[Chaos]

Appeals court rules against Obama healthcare mandate
By Jeremy Pelofsky and James Vicini

(Reuters) - President Barack Obama's signature healthcare law suffered a setback on Friday when an appeals court ruled that it was unconstitutional to require all Americans to buy insurance or face a penalty.

The U.S. Appeals Court for the 11th Circuit, based in Atlanta, ruled 2 to 1 that Congress exceeded its authority by requiring Americans to buy coverage, but it unanimously reversed a lower court decision that threw out the entire law.

The legality of the individual mandate, a cornerstone of the healthcare law, is widely expected to be decided by the U.S. Supreme Court. Opponents have argued that without the mandate, which goes into effect in 2014, the entire law falls.

The law, adopted by Congress in 2010 after a bruising battle, is expected to be a major political issue in the 2012 elections as Obama seeks another term. All the major Republican presidential candidates have opposed it.

Obama has championed the individual mandate as a major accomplishment of his presidency and as a way to try to slow the soaring costs of healthcare while expanding coverage to the more than 30 million Americans without it.

The White House voiced confidence the law would be upheld. "We strongly disagree with this decision and we are confident it will not stand," Obama aide Stephanie Cutter said in a statement.

Because it conflicts with another appeals court ruling that upheld the law, the Supreme Court is expected to take it up during its term that begins in October with a ruling possible just months before the November 2012 presidential election.

Legal experts said it was impossible to predict how the high court will rule but agreed that it may be a close vote by nine ideologically divided justices, with moderate conservative Justice Anthony Kennedy as the possible swing vote.


SPLIT DECISION

Twenty-six states together had challenged the mandate, arguing that Congress had exceeded its authority by imposing such a requirement. But the Obama administration had argued it was legal under the Commerce Clause of the U.S. Constitution.

A federal judge in Florida sided with the states and struck down the entire law, leading the administration to appeal.

A divided three-judge panel of the 11th Circuit found that it did not pass muster under that clause or under the power of Congress to tax. The administration has said the penalty for not buying healthcare coverage is akin to a tax.

"This economic mandate represents a wholly novel and potentially unbounded assertion of congressional authority: the ability to compel Americans to purchase an expensive health insurance product they have elected not to buy, and to make them repurchase that insurance product every month for their entire lives," the majority said in its 207-page opinion.

That opinion was jointly written by Judges Joel Dubina, who was appointed to the appeals court by Republican President George H.W. Bush, and by Frank Hull, who was appointed by President Bill Clinton, a Democrat.


REPUBLICANS AGAINST IT

Republicans have sought to undercut or repeal the healthcare law at every level of government -- in federal court, in the state legislatures and in the U.S. Congress.

The decision contrasts with one by the U.S. Appeals Court for the 6th Circuit, based in Cincinnati, which had upheld the individual mandate as constitutional. That case has already been appealed to the Supreme Court.

The Court of Appeals for the 4th Circuit, based in Richmond, has yet to rule on a separate challenge by the state of Virginia. A federal judge in that state had ruled the mandate unconstitutional as well.

Either side could ask the full 11th Circuit court to reconsider the decision or go straight to the Supreme Court. The Justice Department said it was weighing its options.

"Today we have prevailed in preventing Congress from infringing on the individual liberty protected by the U.S. Constitution," Florida Attorney General Pam Bondi said.

The 11th Circuit did not agree that the entire Obama healthcare law should be tossed out. Many provisions are already being implemented, including allowing children to stay on their parents' health insurance plan until age 26 and banning lifetime coverage limits.

Further, the Obama administration on Friday issued new incentives for states and people to participate in health insurance exchanges, including tax credits and funding grants for the states.

The Obama administration did win some support from the appeals court for the individual mandate. One of the three judges, Stanley Marcus, dissented from the majority opinion in his own 84-page opinion.

The majority "has ignored the undeniable fact that Congress' commerce power has grown exponentially over the past two centuries and is now generally accepted as having afforded Congress the authority to create rules regulating large areas of our national economy," wrote Marcus, also a Clinton appointee to the appeals court.

He also cited a past opinion about Congress' broad power by the possible Supreme Court swing vote, Justice Kennedy.

Cutter from the White House said that without the individual mandate, healthcare premiums could go up as much as 20 percent. America's Health Insurance Plans, the trade group for the industry, said repealing the individual mandate would cause "significant disruption and skyrocketing costs."

(Additional reporting by Jane Sutton in Miami and Lisa Lambert and Anna Yukhananov in Washington; Editing by Eric Beech and Howard Goller)

http://www.reuters.c...E77B4J320110812

[FlyHiJets]

I still say it's bull$hit to mandate that everyone MUST buy health insurance. Some of us either can't afford it but don't burden the rest of the taxpaying people in this country by not attempting to get free healthcare. I pay my medical expenses out of pocket because the costs of HMO's are absolutely ridiculous and it's a little difficult to afford coverage for myself, my new bride to be, my two kids AND an ex blood sucking wife. I'm supposed to afford coverage for all of us and pay the rest of my bills and child support on a 40K annual salary? Kiss my as$ Obama!!

OBAMA = One big As$ Mistake America

Keep in mind the words of one of this country's forefathers Thomas Jefferson........A government big enough to give you everything you want is also strong enough to take away everything you have.

[azjetfan]

Where the heck has Mr.Jet been?

[Mr_Jet]

[Smedsthejet]

Mr_Jet, on 29 June 2012 - 04:13 AM, said:

From a British perspective the ruling makes so much sense. It's shameful that a number of people in the most powerful democracy in the world could not afford health insurance, while the state was unwilling to provide healthcare free at the point of delivery to all. Although Obamacare doesn't do the latter (which the British NHS does), at least now insurance providers should lower costs in order to make insurance affordable to those for who it was previously out of reach.
It could potentially reduce state expenditure on healthcare in the US too, which is much higher as a % of GDP in Britain with its supposedly 'socialist' model of provision!

[SecondHandJets]

I'm out of the loop on this, what does this mean?

[Mr_Jet]

SecondHandJets, on 30 June 2012 - 12:52 PM, said:

I'm out of the loop on this, what does this mean?

Not much until 2014. Basically it means people can't be denied coverage by private insurers because of a preexisting condition and can't be charged more for having a preexisting condition.

• College students and young adults can stay on their parents' health insurance until the age of 26.
  
  
• Seniors can continue to get a discount on their prescription drug costs after they reach the coverage gap (aka the donut hole).
  
  
• Medicaid can be expanded to cover more people, meaning the working poor will qualify and you don't have to be damn near impoverished to qualify.
  
  
• They kept the individual mandate which basically means if you can afford to buy it you have to. The debate was whether or not the mandate was constitutional or not. The Supreme Court said it was basically a tax and that the congress does have the power under the constitution to implement taxes. You can either buy health insurance or not and pay a penalty. But there is nothing in place to enforce this penalty so basically you don't have to pay it.

All it means IMO is at some point we're going to end up having a single payer system like Canada has now. It's just going to take longer than it needs to. The ACA (Obamacare) is just the first step in that process.

Quote

AFFORDABLE CARE ACT BENEFITS ALREADY IN PLACE: NO CHANGE

Young adults up to age 26: Approximately 2.5 million young adults are now covered on their parents' policies. Before the decision, UnitedHealth Group Inc. (UNH), Aetna Inc. (AET) and Humana Inc. announced that they would keep children on plans to age 26. Additionally, many states had laws on the books that support the young-adult rule.

Ban on lifetime limits: The three insurance companies noted above have also said that they would have kept these popular rules in effect

Ban on denying care due to pre-existing conditions: The insurance industry had said that it would be willing to abide by this rule, except in cases of fraud (i.e. when people lie about their conditions on the application). This provision would have been expensive, however, without the mandate, because of the possibility that only sick people would have signed up for insurance.

Preventive healthcare benefits without imposing co-pays/other out-of-pocket charges: Some of the popular tests that this rule covers are mammograms and colonoscopies. About 54 million Americans now have expanded coverage of at least one preventive service since the law went into effect, according to an analysis by the Kaiser Family Foundation. Additionally, 32.5 million seniors took advantage of these preventive services.

Gap in Medicare coverage (aka the "doughnut hole"): Seniors who fell into this coverage gap have enjoyed a 50 percent discount on covered brand-name drugs and 14 percent savings on generic drugs.

Temporary insurance coverage: Two programs have provided coverage for retirees who are over age 55 but not eligible for Medicare and for adults with pre-existing medical conditions who have been uninsured for at least six months. These pools were intended to create coverage until 2014, when permanent solutions are in place.

Require health plans to report the proportion of premium dollars spent on clinical services, quality, and other costs and provide rebates to consumers: When the law went into effect, insurance companies paid out 74 cents on every dollar -- new rules required that amount rise to 80-85 cents

Requirement that insurance companies justify "unreasonably" large healthcare premium increases: ACA also established standards for insurers to use in providing information on benefits and coverage and will eventually create a new federal body that will have power to block insurers from raising rates

Small Business Tax Credits: Employers with fewer than 25 employees and average annual wages of less than $50,000 that provide health insurance for employees will receive tax credits for providing coverage

ACA PROVISIONS TO GO INTO EFFECT IN 2014: CHANGE TO MEDICAID PROVISION

Medicaid Expansion: The ACA was supposed to expand Medicaid to all individuals under 65 earning less than 133 percent of the poverty line, or around $30,000 a year for a family of four. The expansion would have provided coverage to 16 million Americans. The Court prohibited the federal government from punishing states for not complying. The feds can withhold new funds from states that don't comply, but cannot withhold all Medicaid funding.

State insurance exchanges: Exchanges will be established to provide access to insurance for those who don't have coverage through work. The Congressional Budget Office (CBO) estimates that 23 million Americans will gain coverage through the state exchanges by 2019. The government will provide tax credits for individuals and families making less than 400 percent of the federal poverty level, which is currently $92,000 for a family of four.

Paying for ACA: The law will be paid for through new taxes and penalties:

-- A new excise tax on high-premium insurance (Cadillac) plans, equal to 40 percent of premiums paid on plans costing more than $27,500 annually for a family, starting in 2018

-- An increase in Medicare payroll taxes on couples with income of more than $250,000 a year

-- Unearned income, like capital gains, subject to additional 3.8 percent tax

-- Customers of indoor tanning salons would pay a 10 percent tax

-- Fees on insurance companies, pharmaceutical companies and medical device manufacturers, including $33 billion over 10 years on fees on drug makers, starting in 2014

-- A tax on individuals without qualifying coverage, maximum penalty set at 2.5 percent of income

[SecondHandJets]

My friend was explaining shit to me, and he was saying that basically this put a cap of 20% on the earnings of insurance companies. Something along the lines of them having to spend a certain amount per year. Is that at all true? He's a pot head, so this maybe something he imagined. He's also a physics teacher, so he's not an idiot.

[Mr_Jet]

SecondHandJets, on 30 June 2012 - 05:45 PM, said:

My friend was explaining shit to me, and he was saying that basically this put a cap of 20% on the earnings of insurance companies. Something along the lines of them having to spend a certain amount per year. Is that at all true? He's a pot head, so this maybe something he imagined. He's also a physics teacher, so he's not an idiot.

I haven't heard or read anything like that. I doubt it though.

[Mr_Jet]

Smedsthejet, on 29 June 2012 - 04:09 PM, said:

From a British perspective the ruling makes so much sense. It's shameful that a number of people in the most powerful democracy in the world could not afford health insurance, while the state was unwilling to provide healthcare free at the point of delivery to all. Although Obamacare doesn't do the latter (which the British NHS does), at least now insurance providers should lower costs in order to make insurance affordable to those for who it was previously out of reach.
It could potentially reduce state expenditure on healthcare in the US too, which is much higher as a % of GDP in Britain with its supposedly 'socialist' model of provision!

I wish Americans truly understood the British and Canadian systems. But the moment someone even talks about adopting systems like the British or Canadian ones, the critics bring up the wait times. As if somebody having a heart attack gets turned away and are forced to wait a month to see a doctor in the UK or Canada. There are some people in this country who go years even decades without seeing a doctor. I think waiting a few weeks is much better than waiting years or not seeing a doctor until it's an emergency like millions of Americans do. We already work together to pay to make sure our food is safe to eat, our water is safe to drink, and our air is safe to breath. We need all those things to live and you need health care to live too.

No system is perfect but some are better than others and the system we have of delivering health care in the U.S. is ridiculous. Like that old saying, we can't let the perfect be the enemy of the good. We have to keep progressing.

[SecondHandJets]

http://www.washingto...idual-mandates/