ObamaCare (PPACA)
A simple summary of where we are with the Patient Protection and Affordable Care Act (PPACA) or ObamaCare. The Supreme Court ruled on June 28, 2012 that the law was not unconstitutional, but offered confusing explanations within its decision. “The Affordable Care Act is constitutional in part and unconstitutional in part,” Roberts wrote. First, The Court upheld the federal takeover of 1/6th of the US economy and ObamaCare implementations will continue. On August 1, 2012 the controversial HHS contraceptive mandate took effect. Second, the Court said that it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but (who) choose to go without health insurance. Such legislation is within Congress’s power to tax.” But, “the individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause. That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it.” Third, as for the Medicaid expansion, "that portion of the Affordable Care Act violates the Constitution by threatening existing Medicaid funding," Roberts wrote. "Congress has no authority to order the States to regulate according to its instructions. ... The remedy for that constitutional violation is to preclude the Federal Government from imposing such a sanction." So there you have it; ObamaCare continues as a tax, the mandate is unconstitutional (but because the program continues as a tax that item is irrelevant), and the Medicaid expansion cannot be forced on the states. Open enrollment for the new federally run health-care exchanges are scheduled to start Oct. 1, 2013, with all Americans having access to affordable health insurance options effective January 1, 2014. See timeline here. Find your state's Health Exchange here. State-by-State Insurance Information is available at this site.

Voters may repeal and replace the Senators who broke their promise

7/19/17
from The Wall Street Journal,
7/18/17:

The ObamaCare Republicans.

Senate Republicans killed their own health-care bill on Monday evening, and some are quietly expressing relief: The nightmare of a hard decision is finally over, and now on to supposedly more crowd-pleasing items like tax reform. But this self-inflicted fiasco is one of the great political failures in recent U.S. history, and the damage will echo for years. The proximate cause of death was Mike Lee of Utah and Jerry Moran of Kansas linking arms and becoming the third and fourth public opponents. The previous two public holdouts were Susan Collins of Maine and Rand Paul of Kentucky, and Majority Leader Mitch McConnell could lose only two GOP Senators. But this defeat had many authors, some of whom are pictured nearby and all of whom hope to evade accountability for preserving the ObamaCare status quo. But this wasn’t the inevitable result of some tide of progressive history. These were choices made by individuals to put their narrow political and ideological preferences ahead of practical legislative progress. The GOP’s liabilities now include a broken promise to voters; wasting seven months of a new Administration in order to not solve manifest health-care problems; less of a claim to be a governing party; and the harm that these abdications will wreak on the rest of the Republican agenda and maybe their hold on Congress.

The ObamaCare Republicans come from both the conservative and moderate wings, but all of these Senators campaigned for nearly a decade on repealing and replacing ObamaCare. Now they finally have a President willing to sign literally any bill that lands on his desk, but in the clutch they choked. Some wouldn’t even allow a debate on the floor and the chance to offer amendments.

The ObamaCare Republicans ran on fiscal discipline but they rejected the best chance for entitlement reform in a generation. They campaigned against deficits—and some like Mr. Moran and Nevada’s Dean Heller have endorsed a balanced-budget amendment—yet they dismissed a $1.022 trillion spending cut. They denounced ObamaCare’s $701 billion in tax increases but then panicked over repealing “tax cuts for the rich.” Conservatives like Ted Cruz and most GOP Senators played constructive roles, but a question for the ages is which cargo cult Messrs. Lee and Paul have joined. They pose as free-market purists but reject progress toward a freer market. Their claim that the bill didn’t do enough to reduce insurance premiums is risible given that Mr. Cruz’s deregulation amendment was adopted and the alternative is ObamaCare’s even higher rates and fewer choices.

Messrs. Lee and Paul will try to absolve themselves by voting to move to a debate about straight repeal with no replacement, but no one should believe the ruse. They want to vote against anything that can pass lest they have to take responsibility. By the way, Mr. Lee’s stunt of holding hands with Mr. Moran so neither was the deciding killer vote is a political-evasion classic on par with Arlen Specter voting “not proved” on Bill Clinton’s impeachment. The same applies to the centrists who behind the scenes formed a death panel for the bill. No concession was ever satisfactory, and their demands watered down reform. Yet they wouldn’t defend their own compromises, or even try to rebut the media-Democratic caricature of the bill as a human-rights violation.

Mr. McConnell says he will hold the repeal-only vote, and Americans should understand that any Senator who votes against moving to the floor is voting to preserve ObamaCare. If the moderates really want a bipartisan solution, they will vote for repeal with a delayed replacement fuse and then try to persuade Democrats. But they don’t want that amount of political responsibility.

If the ObamaCare Republicans now get primary opponents, they have earned them. In two weeks nobody will recall this or that grievance about the Senate bill, but GOP voters will wonder about the bill of goods they were sold. The damage to the GOP’s political image will radiate in ways that are hard to predict. If Republicans can’t be trusted to fulfill a core commitment to voters—whether repeal and replace, or simply to reduce the burden of government—then what is the point of electing Republicans? “Sorry, it was too hard” isn’t a winning 2018 message, and botching health reform will add to the betrayal narrative that has so inflamed conservative politics. In this case the critics will have a point. Perhaps this Congress can recover with a rewrite of the tax code. But failure tends to compound, and this show of dysfunction will make Senators even edgier about taking difficult votes. The coming days will see more than a few liberal tributes to the invincibility of the entitlement state, and how Republicans miscalculated by declining to accommodate ObamaCare. Entitlements by their nature are hard to reform once they’ve gained a constituency, but what these odes will omit is how close Republicans came. They had the power to reverse the march toward single-payer health care, and most wanted to use it but were blocked by a few feckless deserters. The ObamaCare Republicans are betting voters won’t remember, but implosions this consequential take a long time to forget.

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