Trump No Collusion No Harm No Foul: From Here on Out Open Season on Healthcare

Trump “Promises Made, Promises Kept” (Eventually)

(Here we go again)

ACA (Obamacare) the Individual Mandate Provision’s History:

An individual mandate to purchase healthcare was initially proposed by the politically conservative Heritage Foundation in 1989 as an alternative to single-payer health care. 

Stuart Butler, an early supporter of the individual mandate at the Heritage Foundation wrote:

“If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate, but society feels no obligation to repair his car. But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. The Heritage Foundation changed its position in 2011, calling the individual mandate unconstitutional.”

From its inception, the idea of an individual mandate was championed by Republican politicians as a free-market approach to health care reform. Supporters included Sens. Charles Grassley and Mitt Romney, and the late Sen. John Chafee who all supported basic conservative principles of individual responsibility and that the healthcare market was unique.

In 1993, President Bill Clinton proposed a health care reform bill which included a mandate for employers to provide health insurance to all employees through a regulated marketplace of health maintenance organizations and an individual mandate. 

However, the Clinton plan failed amid concerns that it was overly complex or unrealistic, and in the face of an unprecedented barrage of negative advertising funded by politically conservative groups and the health insurance industry. Republicans proposed a bill that would have required individuals, and not employers, to buy insurance, as an alternative to Clinton's plan.

The ACA Rationale Specifically for the Individual Mandate:

Health insurance, like other kinds of insurance, works by creating “risk pools which are groups of policyholders.”

In a typical risk pool, everyone pays insurance premiums, but only some will file claims.

If a health insurance risk pool is large enough and has enough healthy people paying premiums, then there will be enough money available to cover the costs of those who get sick, and if everyone is required to have insurance, including healthy people, then the risk pools will be broad enough to lower premiums for everyone, even those with expensive medical conditions.

The ACA became law in 2010. It requires most Americans to have a basic level of health insurance coverage and that is called the “individual mandate.” The law imposes a tax penalty through 2018 on those who fail to have the required coverage.

Who must have coverage: Unless they're in a category of people exempt from the individual mandate, all U.S. citizens and permanent residents must have health insurance. Exempt groups include:

1.    People whose religion forbids them from having any health insurance.

2.    People who are incarcerated.

3.    Members of Native American tribes; undocumented immigrants.

4.    Families whose income is so low that they are not required to file a tax return.

5.    Individuals who would have to pay more than 8 percent of their income for insurance, after taking into account employer contributions or other subsidies.

If you're required to have coverage, what kind of coverage meets the federal definition of “essential care?”

§  In general, health insurance obtained through an employer's plan qualifies as essential care.

§  So do Medicare, Medicaid, and the Children's Health Insurance Program (CHIP).

Also qualifying are:

Tricare for military service members, retirees and their families; veterans; individual health care policies that provide a certain minimum level or benefits; and any plan that existed before the law was enacted that has been grandfathered in by the federal government.

Apparently only his kind for needy and ill Americans:

Trump solution for most needy: Always simple right

(Or another con job)

Tax penalty legislation was passed in late 2017 and it ended the penalties for not have coverage beginning with the 2019 tax year.

Tax penalties for lack of coverage began accruing in 2014, and they were to phase in over a three-year period. Taxpayers are penalized for lacking coverage for themselves and for their dependents.

Beginning in 2019 the penalties will no longer be assessed.

This latest major Court ruling update on ACA challenges:

The headlines: A federal appeals court (Dec 18, 2019) struck down Obamacare’s individual mandate in a decision that immediately thrusts the health care law to the forefront of the 2020 elections.

However, the appeals court ruling largely ducked the central question of whether the rest of the ACA remained valid after Congress removed the mandate penalty for not having health insurance.

The three-judge panel instead sent the case back to a Texas federal judge, who previously threw out the entire law, to reconsider how much of Obamacare could survive.

Specific Details: This appeals court (5^th District) decision could renew pressure on Trump and Republicans to explain how they will preserve insurance protections for preexisting conditions after failing to agree on an Obamacare replacement for years (even when they held all three branches of government).

The latest challenge to Obamacare was brought by more than a dozen Republican-led states that argued the law is no longer constitutional after Congress jettisoned the individual mandate penalty in the 2017 Republican tax package.

Key: The mandate was originally upheld by the Supreme Court seven years ago as a legitimate use of congressional taxing power — and without that penalty, the states argued, the entire law should fall.

Noteworthy: The Appeals Court said its decision to send the case back to the District Court (Judge Reed O'Connor) was largely precipitated by the Trump administration switching legal positions in the case earlier this year.

My insert: That is how the GOP wants their tactics to work: No mandate, then toss the whole bill away – i.e., throw the baby out with the bath water mentality.

The DOJ originally argued just the law's individual mandate and main insurance protections should be abolished. The department, under AG Barr, earlier this year expanded its legal assault on Obamacare to argue the entire law should be found unconstitutional only in the Republican-states challenging the law.

“The rule of law demands a careful, precise explanation of whether the provisions of the ACA are affected by the unconstitutionality of the individual mandate as it exists today,” reads the 5th Circuit's majority opinion, which was signed by the panel's two Republican-appointed justices.

The appeals court was silent on whether it thought the law's insurance protections should be struck down. The decision, issued hours after the latest Obamacare enrollment season ended, does not interrupt coverage for anyone covered through Obamacare's insurance marketplaces or Medicaid expansion.

My 2 cents: This from California’s AG Xavier Becerra “It's time to get rid of the uncertainty. In many respects, many of us believe that this is a merry-go-around. The last thing Americans need is to have their security and the health of their kids depend on these circular arguments that are going around.”

I totally agree and the only ones playing politics with decent healthcare are Trump, Barr, most RED states, and a few diehard GOPers who already have government healthcare and don’t give a damn about average Americans and especially those in dire need or those who suffer from pre-existing conditions. 

Hardline conservatives like Texas AG Paxton, leading the conservative states' lawsuit against Obamacare, celebrated the 5th Circuit ruling and cheered and they are the ones who are a real threat to decent affordable healthcare.

The USSC should consider this a real emergency and make a final ruling on the ACA now will allow people in need and the country to move on to other issues… now would be better than later.

Thanks for stopping by.