Obamacare is the law of the land

[scottagibson]

Would they, though? Without the individual mandate adverse selection would send the ACA into a death spiral pretty quickly, I’d have thought.

That was the idea of the mandate, but I imagine that since the penalty has already been repealed, the toothless mandate leads to a similar result anyway.

With Democrats in control of at least the House and the Presidency, a decision by the courts to invalidate the ACA simply moves healthcare to the top of the “to-do” list assuming it wasn’t there already. That would make a Medicare For All proposal that much more likely.

Without control of the Senate, no health care bill is getting done, much less MFA.

Twitter thread from a law professor, make of it what you will.

Yes, that’s a good argument.

Roberts didn’t overturn the ACA even when he had far better legal support for doing so.

But that is not. Roberts pinned saving the ACA on calling the mandate a tax, which means he bought the argument that a mandate on its own was an unconstitutional thing.

[magnet]

It doesn’t matter any more if the mandate is constitutional.

Remember, when courts invalidate part of a law, they are supposed to determine whether Congress would want the rest of the law to stand without it. For instance if a law issues bonds in order to build a school, but the bond issue is ruled illegal, then courts should probably also invalidate the section about building a school.

Back when Sebelius was decided, there was a plausible argument that Congress would not want the rest of the ACA to stand if the mandate were eliminated. People seemed to think that the ACA could not work without a mandate.

But in 2019, the Congress has made its will explicitly clear. Congress zeroed out the mandate, without making other changes to ACA. Even though they had every opportunity to do so. Obviously, Congress now thinks that the ACA does not require a mandate.

There is no longer a plausible argument that the mandate is inseverable. Congress itself severed it.

So to overturn the ACA, Roberts would have to invent a radical new severability doctrine where Congress is forever bound by the will of a previous Congress. Why would he do this, when he went out of his way to protect the ACA years ago?

[SlainteMhath]

Without control of the Senate, no health care bill is getting done, much less MFA.

That’s pretty much my point. Fucking with the ACA while Dems control both the House and the Oval Office thrusts healthcare into the national spotlight as millions of American lose coverage. There will be heavy demand for Congress to do something, and if a GOP controlled Senate decides to play obstructionist games (and who are we kidding, they most certainly will) then it will be political suicide for them in 2022, hopefully leading to Democratic control of everything by 2024. We already saw a mini-version of this play out in 2018 as a lot of Democratic candidates campaigned on the GOP’s promise to destroy the ACA and the coverage and pre-existing conditions clause that come with it.

The GOP’s single-minded pursuit of destroying Obamacare without actually having anything to replace it with is going to lead to their downfall, perhaps even more so than their ridiculously sycophantic devotion to Trump.

[scottagibson]

That’s pretty much my point. Fucking with the ACA while Dems control both the House and the Oval Office thrusts healthcare into the national spotlight as millions of American lose coverage.

The history of the ACA, from start to finish, is testament to how little the GOP worries about the reaction to voters learning that the GOP doesn’t give a fuck about their health care.

This lawsuit was an attempt to dump the entire law, and it is being advanced by the GOP.

The GOP’s single-minded pursuit of destroying Obamacare without actually having anything to replace it with is going to lead to their downfall, perhaps even more so than their ridiculously sycophantic devotion to Trump.

I wish that were true, but there is little evidence that they’ll pay any sort of lasting price for it. I mean, they won the White House and the Senate and the House after trying to repeal it eleventy-seven times, didn’t they?

[Matt_W]

Not to mention that, you know, millions of people will lose health care coverage during the debacle and people will undoubtedly die as a result.

[ravenight]

If the law is constitutional as originally written, and then unconstitutional because of a revision, shouldn’t the revision be the part struck down? Why would the whole law be struck?

[Matt_W]

Because Republicans are evil fucking bastards who are quite willing to kill thousands to say fuck you to the libs.

[Menzo]

If the law is constitutional as originally written, and then unconstitutional because of a revision, shouldn’t the revision be the part struck down? Why would the whole law be struck?

Because the revision isn’t unconstitutional. It just makes the law it revised so.

The solution is simple in concept but probably impossible in practise: if Dems take the Presidency in 2020 just pass a new law reinstating the penalty. That puts it back where it was.

[ravenight]

Because the revision isn’t unconstitutional. It just makes the law it revised so.

I don’t see how that makes any sense. A revision can’t stand on its own, so the only way to judge it’s constitutionality is to see whether the law it revised was ok before the revision and whether it is ok afterwards. If you changed a law that laid out a penalty for workplace discrimination into one that provided a benefit for workplace discrimination, should the original law now be struck down?

[Mark_Asher]

Not to mention that, you know, millions of people will lose health care coverage during the debacle and people will undoubtedly die as a result.

A lot of those people will turn around and buy cheap insurance that’s no good but unless they get sick they will never know. To them lowering premium costs and still having shitty coverage will be a win because they won’t know it’s shitty coverage.

[magnet]

A revision can’t stand on its own, so the only way to judge it’s constitutionality is to see whether the law it revised was ok before the revision and whether it is ok afterwards.

You are absolutely right.

The courts are supposed to decide whether the legislature wanted the law to stand without the part that was struck down. Ideally, the law itself should make this clear but unfortunately the ACA did not.

In 2012, it could be argued that the ACA wasn’t supposed to be implemented without a mandate. Thus, the constitutionality of the mandate was paramount.

In 2019, that argument is no longer plausible. Congress clearly thinks the ACA can exist without a mandate, since it deliberately zeroed out the mandate but left the rest of the law intact. So there is no longer a basis for invalidating the rest of the ACA.

[scottagibson]

A revision can’t stand on its own, so the only way to judge it’s constitutionality is to see whether the law it revised was ok before the revision and whether it is ok afterwards.

In context, the ACA was only constitutional because the mandate was actually a text penalty. Remove the tax penalty but keep the mandate and the mandate is a mandate, not a tax penalty. The plaintiffs argue that this makes the mandate and the whole law unconstitutional. The district court agreed with the plaintiffs. The appeals court agrees on the question of the mandate but asks the district court to rethink whether the entire law fails. The question is what the appeals court will do if that district judge stands his ground.

On the other hand, this:

So to overturn the ACA, Roberts would have to invent a radical new severability doctrine where Congress is forever bound by the will of a previous Congress. Why would he do this, when he went out of his way to protect the ACA years ago?

…is a good argument, suggesting that no matter what the district judge or the appeals court do, there probably aren’t 5 votes on the Supreme Court to strike down the entire law.

[antlers]

…is a good argument, suggesting that no matter what the district judge or the appeals court do, there probably aren’t 5 votes on the Supreme Court to strike down the entire law

Provided Ginsburg’s health coverage remains good.

[ravenight]

the ACA was only constitutional because the mandate was actually a text penalty. Remove the tax penalty but keep the mandate and the mandate is a mandate, not a tax penalty. The plaintiffs argue that this makes the mandate and the whole law unconstitutional. The district court agreed with the plaintiffs.

I understand this, but I don’t see how it makes any sense for a lower court to retroactively overturn Sebelius rather than to rule that the revision was unconstitutional.

It’s like someone wrote a law that imposed a new tax on all Americans and that tax was deemed ok by the SCOTUS, and then someone else gave specific people an exemption from the tax and a lower court ruled that therefore the whole tax was unconstitutional.

[KevinC]

Sorry if this was posted earlier, it’s an article from Dec 20th but I just saw it today.

Congress showers health care industry with multibillion-dollar victory after...

How are we going to achieve any kind of healthcare reform when it seems like this is the one issue that Republicans and Democrats can come together on? Ugh.

The spending package permanently repeals three major taxes created to help fund former president Barack Obama’s Affordable Care Act: a tax, opposed by labor unions, on expensive health-care plans; a tax on medical device manufacturers; and a tax on health insurance companies, which have an influential lobby in Washington.

The taxes have been largely postponed by Congress since they were created as part of Obama­care, but they were never fully removed, in part because of the large impact such a change would have on the budget deficit. Repealing them is projected to cut tax revenue by about $375 billion over the next 10 years — roughly one-quarter of the estimated cost of the GOP tax bill when it was approved in 2017, according to the Committee for a Responsible Federal Budget, a nonpartisan group.

[Strollen]

Who said that bipartisan compromise was dead. MMT tells us that deficits don’t matter, so there is no reason to burden, labor unions, medical device manufactures, or health insurance companies, with unnecessary taxes.

[magnet]

MMT tells us that deficits don’t matter

MMT tells us that debt doesn’t matter, but deficits sometimes do matter.

[Papageno]

MMT tells us that deficits don’t matter

MMT tells us that debt doesn’t matter, but deficits sometimes do matter.

If they’re high enough to create so much effective aggregate demand as to cause greater than the target rate of inflation, yes. And as long as the debt is denominated in the sovereign fiat currency that the borrowing government controls.

It’s pretty clear that the US inflation that got worse and worse during the 1970s had its origins in the massive spending on the Vietnam War + moon shots + lesser spending boosts on then relatively new Medicare and COLAs starting to become a thing for Social Security retirement benefits. Plus the Interstate Highway System was still being built out then. But there had been tax cuts in the Kennedy Administration and I’m not sure if maybe even further ones later. Had there been any federal tax hikes during the 1960s or early 1970s?

[Sharpe]

It’s pretty clear that the US inflation that got worse and worse during the 1970s had its origins in the massive spending on the Vietnam War + moon shots + lesser spending boosts on then relatively new Medicare and COLAs starting to become a thing for Social Security retirement benefits. Plus the Interstate Highway System was still being built out then. But there had been tax cuts in the Kennedy Administration and I’m not sure if maybe even further ones later. Had there been any federal tax hikes during the 1960s or early 1970s?

You only mention government spending and taxes as contributors to 70s inflation but there was this very small thing called an oil crisis, (crises IIRC) plus war in the Middle East, a revolution in Iran and of course the persistent policy of OPEC during the decade.

Relative to the debt increased by Reagan and thereafter, US debt in the 70s as a percentage of GDP was a fraction of modern levels.

Government activity may have contributed to the 70s inflation but there was a lot of other stuff going on also.

Edit: Here’s a link to a chart of debt to GDP ratio over time which is very helpful. For the decade of the 70s, the average was about .35, compared to roughly 1.0 over the 20teens. A relative difference of 3X, but inflation for the recent decade was only one quarter or one third of the 70s. Thus, debt is almost certainly not a huge factor in the 70s.

[magnet]

You only mention government spending and taxes as contributors to 70s inflation but there was this very small thing called an oil crisis,

It’s just two sides of the same coin. Inflation occurs when demand outstrips supply. That can be caused by too much government spending (which increases demand), too little taxation (which serves purely to decrease demand), or not enough supply (e.g. oil shock). However, debt plays no role according to MMT.