Mr. Romney Changes His Mind, Again
Massachusetts residents who file a state tax return have to provide proof that they have health insurance. If they can afford insurance but don’t have it, they must “pay a penalty through their tax returns,” according to the state Department of Revenue’s Web site.
This is all thanks to former Gov. Mitt Romney, who set up the system — the best of its kind in the country — and is now trying to pretend he doesn’t remember how it works. On Monday, his campaign said Mr. Romney believed the identical requirement in President Obama’s health care law was a penalty, paid through the tax system. Two days later, Mr. Romney rushed to the camerasto contradict the campaign and insist the mandate was a tax.
Why the switch? As he has on so many issues, Mr. Romney caved to Republican conservatives who want him to campaign on the falsehood that the mandate is a vast tax increase on the middle class. The Supreme Court’s decision that the law is constitutional was disastrous to their cause, so they distorted its basic reasoning. Chief Justice John Roberts Jr. wrote that the mandate is legal under the Congressional taxing power, which Republicans took a step further, saying the mandate must now be a tax. And not just a tax, but a huge, oppressive tax, one of the largest in history.
It is, of course, no such thing. How many “oppressive taxes” are entirely optional? Anyone who does the smart thing and gets health insurance won’t have to pay it. It is, as Mr. Romney himself described it in 2006, a fee to promote “personal responsibility” and prevent healthy people from freeloading. (Among those who won’t be able to comply with the law are poor people living in states where Republican governors refuse to expand their Medicaid programs using federal dollars — though most of those people don’t make enough to have to pay the penalty.)
Consumer Questions on Health Care Act, and the Answers
By KATIE THOMAS
Q. Now what? The law is upheld, so where does it go from here?
A. Now the scramble to enact the law continues. Unless the law is repealed by Congress, most of the major changes take effect on Jan. 1, 2014. By then, states must have set up health insurance exchanges, where people can buy coverage. Insurers will have to offer policies to anyone who applies, including people with expensive medical conditions. And people who do not qualify for exemptions based on income or religion will be required to have minimum insurance coverage or pay a penalty.
Q. In what way was the Medicaid expansion “limited”? What is the meaning of this portion of the decision?
A. The Supreme Court’s decision means that the Medicaid expansion is now an option for states, not a requirement. If states do not participate, experts have speculated that it could create a subset of people who earn too much to qualify for Medicaid — the exact threshold varies — but not enough to qualify for the tax credits that would help them pay for insurance. States will not have to pick up the added costs of the Medicaid expansion until 2016. After that, the federal government will gradually reduce its contribution until it reaches 90 percent of the costs by 2020.
Reluctance in Some States Over Medicaid Expansion
By ROBERT PEAR and MICHAEL COOPER
WASHINGTON — Millions of poor people could still be left without medical insurance under the national health care law if states take an option granted by the Supreme Court and decide not to expand their Medicaid programs, state officials and health policy experts said Friday.
Republican officials in more than a half-dozen states said they opposed expanding Medicaid or had serious doubts about it, even though the federal government would pick up all the costs in the first few years and at least 90 percent of the expenses after that.
While upholding the most hotly debated part of the health care overhaul law — a requirement that most Americans have health insurance or pay a penalty — the Supreme Court said in its ruling on Thursday that states did not have to expand Medicaid as Congress had intended — leaving a huge question mark over the law’s mechanism for providing coverage to 17 million of the poorest people.
In writing the law, Congress assumed that the poorest uninsured people would gain coverage through Medicaid, while many people with higher incomes would receive federal subsidies to buy private insurance. Now, poor people who live in a state that refuses to expand its Medicaid program will find themselves in a predicament, unable to obtain either Medicaid or subsidies.
India Weighs Providing Free Drugs at State-Run Hospitals
By VIKAS BAJAJ
MUMBAI, India — In what would be a landmark increase in the Indian government’s spending on public health, New Delhi is completing a proposal to provide hundreds of essential drugs free to patients in government-run hospitals and clinics at a cost of nearly $5 billion over five years, officials said Thursday.
The proposal, which could receive government approval next month, would try to fill a gaping hole in the provision of health care at state-owned hospitals, many of which require patients to buy their own drugs, including substances as basic as intravenous fluids. Specialists say it could also be the first step toward a more comprehensive universal health care system in India, which, with 1.2 billion people, is the world’s most populous country after China.
Drugs account for more than 70 percent of out-of-pocket medical costs for Indians. Government hospitals and clinics provide free or low-cost care, but most of them struggle to keep up with demand, and the quality of care can be poor.
For Western drug makers, which have long chafed at India’s comparatively weak protection of their patents, the government’s plan could be another blow. Although they only have a tiny share of the Indian market, Western drug companies are looking at India and other emerging markets as a vital source of growth as sales flatten in the United States and Europe. Under the proposal, the government would only buy cheap generic versions of drugs, making it more difficult for brand-name drugs to be sold.
Thousands in Massachusetts still forgo health care insurance, pay penalty
Everything you ever wanted to know about Canadian health care in one post
By Sarah Kliff ,
We spend a decent amount of time talking about the Canadian health care system in our health care debate. Today being Canada Day (yes, really), it feels like a good time to brush up on how our northern neighbors actually deliver health care and how well it works. Without further ado, a completely painless guide to the Canadian health care system.
So, how exactly does the Canadian health care system work?
The Canadian health care system was built around the principle that all citizens will receive all “medically necessary and hospital physician services.” To that end, each of Canada’s 10 provinces and three territories finance and run a statewide health insurance program. There is no cost-sharing for the health care services guaranteed under federal law.
While Canadians are guaranteed access to hospital and physician services, it is up to each province to decide whether to cover “supplementary” benefits, like dental care and drug coverage. About two-thirds of Canadians take out private, supplemental insurance policies (or have an employer-sponsored plan) to cover these services.
While Canada is traditionally thought of as a publicly financed system, spending on these supplemental benefits means that 30 percent of health spending comes from private sources. One 2011 study found that nearly all Canadian spending on dental care came from non-government dollars, 60 percent covered by employer-sponsored plans and 35 percent paid out of pocket. Some Canadian legislators have made pushes to increase the scope of Canada’s public health plan, to cover more services, but have so far proved unsuccessful.
No comments:
Post a Comment