July 15, 2019

Obamacare in Jeopardy

Last Tuesday, a federal appeals court heard arguments “in a 2018 lawsuit [against the ACA, also known as Obamacare] by 18 Republican-leaning states claiming that the absence of a tax converts the law into an unconstitutional directive to U.S. citizens to buy a product. A lower court judge ruled in December that it did, and that the entire law must fall as a result… [the judges] seemed inclined Tuesday to rule that the core provision of President Barack Obama’s signature health care law is unconstitutional… It was less clear after the arguments whether the judges also would invalidate the entire health care law.” AP News

See past issues

From the Left

The left believes the lawsuit to be without merit and thinks the ACA should remain in place, but is divided on future healthcare policies.

“Obamacare, the [challengers’] argument goes, is an intricately designed system. Lawmakers at the time of its passage believed that the law’s individual-mandate payment, a charge on those who went without health-care coverage, was a key piece of that system, compelling enough healthy people to buy into the insurance pool to keep its finances stable. Republicans zeroed out the payment in their 2017 tax-cut law, which, the challengers argue for complex but unpersuasive reasons, rendered the mandate unconstitutional. And, without the mandate, the system cannot work as its drafters anticipated, so the whole law must go…

“Yet Congress made a different call when it zeroed out the mandate payment in 2017… For the 5th Circuit to rule that Obamacare could not function as designed without the mandate — despite the fact that congressional intentions, as of 2017, were to have it function without the mandate — would require the appellate judges to replace their policy judgment for that of the policymakers in Congress, in effect to usurp the legislative function.”
Editorial Board, Washington Post

“It’s clear that the Trump administration and some supposedly conservative judges are doing exactly what they so often accuse liberal judges of doing: Pretending that they are legislators.”
David Leonhardt, New York Times

“It’s not just that 21 million people would probably lose health insurance, or that 133 million Americans with pre-existing conditions would lose their protection… health plans could also begin limiting the total amount of financial protection they offer customers, increasing deductibles, charging higher prices to older customers, and dropping expensive categories of benefits, like prescription drugs.”
Margot Sanger-Katz, New York Times

Many argue that “despite relentless Republican attacks, the benefits provided [by the ACA] -- guaranteed insurance and coverage of pre-existing conditions -- are now seen by many as a benefit to which they're entitled. Moving to Medicare for those who want it is a logical next step toward a single-payer option, one that maintains choice for millions of Americans… 56% of Americans say they support full Medicare for All… [but] when voters are presented with the full details of the Sanders and Warren plans, support falls dramatically… I believe it's critical for Democrats to maintain their advantage on health care going into 2020, and the best way to do that is to reject Medicare for All and embrace Medicare for those who want it.”
Joe Lockhart, CNN

Others counter that “those who lean to the left are repeatedly castigated for embracing Medicare-for-all minus a detailed and specific outline for how it will be paid for, while Republicans are rarely challenged on how repealing the ACA will weaken the entire American health-care system as we know it. At the same time, many believe the Republicans are fighting the ACA as a show for their rabid base, and aren’t serious about taking it out. As a result, all too many can’t bring themselves to accept that Republicans might be for real, that they want to destroy the ACA, and they don’t much care about what happens [to] individual Americans or the entire health-care system…

It would be one of the great ironies of all time if it were Donald Trump and the Republican Party who all but forced people to turn to the ‘socialist’ Medicare system to save health care. But it’s an irony that’s increasingly not outside the realm of possibility.”
Helaine Olen, Washington Post

Regarding the Cadillac tax, “high-premium employer-based plans raise the cost of health care for everyone by encouraging the overconsumption of expensive services. This means that even Medicare and Medicaid face higher prices. Quite aside from its benefits for the health-care market, the Cadillac tax would also have the effect of expanding the tax base and making the tax code more efficient. It would raise revenues by about $15 billion a year… Rather than killing or delaying the Cadillac tax, Democrats should be trying to make it operational. The tax would raise revenue, lower costs, increase the efficiency of the tax code and give the Obamacare individual market its best chance at success.”
Karl W. Smith, Bloomberg

“The two issues with which he is most often associated, support for a balanced budget and opposition to free trade, put him at odds with both of our major political parties. An old-fashioned, soft-spoken Southerner, he nevertheless held views on so-called ‘social issues’ that would be to the left of the mainstream of the Republican Party, both then and now. He was a fervent supporter of the Vietnam POW/MIA movement in the late '80s and early '90s, but he was not in any sense a hawk. Never mind 2003. Perot opposed the first war in Iraq in 1990… Perot's death should be mourned by all Americans who regret the fact that it is no longer possible to make reasoned, non-ideological arguments about questions of public import, and by the devolution of our political life into mindless partisan squabbling.”
Matthew Walther, The Week

From the Right

The right is skeptical of the lawsuit and critical of the alternatives being offered by the Democratic candidates.

From the Right

The right is skeptical of the lawsuit and critical of the alternatives being offered by the Democratic candidates.

“Whereas many prominent legal thinkers on the Right expressed support for the [previous lawsuits challenging Obamacare], there is a dearth of prominent voices in support of the plaintiffs' theory here. I don't think that's an accident. [The previous cases] were grounded in foundational aspects of conservative legal jurisprudence (the notion of limited federal power and textualist statutory interpretation, respectively). [This one], on the other hand, is a too-clever attempt at legal jujitsu that requires discarding traditional conservative approaches to standing, statutory interpretation and severability.”
Jonathan Adler, Volokh Conspiracy

Moreover, “the GOP has failed to sell their plan on health care to voters in a way that would prevent them from being blown up at the ballot box. It’s never easy campaigning on a platform that is viewed as taking away people’s stuff… while symbolically this could be a win, the GOP has failed to plan for the fallout [from] something like this.”
Matt Vespa, Townhall

“If the Affordable Care Act were to lose in court, and Congress and the president failed to agree on legislation afterward, Americans would go through the largest disruption in health-care arrangements that Washington has ever imposed… In turn, that would create a political problem for Republicans. They have long said they wish to repeal Obamacare while making sure that its beneficiaries, especially those with pre-existing conditions, have access to affordable coverage. If a lawsuit they launched succeeds in delivering the first half of that agenda, voters will expect them to deliver the second…

“[In order to do so] either the Republicans would have to compromise with the Democrats in the end, or they would accept inaction and blame it on the Democrats for not going along with their conservative ideas. The Democrats’ case – ‘We are ready to pass a simple extension of the law and protect everyone’ -- would likely go over better with voters. Republican senators up for re-election in swing states might find the pressure to side with the Democrats irresistible.”
Ramesh Ponnuru, Bloomberg

Many, however, point out that “if [Obamacare is struck down], President Trump has made clear time and again that he wants Congress to pass a replacement law that maintains guaranteed coverage for Americans with pre-existing conditions… President Trump would be waiting with pen in hand if Congress were to send him such a bill. The truth is, he had that pen in hand in 2017 when the House passed that very bill, but one down-turned thumb by a GOP Senator killed [it].”
Mike Huckabee, Fox News

Regarding alternatives, some caution that “a public option would put the country on an inexorable course to single payer. For starters, the public option wouldn't need to cover its costs. It can't go bankrupt—it's backed by the federal treasury. Second, supporters of the public option envision paying doctors and hospitals at rates similar to those paid by Medicare, which are, of course, much lower than those for private insurers…

“The consequences would be predictable. Large numbers of people would sign up for the low-cost government plan. Doctors and hospitals, forced to treat more people at below-market rates, would raise their prices for the privately insured. These insurers would pass those higher prices along to their customers in the form of higher premiums. The cycle would repeat, until everyone had fled their old private insurers for the low-cost government-run plan. At that point, the public option would be the only option.”
Sally Pipes, Forbes

“Trump should be overjoyed. Tariffs are taxes paid by Americans on the things Americans buy. The only way China can be paying any of them is if something else, something extra, then happens — like the yuan dropping. This makes all imports into China more expensive for Chinese citizens. That's China paying for Trump's tariffs when the yuan falls. Without this happening, only Americans pay. With the yuan dropping, China pays as well. This is the claim Trump has been making all along, that China's really paying those trade taxes — now they are… Imposing significant export tariffs on a country should mean the value of that currency falls. This is what is happening. Why is Trump complaining about it?
Tim Worstall, Washington Examiner

“NBC and MSNBC embraced Sen. Elizabeth Warren of Massachusetts in the first debate of Democratic presidential candidates Wednesday night, treating her like the star of the show. The debate led off with Warren, who had a huge popularity advantage from the start… NBC anchor Savannah Guthrie started it off sounding more like Warren’s press secretary. ‘You have many plans – free college, free child care, government health care, cancelation of student debt, new taxes, new regulations, the breakup of major corporations,’ Guthrie said, before teeing up an economy question. Guthrie even used Warren’s plan to break up tech companies as the foundation for a question for Sen. Cory Booker of New Jersey… the round-robin final comments also ended with Warren, as Maddow asked her for the ‘final, final statement.’ That let NBC bookend the entire debate with Warren and Warren.”
Dan Gainor, Fox News

President Trump should be happy. As much as Warren is articulate, obviously intelligent, and energetically supported by Democrats, she would also be far easier to defeat than Joe Biden… Considering Trump's economy, the president is well placed to defeat Warren.”
Tom Rogan, Washington Examiner

A libertarian's take

Outside Hong Kong, the silence Is deafening… Some protesters in Hong Kong today are adopting the British Union Jack flag, the American flag and the ‘Star-Spangled Banner’ as symbols, yet that doesn’t seem to have stirred our collective imaginations… Americans are preoccupied with fighting each other over political correctness, gun violence, Trump and the Democratic candidates for president. To be sure, those issues deserve plenty of attention. But they are soaking up far too much emotional energy, distracting attention from the all-important struggles for liberty around the world…

“It’s 2019, and the land of the American Revolution, a country whose presidents gave stirring speeches about liberty and freedom in Berlin during the Cold War, remains in a complacent slumber. It really is time to Make America Great Again — if only we could remember what that means.”
Tyler Cowen, Bloomberg

On the bright side...

Finland hosts heavy metal knitting championship.
AP News

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