WASHINGTON— Opponents of President Obama’s health care overhaul are taking yet another challenge to the Supreme Court, and they say they’ll be back with more if this one fails.
An appeal being filed Monday by the Pacific Legal Foundation contends the law violates the provision of the Constitution that requires tax-raising bills to originate in the House of Representatives. A lawyer for the group, Timothy Sandefur, said it’s just one example of how ‘‘Obamacare is so unconstitutional in so many ways.’’ He said the justices will face one challenge after another until the law is changed significantly or repealed.
Twice, the court has turned back major challenges to the health care law, in opinions written by Chief Justice John Roberts in 2012 and in June. It also has allowed family-owned businesses with religious objections to opt out of paying for contraceptives for women covered under their health plans. A related case involving faith-oriented colleges, hospitals, and charities is pending.
The latest appeal was filed on behalf of small-business owner Matt Sissel.
The foundation says the health overhaul is expected to generate roughly $500 billion in a dozen separate new taxes by 2019, clearly making it a bill to raise revenue.
The appeal says the legislation debuted in the Senate when then-majority leader Harry Reid, a Nevada Democrat, gutted an unrelated bill that had passed the House and inserted language that became the Affordable Care Act. The original measure was designed to help veterans buy homes.
The House then adopted the revised measure. Both chambers were controlled by Democrats at the time.
concluded the legislation should qualify as revenue-producing. But they would have ruled in favor of the administration anyway. They said the bill properly originated in the House, even if the measure was stripped of its original language.
Nicholas Bagley, a health law expert at the University of Michigan Law School, doubts the high court will intervene. ‘‘There’s disagreement on the appeals court about the rationale, but until there’s disagreement about the right outcome, the Supreme Court has no reason to take the case,’’ he said.
Whatever the outcome, Sandefur said opponents of the law will keep fighting it. ‘‘Obamacare is so unconstitutional in so many ways that the court is going to be having Obamacare cases far into the future until the law is repealed or amended,’’ he said.
Effective Monday, particpants in the federal health care system should be able to check premiums for 2016. Rates are going up in many parts of the country. But people have options if they shop around, and an upgraded government website will help them compare costs and benefits, administration officials say.
HealthCare.gov and state-run insurance markets are entering their third year, offering taxpayer-subsidized private coverage. Massachusetts is among the states that run their own insurance exchanges.
For the third year, the dates for HealthCare.gov’s sign-up have changed. This time, it’s Nov. 1 through Jan. 31. For coverage to start Jan. 1, consumers must enroll by Dec. 15.
The new law has helped cut the share of Americans who are uninsured to about 9 percent, a historical low.
Independent experts are forecasting bigger premium increases in 2016 than last year, averaging from the high single digits to the teens. But averages won’t tell the whole story, because premiums can vary widely.
Too many consumers look only at the monthly premium when picking a plan, but other costs can be just as important, officials say. These include the deductible — the amount individuals must pay each year before their plan kicks in — and copays for medical services.
HealthCare.gov will feature a new calculator that estimates total costs based on a consumer’s expected medical needs.
As before, returning customers who don’t want to make any changes are automatically re-enrolled.
The tax penalty for uninsured people in 2016 will rise to the greater of either $695 or 2.5 percent of taxable income. That’s for someone without coverage for a full 12 months. This year, the comparable numbers are $325 or 2 percent of income, whichever is greater.
Hospitals’ Red Blanket Problem
Thousands Who Didn’t File Tax Returns May Lose Health Care Subsidies
by Robert Pear
WASHINGTON — Tens of thousands of people with modest incomes are at risk of losing
health insurance subsidies in January because they did not file income tax returns, federal officials and consumer advocates say.
Under federal rules, anyone who receives an insurance subsidy must file a tax return to verify that the person was eligible and received the proper amount of financial assistance based on household income.
When the federal insurance marketplace opens for the third enrollment season next Sunday, users will see a new question: “Did your household file a 2014 tax return and reconcile any premium tax credit you used?”
If the answer to that question is no, consumers risk losing the subsidies they receive to help pay premiums. Without such assistance, many would find insurance unaffordable.
Many of the people potentially affected have incomes so low that they would not otherwise have to file tax returns. But if they received insurance subsidies in 2014, they were required to file this year.
In July, the
Internal Revenue Service said 710,000 people who had received subsidies under the Affordable Care Act had not filed tax returns and had not requested more time to do so.
If those people do not return to the marketplace this fall, they may be automatically re-enrolled in the same or similar health plans at full price. And when they receive an invoice from the insurance company next year, they may be shocked to see that their subsidies have been cut to zero.
Erin M. Lackey, 41, of Jacksonville, Vt., was one of many people who received letters from the
I.R.S. saying they were at risk of losing their tax credits.
Her mother, Ruth J. O’Hearn, a nurse who helps her daughter with insurance matters, described her own reaction.
“At first, I was angry,” Ms. O’Hearn said. “Then I felt frustration and fear. You can’t be without insurance. Without the subsidy, health insurance would be unaffordable. Without insurance, the cost of medical care would be unaffordable.”
Crocodile Tears Over The Failing Obamacare Co-Ops--The Canaries In The Obamacare Coal Mine
I can’t believe what I’ve been hearing recently from Obamacare defenders over the failing Obamacare co-ops–the most recent count has eight of them going bust.
The biggest complaint seems to be that those mean Republicans forced these co-ops out of business because of a provision they included in the last budget. That provision capped what could be spent on the Obamacare risk corridor reinsurance provision for health plans losing money at the level of what was paid into the program by health plans making money. In other words, the Congress reminded the co-ops and the administration of something that was assumed all along–that the risk corridor provision had to be revenue neutral.
The specific complaint is that because of this Republican budget cap health plans got only 12.6% of what they asked for and expected to get under the risk corridor reinsurance program.
Said another way, the health plans, including these co-ops that lost money in Obamacare, lost it at a rate eight times greater than the relatively few health plans that made money under Obamacare, a difference of $2.5 billion!
So, are all of these co-op failures the fault of Congressional Republicans?
The temporary risk corridor provision in the Affordable Care Act is an important protection for consumers and insurers as millions of Americans transition to a new coverage in a brand new marketplace. The policy, modeled on the risk corridor provision in Part D that was supported on a bipartisan basis, was estimated to be budget neutral, and we intend to implement it as designed ,” said Aaron Albright, a spokesman for the Centers for Medicare and Medicaid Services.
Sounds to me like the Republicans’ budget cap only reminded the Obama administration, and all of the health plans, of what they said they were going to do in the first place.
Sabotaged by whom?
Is Valeant Pharmaceuticals the Next Enron?
by Joe Nocera
Valeant Pharmaceuticals is a sleazy company.
Although it existed as a relatively small company before 2010, it did a deal that year
that put it on the map . The deal was with Biovail, one of Canada’s largest drugmakers — and a company that had run afoul of the Securities and Exchange Commission.
In 2008, the S.E.C. sued Biovail for “repeatedly” overstating earnings and “actively” misleading investors. Biovail settled the case for $10 million.
As it happens, 2008 was the same year that a management consultant named J. Michael Pearson became Valeant’s chief executive. Pearson
had an unusual idea about how to grow a modern pharmaceutical company. The pharma business model has long called for a hefty percentage of revenue to be spent on company scientists who try to develop new drugs. The failure rate is high — but a successful new drug can generate over $1 billion in annual revenue, which makes up for a lot of failures.
Pearson didn’t have much patience for research and development. And while he certainly wanted moneymaking drugs, he didn’t really need blockbusters to make his business model work. His plan was to acquire pharmaceutical companies, fire most of their scientists and jack up the price of their drugs. Biovail gave him the heft to put his plan in action.
And so he has done, to the delight of Valeant’s shareholders, and the dismay of most everyone else.
Before Pearson took control of Valeant, it spent 14 percent of its revenue developing new drugs. Last year, that number was under 3 percent. Meanwhile, Pearson has been ruthless about price hikes; in February, according to
The Wall Street Journal , the company raised the price of one heart drug by 525 and another by 212 percent — on the very day it acquired the rights to the drugs. Complaints from patients, doctors and insurance companies have prompted investigations by federal prosecutors in Massachusetts and New York.
In the seven years Pearson has run the company, Valeant has done more than 100 deals. Its growth has been supercharged, and so has its stock price. Pearson has become a billionaire.
Fast forward to Oct. 19. During a conference call with investors, Valeant disclosed a relationship with a specialty pharmacy called Philidor RX Services, a relationship in which Philidor seemingly does business with no one besides Valeant, and that is so close that Valeant consolidates Philidor’s financials while holding Philidor’s inventory on its books. During the call, Valeant also disclosed that it had paid for an option to buy Philidor, though it had not actually made the purchase — a very strange deal indeed.
It made these disclosures because Roddy Boyd, a former New York Post reporter who now runs the Southern Investigative Reporting Foundation, had found out about the Philidor relationship
and begun asking questions . So had several Wall Street critics of the company, including
John Hempton of Bronte Capital.
Maine Voices: $15-an-hour minimum wage unhealthy for Maine Medical Center – and its mission
Higher personnel costs could adversely affect the hospital's ability to provide charitable care.
Richard W. Petersen is president and CEO of Maine Medical Center
At Maine Medical Center, we know that to take good care of you, we have to take good care of the people who work here.
That’s why we offer our employees a comprehensive benefits package that includes excellent health and dental insurance, life and disability coverage, retirement benefits and training and education opportunities. And of course, treating people right also means paying them appropriately, something we take very seriously.
As any employer knows, this imperative to compensate people fairly has to be held up against the realities of one’s business. No matter the sector – private, public or nonprofit – every enterprise must live within its means, often while holding a still higher mission. In our case, we are dedicated to the goal of making our community the healthiest in the nation.
Unfortunately, the careful balance that defines the shared interests of our employees and the organization they support could be dramatically disrupted this November with the passage of a misguided ballot initiative to raise the minimum wage in Portland to $15 an hour.
As the city’s largest employer with 6,992 employees, Maine Medical Center will be severely impacted by this proposal – not because we pay our employees unfairly, but rather because our compensation system is built around both pay and benefits and opportunities to advance.
We have long recognized that the minimum wage in Maine of $7.50 an hour is too low to attract and retain good people. That’s why in 2013, we announced that we were voluntarily setting the minimum wage in our organization at $10.10 an hour. And we vowed then to evaluate our minimum compensation guideline on an ongoing basis, balancing the interests of our employees, our patients and the community in the process.
I’m proud to say we’ve done a good job holding all those interests. For instance, as a health care provider, we are dedicated to making sure our people have access to affordable care. That’s why our sliding-scale, premium-sharing model subsidizes lower-wage workers to ensure they can access affordable health coverage.
And we work hard to foster a culture where people can find not just a job, but a career. We offer training opportunities and tuition reimbursement for those who want to gain new skills and move up the ladder in both pay and benefits.
These opportunities rest on a business model that is stunningly complex and constantly changing. Medicare, the government health insurance program for the elderly, pays only 90 percent of the cost of actually providing care to those patients. And Medicaid (known as MaineCare in Maine), which covers low-income and disabled people, pays just 83 percent of the cost of care.
Meanwhile, we are determined to fulfill our promise to care for all regardless of ability to pay. Last year, Maine Medical Center provided approximately $34 million in free care to patients unable to pay.
Layer onto that the efforts we are all making to rein in the rising cost of health care, and what emerges is an enterprise in a complex and delicate balance.
The proposal to raise Portland’s minimum wage is well-intended. Indeed, it is aimed at many of the people who come to us each year for charitable care. And given our efforts to provide that care, it’s hard to conclude we don’t share a concern for how the folks at the bottom of the income ladder are faring.
But opponents of this ballot initiative have it exactly right when they say it amounts to “too far, too fast.”
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