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SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1, 183, 386, 590]

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Charging more not based on better care/coverage or higher risk but simply because it is "fair" is nonsense, nothing more than income redistribution, using the GUISE of the "private" market to "level the field". Obamacare is simply a tax on the young/healthy to pay for care of the old/obese/sick, and nothing more.

So? You pay a bit more when you're young and a bit less when you're old. That's probably a good thing since you're working and more able to pay it when you're younger.

The mandate means NOTHING if I may by the cheapest possible policy (or pay the fine, if it is less), then AFTER I get sick/injured "upgrade" it to the BEST possible plan (no pre-existing condidtion can be considered), paying very high monthly premiums, ONLY until treatment is completed and then reverting back to the cheapest available plan.

Honestly these scenarios about people trying to change their level of coverage to game the system seem a bit far fetched to me. I mean, sure, I'm sure some people would try it. But most people just don't operate that way. Regardless though, the minimums ensure that all plans cover the kinds of catestrophic things that cost a lot of money, so you can't really do that.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

I don't know all the details, but probably not. It's sort of a subspecies of the freeloader problem. People get those kinds of plans and then skimp on preventative care and it ends up creating most costs in the long run.

Thats not neccessarily true. McDonalds has more comprehensive plans for their employees but the majority of their workers are very young--college/high school age, they just want emergency medical, if they need to go for something routine, they pay out of pocket. Younger people dont tend to need comprehensive medical normally unless they have something already in their background.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

We do not know this as a certainty. The CBO has to rescore the bill under its current guidelines as handed down by SCOTUS. No medicare increases and Ive got to assume no exemptions will be allowed as federal taxes are not able to be exempted without direct legislative action.

This is true, the CBO will need to rescore the bill based on the Supreme Court's rulings. However, you are incorrect that there are no Medicaid increases (I assume you meant Medicaid and not Medicare?) The Medicaid expansion is still happening...the Supreme Court merely ruled that the federal government can't threaten states' existing Medicaid funding if they refuse to participate in the expansion.

In terms of how the ruling will actually affect the implementation of the law, the most likely answer is "not much." States are getting an insanely good deal on the Medicaid expansion...the federal government is picking up 100% of the tab for the first couple years, and 90% of the tab thereafter. Are there states that are governed by people with such fanatical hatred for Obama that they'd be willing to turn down a lot of free money just to stick it to him? Possibly, but there aren't very many of them. And even those states will most likely get on board quietly after a couple years, once the furor has blown over a bit.

On a year to year basis its going to run a deficit because of the 2 year funding gimmick.

Incorrect. According to the CBO, the ACA will run a surplus until 2014, which will transition to a small deficit in 2014-2015, then go back to being a surplus from 2016 onward. The ten-year impact is a surplus, which actually gets larger towards the end of the period.

Its also expected to run $700billion more than projected.

This is simply not true.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

The Supreme Court just affirmed that you are free to go without health insurance if you like; that's completely fine. You just have to pay an irresponsibility tax, to cover the costs for when you end up in the emergency room and stick the public with the bill.

Actually no, the SCOTUS affirmed that the congress may levy punitive taxes.

Btw, here's an pretty good fact check of both sides and their claims.
 
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Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Thats not neccessarily true. McDonalds has more comprehensive plans for their employees but the majority of their workers are very young--college/high school age, they just want emergency medical, if they need to go for something routine, they pay out of pocket. Younger people dont tend to need comprehensive medical normally unless they have something already in their background.

The biggest problem with the US's health care system cost wise is that we don't get enough preventative care. It is way, way, cheaper to prevent loads of kinds of problems than to treat them after they arise. For example, many men between say 18 and 40 will only go to the doctor once every 5 or even 10 years when something goes wrong. That is a huge problem because they can develop all kinds of conditions and whatnot during that time and not realize it. High cholesterol, high blood pressure, that kind of stuff. Women on the other hand generally go once a year or more their whole lives and that is part of why women's lifespans are so much longer. In most first world countries they have much more of a focus on preventative care, which is why they often have longer lifespans and it is a big part of why they have so much lower medical costs overall. The goal with the minimums is largely to eliminate barriers to getting preventative care to try to get us back on course in that regard.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Socialized system? Uh... What?

Yes

Obamacare's purpose is to convert our current HC System to a Socialized and Centrally Controlled Institution like they currently have in Europe. Your employer is going to drop you from their HC coverage. Premiums are already going up and will continue to rise as people actually start paying for "Free HC for all" and "Free contraception for women" ect. A new system develops, people learn the system. People game the system. If you think there's waste and fraud in Medicare and Medicaid now just waste. Anything the Government is involved in where they hand out free stuff at taxpayer expense always attracts people who will game the system.

For example in CA if you know the right people you can have your dog registered as a "Service Dog". Having a registered service dogs gives you perks that the Government pays for. One example is medial care for the pet. Your "certified service dog" which is actually just a rat infested chihuaha needs dental work that will cost 1100$? You pay 100$. The taxpayers will cover the rest. You seem to be under the assumption that the money fairies just either print the money at the fed which automatically makes it valuable, or they grab it from "Obama's stash". Obamacare is an absolute disaster and you're sitting there acting like it's not something that it actually is. Like somehow if you mock it and claim it's not a fast track to complete Government control of HC that somehow makes that true. It doesn't. Here, let's see what Obama thought it:

Obama on single payer health insurance - YouTube

You would demanding this law be repealed immediately if wasn't effective at converting the US HC System into a single payer, Government run system.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

Debating you is a wonderful, but laborious process. Fortunately, I'm retired and have plenty of time on my hands. The CBO scores legislation based on the assumptions it is given. The CBO does not look to any info other than the assumptions it is given. There is no independent review. Before passage President Obama sent the bill to the CBO with a set of assumptions that demonstrated it would be revenue neutral.

The only way you can get an extra $700 billion is if you make a series of assumptions completely unrelated to the ACA. For example, Republicans asked the CBO to determine the budgetary impact if the "Doc Fix" continues to be implemented year after year...then pretended that that was part of the cost of the ACA, even though the "Doc Fixes" already existed and had nothing to do with the ACA.

Every time the CBO has scored the budgetary implications of the actual contents of the ACA (rather than things that Republicans might *wish* were in the ACA but aren't), they've found that its effect on the budget is to reduce the deficit.

Furthermore, even if the CBO were to eventually find that it would increase the deficit, that doesn't make reconciliation an illegitimate act. You don't go back and question the legitimacy of every law if the circumstances change in the future; you either change the law or you just deal with it.

Because of that fact the Budget Reconciliation process was used illegitimately, and what you refer to as tweaks should have been subjected to unlimited debate as the filibuster rules would otherwise require. But there wouldn't have been sixty votes to allow those tweaks. So why bother tweaking as you assert?

Are you questioning the legitimacy of the entire PPACA, or just those few small tweaks? If you're only interested in debating the latter, it's simply not important enough of an issue for me to care about. The PPACA is where the meat of the law is, and it was passed with 60 votes in the Senate through the standard process.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

Are there states that are governed by people with such fanatical hatred for Obama that they'd be willing to turn down a lot of free money just to stick it to him? .

Where does one find this "free" money?
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

I mean that they hate the health care reform. Obviously.

You mean they disagree with Socialized HC that liberals try to label as "Health Care Reform"

Socialized Medicine is not Health Care Reform.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

Social Security, Medicare and Medicaid were all enacted on a bipartisan basis. That ensured political peace. Obamacare wasn't enacted on a bipartisan basis. Instead, President Obama put Nancy Pelosi and Harry Reid in charge of getting the legislation enacted. They are probably the two most partisan people on earth.

They did indeed reach out to conservatives. They jettisoned the public option and adopted the individual mandate to get a compromise, precisely because Republicans like Chuck Grassley and Orrin Hatch were telling them that they could find a broad consensus around an individual mandate as late as the summer of 2009. So the Democrats tried it...and the entire Republican Party did an about-face, gave them the finger, burnt down 20 years of intellectual groundwork they themselves had laid for the individual mandate, pissed on the ashes, and salted the earth so nothing could ever grow their again.

Under those circumstances, what possible bipartisan agreement do you imagine was possible? As far as I can tell, the GOP doesn't even *have* a health care platform anymore, because their previous platform is now the law of the land in the form of PPACA.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

The biggest problem with the US's health care system cost wise is that we don't get enough preventative care. It is way, way, cheaper to prevent loads of kinds of problems than to treat them after they arise. For example, many men between say 18 and 40 will only go to the doctor once every 5 or even 10 years when something goes wrong. That is a huge problem because they can develop all kinds of conditions and whatnot during that time and not realize it. High cholesterol, high blood pressure, that kind of stuff. Women on the other hand generally go once a year or more their whole lives and that is part of why women's lifespans are so much longer. In most first world countries they have much more of a focus on preventative care, which is why they often have longer lifespans and it is a big part of why they have so much lower medical costs overall. The goal with the minimums is largely to eliminate barriers to getting preventative care to try to get us back on course in that regard.

I pay CASH now for my medical care and see a doctor every three months, am on blood thinners for life and see no reason to buy insurance to cover NORMAL medical care, at 58 I am in "average" shape dispite having had major past medical problems. I get discounts of well over 60% because I pay cash at the time of my medical treatment, they don't even have to mail a bill to me. I buy my medications 90 days at a time, saving 66% (over the 30 day supply amount) AND get a cash discount for that as well.

Much of our medical care cost inflation is BECAUSE of insurance and its associated massive paperwork overhead and payment delay. The preventive care is only as good as the patient is at following the doctors advice. If you are overweight and out of shape that is a PERSONAL problem that likely becomes a "medical" problem, there is no magic "get in shape" pill. Much of true preventive "care" is simply having a decent diet and execise routine.

I have most of my "health" problems due to the accumulated damage from multiple motorcycle accidents and the related plates/screws, bone grafts and soft tissue damage from them. I "lived hard" and now must pay the price for it. I want only a "catastrophic" medical insurance policy that has a $5,000 annual deductable and pays 100% of medical costs beyond that, so ObamaCare for me is the problem and not the solution.
 
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Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

Where does one find this "free" money?

From 2014 to 2016, the federal government will pay 100% of the cost of the Medicaid expansion for the states that opt in. This share will gradually decline, until the federal government pays 90% of the cost in 2020. Any state government that turns down a 10-to-1 matching Medicaid grant is motivated solely by fanaticism. I'm sure there are a few of them, but there won't be many and they won't hold out for long.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

They did indeed reach out to conservatives. They jettisoned the public option and adopted the individual mandate to get a compromise, precisely because Republicans like Chuck Grassley and Orrin Hatch were telling them that they could find a broad consensus around an individual mandate as late as the summer of 2009. So the Democrats tried it...and the entire Republican Party did an about-face, gave them the finger, burnt down 20 years of intellectual groundwork they themselves had laid for the individual mandate, pissed on the ashes, and salted the earth so nothing could ever grow their again.

Under those circumstances, what possible bipartisan agreement do you imagine was possible? As far as I can tell, the GOP doesn't even *have* a health care platform anymore, because their previous platform is now the law of the land in the form of PPACA.

All talk of tort reform, allowing world free market access to drugs and allowing HSA/catstrophic coverage were rejected in similar fashion by the demorats. I agree that the republicants were acting like idiots as well, but the current DC morons, of both parties are not helping matters by ADDING more gov't control of "private" medical insurance using mandates in place of direct taxation to accomplish "reform". Most of ObamaCare, and the reason that it is so darned complicated, is designed to HIDE the costs, or shift them to the states, rather than to actually control or reduce them.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Were the death panels ruled constitutional? :lol:

Only for everyone but you. :mrgreen:
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Obamacare's purpose is to convert our current HC System to a Socialized and Centrally Controlled Institution like they currently have in Europe.

I wish...

Your employer is going to drop you from their HC coverage. Premiums are already going up and will continue to rise as people actually start paying for "Free HC for all" and "Free contraception for women" ect. A new system develops, people learn the system. People game the system. If you think there's waste and fraud in Medicare and Medicaid now just waste. Anything the Government is involved in where they hand out free stuff at taxpayer expense always attracts people who will game the system.

If what you say were true, health care would be much more expensive in Europe than here. In fact it is way cheaper there than here. And higher quality too.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

They did indeed reach out to conservatives. They jettisoned the public option and adopted the individual mandate to get a compromise, precisely because Republicans like Chuck Grassley and Orrin Hatch were telling them that they could find a broad consensus around an individual mandate as late as the summer of 2009. So the Democrats tried it...and the entire Republican Party did an about-face, gave them the finger, burnt down 20 years of intellectual groundwork they themselves had laid for the individual mandate, pissed on the ashes, and salted the earth so nothing could ever grow their again.

Under those circumstances, what possible bipartisan agreement do you imagine was possible? As far as I can tell, the GOP doesn't even *have* a health care platform anymore, because their previous platform is now the law of the land in the form of PPACA.

If that were true Orrin Hatch and Chuck Grassley would have voted for Obamacare. But let's move our conversation along.

You know there are going to be glitches and problems in the administration of Obamacare over the next decade. That's in the nature of all major legislation. Some of those problems will require legislative resolution. How will the Democrats be able to fix those problems unless they control the Senate with sixty votes, the House of Representatives and the Presidency? It took George Bush's failed presidency to let the Democrats run the table in 2006 and 2008. It's unlikely the Perfect Storm will happen again in your lifetime or mine.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

All talk of tort reform, allowing world free market access to drugs and allowing HSA/catstrophic coverage were rejected in similar fashion by the demorats.

Tort reform - A minor issue. In any case, this *was* offered as a bargaining chip to get Republicans on board. Obama said many times that he was willing to play ball on tort reform. No dice.

World free market access to drugs - Far from being a potential source of bipartisan agreement, this is a virtual nonstarter among the majority of congresspeople of BOTH parties. They get way too much money from pharmaceutical companies to allow this.

HSAs - These are indeed part of the PPACA.

Catastrophic coverage - I agree that a focus on catastrophic coverage would be good, but do you really think that this one offering to Republicans would have got a bipartisan agreement? I find it much more likely that they simply would have abandoned THAT policy too and denounced it as socialist, just like they did with the individual mandate.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

From 2014 to 2016, the federal government will pay 100% of the cost of the Medicaid expansion for the states that opt in. This share will gradually decline, until the federal government pays 90% of the cost in 2020. Any state government that turns down a 10-to-1 matching Medicaid grant is motivated solely by fanaticism. I'm sure there are a few of them, but there won't be many and they won't hold out for long.

Promises can be EASILY broken, what guarantee does this generous medicaid fund matching come with? Once the Medcaid machine gets cranked up, what state can say no? The difference between the "expanded" and normal medicaid is simply an "eligibility" difference, easily "tweaked" to move people from one "class" of medicaid user to another.

The same "deal" was done for federal UI benefit extensions was it not? Unlike the federal gov't, a state must actually tax to spend, the federal gov't now spends 40% more than it dare ask for intaxation, states have no such luxury. The states get LOTS of federal aid as bribes to accept illegal aliens and to provide them "state" services. WHat is givin can be taken away, and ALWAYS has strings attached, just ask AZ after they passed SB1070, and Obama "punished" them for it.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

It now appears that the dissent of the conservative Justices was at one time the majority opinion, and that Roberts changed his vote based on intimidation. He was intimidated by threats to delegitimize the Supreme Court if Obamacare wasn't validated. It may be that Chief Justice put his fears about the institution of the Supreme Court over his duty to interpret the Constitution. If this is true, Chief Justice Roberts breached his duty to the Constitution.


The supreme court long ago gave away its legitimacy...how can it be possible you have 4 justices ALWAYS vote one way and 4 justices ALWAYS vote the opposite of the other 4...with one swinger that swings back and forth...its nonesense has been for years.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

If that were true

Are you denying that Republicans were still touting an individual mandate as a potential source of compromise as late as summer 2009? Are you gonna make me find the quotes to prove you wrong?

Orrin Hatch and Chuck Grassley would have voted for Obamacare.

Nope. They (along with every other Republican who had previously advocated a health care system which looked a lot like PPACA) decided to put raw partisanship ahead of their country, and did an about-face.

You know there are going to be glitches and problems in the administration of Obamacare over the next decade. That's in the nature of all major legislation. Some of those problems will require legislative resolution.

Agreed.

How will the Democrats be able to fix those problems unless they control the Senate with sixty votes, the House of Representatives and the Presidency?

A few possibilities:
1. Perhaps another election will drive out all of the crazies who have taken over the GOP in the last three years, and the party will go back to the sane (if inadequate) health care positions they held in the late 2000s. And therefore compromise will be possible.
2. Perhaps some of those problems will be fixable in exactly the way Republicans want to fix them anyway, and so they'll eagerly vote to fix them.
3. Perhaps the Democrats will indeed get a commanding majority in the Senate, the House, and the White House.
4. Perhaps the filibuster will be eliminated and they'll only need 50 votes in the Senate.
5. Perhaps the ACA will become more politically popular, and the Republicans shrieking for repeal will simply slink away and stop making so much noise about it, allowing for more compromise among the adults.
 
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Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

The supreme court long ago gave away its legitimacy...how can it be possible you have 4 justices ALWAYS vote one way and 4 justices ALWAYS vote the opposite of the other 4...with one swinger that swings back and forth...its nonesense has been for years.

Well, I guess I have to agree with you.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

They did indeed reach out to conservatives. They jettisoned the public option and adopted the individual mandate to get a compromise, precisely because Republicans like Chuck Grassley and Orrin Hatch were telling them that they could find a broad consensus around an individual mandate as late as the summer of 2009. So the Democrats tried it...and the entire Republican Party did an about-face, gave them the finger, burnt down 20 years of intellectual groundwork they themselves had laid for the individual mandate, pissed on the ashes, and salted the earth so nothing could ever grow their again.

Under those circumstances, what possible bipartisan agreement do you imagine was possible? As far as I can tell, the GOP doesn't even *have* a health care platform anymore, because their previous platform is now the law of the land in the form of PPACA.

Actually, the bipartisanship that everyone says they long for was in opposition to the bill.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

The supreme court long ago gave away its legitimacy...how can it be possible you have 4 justices ALWAYS vote one way and 4 justices ALWAYS vote the opposite of the other 4...with one swinger that swings back and forth...its nonesense has been for years.

In the last two courts, about 20% of rulings have been 5-4.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

3. Perhaps the Democrats will indeed get a commanding majority in the Senate, the House, and the White House.

Didn't the Dems have that for a year? For all the "shrieking" about Republican obstructionism (as if the Dems never engage in such things), for awhile there, the Republicans couldn't "obstruct" anything, even when they deeply wanted to.
 
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