Obamacare Exchange subsidies possibly illegal ? How much of the law can withstand legal challenges that inevitably will keep coming ? It would appear this whole mishmash blows up but probably not until after the Mid - term elections in 2014 ! In the interim , as the implementation flounders along with the promises folks bought into , Affordable Care becomes about as popular as the average Congress Critter....

Congress, Experts Question Legality of Obamacare Exchange Subsidies

IRS, Democrats defend administration’s decision to extend subsidies to all exchanges

 

AP

      

BY: Andrew Evans
July 31, 2013 4:40 pm

The Obama administration cannot legally offer federal subsidies to help people buy insurance on federally run health insurance exchanges, legal experts and Congressional Republicans argued Wednesday, potentially threatening the central feature of Obamacare.

Obamacare mandates that each state have a health insurance exchange where people can buy insurance, and the federal government is providing subsidies to help qualifying people buy health insurance on these exchanges.

The law says that the government can provide subsidies for insurance sold on an “Exchange established by the state.” Thirty-four states have refused to set up their own exchanges, leaving the federal government set them instead.

The Obama administration has interpreted the law to allow them to offer subsidies to people buying insurance on exchanges run by the federal government as well as the state governments.

Both legal experts and Republicans on the health care subcommittee of the House Oversight Committee contended that the administration’s implementation of the subsidy provision is beyond the scope of the law and Congress’s intent.

“At issue today is an example of the administration rewriting the law to meet political objectives,” said subcommittee chairman James Lankford (R., Okla.).

Congress originally limited the subsidy only to state-created exchanges to induce the states to set up their own exchanges, argued Jonathan Adler, a law professor at Case Western Reserve University.

Oklahoma Attorney General Scott Pruitt agreed with Adler.

“When Congress passed the health care act, they presented states a choice,” Pruitt told the congressmen. “That choice was to establish a state health care exchange or to opt for a federal exchange. The ACA included with that choice a set of consequences and benefits.”

If states opted to create an exchange themselves, then their citizens would receive federal subsidies to buy insurance on the exchange, but employers would also be subject to fines for not offering affordable health insurance, Pruitt argued. However, if they opted against the exchange, they would not receive subsidies and employers would not be subject to fines.

Pruitt has launched a lawsuit against the administration arguing that they do not have the power to offer the subsidies on federally run exchanges. Experts predict that Oklahoma’s lawsuit, if successful, could fatally cripple the law.

The administration argued that the law permits its interpretation.

“Treasury and IRS believe that the final regulations interpret the statutory language in a manner that is appropriate to its context and consistent with the purpose and structure of the statute as a whole,” said Emily McMahon, deputy assistant secretary for tax policy at the Treasury Department.

Simon Lazarus, a legal expert at the Constitutional Accountability Center, argued that other parts of the law clarify that federally run exchanges count as state exchanges for the purposes of the subsidy.

Lazarus also argued that the administration’s interpretation fits with the intent of the rest of the bill, which was to increase enrollment in health insurance.

Lazarus called the idea that the law’s crafters would create part of the bill so that it would fail if states did not comply “so absurd that I can’t imagine why any judge would spend three minutes with it.”

Adler countered that the bill contained precisely this “sabotage” trigger with Medicaid, by stripping all Medicaid money from the states if they did not agree to expand the program. The Supreme Court subsequently struck this provision down, saying it was too coercive.

Subcommittee ranking member Jackie Speier (D., Calif.) objected to the idea that people could have different access to federal programs in different states, based on what the state leaders decide.

“While I do represent a district in California, I also feel an obligation towards all the people in the United States of America, and that’s the way I look at this legislation,” Speier said.

http://www.npr.org/blogs/health/2013/07/19/203377456/white-house-muddles-obamacare-messaging-again

This summer was supposed to be a time to reintroduce the public to the Affordable Care Act and teach people how to sign up for benefits this fall.

But that's not what's happening.

Instead, earlier this month, the Obama administration decided to delay some key pieces of the law, most notably the requirement for larger employers to provide coverage or risk fines, because they couldn't have reporting regulations ready in time for next year's rollout.

Then this week, the Republican-led House voted to delay the so-called individual mandate for a year to match. It was the 39th such vote against the law.

And now some are starting to worry that the White House is getting dangerously off-message.

The administration tried to regroup Thursday: It put President Obama front and center in theWhite House East Room, surrounded by smiling beneficiaries of the parts of the Affordable Care Act already in effect.

Among those singled out: those who have been on the receiving end of a somewhat obscure provision requiring insurance companies to pay rebates to policyholders if the companies spend too much on administrative costs rather than medical expenses.

"Dan Hart, who's here from Chicago, had read these rebates were happening," said Obama. "But he didn't think anything of it until he got a check in the mail for 136 bucks."

This year an estimated 8.5 million Americans will get rebates thanks to the law's "medical loss ratio" rules. That's actually down from the 13 million who got them last year. And Obama admitted that even those who are getting the checks don't necessarily associate them with the health law.

"I bet if you took a poll, most folks wouldn't know when that check comes in that this was because of Obamacare that they got this extra money in their pockets," he said.

Which is a big part of the administration's messaging problem. According to public opinion polls, many of the law's provisions are extremely popular. But the law itself isn't. Still.

And while the president is talking about a few million people getting refunds of $100 or $200, Republicans have been talking in much more expansive terms.

"A government-run health care system is at its very basis a beginning of socialism in medicine, and we oppose that," said Rep. Pete Sessions, R-Texas, during the House floor debate Wednesday.

At his daily briefing Thursday, White House spokesman Jay Carney derided Republicans' continuing efforts to roll back the law.

Carney said the president is willing to make changes to the law as necessary. "But that is wholly different from this constant and now almost comical effort to spend most of the time in the House of Representatives hoping to repeal in some form or manner a bill that has been passed into law by both houses, signed into law by the president, and upheld as the law by the Supreme Court of the United States."

Still, there's a major difference in the way Republicans talk about the law and the way the president does, says George Lakoff, a professor of linguistics at the University of California, Berkeley and an expert on political messaging.

Lakoff says Republicans talk about the law as a moral issue. "Basically ... they say that democracy is about liberty, the liberty to pursue your own self-interest without you having to take care of anybody else's interests or anybody else having to take care of yours."

But when Obama talks about the health law — at least this week, says Lakoff — "his message was all about money."

And Lakoff says that's pretty much been the president's problem: He's mostly shied away from talking about health care on the same moral terms as have the Republicans.

But he could talk about it from the moral perspective of Democrats if he wanted to, Lakoff says.

"Health care is about life itself, about living a decent life, about living free from fear, and also free from economic fear. Fear of losing your home because you have to pay out of pocket for operations that really ought to be paid for by having health care insurance," he said.

The administration, however, has seemed to be all over the place when it comes to its messaging about the health law.

http://www.washingtontimes.com/news/2013/jul/19/a-union-cloud-over-obamacare/?page=all

“If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what.”

— President Obama, July 2009

As the details of Obamacare become more known, Americans become more concerned, and for good reason. President Obama promised that if you were happy with your health care, you could keep it. As with so many other government promises, this, too, turns out to be an empty one.

Even people you think would be solid Obama supporters are waking up to the more damaging aspects of the Affordable Care Act.

The Teamsters and two other major unions sent a letter to Senate Majority Leader Harry Reid and House Minority Leader Nancy Pelosi this week, writing: “When you and the president sought our support for the Affordable Care Act, you pledged that if we liked the health plans we have now, we could keep them. Sadly, that promise is under threat.”

The union letter continued: “The unintended consequences of the ACA are severe. Perverse incentives are already creating nightmare scenarios: First, the law creates an incentive for employers to keep employees’ work hours below 30 hours a week. Numerous employers have begun to cut workers’ hours to avoid this obligation, and many of them are doing so openly.”

The letter concludes: “The impact is two-fold: fewer hours means less pay while also losing our current health benefits.”

In 2010, Mrs. Pelosi, then House speaker, famously said of Obamacare, “We have to pass the bill to find out what’s in it.” As Americans find out what’s in it, even significant parts of the Democrats’ base don’t like it one bit.

Government intervention ends up causing higher taxes or the costs of regulation being passed on to the consumer. Obamacare is no different, and as a result many employees no longer will be able to keep their current health care.

Those of us who champion the free market and understand how it works knew this would happen, even as the president promised it wouldn’t. Now Americans happy with their health care are seeing it threatened.

That is just one aspect of this highly problematic law. We know that Obamacare will cost more than any of its authors predicted, and many individuals will begin to see their premiums go up significantly. Even the White House is afraid of what will happen. Their delay of the employer mandate will delay the pain for some, but won’t help the millions of individuals still subject to the mandate.

Not surprisingly, a recent Fox News poll showed that 56 percent of Americans wanted to be rid of Obamacare. The same poll showed that 55 percent of Americans younger than 35 want the same. I wouldn’t be surprised to see these numbers rise in the weeks and months to come.

Perhaps Mrs. Pelosi should have read this bill beforehand.

There are many significant and even tragic faults with America’s health care system, but Obamacare was never the answer. It is telling that this week some of the largest unions in the country have expressed the same sentiment.

As many problems as we have with health care — and there are many — Obamacare now promises to do even worse damage. That is about the only promise concerning this law we can count on.

Sometimes, the cure can be worse than the disease.