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

Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

Isn't it a fact that the Budget Reconciliation process was used after Scott Brown took away the 60th vote from Obamacare?

Correct. But by that point, the bulk of the bill (PPACA) had already passed the Senate with 60 votes. The reconciliation process was then used to make some tweaks to the provisions as described above.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

If it is, you should be able to link to a source for that claim without trouble.

Notice that I put my comment in the form of a leading question, and not in the form of an assertion.

What date was Scott Brown sworn into the Senate, and what date did Obamacare pass through the Reconcilation process?
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

But you based your conclusion on the Commerce Clause and not the power of taxation. So we both missed the mark as far as the rationale goes.

Agreed.

The fight over Obamacare will continue, but not before the Supreme Court. The fight goes back to the political realm and will last for years to come.

Yeah. And I think that is a good thing. IMO, the elected officials have a more legitimate role in making that kind of decision. I'm not terribly happy with the ACA either. Maybe for different reasons than you. I think we desperately need a public option. But either way, IMO, we're better off with the legislature deciding how to handle it than the courts.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

Correct. But by that point, the bulk of the bill (PPACA) had already passed the Senate with 60 votes. The reconciliation process was then used to make some tweaks to the provisions as described above.

Your point is well taken. However, if the Budget Reconciliation process had not been illegitimately used the provisions that passed the Senate through Budget Reconciliation would not have become law because Scott Brown would have ensured the success of a filibuster.

What impact would that have had on the totality of the legislation?

You see where I'm going with this. The base is being enraged because of perceived illegitimate tactics. This means that Obamacare is going to become the source of ongoing controversy because conservatives won't let this go. That's the action dictated by American political culture. Neither left nor right lets anything go any more. The net effect is to ensure political paralysis. I didn't make up these rules. They are simply the way the game is played. Each side never gives in or compromises. It doesn't bode well for the idea of American social cohesion as the country faces a series of interrelated political, economic, and social crises.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Agreed.



Yeah. And I think that is a good thing. IMO, the elected officials have a more legitimate role in making that kind of decision. I'm not terribly happy with the ACA either. Maybe for different reasons than you. I think we desperately need a public option. But either way, IMO, we're better off with the legislature deciding how to handle it than the courts.

The country could have had a public option without destroying the quality of health care for tens of millions of people who had good existing coverage. It wasn't necessary to poison the well.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

The country could have had a public option without destroying the quality of health care for tens of millions of people who had good existing coverage. It wasn't necessary to poison the well.

Not sure what you mean. How does anything in the ACA reduce the quality of care for anybody?
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

Notice that I put my comment in the form of a leading question, and not in the form of an assertion.

What date was Scott Brown sworn into the Senate, and what date did Obamacare pass through the Reconcilation process?

The sequence of events was like this:

December 24, 2009 - The Senate passes the Patient Protection and Affordable Care Act (PPACA) on a vote of 60-39. PPACA contains all of the major provisions we now associate with "Obamacare" (e.g. individual mandate, Medicaid expansion, ban on preexisting conditions, end of lifetime maximums, health insurance exchanges, subsidies and taxes, Independent Payment Advisory Board, ban on rescission, restrictions on price discrimination).

January 19, 2010 - Scott Brown is elected to the Senate.
February 4, 2010 - Scott Brown takes office, reducing the number of Democratic senators to 59.

March 21, 2010 - PPACA passes the House of Representatives, as-is, on a vote of 219-212, and heads to the White House to be signed into law.
March 21, 2010 - The Health Care and Education Reconciliation Act of 2010 (HCERA) passes the House of Representatives on a vote of 220-211. This bill made some tweaks to the dollar amounts and timetables in PPACA.

March 23, 2010 - President Obama signs PPACA into law.

March 25, 2010 - A slightly modified version of HCERA passes the Senate under budget reconciliation rules, by a vote of 56-43.
March 25, 2010 - The modified version of HCERA passes the House, by a vote of 220-207.

March 30, 2010 - President Obama signs HCERA into law.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

Your point is well taken. However, if the Budget Reconciliation process had not been illegitimately used

How was it illegitimately used? It was used for precisely its intended purpose; two provisions of the reconciliation bill were even removed because they failed to meet the standards necessary for reconciliation.

the provisions that passed the Senate through Budget Reconciliation would not have become law

An academic point, since the main content was in PPACA which passed under the normal process. The only things that passed via budget reconciliation were relatively minor tweaks to the bill.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Agreed.



Yeah. And I think that is a good thing. IMO, the elected officials have a more legitimate role in making that kind of decision. I'm not terribly happy with the ACA either. Maybe for different reasons than you. I think we desperately need a public option. But either way, IMO, we're better off with the legislature deciding how to handle it than the courts.

Actually all we really have is a "public option", since ALL "private" medical care insurance must now play by totally gov't mandated "rules". With the gov't controlling the basis for setting "private" premium amounts (limits on age, gender height/weight and current health), setting the minimum AND maximum coverage rules and establishing an "acceptable" level of overhead/profit of no more than 20% of actual payments to medical care providers. Essentially we ALL lost the "private option", including the basic right to simply pay cash for our medical care.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Essentially we ALL lost the "private option", including the basic right to simply pay cash for our medical care.

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.
 
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Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Actually all we really have is a "public option", since ALL "private" medical care insurance must now play by totally gov't mandated "rules". With the gov't controlling the basis for setting "private" premium amounts (limits on age, gender height/weight and current health), setting the minimum AND maximum coverage rules and establishing an "acceptable" level of overhead/profit of no more than 20% of actual payments to medical care providers. Essentially we ALL lost the "private option", including the basic right to simply pay cash for our medical care.

If just because a market is regulated, you no longer consider it to be the private sector, then no private sector has really existed in the first world for many decades. With the possible exception of a handful of industries that periodically move so quickly that it takes government a while to catch up. Usually with devastating consequences like high finance and to some extent, software.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

How was it illegitimately used? It was used for precisely its intended purpose; two provisions of the reconciliation bill were even removed because they failed to meet the standards necessary for reconciliation.

What was the number for Obamacare that the administration gave to the CBO to score the legislation? Less than $1 trillion. That was the magic number. It was a lie.

What was the number the CBO came up with later after passage? More than $1.7 trillion.

If the real number had been used instead of a false number Obamacare wouldn't have been revenue neutral...in which case the Budget Reconciliation process couldn't have been used. In which case President Obama would have needed sixty votes to pass the full legislation. It's not just the ends that count. The proper means must be used to prevent the conclusion of bad faith on the part of the Democrats. Have you ever negotiated with someone you believe is acting in bad faith? If so, how do you treat that person henceforth?



An academic point, since the main content was in PPACA which passed under the normal process. The only things that passed via budget reconciliation were relatively minor tweaks to the bill.

I don't agree. If these matters were just tweaks why did the Senate Democrats bother to tweak these provisions instead of just sending the origninal Senate and House passed legislation directly to President Obama for signature? They only roiled the pot by using false numbers for the orignial CBO scoring and then using Budget Reconciliation for what some believe to be insignificant matters.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Not sure what you mean. How does anything in the ACA reduce the quality of care for anybody?

Bans on "cadillac" plans for one thing, by establishing MAXIMUM levels of benefits provided. It also limits the difference in risk based establishment of premiums (removing the use of gender and height/weight, and severly limitting even the use of age), making the young/healthy pay FAR more, and the old/sick pay far less, skewing the actuarial basis for setting premiums.

This is much like demanding that a guy with 4 DUIs, that has totalled 6 cars in the last 10 years, pay no more for auto insurance than 3x the "base" liability rate, even though their actuarial risk is 50x that "base" risk. When auto insurance companies give female drivers lower rates, based on sound actuarial risks, nobody complains, but when medical care insurance does the SAME THING, assigning higher rates for females or the obese, it is then "unfair".

It is insane to let people wait until they are sick and THEN buy insurance, or "upgrade" their medical care coverage with NO NEW RISK ASSESMENT. What this does, is a give a GREAT deal to the sick/obese, but costs the average person MUCH more for the VERY same care that they now get, and lets more people get in the line for it; a clear reduction in the VALUE (quality?) of care.
 
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Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Bans on "cadillac" plans for one thing, by establishing MAXIMUM levels of benefits provided.

There is no ban on cadillac plans. They just tax them.

It also limits the difference in risk based establishment of premiums (removing the use of gender and height/weight, and severly limitting even the use of age), making the young/healthy pay FAR more, and the old/sick pay far less, skewing the actuarial basis for setting premiums.

This is much like demanding that a guy with 4 DUIs, that has totalled 6 cars in the last 10 years, pay no more for auto insurance than 3x the "base" liability rate, even though their actuarial risk is 50x that "base" risk. When auto insurance companies give female drivers lower rates, based on sound actuarial risks, nobody complains, but when medical care insurance does the SAME THING, assigning higher rates for females or the obese, it is then "unfair".

What does that have to do with the quality of care? That's just about how we want to distribute the costs as a society.

It is insane to let people wait until they are sick and THEN buy insurance

Exactly. Hence the need for a mandate.
 
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.

There is no way to know if this is true and I seriously doubt it is. I think it's more likely that he believed that overturning Obamacare would have been a form of judicial activism.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

Bans on "cadillac" plans for one thing, by establishing MAXIMUM levels of benefits provided. It also limits the difference in risk based establishment of premiums (removing the use of gender and height/weight, and severly limitting even the use of age), making the young/healthy pay FAR more, and the old/sick pay far less, skewing the actuarial basis for setting premiums.

This is much like demanding that a guy with 4 DUIs, that has totalled 6 cars in the last 10 years, pay no more for auto insurance than 3x the "base" liability rate, even though their actuarial risk is 50x that "base" risk. When auto insurance companies give female drivers lower rates, based on sound actuarial risks, nobody complains, but when medical care insurance does the SAME THING, assigning higher rates for females or the obese, it is then "unfair".

It is insane to let people wait until they are sick and THEN buy insurance, or "upgrade" their medical care coverage with NO NEW RISK ASSESMENT. What this does, is a give GREAT deal to the sick, but costs the average person MUCH more for the VERY same care they now get, and lets more people get in the line for it; a clear reduction in the VALUE (quality?) of care.

Put 30 million more people into the existing health care system without an increase in health care professionals, equipment and facilities and you get rationing of a different kind and magnitude than existing de facto rationing. The circle can't be squared.

Add to that a bazillion ambulance chasing lawyers whose voraciousness isn't tempered by tort reform, and you get things like drug shortages on a whole new level.

Many people who have had excellent health care will now have health care which isn't so excellent. They will blame someone. Obamacare will be in effect and in the direct line of causation. They will blame Obamacare.

There are winners and losers in life. Obamacare is going to have a hand in making some people winners and some people losers. Don't expect the losers to be happy.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

What was the number for Obamacare that the administration gave to the CBO to score the legislation? Less than $1 trillion. That was the magic number. It was a lie.

What was the number the CBO came up with later after passage? More than $1.7 trillion.

First of all, "the administration" doesn't give the CBO any numbers to score. The CBO looks at the legislation on its own and assesses the ten-year cost of the bill. Want to know why the ten-year cost is higher now than it was when the bill was first past? Because it's two years closer to actually being implemented. This was hardly an unforeseen cost of the bill; that's been part of the cost all along. In fact, the financial figures are actually slightly BETTER (although within the margin of error) for the ACA than they were at the time it was passed.

If the real number had been used instead of a false number Obamacare wouldn't have been revenue neutral

The CBO confirmed a few months ago that the ACA is still on track to reduce the deficit. And the most recent estimates I've seen indicate that they initially slightly underestimated the deficit reduction.

in which case the Budget Reconciliation process couldn't have been used.

As I already mentioned, only a minor part of the act was passed via budget reconciliation. So even if your misinformation about the ACA increasing the deficit were true, all that Congress would need to do was make sure that those minor provisions passed via reconciliation didn't increase the cost of the deficit, rather than the entire bill.

In which case President Obama would have needed sixty votes to pass the full legislation.

60 senators did indeed vote for the PPACA, which was signed into law as-is.

I don't agree. If these matters were just tweaks why did the Senate Democrats bother to tweak these provisions instead of just sending the origninal Senate and House passed legislation directly to President Obama for signature?

Because that's the agreement that the Senate Democrats made with House Democrats: The House would vote to pass the Senate bill (PPACA) as-is, but in exchange the Senate had to pass the House's minor tweaks via budget reconciliation.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

If just because a market is regulated, you no longer consider it to be the private sector, then no private sector has really existed in the first world for many decades. With the possible exception of a handful of industries that periodically move so quickly that it takes government a while to catch up. Usually with devastating consequences like high finance and to some extent, software.

The policy that I want is a "catastrophic" plan that pays ZERO until I reach $5,000 in annual medical expenses then it pays 100% over that. Is that LEGAL under ObamaCare?
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

The policy that I want is a "catastrophic" plan that pays ZERO until I reach $5,000 in annual medical expenses then it pays 100% over that. Is that LEGAL under ObamaCare?

Yes. Its not comprehensive enough to pass the rules of the bill. Its one of the exemptions McDonalds got was to allow that sort of plan, which is normally not allowed.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

There is no way to know if this is true and I seriously doubt it is. I think it's more likely that he believed that overturning Obamacare would have been a form of judicial activism.

X...the American political culture is a game within a game within a game. The truth of the matter asserted can't be proven in a court of law...but we aren't in a court of law. And we aren't in the court of public opinion generally. We are in the court of conservative opinion. This is all part of the process of delegitimization dictated by the American political culture.

I know you don't like this. And I agree with you that this is unhealthy for the established order in this country. But the political culture demands that this approach be taken. The left uses the same approach. I didn't make the rules. Conservatives believe Obamacare was enacted based on lies and bad faith. What do you expect conservatives to do?

Obamacare is going into effect. Obama could very well be reelected. But this doesn't mean that Obamacare will be accepted. The outrage among most conservatives dictates that over the next ten years they will use increased health care costs, decreased quality, and clear rationing to monkey wrench Obamacare. It doesn't matter whether this is good, bad or indifferent. This is the way both sides play the game under the terms of America's existing political culture.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

The CBO confirmed a few months ago that the ACA is still on track to reduce the deficit. And the most recent estimates I've seen indicate that they initially slightly underestimated the deficit reduction.

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.

Obamacare: So what happens now? - Right Turn - The Washington Post

In the next week or so you can expect the Congressional Budget Office to re-score Obamacare. The CLASS Act is gone, as are the two years of ramp-up time that allowed the original 10- year scoring to disguise the extent of the taxes and spending in the bill.

On a year to year basis its going to run a deficit because of the 2 year funding gimmick. Its also expected to run $700billion more than projected. If you really expect this to lower the deficit, pass some over, Id like a hit.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

There is no ban on cadillac plans. They just tax them.



What does that have to do with the quality of care? That's just about how we want to distribute the costs as a society.

air"

Exactly. Hence the need for a mandate.

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.

Instead of doing it directly, like Medicare or Medicaid, where the costs are SEEN they instead use mandates, making it APPEAR that the medical care/insurance industry is simply "raising costs", when all it is doing is shifting costs around. Fooling the sheeple into believing that medical care costs went up, in general, when they did not.

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.

The average cost for each person covered by Medicaid is INSANE, yet we STILL let the gov't run that and expand it as well: What is the cost per person annually for medicaid
 
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Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2[W:1]

First of all, "the administration" doesn't give the CBO any numbers to score. The CBO looks at the legislation on its own and assesses the ten-year cost of the bill. Want to know why the ten-year cost is higher now than it was when the bill was first past? Because it's two years closer to actually being implemented. This was hardly an unforeseen cost of the bill; that's been part of the cost all along. In fact, the financial figures are actually slightly BETTER (although within the margin of error) for the ACA than they were at the time it was passed.

The CBO confirmed a few months ago that the ACA is still on track to reduce the deficit. And the most recent estimates I've seen indicate that they initially slightly underestimated the deficit reduction.



As I already mentioned, only a minor part of the act was passed via budget reconciliation. So even if your misinformation about the ACA increasing the deficit were true, all that Congress would need to do was make sure that those minor provisions passed via reconciliation didn't increase the cost of the deficit, rather than the entire bill.



60 senators did indeed vote for the PPACA, which was signed into law as-is.



Because that's the agreement that the Senate Democrats made with House Democrats: The House would vote to pass the Senate bill (PPACA) as-is, but in exchange the Senate had to pass the House's minor tweaks via budget reconciliation.

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.

After passage the CBO was asked by Republicans to score Obamacare based on new numbers based on subsequent experience. The CBO conclusion was that the original set of numbers were wrong. The number was $1 trillion originally, and became $1.7 trillion subsequently.

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?

Your real audience is those people you need to persuade so the Democrats can have peace. Those folks are conservatives. Just as George Bush never knew peace after he screwed up, so it shall be in the case of Obamacare. That's the way the system works.
 
Re: SCOTUS LIVEBLOG - Obamacare Mandate Survives-Part 2

The policy that I want is a "catastrophic" plan that pays ZERO until I reach $5,000 in annual medical expenses then it pays 100% over that. Is that LEGAL under ObamaCare?

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.
 
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.

Why would any one expect conservative reaction to be any different given these circumstances?
 
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