Politics, the Kennedy Court and Health Care 2

If I were a member of the Supreme Court I’d be a bit embarrassed at how easy it is to predict Supreme Court rulings knowing only a few elementary political facts.
I expect a 5-4 ruling and i expect it to break down along political lines. It shows me this, the Supreme Court is only there to support certain ideology, making this less about the Constitution and more about what it is to hold power for more than 30 years.  This, whether the members of the court care or not this is the problem. They’ve become, based on Bush v Gore merely an arbiter that always errs on the side of promoting the political ideology of one side or another. Imagine if  Brown v. Board of Education, Bolling v. Sharpe, Cooper v. Aaron, Gomillion v. Lightfoot, Griffin v. County School Board, Green v. School Board of New Kent County, Lucy v. Adams, Loving v. Virginia had been left for this court to decide, shit, we be where South Africa was in the 1980′s in terms of civil rights. We’d be the largest segregated nation  on earth!

Well let’s get past the rant, let’s talk about Anthony Kennedy.

I’ve heard all the popular analysis about Kennedy, he is the swing vote, etc and so on. Well yesterday in a little noted exchange he seemed to be telling the government lawyer the route he sh0uld take to defend the Constitutionality of the law.

In an exchange with Paul Clement, (he is representing those 25 states) this went down:

Kennedy asked Clement this: Is the government’s argument this–and maybe I won’t state it accurately. It is true that the noninsured young adult is, in fact, an actuarial reality insofar as our allocation of health services, insofar as the way health insurance companies figure risks. That person who is sitting at home in his or her living room doing nothing is an actuarial reality that can and must be measured for health service purposes; is that their argument?

And just a short while later:

MR. CLEMENT: And with respect to the health insurance market that’s designed to have payment in the health care market, everybody is not in the market. And that’s the premise of the statute, and that’s the problem Congress is trying to solve.

And if it tried to solve it through incentives, we wouldn’t be here; but, it’s trying to solve it in a way that nobody has ever tried to solve an economic problem before, which is saying, you know, it would be so much more efficient if you were just in this market–

JUSTICE KENNEDY: But they are in the market in the sense that they are creating a risk that the market must account for. 

MR. CLEMENT: Well, Justice Kennedy, I don’t think that’s right, certainly in any way that distinguishes this from any other context.

What does this mean? It almost seems like Justice Kennedy is signalling the defense the government should be making, (and why aren’t they anyway??? WTF, seriously).

And a little later this:

MR. CARVIN: It is clear that the failure to buy health insurance doesn’t affect anyone. Defaulting on your payments to your health care provider does. Congress chose, for whatever reason, not to regulate the harmful activity of defaulting on your health care provider. They used the 20 percent or whoever among the uninsured as a leverage to regulate the 100 percent of the uninsured.

JUSTICE KENNEDY: I agree–I agree that that’s what’s happening here.

MR. CARVIN: Okay.

JUSTICE KENNEDY: And the government tells us that’s because the insurance market is unique. And in the next case, it’ll say the next market is unique. But I think it is true that if most questions in life are matters of degree, in the insurance and health care world, both markets–stipulate two markets–the young person who is uninsured is uniquely proximately very close to affecting the rates of insurance and the costs of providing medical care in a way that is not true in other industries.

That’s my concern in the case.

I fully expect this to be a 5:4 decision based on the politics of the court. I have no faith that what-so-ever in the non-partisanship of the court. Sorry Bush V Gore cured me of believing in the non-partisanship of the court. And I know that 75% of the country is with me on that, this is something that the Court itself should be ashamed of and it is telling that they are not.

Oh well, we tried. Get ready for your health insurance costs to skyrocket.

CrossPosted @DAGBlog

Helping the Working Poor — A Practical Defense of PPACA 3

The Health Care Bill, more often than not, raises the ire of both conservatives and progressives. They’ve teamed up to spread as much misinformation about the bill as possible. Why? I am not sure, because this bill goes a long way to get more people access to health care.

I think it all began with a guy named Howard Dean and some comments he made In December of 2009.  Dean was very angry that the public option was eliminated from the Senate bill. The target of Dean’s rant was Joe Lieberman, ( I)CT, he was pretty pissed at Lieberman and he seemed to feel no bill would be better than this bill now. He was angry at the process. And his anger is not unfounded. This Senate has become a branch of our government that is immovable, ideologically entrenched, almost completely unable to pass any worthwhile legislation. Dr. Dean was pretty pissed about that, as we all should be. However, instead of directing his anger at the improbable 60 vote requirement to pass any legislation of substance, he decided it would be time to just let Republicans win by killing the bill. That didn’t happen of course, but that was an extreme reaction, one Republicans were relying upon, this is where they were able to begin to sow the seeds of discontent among voters, they have filled the air with misinformation, with the help of people who are otherwise quite progressive. All that discontent, and the Executive Branches unbelievable inability to fight back against the propaganda has left people with a sour taste in their mouths when it comes to their thoughts about PPACA.

A number of people jumped on Dr. Dean’s bandwagon, Keith Olbermann went on the air to loudly proclaim why the Senate Bill should not be passed. Two days after Dean’s rant against the bill, a number of left leaning organizations and people banded together to help kill the bill:

Dave Linderhoff of The Public Record
Jane Hamsher of FireDogLake
Markos Moulitsas; Daily Kos Founder
Darcy Bruner; a past candidate for Congress

Lying about ACA has become something of a cottage industry. But don’t believe the hype, the reforms already implemented have brought down insurance costs, added more people to insurance rolls, new benefits for senior citizens, implemented necessary regulations regarding pre-existing conditions and an 80% requirement that premiums be spend on the consumers health care costs, with 20 mandated for administrative costs.

People who will benefit most from the bill:

  1. Those without any insurance.
  2. Those who have paid for expensive individual policies on their own.
  3. Employees of small businesses that have trouble affording the cost of joining a group plan.
  4. Low income Medicare participants who are left paying for whatever is not covered by Medicare for their medical bills and prescriptions.

Who is without access to health insurance? Some of those people are the working poor. It has been a long struggle to get federal legislation dealing with this problem, the estimates are there are some 45 million people without access to basic heath care.  In the past, some states attempted to solve this problem on their own by setting up their own state run “group” for people who didn’t qualify for Medicaid. When the boom of the 1990’s ran its course, those programs began to be cut severely because of the expense of running the programs and because states don’t have as much revenue since the economic downturn and they are having to make tough choices.  Many states of course never attempted such things. Washington State has such a program, but its funding has been cut in the past few years so although people may qualify by their income, there are no slots open to take them as customers, in fact the plan has had to disenroll people because of a lack of funding, in total 17,000 members were disenrolled.

However the results of PPACA have been positive.

  • More young adults have coverage
  • Requires beginning this year, insurers must spend 80% – 85% of premiums in actually delivering care
  • Premiums decreasing even for state employees.
  • Our health insurance plans now have to justify their premium rate increases to the State and pass an approval process before they can raise prices.
  • Because of the ACA, young adults can now stay on their parents’ insurance until the age of 26.
  • New York has something called “community rating,” which means that health insurers can’t charge you higher rates simply because of your age, gender, or health history.
  • Because of the ACA, we no longer have to pay co-pays for many preventative care services.
  • Because of the ACA, people with pre-existing conditions now have choices for coverage, one example the NY Bridge Plan.
  • Because of the ACA, seniors who hit the Medicare “donut hole” are now getting help with their prescription drug costs.
  • States like New York have a law in place called “guaranteed issue,” which means that insurers have to offer health insurance to everyone, even if they have a pre-existing condition (even though they have waiting periods for coverage related to that condition.  But thanks to the ACA - those waiting periods will soon be a thing of the past!). 
  • More changes to Pre-existing condition plans by states, here is a preview, premiums have decreased.
  • Premium and Cost sharing subsidies to individuals: the mechanism provides refundable and advanceable premium credits to eligible individuals and families who fall between 133% and 400% of FPL (Federal Poverty Level) to purchase insurance through state created health exchanges.
  • Provide Costsharing subsidies to eligible individuals and families. Cost-sharing credits reduce the cost sharing amounts and annual cost-sharing limits and have the effect of increasing the actuarial value of basic benefit plan to the following percentages of the full value of the plan:
    • 100 – 150% FPL  94%
    • 150 – 200% FPL  87%
    • 200 – 250% FPL  73%
    • 250 – 400% FPL  70%

Health Exchanges: a few examples

  • Vermont : passed legislation to build a single payer plan for the state of Vermont and in October  of this year, (2011) that plan got one step closer to implementation.

These new federal policies are working. I think this is good. There seems to be a small, but loud coalition of people on both sides of the ideological aisle who would have you believe PPACA is a complete failure, but the evidence says otherwise. Let’s stop letting them get away with their propaganda war against delivering health care to those who would not otherwise have access. Let’s fight back with the facts at hand, because the facts indicate the legislation is working.

Crossposted at DAGBlog