Sunday, August 3, 2014

Obamacare Schadenfreude: Halbig is Too Big?

Our third straight day of cool (by August standards), cloudy weather. We had another inch of rain overnight. Take that, West Coasters!

Time to clean out the Obamacare Schadenfreude fridge, as some of these delicacies are starting to wither and grow mold.

This one is not exactly shocking news, just the normal progression of Halbig through the courts. Obama administration asks full D.C. Circuit to revisit Halbig decision
On July 22, two federal appeals courts issued contradictory rulings on the whether this rule was legal.
In the Halbig case, two of three judges on a D.C. Circuit panel sided with the challengers.

But challengers in the similar case, King v. Burwell, received an adverse ruling before the Fourth Circuit Court of Appeals and have asked the Supreme Court to weigh in as soon as possible.

Obama administration lawyers have now formally asked the whole D.C. Circuit to rehear the case, a scenario in which they expect to fare better. Senate Majority Leader Harry Reid's recent deployment of the nuclear option to confirm Obama's nominees to the court tilted the balance toward Democratic-appointed judges.

It is far from assured that the the full court will take up the case in what's known as an en banc hearing. But should the court do so, Obama's legal team would likely ask the Supreme Court to await such a decision before deciding whether to take up the case. And if the D.C. Circuit reversed the panel, it would eliminate the split among the appellate courts and perhaps take pressure off of the Supreme Court to take up the case.

Ultimately, however, if four Supreme Court justices want to tackle the issue, they have the ability to take the case regardless of what's going on at the D.C. Circuit.
Couldn't we just skip all the drama and ask Chief Justice Roberts to flip his coin?

Case Against The D.C. Court's Halbig Ruling Crumbles
The more ObamaCare backers try to attack the D.C. Circuit Court's decision that limits subsidies to state-run exchanges, the more it looks like the two judges on that panel got it right.

On Tuesday, liberal Washington Post blogger Greg Sargent posted what he thought was the death blow to the claim that ObamaCare — as written — only allows subsidies for those signing up in state-run exchanges.

Liberals are desperate to see the court's 2-1 Halbig v. Burwell ruling overturned, because it would upend ObamaCare entirely, denying roughly 4.7 million people in 36 states their subsidies.

Sargent says that an earlier Senate bill included subsidies for both state and federal exchanges, so, ergo, even if the final bill didn't say so, lawmakers surely meant to.
Except Sargent has it upside down. As he notes, the bill's "structure did delay subsidies to those in states that hadn't yet set up their exchanges."

Clearly, then, its authors intended to use the subsidies as incentive to get the states to do the federal government's bidding.

And, as several legal eagles have pointed out, the fact that there was no mention of federal exchange subsides in the final bill provides stronger evidence that lawmakers did, in fact, want subsidies restricted to state-run exchanges.

Meanwhile, over at the New Republic, Brian Beutler argues that there's no way this limitation was intended, since lawmakers didn't know about it, reporters didn't report on it, and states trying to decide whether to set up an exchange didn't mention it.

But lawmakers for the most part had no idea what was in the bill, which is why so many were shocked to find out they and their staffs had to buy full-priced coverage through an ObamaCare exchange.
Hence the need to pass the bill to see what was in it. Now that we've seen it, can we kill it?

ObamaCare caused some premiums to nearly double in California
The bad news in California: If you liked your plan and/or your doctor, many of you couldn’t keep either if you had an individual-market plan. The worse news in California: If you liked your premiums, you definitely couldn’t keep those. In the first year of ObamaCare, premiums rose in the Golden State anywhere from 22% to 88% from the previous year — even as insurer networks narrowed so much that consumers had a tough time finding a provider at all:
The cost of health insurance for individuals skyrocketed this year in California, with some paying almost twice what they did last year, the state’s insurance commissioner said. …
For 2014, consumers purchasing individual policies paid between 22% and 88% more for health insurance than they did last year, depending on age, gender, type of policy and where they lived, Jones said Tuesday.
[State Insurance Commissioner Dave Jones] said he has authorized a study of health insurance rates after receiving numerous complaints about rising costs.
“The rate increase from 2013 to 2014, on average, was significantly higher than rate increases in the past,” Jones said in a news conference in Sacramento.
The hardest-hit were young people, he said. In one region of Los Angeles County, people age 25 paid 52% more for a silver plan than they had for a similar plan the year before, while someone age 55 paid 38% more, according to a report that Jones released Tuesday.
Now for the good news in California. Rates won’t go up that much this year, Jones says, because of a ballot measure in this year’s election that will give the state the power to regulate rate increases. Prices won’t go down, Jones predicts, but just not skyrocket like they did for 2014. The threat of government control will force insurers to keep increases lower in order to push back against the referendum. That, however, ignores the economics of risk pools, which react to increased costs by either raising premiums or reducing payments. The next wave of reconciling the costs of ObamaCare in California may not take the form of higher premiums but of reduced coverages or — most likely — even greater reductions in provider networks, reductions which California has tried to reverse after Covered California turned into a nightmare for consumers.
Yeah, like price controls traditionally produce better choices and service.  The only bright spot is that California got what they voted for; they just hadn't read the bill at the time.

This is more of a neutral story, really a comment on how the people who Obamacare was designed to cover weren't really aware of what health insurance entailed: Newly Insured, Many Now Face Learning Curve
Advocates of the Affordable Care Act, focused until now on persuading people to buy health insurance, have moved to a crucial new phase: making sure the eight million Americans who did so understand their often complicated policies and use them properly.

The political stakes are high, as support for the health care law will hinge at least partly on whether people have good experiences with their new coverage. Advocates of the law also say teaching the newly insured how to be smart health care consumers could advance the law’s central goal of keeping costs down, such as by discouraging emergency room visits, while still improving care.
. . .
Last week, Salwa Shabazz arrived at the office of a public health network here with a bag full of paperwork about her new health insurance — and an unhappy look on her face. She had chosen her plan by phone in March, speaking to a customer service representative at the federal insurance marketplace. Now she had problems and questions, so many questions.

“I’ve had one doctor appointment since I got this insurance, and I had to pay $60,” Ms. Shabazz told Daniel Flynn, a counselor with the health network, the Health Federation of Philadelphia. “I don’t have $60.”

Mr. Flynn spent almost two hours going over her Independence Blue Cross plan, which he explained had a “very complicated” network that grouped doctors and hospitals into three tiers. Ms. Shabazz, who has epilepsy, had not understood when she chose the plan that her doctors were in the most expensive tier.

“None of that was explained when I signed up,” she said. “This is the first I’m hearing it.”
Another one who didn't read the bill.

Freed from the need to shill for Obama, even Barney Frank admits Obamacare was sold on a lie:

Barney Frank 'Appalled' By Obama Administration: 'They Just Lied To People'
WASHINGTON -- President Barack Obama made a major political mistake by lying about the details of his health care plan, according to former House Financial Services Committee Chairman Barney Frank (D-Mass.).

"The rollout was so bad, and I was appalled -- I don't understand how the president could have sat there and not been checking on that on a weekly basis," Frank told HuffPost during a July interview. "But frankly, he should never have said as much as he did, that if you like your current health care plan, you can keep it. That wasn't true. And you shouldn't lie to people. And they just lied to people."
And you kept quiet and voted for the lie, asshole.

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