Court ruling that narrowly upheld President Obama’s health care law, a debate erupted Friday as lawmakers sought to brand the law and how Americans think of it.
The debate is infused with an ample amount of politics, a dollop of legalese, and plenty of spin. “Don’t believe the hype that the other side is selling,” Governor Deval Patrick said Friday morning on a conference call organized by Obama’s campaign.
“I just want to respond to the, frankly, bizarre attack, which is the claim this act represents a big tax increase on the middle class,” Patrick said. “First, this is a penalty. It’s about dealing with the freeloaders — the folks who now get their care without insurance in high-cost emergency room setting. And all the rest of us pay for it today.”
Who is paying, governor?
The decision, written by Chief Justice John Roberts, upheld the law on the grounds that Congress can impose a mandate for people to buy insurance as a form of its taxing powers. Under the law, those who fail to obtain insurance will be required to pay a tax penalty starting in 2014.
In legal terms, the ruling sought to be clear: The Constitution allows Congress to assess taxes, the law included taxes, therefore the law is constitutional. Politically, the definitions were not so clear.
“Obamacare is now a tax imposed on all Americans,” Texas Attorney General Greg Abbott, a Republican, said on MSNBC.
“They’re retreating to the last bastion of scoundrels, which is to try to cast this as some sort of tax increase,” Maryland Governor Martin O’Malley, a Democrat, said on a conference call. “It’s a penalty.”
Making the case that it is a tax allows Republicans to portray their Democratic rivals as tax-and-spend liberals and Obama as a deceiver in chief.
Something seems to happen to them when they win that office.
“They knew it would have never passed if they said it was a tax,” Senate minority leader Mitch McConnell said just after the health care ruling. “The Supreme Court has spoken. This law is a tax. This bill was sold to the American people on a deception.”
Like wars.
But some on Friday compared the “tax” charge with the “death panel” distortions from three years ago.
Actually, death panels are real, but why let that get in the way of the agenda?
The law does not affect the vast majority of Americans, Democrats pointed out, because most people already have health insurance and would be exempt from paying. The law also provides assistance to those who cannot afford health insurance.
So what happens when employers start dropping coverage?
“You can call it what you want,” White House press secretary Jay Carney told reporters on Air Force One. “If you read the opinion, it is not a broad-based tax. It affects 1 percent, by [Congressional Budget Office] estimates, of the population. It is not something that you assess like an income tax.”
Then why is the IRS in charge of collections?
But by making the tax component a crux of their argument, Republicans could face challenges. Romney signed into law a nearly identical setup in his health care plan in Massachusetts. That law also included an individual mandate and a penalty on those who did not obtain health insurance. Romney has often said that he never raised taxes in Massachusetts, although there are several instances where he referred to the health care penalty as a “tax.”
It shows you that ONCE AGAIN all we have is ANOTHER SHIT POLITICAL FOOLEYS!!!
In a 2009 op-ed in USA Today, Romney wrote, “Using tax penalties, as we did, or tax credits, as others have proposed, encourages ‘free riders’ to take responsibility for themselves rather than pass their medical costs on to others.”
So when is that philosophy going to be brought to bear against lying, thieving banks and cost overrunning war profiteers?
Jonathan Gruber, an architect of the Massachusetts and the federal laws, said the assessment should not be considered a tax. Instead, people have a choice of whether they want to pay for insurance or to pay the government. In Massachusetts, less than 1 percent of state residents pay the state, he said.
“It’s not a tax on the middle class,” Gruber said. “It’s a choice they’re making that they would rather stay out of the medical care system and pay the costs of their doing so.”
Related: Grubby Gruber
Also see: Romney Erased Mass. Records
A preview of his presidency?
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"States may opt out of Medicaid expansion; Court ruling made refusal local decision" by Brian MacQuarrie | Globe Staff, June 30, 2012
The Supreme Court’s ruling that states cannot be penalized if they refuse to expand Medicaid under the federal health care overhaul has left an opening for legislators who have assailed the health care act as a crippling budget-buster. It is,
Legislators in many states, from tiny New Hampshire to Texas, say they are inclined to resist the expansion of Medicaid that is intended to provide coverage for 17 million uninsured people. Before the high court’s decision on Thursday, states that did not comply had been threatened with the loss of all federal Medicaid funds, which have covered an average of 57 percent of the cost of the program.
Looks like federal blackmail to me.
“I think there’s a very good chance that the state will not adopt an expansion,” said Representative William O’Brien, a Republican who is speaker of the House in New Hampshire. “We’re just not going to participate in a program that involves potentially wrecking state government finances throughout the country.”
Already destroyed because of debt interest payments to looting banks and corporate welfare to the well-connected.
In Maine, Governor Paul LePage also is weighing whether to boycott the Medicaid expansion, which is aimed at people under age 65 whose income is less than 133 percent of the federal poverty level. For a family of three, that threshold is $25,390.
“We’re still analyzing exactly what this will mean for Maine,” said Evan Beal, a spokesman for LePage, a Republican and Tea Party favorite who is a fierce critic of the health care act. “He wants to make sure we fully understand.”
After the ruling on Thursday, LePage said the decision means “the federal government can force you to do or buy anything, as long as they call it a ‘tax.’ ”
He's right.
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Related: Authors of Affordable Care law astounded by its trials
"Control of costs a test for health overhaul; Mass. experience foreshadows challenge in US health care law" by Tracy Jan and Liz Kowalczyk | Globe Staff, July 01, 2012
Just as the health care overhaul in Massachusetts is widely accepted as the model for the national bill upheld as constitutional Thursday by the US Supreme Court, it is also seen by many as a model and a caution for the necessary sequel to much broader insurance coverage: cost control.
Yes, I spent over a year writing stories with the moniker the Massachusetts Model on it. Not a good one for the rest of the country, but....
Bringing almost everyone under the umbrella of health insurance is considered by advocates of the 2006 Massachusetts law, and of President Obama’s 2010 plan, as the essential precondition for reining in medical expenses. All consumers, employers, hospitals, and insurers now abruptly, with the law’s implementation, have a major stake in that goal.
But nothing about the journey is easy — as six years’ experience in Massachusetts shows.
Consumers should not expect to see Obama’s plan lead to lower medical bills, at least not anytime soon. What they can expect is a vigorous clash of interests, leading eventually, the hope is, toward accommodation and compromise.
Meaning YOUR PREMIUMS will be GOING UP!!
That has been the Massachusetts story so far. With Governor Deval Patrick threatening the state’s robust health care industry with aggressive intervention, a patchwork coalition of hospitals, insurers, businesses, doctors, and lawmakers has been working to come up with ways to make care more affordable....
They are going to RATION IT, folks!
Message from Massachusetts: DON'T GET SICK!
Critics of the plans say the changes will do little to actually control costs, given aggressive lobbying by powerful provider networks to remove the most onerous regulations that they claim could devastate such a vital sector of the state economy. The proposed bills, many say, also lack a meaningful accountability mechanism, with no real penalty if the spending target is not met....
The penalty is ONLY FOR YOU, taxpayers!!!
Unlike the Massachusetts bill, the federal law includes some provisions designed to restrain cost growth. It requires states to review insurance premiums and consider denying unreasonable increases. It restricts Medicare payments for hospital readmissions that occur within 30 days and prohibits payments for provider errors such as operating on the wrong limb. And an independent advisory board has been set up to recommend cuts if Medicare spending reaches a certain level.
A Medicare and Medicaid innovation center is supposed to rethink how providers are paid, such as moving away from fee-per-service toward outcome-based payments, similar to what Massachusetts is now trying to do....
Yeah, they called them global payments in the past.
Related: Obamacare Complicated? - Check Out The Flow Chart
I couldn't find the innovation center(?), could you?
Like the Massachusetts law, the federal Affordable Care Act uses Medicaid expansion and subsidies for private insurance to cover the uninsured.
“Both will rapidly become unaffordable if health care costs grow as rapidly as they have in the past decade,’’ said Andrew Dreyfus, chief executive of Blue Cross Blue Shield of Massachusetts, the state’s largest health insurer. “When you require people to buy insurance there’s almost a related promise you have to make that the coverage will be affordable. If not, then support for the law will fade.’’
Blue Cross Blue Shield of Massachusetts’ alternative quality contract puts providers on a budget to care for groups of patients.
So if anyone in my group gets sick they take money away from my care?
Yeah, they are going to end up in the hospital when I'm done with them.
Under this type of contract, considered a promising arrangement for improving quality while reducing costs, the insurer gives doctors and hospitals fixed budgets to cover patient care rather than being reimbursed for every visit and procedure. The arrangement encourages doctors to coordinate care and therefore improve patients’ health.
Obama’s law is pushing the same solutions through Medicare that are already occurring in the private market in Massachusetts.
An example of this is the 32 Accountable Care Organizations already established under the federal law. In this payment model, large groups of providers are put on the hook if the cost of caring for Medicare patients is more than expected, and it allows them to reap some benefit if they come in under budget.
In other words, they will profit from denying care.
Related: Obama's HMOs
You didn't like them before so why would you like them now, 'murkns?
However, Dreyfus said, national adoption of these new models could be somewhat slower than in Massachusetts because Massachusetts is headed toward passing a law that limits the amount by which health care spending can grow – an aggressive approach.
Nothing about global payments.
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Also see: Health care ruling fulfills Kennedy’s ‘cause’
Well, Ted once advocated for single payer, but the corporations eventually beat him down. And what is this?
Obama on single payer health insurance
I used to be for that; however, I no longer trust this government to deliver good, decent, health care like those countries mentioned in "Sicko." Look what a horror show the VA has become.
"In awkward agreement, Mitt Romney backs President Obama’s contention on mandate" by Callum Borchers | Globe Correspondent, July 02, 2012
Mitt Romney and President Obama, typically at distant poles on the national health care law and on taxes, found themselves in awkward agreement Monday, sharing the position that “penalty” — not the politically riskier “tax” — is the proper word to describe money owed to the government by people who flout the law’s mandate for health insurance.
Not really. Only awkward if you buy into the s*** political fooleys.
Romney’s spokesman, Eric Fehrnstrom, begrudgingly conceded his candidate’s belief that Obama and his team — and not Republicans — are on the right side of a dizzying debate over how to characterize what the Affordable Care Act officially calls a “shared responsibility payment.”
Romney “disagrees with the court’s ruling that the [federal] mandate was a tax,” Fehrnstrom said in an interview on MSNBC.
It is a twist in political logic. Yet, Romney needed to back Obama on this in order to guard one of his most vital conservative credentials: that he did not raise taxes as governor of Massachusetts, where he championed a state law that, like Obama’s federal legislation, included an individual insurance mandate. If Romney were to label mandate payments as taxes, he would effectively undercut his own antitax credibility.
But Romney’s accord with Obama has several downsides. It puts him at odds with GOP leaders and deep-pocketed super PACs whose continued support he needs. They have declared the levy against people who fail to obtain health insurance a massive tax.
It also makes Romney, the presumptive Republican presidential nominee, open to charges of hypocrisy because he, too, has called the payment a tax at times.
And it, again, points out the difficulties Romney has in distinguishing his state health care law from Obama’s overhaul.
I'm feeling overtaxed at this point.
In a rare moment when he could not draw a sharp contrast between the two candidates, Fehrnstrom instead blasted the president’s vacillation, saying Obama changed his tune when the time came to defend the law before the Supreme Court.
“In order to get it past the Congress, he insisted publicly and to the members of Congress that the mandate was not a tax,” Fehrnstrom said.
“After it passed the Congress, he sent his solicitor general up to court to argue that it was a tax. Now he is back to arguing that it’s not a tax. So he’s all over the map,’’ he said
Since the Supreme Court upheld the health care law in a 5-4 decision last Thursday, on the premise that the payment is a tax, the Obama administration has struggled to reconcile its winning argument with the president’s repeated insistence that the payment is not a tax. Ironically, it was Chief Justice John Roberts’s disagreement with Obama on that point that saved the president’s signature domestic achievement from invalidation.
Top Republicans have claimed Roberts’s reasoning as a small victory: Obama won, they say, but only by presenting a case that contradicted his public rhetoric....
I think the public is numb and jaded to the lies now.
In an op-ed published in USA Today in 2009, before the national health care law passed, Romney used the word “tax” when describing what federal lawmakers could learn from Massachusetts.
“Using tax penalties, as we did, or tax credits, as others have proposed, encourages ‘free riders’ to take responsibility for themselves rather than pass their medical costs on to others,” Romney wrote.
And on the day of the Supreme Court’s health care ruling, Romney at a news conference in Washington repeated his familiar assertion that “Obamacare raises taxes on the American people by approximately $500 billion.”
That tax estimate is a favorite of conservative super PACs and has featured prominently in some ads. The estimate comes from a report by the Heritage Foundation, which counted mandate payments as one of the health care law’s largest tax increases.
To the extent that Romney discusses his Massachusetts record, it is critical for him that the shared-responsibility payment be considered a penalty. Romney points to his early-term closure of a $2 billion budget gap, saying proudly that he balanced the state budget with no tax hikes.
In recent weeks, the Obama campaign has fiercely attacked Romney’s no-tax claim. One ad airing in swing states points to a long list of fees that Romney raised.
“Fees are an increase out of the pockets of every Massachusetts resident. That’s a tax,” said Mayor Rob Dolan of Melrose, a Democrat, in a separate Obama campaign video. “Let’s call it what it is.”
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Related: Romney now says health care fee is a tax
Whatever.
"Poll finds many want health law stalemate put in past
WASHINGTON — Most Americans now say they would like to see the critics of the health care law stop trying to block its implementation and move onto other national problems, a poll released by the Kaiser Family Foundation on Monday found following last week’s Supreme Court decision upholding the overhaul.
Yes, like the EMPIRE and ECONOMY!
As was the case before the historic decision, public opinion on the law to expand health care to tens of millions of Americans remains about evenly split — with 47 percent in favor of the court’s ruling and 43 percent against. Not surprisingly, the split occurs along partisan lines. Eighty-three percent of Democrats say the law’s opponents need to move on to other issues, as do 51 percent of independents and 26 percent of Republicans — overall, 56 percent of Americans feel this way.
However, 69 percent of Republicans say they want to see efforts to stop the law continue, a sentiment shared by 41 percent of independents and 14 percent of Democrats.
Most voters, no matter their political affiliation, say the ruling will not affect whether they vote in November.
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Let's give you a little look at the future:
"Thousands in Massachusetts still forgo health care insurance, pay penalty" by Chelsea Conaboy | Globe Staff, July 06, 2012
Francisco Machado of Lowell had long gone without health insurance. Strong and healthy, he preferred to save the money or send it to family in Brazil, until pain and buzzing in his ear sent him to the emergency room. The $600 bill persuaded him to enroll in a plan offered by his employer, a cleaning company.
Having coverage meant that the 45-year-old would no longer be hit with a state fine — he paid $406 in 2011 — for being uninsured. But this spring Machado moved to a part-time job and became uninsured again.
Massachusetts had the nation’s highest rate of health coverage even before passage of a pioneering 2006 law requiring most residents to have insurance. Yet tens of thousands of people like Machado go uncovered each year and pay a fine. Starting in 2014, when much of the national Affordable Care Act kicks in, millions of other Americans could face a similar fine, putting Massachusetts in the spotlight as a possible indicator of what lies ahead for the country.
The federal plan mimics the state’s law in its basic approach to expanding coverage: Make health insurance more affordable through new subsidies and a state-run insurance market. Then compel most people to buy plans and penalize those who do not.
Policy advocates say the Massachusetts law lays out a financial and moral incentive to get coverage. But it is not clear that this approach can be effectively replicated nationally.
“Massachusetts is culturally more open to that kind of a bargain,” said Alan Weil, executive director of the National Academy for State Health Policy.
Many more of the uninsured in other states could decide to pay the penalty than have in Massachusetts, where the vast majority of residents already had insurance before passage of the state law.
People may be less persuaded to purchase a plan in states where politicians and others deride the federal law and encourage people not to comply, Weil said....
Much has been made about what to call the fine imposed by the national law. The Obama administration repeatedly has said it is not a tax. But the Supreme Court upheld the law on the basis that it is a tax.
A spokesman for presidential candidate Mitt Romney, who claims as a hallmark of his time as governor of Massachusetts that he did not raise taxes, said after the decision that Romney disagreed with the court’s tax label. But Romney reversed course Wednesday and said the court got it right: The federal fine is a tax, while the state’s is not.
Whatever it is called, the fine for not having insurance in Massachusetts is collected by the Department of Revenue through tax filings. Nationally, the Internal Revenue Service will handle collection through tax filings....
It's a tax.
In Massachusetts, the penalty is set at up to half the cost of the lowest-priced plan available through the state-run insurance market.
Yeah, that's another difference: Massachusetts has a public option.
It kicks in when someone has been uninsured for more than three consecutive months. Annual penalties for 2012 range from $228 to $1,260, depending on income and age.
Nationally, the penalty is determined through a more complicated formula. It will start in 2014 at $95 or 1 percent of an individual’s income that year, whichever is higher, rising in the following years but with certain caps. In 2016, the tax penalty will be the higher of $695 or 2.5 percent of a person’s income.
That means federal penalties will be larger than the state’s for many people. The state has not determined what will happen to its penalty structure under the federal law, said Richard Powers, spokesman for the Massachusetts Health Connector Authority, one of the agencies overseeing compliance with the Affordable Care Act. The Legislature may decide the issue, he said.
For many across the country, paying the penalty may be less expensive than buying coverage. But the penalty is money lost, while people ostensibly get something in return for buying coverage.
Plus, people in this “God-fearing, tax-paying society” are prone to obey the law, said Amitabh Chandra, a health economist at the Harvard School of Public Health.
“It’s really the moral suasion of the mandate and the fear of the tax that gets people to comply with it,” Chandra said....
I'm sorry, but it smells like fascist persuasion to me.
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Speaking of persuasions:
"Roberts can reclaim conservative bona fides; Court to review laws on voting, affirmative action" by Greg Stohr | Bloomberg News, July 06, 2012
WASHINGTON — Chief Justice John Roberts, whose majority opinion upheld President Obama’s health care law, won’t have to wait long for a chance to reassert his conservative credentials.
In the nine-month term that starts in October, the Supreme Court will consider rolling back university affirmative action and may take up same-sex marriage and the Voting Rights Act, the 1965 law that protects minorities at the polling place.
On the race issues in particular, Roberts is a good bet to rejoin the wing of the court that has been his ideological home since he became chief justice in 2005. He has taken a leading role on such questions, pushing for a color-blind Constitution.
From what I've read they ain't talking to him!
‘‘With respect to race, I don’t think Chief Justice Roberts will have the same hesitation to advance a conservative agenda,’’ said Kermit Roosevelt, a constitutional law professor at the University of Pennsylvania Law School in Philadelphia.
Opponents of the Patient Protection and Affordable Care Act criticized Roberts for joining with the court’s four Democratic appointees to uphold the health care law. Roberts, 57, was accused of ‘‘arrogance’’ by columnist Michael Gerson and ‘‘judicial betrayal’’ by economist Thomas Sowell. The Wall Street Journal said in an editorial that he ‘‘behaved like a politician.’’
That's why they are so unpopular.
What bothers me the most is pre$$ure can be brought to bear on supposedly untouchable judges.
The criticism escalated after CBS News, citing two unnamed people, said Roberts originally voted to strike down the part of the law that requires Americans to get insurance — an idea once championed by the Heritage Foundation and leading Republicans — then switched sides during the court’s internal deliberations.
So the AmeriKan media, on a Slow Saturday nearly two weeks later, confirm what bloggers were saying before the decision was even announced.
That led to speculation among some Republicans that the chief justice had sought to first protect the court from charges of flagrant partisanship instead of deciding on the constitutionality of the law, which is intended to expand coverage to at least 30 million uninsured Americans.
Some commentators praised Roberts for parts of his opinion that may limit Congress’s power in the future.
Even so, the ruling has left some legal conservatives questioning Roberts’s reliability on other issues. The decision came three days after he joined a 5-3 majority to strike down most of an Arizona law designed to crack down on illegal immigrants.
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Related:
"Roberts responded with the Malta quip after Chief Judge David B. Sentelle of the D.C. Circuit Court asked him whether he was ‘‘going to Disney World’’ now that the court has adjourned for the summer."
Also see: Roberts Reversal Led to Obamacare