Health care now, what’s next?
Last Modified: Saturday, June 30, 2012 9:29 PM
The state’s two largest newspapers said last week it’s time for the states to start implementing Obamacare now that the U.S. Supreme Court has upheld its key provisions. Don’t hold your breath waiting for that to happen in Louisiana. Gov. Bobby Jindal has other plans.
“Come this November, we are going to elect a new president and a new Congress who will repeal and replace Obamacare,” Jindal said after the high court’s 5-4 ruling upholding the Affordable Health Care Act. “That’s why we have refused to implement the Obamacare health care exchange or the Medicaid provision,” the governor added.
Jindal is talking about not pursuing features of the law that take effect in 2014. Medicaid will be expanded to 17 million people under 65 who are earning less than about $30,000 for a family of four. Health care exchanges are those places where 23 million Americans will go to get coverage by 2019.
Democrats haven’t been happy to hear the new health care law referred to as Obamacare, but they might as well get used to the idea. It’s going to stick, and even President Obama may like the name if his hallmark legislation survives after the Nov. 6 presidential election.
Mitt Romney, the expected GOP presidential nominee, and Obama will both be using the law as the centerpiece of their election campaigns. Romney said he would begin repeal of the law on his first day in office if he is elected, and everyone knows it couldn’t happen that quickly. However, it could be a great rallying cry for his party. Obama will be singing the law’s praises at every campaign stop between now and election day.
Romney has a major disadvantage to overcome. Democrats plan to harp on the fact he backed an individual health insurance program when he was governor of Massachusetts. One Democratic consultant called Romney “the intellectual godfather of Obamacare.”
Passage of the health care law is reminiscent of the way President Lyndon B. Johnson was able to pass Medicare for the elderly and Medicaid for the poor in 1965. The Associated Press said Johnson used his “legendary arm-twisting” and a Congress dominated by his fellow Democrats to create the landmark programs 47 years ago.
You have to give it to the Democrats again this time around. They were able to sell this new law even though many of them weren’t sure what it contained. They made the desirable parts effective early and delayed the taxing and other controversial parts until 2014 and later, after the fall elections.
The people who are already benefiting from Obamacare will be hesitant to lose those advantages. Whether their numbers are large enough to make a difference in the election is difficult to determine, but they could play a key role in the outcome.
Consider, for example, those families that have been able to keep their approximately 2.5 million children under age 26 covered under their health care policies. Millions more have seen a ban on lifetime coverage limits and on pre-existing conditions. Others are enjoying preventive health care benefits without having co-pays or other out-of-pocket expenses. Citizens on the federal government’s Medicare prescription drug program get discounts on medicines when they hit the coverage gap called the “doughnut hole.”
New taxes are also on the horizon. Holders of high-premium health insurance plans will pay 40 percent of those premiums in taxes. Medicare payroll taxes for couples making more than $250,000 a year will increase. Capital gains will be subject to an additional 3.8 percent tax. Pharmaceutical, insurance and medical device companies will be paying $33 billion in fees over 10 years. And 4 million people not expected to buy health insurance will face a maximum penalty of 2.5 percent of income.
Critics of Obamacare didn’t get much from the Supreme Court, but Chief Justice John Roberts gave them some consolation. Roberts injected what many consider a new line of thinking when he said Congress has the power to tax people without health insurance, even though it doesn’t have the power to order them to buy it. Congressional supporters of the law had called the tax a “penalty.
Roberts added, “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”
Supreme Court observers think Roberts was reaching to arrive at his conclusion in order to erase the popular conception that the court’s rulings in recent times have been based on political rather than constitutional grounds.
Jindal isn’t the only governor who plans to resist adapting to Obamacare. Wisconsin Republican Gov. Scott Walker, who survived a recall vote, said he doesn’t plan to phase in any parts of the law prior to the presidential election. And there will be others because 26 states challenged Obamacare.
The presidential election has taken on new significance in light of the Supreme Court health care ruling. Political writers, Democrats, Republicans and ordinary citizens have been given a lot to write and talk about for the next four months.
Texas Attorney General Greg Abbott sized up the possible impact of the high court’s ruling this way: If the federal government tells us we should all buy fuel-efficient automobiles, can it tax us if we don’t?
Good question.
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Posted By: Joseph LeFevre On: 7/1/2012
Title: Health care now, what's next?
Jim,
I also want to comment that I think Gov. Jindal's refusal to cooperate with the implementation of health care reform is nothing other than one more demonstration of most Republicans complete lack of concern for the financially less well off. He is refusing to accept the law's provision that would extend medicaid to those who desperately need it in this state, even though the federal government would pay most of the cost, and he is refusing to do his part to allow the middle class citizens who don't have health care to be able to afford it. I don't want to argue ad hominem, but I do have to wonder how he and others like him reconcile this with their claimed allegiance to Christian principles.
I hope I live long enough to see the day when the majority of the poor and middle class realize that our government is increasingly being taken over by corporations and the rich and begin to demand that it address the interests of average citizens as well.
Joe
Posted By: Joseph LeFevre On: 7/1/2012
Title: Health care now, what's next?
Jim,
The comparisons Republicans such as Greg Abbott are making between health care and such things as fuel efficient automobiles are ignoring an extremely important difference between health care and all the other things they bring up. In effect our country has always accepted as part of the social contract that all of us have a right to have our health reasonably maintained. In its current form, this assumption takes the form of our requiring emergency rooms to provide care to all who appear, whether or not they have the means to pay. This requirement, along with the fact that so many citizens do not have the means to pay because they are lacking insurance, is one of the reasons health care in this country is so expensive and inefficient. It is therefore entirely reasonable that those who are able to get health insurance and refuse to do so should pay something toward the care they are guaranteed by this assumption of our social contract.
There is no assumption that all of are entitled to have transportation via automobiles. If there were such an assumption then, yes, it would make sense to penalize those who are exercising that right responsibly--but of course, such an assumption is ridiculous. What follows is that if we want to make these comparisons as reasons to oppose the individual mandate, then we should also say we should drop the assumption that all are entitled to basic health care. In other words, we should agree with those at the presidential debate who said we should let those without insurance die if they catch a (curable) disease rather than provide them with care.
Best wishes--keep up the good work.
Joe
Posted By: docjang On: 7/1/2012
Title: Why not just mandate healthy lifestyle and tax those who don't?
What's going to happen to illegal immigrants and tourists? Are they going to jail for not having health insurance on our tax money, too? Can US tax non-US citizens?
The government should also make patients get their own insurance authorizations from their own choice of insurance. They should also punish parents who CHOOSE to have babies with mental disability who will probably depend on our tax payers' money for rest of their lives. If they mandate everybody to get health insurance, why not mandate everybody to live healthier life style...(sugar tax, obestiy tax, increase smoking tax, increase alcohol tax, illegal drug use tax, no sex/pregnancy tax until you can afford to raise your own baby....)
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