Health-care reform law: How Supreme Court ruling affects families

Posted by Kendall Harmon

For the roughly 50 million uninsured Americans, the court's ruling has the biggest implications. For the majority of citizens who currently have insurance, the ruling could mean some important changes as well, such as to their health plans or their personal tax rates.

Many less affluent Americans who do not qualify for Medicaid may now gain health coverage as the program is expanded.

For others among the ranks of some 50 million uninsured Americans, the law creates a system of tax subsidies – designed to help more Americans afford health coverage – plus the mandate to buy insurance or pay a fine.

Read it all.


Filed under: * Culture-WatchHealth & Medicine--The 2009 American Health Care Reform DebateLaw & Legal IssuesMarriage & Family* Economics, PoliticsEconomyPersonal Finance

13 Comments
Posted June 28, 2012 at 1:15 pm [Printer Friendly] [Print w/ comments]



1. clayton wrote:

Thank you for posting this - it’s a calm, useful explanation.

June 28, 4:49 pm | [comment link]
2. SC blu cat lady wrote:

#1.  yes and it may be totally wrong! I suspect there are many things in this that won’t be known for years.  Perhaps the HHS czar knows but not the rest of us.

June 28, 11:15 pm | [comment link]
3. Teatime2 wrote:

Indeed, clayton. But why appreciate calm and useful when we can go crazy-hyperbolic, lol?! On the 6 p.m. news, I watched my Republican governor (Perry) shake his head mournfully and make dire predictions in the wake of this SC decision. Did he really not count on the fact that some of us who follow the issue know he has been working with the Feds to expand Medicaid and find solutions along the lines of what they like to call “Obamacare?”

We live in Bizarro-world if someone who is doing a good job of navigating the system and making realistic and beneficial changes is trying to hide that fact and pretend that the changes are devastating. Perry knows darn well that having 25 percent of our citizens being uninsured costs our state and the hospitals a lot of money and his measures to permit Medicaid buy-in programs and creating affordable care clinics make sense. He should be proud of his work.

June 28, 11:36 pm | [comment link]
4. Boniface wrote:

Politics is a game. Those that personalize it, lose perspective.

June 29, 6:51 am | [comment link]
5. Sarah wrote:

I agree, Boniface.  That’s why it won’t be personal when American citizens will get to vote—straight up or down—on whether they want this in November.

As far as how Obamacare “affects my family” my health insurance skyrocketed last year in the wake of the new law.  I have no doubt it will continue to skyrocket now as I, along with other citizens, take on the financial burden of absorbing millions of others health insurance costs—a simple crude transfer of wealth enforced by the power of the State and assisting in further collectivizing something that was not a free market anyway, which means prices will continue to soar and the healthcare bubble will continue to expand—just like the old housing bubble.

We’ll see—I’m pretty energized!  ; > )

June 29, 8:17 am | [comment link]
6. Cennydd13 wrote:

Perhaps the idea of Public Charity hospitals should be resurrected for those who can’t afford healthcare.  Then our taxes would really skyrocket, wouldn’t they?

June 29, 10:15 am | [comment link]
7. Mike L wrote:

Funny, I found my health insurance costs skyrocketing before the AHCA was passed, even before Pres Obama was even elected as well. What evidence do you have that AHCA is the cause of the price increases where for the most part very few of it’s provisions have yet to be enacted? I’m truly interested in knowing.

June 29, 11:30 am | [comment link]
8. Uh Clint wrote:

#6 - What makes you think public hospitals are gone?

In Dallas, Parkland Hospital is a “charity hospital”, offering care to everyone regardless of ability to pay.  Dallas County funds it with a line-item tax that appears on every property owner’s bill - and I assure you, it’s not a trivial amount.  Ft. Worth also has a charity hospital for Tarrant County; I can’t recall the name of it.

This is one of the reasons the meme about “what are people with no health insurance to do?” is so irritating.  I’m already paying my own health insurance costs and that for the uninsured in my community; now I’ll end up losing some of my benefits (the insurer has already announced that compliance wityh ACA will change things) and paying more for it.

June 29, 12:18 pm | [comment link]
9. Sarah wrote:

RE: “Funny, I found my health insurance costs skyrocketing before the AHCA was passed . . . “

Certainly the health care central collectivization of the industry led to growing costs every year prior to Obamacare.  That’s not in question—we all already know that we’re in a health care industry bubble, just like the housing bubble.

RE: “What evidence do you have that AHCA is the cause of the price increases where for the most part very few of it’s provisions have yet to be enacted?”

There has been no controlled quantitative study on this.

I assume you’re not asking for that.  In the absence of the controlled quantitative study, we have 1) qualitative evidence and 2) rational thinking.

In the way of qualitative evidence, 1) many of my friends work at corporations—very very very large corporations.  Many of them received very specific detailed letters after Obamacare passed explaining why their costs were going up or why their choices were going away. For example [just to name one] a major bank—a name you would recognize and one of the big 10 in the country, sent out a letter to their employees explaining why their plans were *going away* [due to the recently passed legislation which larded up policies with further entitlements and mandates] and they would now have a choice of a very very very high deductible HSA or a very very very very very very very very high cost alternate plan. Those were the two choices the employees were given. I sat across the breakfast table with one of these employees as she tried to figure out what the heck she was going to do.

They went from cadillac to beetle bug car—and it was clearly named as to the reasons why.  This bank is not “conservative” by any remote standard—I’d imagine the bank executives happily voted for Obama in 2008, although I’m sure their costs of employment going up have made them none too pleased.

All around the country, employees have gotten called into mass meetings.  For example, another friend got called into a huge meeting at her manufacturing company—very solemn, and with lots of information, graphs, and intel on what this had done to their health insurance costs. 

Companies have insurers.  Those insurers talk to the corporate heads and inform them of how much higher their insurance costs will now be.  And corporations pass those higher costs on to their employees and limit the choices that they offer.  And . . . of course . . . since the cost of hiring additional employees has now been raised, companies put hiring freezes on their expansion plans.

I just marvel at the divide in this country. Anybody working with leaders in companies or talking with the peons who work in those companies gets the same stories.  Corporate leaders of small to mid-sized businesses are agonizing over these changes and the devastating hit this has given to their cost of hiring and cost of keeping employees. Those who don’t know this and don’t have real-life examples of these decisions having to be made are . . . well . . . they’re just not in the world that business people are in.  They’re not in the same world, and that’s fine, I guess—the chasm will continue to grow.

In my own case, approximately two months after the act was signed into law—and for the first time ever—I received a “special letter” from my insurance company—around six months *earlier* than the usual annual letter explaining why my health insurance cost was going up. It explained that due to additions to their costs I’d have a massive increase in health insurance costs.  Of course, many many Americans got that letter and no amount of wide-eyed “what evidence do you have” questions from people who approve of state central planning of health care is going to make people not see the rather striking correlation between a) Obamacare passing and b) unusual second letter raising my bill in the middle of the year.

Then there’s, of course, the rational thinking.

When you take a product, and force the product manufacturers to add all sorts of special “features” to it in the way of mandates and add further draconian regulations, and also demand that 16 million people should “have” this new highly gizmoed, larded up product, it stands to reason that the actual people who are paying for this new lovely-featured product for 16 million more people will pay more money for the product.

Just to name one—of hundreds—of the little special gizmos . . . is the wretched, grindingly-regulated, horrific electronic health records requirement. My father and brother are in medicine; they are medical directors of practices, on hospital staffs, and a part of boards of multiple healthcare entities of all sorts.  Thanks to Obamacare, they and the hospitals and medical practices and non-profits they are a part of are grinding to a halt.  It is taking 40% longer to deal with the paperwork requirements now—they are seeing far fewer patients as a result and having to send patients away, or delay their discharges from hospitals due to the unbelievable amount of time that it is taking now to deal with the massive tsunami of new paperwork required.

Further, the sheer cost of implementing the Federally regulated EHR—regulated to the point that it is unworkable—is massive.  It is driving the smaller practices into the ground because some places just can’t afford to be in compliance.  No worries—we can all enjoy Walmart-Care!

The irony of EHR is that doctors and other providers like EHR.  And Obamacare didn’t “invent” EHR—oh no.  But now they’ve ruined it.  They’ve made it utterly unworkable, like adding an anchor to an already overloaded car.

So now we all get to wait longer, and they get to slow down the rate of patient care, and providers and practices get to throw in the towel—not because they’re providing better patient care, but because they’re in the back cubicle, trying to get the clunky, grinding, horrible EHR to work. 

One of the best nursing home administrators in one of our SE states is retiring early—he simply cannot keep up the pace of compliance with all of the latest draconian regulations and mandates the government has piled onto his and the board’s back.

Of course, there are thousands more such examples, town by town, state by state.

I recognize that none of the above qualifies as “evidence” for those who do not value individual liberty, private property, the Constitution and free markets. If I quadrupled the qualitative evidence I listed or multiplied it by 1000—or if a quantitative study were produced pointing all of this out—it wouldn’t be “enough” to counter the high value that those who believe in collectivist, central-planning place on Obamacare.

No amount of cost-escalation, or quality decline, or supply-loss is too much when it comes to the ultimate value, which is a small group of bureaucrats in the State getting to decide how it wants to manage and control an industry and the decisions of individuals who use or serve in that industry.

That’s the highest value.  None of the rest matters.

So I say all of the above for the benefit of those who *do* care about individual liberty, private property, the Constitution, and free markets.

The good news is that all of this is now a political matter. The entire country gets to vote on whether central planning of an industry is a good idea.

Perhaps a majority will decide that yes, this is a great idea and in that case all of us must suffer their choices.

But one never knows.

All I have thought about for three plus years is the Senate and the House; every conservative [not Republican, but conservative] that replaces a collectivist central planner from the parties of the Republicans or the Democrats is all to the good.

June 29, 1:04 pm | [comment link]
10. Sarah wrote:

Just to be clear, since it’s possible that it could be misinterpreted, I am in no way asserting that any particular person on this thread “approves of state central planning of health care.” I merely point out that if someone does, then no amount of qualitative evidence or rational thinking will get them to strike their forehead and say “goodness, it looks as if state central planning of health care will create more bad then good.”  The intrinsic value of state central planning of health care for such people far far outweighs any relatively trivial other disadvantages.

June 29, 2:16 pm | [comment link]
11. Catholic Mom wrote:

Actually, all that “evidence” was totally anectodal.  I have equally long anecdotes in the opposite direction.  The problem with anecdotes is that they only convince people of what they’re already convinced of.

My private health insurance went up to $24k a year (unsustainable) in 2009 before my husband quit the start-up work that he loved and took a soul-destroying corporate job that he hates because that’s the only way we could get insurance that we could afford (my younger son has a medical condition that requires unbroken medical attention.)  So this is a total distortion of the labor market and free enterpreise related to the fact that we have insurance tied to employment in this country, which is crazy.  Imagine if, by equal random walk, we ended up with education being linked to employment, so we had no public education paid by taxes in this country—only education paid for by your employer or education paid for by direct tuition (which cost twice as much as it would when it was paid by an employer).  So you might end up saying “I’d like to change jobs or take a sabbatical or take time off to get a master’s degree but I can’t because my son would have to drop out of high school.” If you lost your job, your kids would be kicked out of school.  How crazy would that be?  But that’s exactly what we have in health care.  You want to know why we’re not competitive with other countries?  Because GM pays more for health care than for steel.  And that is NOT an anecdote.

When ANY politician in this country would like to talk bout de-linking insurance and employment, I will be the first to listen.

June 30, 12:37 pm | [comment link]
12. Sarah wrote:

RE: “Actually, all that “evidence” was totally anectodal.”

Yup—as I said originally:

There has been no controlled quantitative study on this.

I assume you’re not asking for that.  In the absence of the controlled quantitative study, we have 1) qualitative evidence and 2) rational thinking.

The standard definition of “qualitative:”

In the conventional view, qualitative methods produce information only on the particular cases studied, and any more general conclusions are only propositions (informed assertions). Quantitative methods can then be used to seek empirical support for such research hypotheses.

The qualitative evidence Catholic Mom provides, while interesting, doesn’t seem to bear any relevance to the original request: “What evidence do you have that AHCA is the cause of the price increases [of last year] where for the most part very few of it’s provisions have yet to be enacted?”

It *does* bear relevance to this point, however:

“Certainly the health care central collectivization of the industry led to growing costs every year prior to Obamacare.  That’s not in question—we all already know that we’re in a health care industry bubble, just like the housing bubble.”

The forced connection to employment of health insurance is a product of the horrific regulations and mandates and limits on competition that the Federal government has created.

Obamacare makes a very bad system that is the product of central planning and little to no free enterprise much much worse.

June 30, 3:29 pm | [comment link]
13. Sarah wrote:

But as I also said:

. . . if a quantitative study were produced pointing all of this out—it wouldn’t be “enough” to counter the high value that those who believe in collectivist, central-planning place on Obamacare.

No amount of cost-escalation, or quality decline, or supply-loss is too much when it comes to the ultimate value, which is a small group of bureaucrats in the State getting to decide how it wants to manage and control an industry and the decisions of individuals who use or serve in that industry.

That’s the highest value.  None of the rest matters.

So I say all of the above for the benefit of those who *do* care about individual liberty, private property, the Constitution, and free markets.

The good news is that all of this is now a political matter. The entire country gets to vote on whether central planning of an industry is a good idea.

It feels good that this will be now fought out in the most crass, brute force manner that is legal—through an up or down vote in November of 2012. It doesn’t matter if it’s Constitutional or not from a *practical* standpoint now—it’ll be voted on by the people.

June 30, 3:41 pm | [comment link]
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