Lawyer Matt Kinley of a Downey Law Firm and member of the Long Beach Rotary Club, shed light on Obama Care and the Supreme Court Case to be heard later this year. Although he is not a supreme court lawyer or expert, he provided insight into The Patient Protection and Affordable Care Act, the official title of what could change the face of healthcare and health insurance for every US individual.
PPACA is a living law, not only did no one know what was in the bill when it passed, it gave many bureaucracies, like the IRS, Health & Human Services, the Center for Medicare and Medicaid Services, the right to tens of thousands of pages of regulations.
This Supreme Court Case has the prospect of fundamentally changing the relationship between the states and the federal government. Not one Republican voted for this legislation. It is an intensely partisan manner compared to Social Security Act in 1935, or Medicare or Medicaid in 1965, or Medicare Part D in 2003. 26 states, all with Republican governors, have filed a class action against the US government to rescind the legislation; the first time ever this many states have joined in a case against the feds.
FYI, many states have filed amicus briefs in favor of the law, including CA.
The law does lots of things including: Insured can keep their children under their policy until age 26. No matter your health condition, you're covered, requiring insurers to offer the same premium to all applicants. Meaning insurance companies have to insurer the sickest along with the healthy. Also provides for a simplified enrollment in Children's insurance programs; requires rebate to purchaser of insurance if insurance companies fail to spend on certain things; co-payments are eliminated for preventive care; low income persons are subsidized; and minimum standards for health insurance policies are to be established and caps will be banned.
This is a unique law, called Individual Mandate, requiring all persons not covered by an employer sponsored health plan, Medicaid, Medicare or other insurance, to be covered or be in violation of Federal law.
For business, firms employing 50+ and not offering health insurance will also pay a shared responsibility requirement--about $2,000 per year per employee. Very small businesses will be able to obtain subsidies.
Effective Jan. 2, 2013: all employers with 200 or more full time employees must provide heath insurance. Under 200 not required.
The Act's provisions are intended to be funded by a variety of taxes and offsets. Major sources of new revenue include broadened Medicare tax on incomes over $200,000 and $250,000, for individual and join filers respectively. An annual fee on insurance providers, and a 40% tax on "Cadillac insurance policies.
Total new revenue from the Act will amount to $409.2 billion over the next 10 years. $78 billion will be realized before the end of fiscal 2014.
There are legal challenges: there are six cases filed against the law in federal court. The most significant is Florida v. US Dept. of Health & Human Services. Oral arguments are set for March 2012 with an extraordinary three days and five half hours for oral argument. At the time this is heard, there will have been over 150 briefs filed by parties and friends of the court brief.
Constitution and the Bill of Rights:
The Federal government can't do anything without authority to do so: Congress has certain enumerated powers. The constitution also has specific limits to what the federal government can do: Bill of Rights. These issues could redirect government in a way not seen since the New Deal.
The Administration's position is this is a $2.5 Trillion industry. It's an industry with particular need for federal intervention because if a state tries to reform healthcare, people who need healthcare move to that state. Classic intrastate commerce problem. Because there is mandated coverage, people can wait until after they are sick to buy healthcare.
The heart of the government argument is we must require people to buy insurance. And, we want to cover everyone, even people with preexisting.
The state's position: the young are the cash cows, needed to pay for all the sick out there. States argue the mandate is an inappropriate attempt to make people buy something or face a fine. If the feds can force you to buy something, what limits exist at all?
The Supreme Court has set 90 minutes for oral argument. If the court decides that the mandate is unconstitutional, the court will need to decide whether any of the rest of the ACA falls with it. Could Congress achieve its regulatory objectives without the minimum mandate?
So later this year we will know whether Obamacare stands or falls!
