King v. Burwell was a decision by the Supreme Court to avoid a drop in the lukewarm enrollment in Obamacare plans by forcing individuals to take government money to help pay for premiums so that those individuals who would otherwise be exempt from the buy-or-be-taxed consequence of the individual mandate would NOT qualify for an exemption based on an income-to-cost-of-health-insurance-premium calculation.
But for consumers, King v. Burwell should be the final proof to silence even the most deranged Obamacare fans from couching Obamacare as anything but a complex scheme that works against consumers...Fun while it lasted for them, but all good things must end.
It is a victory for the government because though in King v. Burwell the government won the right to pay more money out in premium assistance, it also won the right to tax a larger group of people in the event they don’t buy a plan that has the Obama Administration’s seal of approval.
King v. Burwell gives the government the right to force people to take government money in order to bring their income to premium cost numbers within criteria so that if they don’t purchase the kind of health insurance Obamacare requires they’ll be taxed regardless of whether they enroll through an exchange established under 1311 of the PPACA as required by IRS 36 in the Act under section 1401 or not, as long as they enroll.
But as untrue as the exaggerated language of Obamacare liars that NOT forcing this government handout money on people would “gut” Obamacare, is the unlikelihood that forcing government handouts will “save” Obamacare because Obamacare is merely a legalization of the very practices that contributed to the healthcare crisis in our country to begin with.
Ultimately, Obamacare is a law created and put forth by the insurance industry as is easily discernible in the 2008 document by the industry, “Health Plans Propose Guaranteed Coverage for Pre-Existing Conditions and Individual Coverage Mandate.”
But the folly of Obamacare is that its ideas are one-layer deep and old-fashioned. Its assumptions are absurd, tried and failed ideas that contributed to our healthcare crisis to begin with.
Assumption: Health insurance improves health care. Wrong. Having health insurance that is not of a quality that makes preventive services AND treatment affordable has no proven benefit to health. The over-simplification of this idea has made Obamacare a monument to one of the key contributors of our health crisis in the first place…When the cost of obtaining needed medical care is too much, people don’t get the health CARE they need.
All legitimate research that asserts a connection between having health insurance and an improvement in health care considers deductibles, copayments, coinsurance payments for goods and services necessary to maintain and regain health which speaks to the QUALITY of the health insurance not whether an individual “has” health insurance.
Obamacare cheaped out on the legitimate public health concern of making sure people could afford needed health CARE because it includes all kinds of preventive check-ups that MUST be paid for in insurance, including males paying for annual female exams when they don’t get one of their own, combined with increased costs to consumers in the form of actually needed medical care services that require HIGHER copayments, HIGHER coinsurance and HIGHER deductibles.
There is no right to health care in the US. Obama’s half-assed PPACA worsens the problem by requiring coverage of preventive services spread out among all people regardless of need for such preventive care (that’s right, we’re all paying for kid dental checkups even if we don’t have kids and even though if you have kids you have to put them on your policy for the coverage to apply to them because ALL plans have to have that under Obamacare) which raises out-of-pocket expenses in the form of coinsurance, copayments and deductibles.
Obamacare’s over-simplification actually exacerbates our health-CARE crisis because what is well-known is that "High cost sharing (including deductibles, coinsurance, and copayments) can create barriers to obtaining care, reducing necessary service use among those who are insured.” (Look up any research including Jill Bernstein, Deborah Chollett, Stephanie Peterson, “How Does Insurance Coverage Improve Health Outcomes?” April 2010, Mathematica Policy Research, Inc.)
Assumption: Insurers Need Mass Participation to keep Rates Reasonable. Wrong. Insurers have NO incentive to keep rates reasonable in the absence of a downside for raising rates and-or reducing coverage, neither of which is present in Obamacare.
Yes, there was an old-time idea that GROUPS of customers were offered to insurers in exchange for cheaper rates on great plans, that is what group health insurance was premised on. We give you more customers and you give us a better plan. Employers contributed some of the costs of those plans as part of their deal with their workers that they acknowledged them as workers and that taking away the worry of getting them well or keeping them well by helping them pay for a health insurance product that assured them access to quality healthcare made sense all around. The employer contributions AND their interest in valuing their workforce made employers reliable negotiators on behalf of their GROUP for the best plans.
So what went wrong? The gradual erosion of the value of the American worker and the availability of off-shore help, off-shore banking and a calamitous rise in the disparity between what companies pay their top people versus their workers all combined to team employers up with insurers AGAINST employees.
Suddenly the negotiations shifted from getting the best deal for their employees by offering the group business in exchange for the best policy became a lazy executive plan to simply settle for worse coverage for the group in order for employers to save money. Suddenly like insurers employers felt the only good employee was an employee who costs them nothing besides salary and they would pay as little as possible in salary as well.
Instead of heralding in an era of remembering the value of the American worker, Obamacare jumped on the bandwagon, teaming up with insurers to offer plans that charged individuals more and discourage claims by making copayments, deductibles, and coinsurance more burdensome. This was not progress, it was the insurance companies’ dream…a ready-made group of people who have no choice but to purchase a plan. To think that this would help to keep rates low was another over-simplification of an idea (group good) that is WRONG.
There is already evidence that the idea was wrong, since even with government handouts people have so far have chosen far more bronze plans to save money than the government anticipated: “…more people will forgo those subsidies by choosing to enroll in a bronze plan instead of a silver plan…the agencies expect that some people purchasing coverage through exchanges solely to comply with the individual mandate will be focused on minimizing their premium payments and thus will continue to choose bronze plans.’”(CBO, Pub. 49892, page 13).
But now, with employers and the government working to preserve insurance company profits by forcing people to buy health insurance even as the cost of actually USING it for needed medical services continues to rise precipitously in the form of higher deductibles, coinsurance and copayments, STILL getting insurance companies to participate required government bribes that they wouldn’t lose money in the event they had to actually pay claims which Obamacare did through RISK REINSURANCE and RISK CORRIDORS payments to insurance companies to protect them from losses in sections 1341 and 1342 of the PPACA.
These provisions make exchange participation a no-lose deal for insurance companies, because if they lose money the government will pay. Unfortunately as of now, but again, just because it’s in the law doesn’t make it so, some of those payments to insurance companies are set to expire in 2016 (after the national election).
Furthermore, the Congressional Budget Office admits that part of what kept policies cheap on exchanges was not only the reliance on bribing insurers through REINSURANCE PAYMENTS but by providing narrow networks of providers and the CBO anticipates that as REINSURANCE PAYMENTS expire and continually narrowing networks becomes unsustainable that prices for plans will go up. (CBO, Pub. 49973, page 22).
Of course, people enrolled in exchanges won’t yet feel the bite because the government will pay the increased costs in the form of paying a larger percentage of the premiums under premium assistance.
ASSUMPTION: Obamacare is saving the government money. Wrong. What the government is saving money on is its share of payment of health insurance costs EVEN WITH the increased number of payments it's making to insurance companies, premium assistance and Medicaid.
How can this be? Two ways, increased taxes on individuals and corporations and slashed benefits for Medicare beneficiaries as well as reduced health CARE options for Medicaid-covered individuals. In other words, the government adopted the insurance company formula…charge more, pay less.
So how can the government claim it’s saving money? Two reasons. It is saving money on how much it spends on American citizens for health insurance costs through the above two methods of covering less and collecting more in taxes from other areas AND it’s NOT COUNTING money the government spends on administering Obamacare.
As the Congressional Budget Office noted, they can’t calculate the full budgetary impact of the law, only the health insurance coverage only provisions. CBO Publication 49892, 1/15/15, page 1, “…estimates address only the insurance coverage provisions of the ACA and do not reflect all of the act’s budgetary effects…because the provisions of the ACA that do not relate directly to health insurance coverage generally modified existing federal programs (such as Medicare) or made various changes to the tax code, determining what would have happened since the enactment of the ACA had the law not been in effect is becoming increasingly difficult.”
Now it becomes clear why a government “win” was the right to force people to accept government handouts to help pay premium costs…So that more people would be brought within the taxable class created by the individual mandate and upheld as a tax by the Supreme Court.
Through its win the government has proven only one thing…Obamacare is a TAX that requires most people to be paying that tax or complying with the forced purchase of health insurance plans and forcing acceptance of government payments towards the purchase of health insurance plans in order to preserve for the government the size of the group of tax liable citizens.
Obamacare did not improve or alleviate the key causes of our healthcare crisis, an unaffordable tool (health insurance) that inadequately covered unaffordable costs (needed health CARE services) but instead codified the very worst practices (more expense-less coverage, no limits on what can be charged unless people use narrow selections of providers). Obamacare actually made some of the causes of our health care crisis worse such as consumers having to meet a higher threshold to obtain tax relief for such expenses (from 7.5 to 10 percent) and being forced to buy coverage they don’t need or face a new tax (the individual mandate).
King v. Burwell is simply a Supreme Court rejection of one effort to find a get-around to the tax of the individual mandate. There are still many exemptions from the TAX of the individual mandate (see http://www.irs.gov/Affordable-Care-Act/Individuals-and-Families/ACA-Individual-Shared-Responsibility-Provision-Exemptions is NOT available to consumers) but this one didn't go through.
But King v. Burwell simply proves that Obamacare is about taxing individuals and surely we can anticipate that we will continue our American way that for every tax imposed by government there will be people, corporations and others trying to find a way around it…That’s what King v. Burwell was and it won’t be the last effort.
