SCOTUS and Health Care
  • For the past few days, the US Supreme Court has been host to the most significant court case since Citizens v. United. The case centers around, specifically, the mandate in the recent health care reform bill that requires all adults to purchase health care or pay a higher tax. If the mandate is ruled unconstitutional, than it fully appears that the entirety of the bill will be struck down.

    As of right now, the final decision looks to be a toss-up leaning towards a full repeal of the law.

    The debate about health care and SCOTUS comes at a time when a new study shows that the average family of four in the US pays $20,000 a year in health care expenses, and that it will continue to raise 6-8 percent every year in the near future. It is expected that a repeal of the mandate will result in an immediate increase in prices to combat the loss of young adults who have been able to stay on their parent's plan under the new bill.

    Any thoughts on the proceeding? Predictions? Do you want to see it repealed or maintained? Why?
  • If they strike it down, just one more sign that the US is paralyzed to the point that we can't address some of the key issues facing us. Health costs are out of control, the lauded "invisible hand of the market" has given us the most expensive health care in human history, yet not the best. Health is not like other markets, time is the most precious commodity.
  • The health care bill has good intentions but it is an unrealistic expectation for our current healthcare system we have in place. Unless the government were to step in and say that premiums could not exceed X amount per person with an average household income of _____ I do not see it working. As it is there are several states that can not afford to place 'low income' adults into the states health care plan and there is a lottery system in place for those adults just to get health care with few exceptions to bypass the lottery system.

    I understand that hospitals treatments cost allot of money and that people should have insurance but it is not always possible to have coverage. It was a well intend bill I believe with unrealistic expectations.
  • The low income adults would be federally funded, not state funded. There would also be a maximum deductible and an excise tax.
  • The federal government sends out a certain amount of money to cover the health care costs of the low income adults. That money is then placed into a fund that is ran on 2 year budget (at least that is how it is here in Oregon). Once the funds are gone from that budget because of the amount of low income people due to unemployment or lower paying jobs that need that assistance the State is then required to make up the short fall from the States general fund. Because the short fall has to be made up by the state other services are cut that low income family's need such as the ERDC program (day care assistance for low income family's) and the amount of snap benefits (food stamps) that a family is able to get and a reduction of employees DHS offices. When the state still is not able to cover the short fall then a lottery system is put in place so that everyone has an equal chance of getting heath care unless you fall into a special category. This is not something that I am making up. I know that is the way that it is here in Oregon and I can only assume that other states with a high unemployment rate are having the same issues. If medical insurance was provided to the over 50 thousand people that need it at this time then the State of Oregon would go bankrupt. As it states in the link that I posted there is 140,000 adults that chose not to take part in the lottery system because they know someone that has been on it for years now.

    I know a little bit more on how it works than most people because I did work in a DHS office, I was laid off due to the stupid health care bill. When a state does layoffs it is strictly done by seniority and when the 33% layoff took place some of the people that lost their jobs had been doing it for years. The heath care bill had good intentions but it is not realistic the way that it is set up.
  • The federal funding has not kicked in for the new bill yet, as it doesn't go into effect until 2014. What you have right now is still, essentially, the old system.
  • Yes it is the old system that has to pay for it with very little outside help from the federal government. The issue is that states were told to up the money people can make in order to get healthcare from the state. They were also told that they had to do the Healthy Kids Initiative So they did. Now some states are... well excuse the expression but fucked. This was done back in 2010. Now it could be that I just have mistaken all the the information that I have but to my understanding states have to do what the white house tells them to. Don't know what you do in a country if one state says no because its not like D.C. can send that state to their room for time out.

    Now I could be mistaken but I think this is why we are talking about scotus now.
    http://www.bloomberg.com/news/2010-12-13/u-s-health-care-law-requirement-thrown-out-by-judge.html

    There is more than the one link but wiki is more credible than a bunch of republicans that are looking to make Obama look bad anyways. Personally I see things that Obama has done both right and wrong but over all seems to be doing a pretty good job. I think that at times, like most people, he has unrealistic views and the health care plan is one of those things. so far it has done far more harm than good. The theory behind it was a great one.
    http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
  • GoodEnoughForMe said:
    a new study shows that the average family of four in the US pays $20,000 a year in health care expenses, and that it will continue to raise 6-8 percent every year in the near future.


    This blows my mind. $5000 per person, on average? Sweet Jesus!
  • jaded_sapphire said:
    Yes it is the old system that has to pay for it with very little outside help from the federal government. The issue is that states were told to up the money people can make in order to get healthcare from the state.


    I... have no idea what you're talking about here? Up the money people can make? The state isn't giving paycheks to everyone... and the federal subsidies that aren't kicking in until 2014 are just that; federal subsidies. They are funded by federal taxes. Plus, if people made more money, then less would qualify for the subsidies, since they are based on federal poverty level numbers. If you are only talking about the current private system, then it's screwed up, yes. But that's why it will hopefully allowed to be reformed. I don't know how it works in Oregon right now.

    And yes, as stated in the OP, the case primarily revolves around the individual mandate.

    Dr Flibble said:
    This blows my mind. $5000 per person, on average? Sweet Jesus!


    Yep, it's incredibly expensive. No wonder so many don't have it, and many others are bankrupted by it.
  • There is an income requirement that the states. If you make under that amount of money then you can attempt to get medical from the state. If you are over that amount then you are sol... even it it is just by a penny. the states were told that they had to raise the income that a person can make in order to being able to qualify for benefits not only for medical but snap as well. When the federal government put that into place it left many states in a bad position because they did not have the funding to provide insurance to all the people that were now eligible for it. The law says that anyone that meets the guidelines has an equal right to getting the service as any other person so that decimation is not a factor... Children are accepted no questions asked, the adults are placed into a lottery unless they have a life treating condition at that moment and delaying treatment could place the persons life at risk.

    I hope that I made it more clear for you. Short of it... 2010- Obama says people can make more money and get state assistance with very little to no help from the federal government. Federal government for the most part says figure it out until 2014 and then we will give me funds for the program(s).

    I am not talking about private insurance, I am talking about the medical insurance that the government requires each state to provide for the people that live in poverty and low income people that just barley make it. Anytime you have to pray that you win a lottery so that you can go to a doctor is messed up imo. That is what Obama has done so far. When the federal funding comes it it might be better it might not. i don't know. At this point I know that Oregon is barley hanging on and that they have to keep asking to federal government for assistance that they sometimes get and sometimes dont.
  • jaded_sapphire said:
    There is an income requirement that the states. If you make under that amount of money then you can attempt to get medical from the state. If you are over that amount then you are sol... even it it is just by a penny. the states were told that they had to raise the income that a person can make in order to being able to qualify for benefits not only for medical but snap as well. When the federal government put that into place it left many states in a bad position because they did not have the funding to provide insurance to all the people that were now eligible for it. The law says that anyone that meets the guidelines has an equal right to getting the service as any other person so that decimation is not a factor... Children are accepted no questions asked, the adults are placed into a lottery unless they have a life treating condition at that moment and delaying treatment could place the persons life at risk.

    I hope that I made it more clear for you. Short of it... 2010- Obama says people can make more money and get state assistance with very little to no help from the federal government. Federal government for the most part says figure it out until 2014 and then we will give me funds for the program(s).

    I am not talking about private insurance, I am talking about the medical insurance that the government requires each state to provide for the people that live in poverty and low income people that just barley make it. Anytime you have to pray that you win a lottery so that you can go to a doctor is messed up imo. That is what Obama has done so far. When the federal funding comes it it might be better it might not. i don't know. At this point I know that Oregon is barley hanging on and that they have to keep asking to federal government for assistance that they sometimes get and sometimes dont.


    If we're talking about health care for poverty, then it's Medicaid, which hasn't had changed requirements and won't until 2014, when it goes up.

    Obama did not bring you the different requirements and lottery on account of the fact that the Oregon lottery started in February/March 2008, a year before Obama assumed office, and because Oregon has their own state run health insurance program which sounds like it's being poorly mismanaged, but isn't run by the federal government.
  • I read this as "SCROTUM". lol
  • As this site it outlines the changes that were to be made to the state funded medical programs. I am not sure about every state but here in Oregon we do not call it medicare or anything like that. It is simply The Oregon Health Plan. Its funding mostly comes from the tax payers in Oregon.

    Federal subsidies would be provided to help people with incomes of up to 400 percent of the poverty level purchase coverage on the exchange. Proposed changes would sweeten those subsidies for lower income people.

    Medicaid, the government health insurance program for the poor, would be available to everyone with incomes up to 133 percent of the poverty level, which stood at $10,830 for an individual and $22,050, for a family of four. Many states have eligibility requirements below those levels.


    When that change went into effect the states were required to comply with little to no federal assistance at that time.

    As it clearly states from this site the law was enacted in 2010. This law has been hurting at the bare min the State of Oregon but as I stated before I am sure that there are more states that have been severely impacted by this law. From what I understand Ca and WA are in similar situations.
    Of course, everybody knows that if the Supreme Court invalidates the mandate, the current Congress would not try to save it. Since the law was enacted in 2010, the membership of Congress has changed, and the health care law has become a central issue in electoral politics. When the plaintiffs brought their legal challenge to the court, they embroiled the justices in a political fight


    At this point its not really a matter of if the law is over turned in some places the damage has already been done and regardless of if it stays in place or it is revoked it will take a long time for some of the states to recover.
  • Jaded, the law was passed in 2010 but almost all of it hasn't even gone into effect. The biggest part that has taken place is being able to stay on your parent's health care until age 26.

    - Medicaid has not changed, neither has low-income funding changed, and the whole 400% verbiage and 133% verbiage is not in action yet. These will take place in 2014 and will be fully federally funded, not state funded.
    - The mandate is not in place, and won't be until 2014.

    Nothing about the law has changed Oregon health care, because A) Oregon runs its own state program, and B) The entire lottery system was in place before the law, and C) the law hasn't even really done a whole lot yet besides allow young adults to get insurance via their parents. The low-income changes you mention are still 2 years away. It's even right there in your Wikipedia link from earlier: http://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act#Effective_by_January_1.2C_2014

    "When that change went into effect" as you say, hasn't actually taken place anywhere. The Federal subsidies quote you used hasn't hurt any state because it doesn't exist yet. In 2014 it will. That's when most of the 2010 bill actually kicks in. It was passed in 2010 but the reform is gradually worked into the system, again, the most important pieces coming in 2014.

    It has not affected the situation in Oregon, California, or any state yet, funding-wise, because it's still waiting to fully take place.

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