The legal challenges to the Patient Protection and Affordable Care Act (PPACA) are moving toward a final decision by the US Supreme Court.
The Thomas More Law Center has filed a petition asking the Supreme Court to review the decision of the Sixth Circuit U.S. Court of Appeals which upheld the constitutionality of Obamacare.
According to the appeal petition, “Review is necessary to establish a meaningful limitation on congressional power under the Commerce Clause….If the Act [the PPACA] is understood to fall within Congress’s Commerce Clause authority, the federal government will have absolute and unfettered power to create complex regulatory schemes to fix every perceived problem imaginable and to do so by ordering private citizens to engage in affirmative acts, under penalty of law….”
Specifically, the petition asks the Supreme Court to rule on the following questions:
1. Does Congress have authority under the Commerce Clause to require private citizens to purchase and maintain “minimum essential” health insurance coverage under penalty of federal law?
2. Is the individual mandate provision of the ACA unconstitutional as applied to petitioners who are without health insurance?
A Thomas More Law Center press release noted that the Obama administration will now have 30 days to file a response, and the Law Center will then have approximately ten days to file a reply. The case will subsequently be submitted for a decision by the Justices as to whether the petition should be granted. The Law Center predicts that “if granted, the case will in all likelihood be briefed, argued, and decided in this upcoming term, with a decision rendered prior to the Court recessing next summer.”
Small business owners are fighting back against the massive regulations which the PPACA requires of them. The NFIB is joining a coalition of small business groups to expose the cost involved to comply with the PPACA. Their tactic will be to explain to the public the expenses involved in complying with the PPACA and how these costs hinder small businesses from retaining existing or hiring new employees. With the economy, and specifically job creation, a high priority for most Americans and claimed as such by many politicians, this could be a significant campaign to help elect politicians who understand that governments can effect job growth through reducing regulations. I wish them success in this venture.
Individual states are asking for, and receiving waivers exempting them from complying with mandates required within the PPACA. The Center for Consumer Information and Insurance Oversight (CCIIO) has now issued five waivers from the medical loss ratio (MLR) requirements of the PPACA. In March, CCIIO issued its first waiver to Maine, and through July 2011 has issued waivers to New Hampshire, Nevada, Kentucky, and Iowa. A waiver request from North Dakota has been denied. Waiver determinations are still pending for Louisiana, Guam ( really, GUAM?), Kansas, Delaware, Indiana, Florida, and Georgia.
Question: What do the five states that have received waivers have the North Dakota does not have, so that the CCIIO rejected their waiver request? Answer will be provided next week.
MLR is calculated as the cost of health care services provided as a percentage of premium revenues. In general, the higher the MLR, the more an insurer spends on claims reimbursements and the less it spends on administration and marketing, or retains as profit. The ACA established an 80% MLR beginning in 2011. The states that were granted waivers are allowed to have MLR’s ranging from 60-75%. Makes me wonder why the PPACA was passed in the first place, if so many waivers are being granted to so many states and companies who claim that they cannot the standards set by the law. But then, I try to be logical.
The Congressional Budget Office (CBO) came out with a new report this week which indicated that Obamacare will end up decreasing the workforce by 800,000 jobs, or 0.5% of the work force. In the report the CBO points out that some people are working just for the healthcare benefits, while some people are working extra hours to be able to afford health insurance. The report also indicates that some businesses will shut down or not hire employees because of the costs involved with complying with the mandates on businesses in order to comply with Healthcare Reform Bill. So, according to the CBO some people will quit working because they think they will get health insurance from some other source rather than their job, and some businesses will decrease, or at least not increase, the number of employees due to the costs involved with the Healthcare Reform Bill.
How this affects the total unemployment picture is unclear. If more people stop working than are laid-off or not hired, then unemployment will decrease. But, no matter what the effect on the total unemployment picture, the CBO figures still show 800,000 fewer taxpayers paying taxes. If you assume the average wage of these 800,000 non-workers to be $30,000, then the total decrease in wages paid is $24 billion. At an average tax rate of 15% that means $6.45 billion less in tax revenue to the government, increasing the Federal deficit further.
Speaking of the CBO; the estimate of the impact of the Healthcare Reform Bill on the Federal budget ranges from a reduction in the deficit of $1.3 trillion over ten years to a cost of $1.06 trillion in the next ten years. Why such a wide discrepancy? It depends on the data that is presented to the CBO for its analysis. As we previously discussed, the only figures that the CBO can use to calculate the financial impact is based on the figures that it receives from the sponsors of legislation. GIGO (Garbage in, Garbage out) clearly describes the impact of the CBO’s analysis. Even though the media consistently quotes the CBO figures on many items, I would always be suspicious of any figures put out be the CBO.
Part of the revenue that the CBO includes in its calculations is $167 billion in new penalties on individuals and businesses. This is the penalty levied on people who choose not to participate, and purchase or provide health insurance. What does this penalty actually accomplish? The individuals or businesses which are assessed the penalty are still uninsured. If the goal of the Healthcare Reform Bill is to provide healthcare insurance for all Americans, then the penalty only makes it worse for individuals or small businesses. Now they not only don’t have insurance, but they have less money with which they can buy insurance,
This week an organization which advocates for kidney transplant recipients, released a statement that they favor younger, healthier patients needing a kidney transplant should be moved to the head of the list for transplants. Traditionally, the waiting list for transplants has been on a priority basis: First come, first served .Their logic is that we need to get the most benefit out of every kidney available for transplant. Older, less promising transplant recipients should not necessarily get kidneys, just because they have been waiting longer. This position by the kidney transplant advocates is a harbinger of the treatment that we can expect courtesy of the Healthcare Reform Bill. With a limited amount of healthcare resources, someone (a government official) will have to make a decision on who gets treatment first. This is the direction that healthcare in this country is headed. This is exactly what many opponents of nationalized healthcare have feared. The elderly will get less care, as it will be more cost effective to spend healthcare dollars on younger people, who will have the most to gain from healthcare. While, we are not at this point yet, is it the only reasonable outcome of nationalized healthcare and the Healthcare Reform Bill is the first step in that direction.
The Internal Revenue Service has requested an additional 1054 staffers and additional office space to implement the initial tax implications of the Healthcare Reform Bill of 2010. The IRS estimates that the additional auditors, and office space to house them, will cost the American taxpayers over $359 million in fiscal 2012, to ensure that that taxpayers comply with the tax codes embedded within the Affordable Care Act (ACA) also known as Obamacare.
The IRS breaks down some of the categories that will require additional enforcement officers such as:
- 81 auditors assigned to enforce the new 10% excise tax on tanning salons
- 76 auditors to make sure that drug manufacturers and importers pay a new fee
- Additional auditors required to enforce and correlate the 1099 forms required
In a statement released with the request for the additional staffers the IRS claims that:
“Implementation of the Affordable Care Act of 2010 presents a major challenge to the IRS. ACA represents the largest set of tax law changes in more than 20 years, with more than 40 provisions that amend the tax laws.”
and
“The Affordable Care Act will require additional resources to build new IT systems; modify existing tax processing systems; provide taxpayer outreach and assistance services; make enhancements to notices, collections, and case management systems to address and resolve taxpayer issues timely and accurately; and conduct focused examinations to encourage compliance,”
Conduct “focused examinations to encourage compliance”?
If this bill was good for everyone, then why the need to ‘encourage compliance’? I thought that this Affordable Care Act, was a healthcare reform act, not a tax law change bill; silly me. Also, why the exemption for Public Sector Union members from compliance with the law, if the law is so good for everyone?
If the newly elected Republicans want to make good on their campaign promises to cut the deficit, then the IRS has given them a great place to start. John Barrasso (R-Wyoming) has stated that adding hundreds of IRS auditors to the government payroll, at a cost of millions of dollars to the US taxpayer, won’t provide healthcare for a single American citizen. Also noted was the implication that this increase in the number of IRS auditors is only the start of the number of IRS agents required. Most of the provisions within the Affordable Care Act don’t take effect until 2014. How many more IRS agents will be required to ‘encourage compliance’ with the bill, and at what cost? While hiring thousands of IRS agents will lower unemployment, this is not the type of job that helps the economy.
It is interesting to note that the IRS is requesting this increase in staff and funding to implement what is (as it currently stands) an unconstitutional bill. The Republicans can use US Federal Judge Roger Vinson’s January 31st, 2011 ruling that the entire Healthcare Reform Bill is unconstitutional, and claim that they will not provide any funds for an unconstitutional bill. As a taxpayer, I have a hard time accepting the fact that the any part of the government is requesting more of my money to enforce a law that has been declared unconstitutional. I would hope that responsible members of congress would not fund any unconstitutional activity.
In a separate item, a recent poll of media personnel showed that 95% of those persons within the media polled were against the defunding of the Healthcare Reform Bill. This is in sharp contrast with a recent CBS News poll which indicates that only 55% of Americans disapprove of defunding the implementation of the bill.
Depending on the poll that you cite, Americans are about evenly split on whether or not the bill should be repealed.
