ACA at risk?

[LRDave]

Without getting "porky", what do you think the chances are that ACA - particularly the subsidies - is at risk of disappearing?

Just the likelihood of elimination, possible program changes, etc.,. No politics please.....


(question spurred by recent Justice Dept. ruling...)

 

[ShokWaveRider]

It is very hard to make it non political, as it is a political move to start with, given the move has a poor constitutional merit. No replacement recommended at all just abolishment of the existing law. All the move really Ensures is that it will be one of, if not the main bargaining chip for 2020.

 

[Aerides]

I think the chances are low if it get to the SC, since it has already been there and been withheld, but who knows.

It's all a guessing game, and there's little that can be said other than that except... politics.... and prior attempts at this discussion have gone there very quickly.

 

[MichaelB]

Any discussion can center around the legal / technical aspects of the case, how it impacts each of us as individuals, or options we may have. We need to avoid discussing elections, partisan politics or general snark.

 

[footenote]

The lawsuit the Administration is now supporting argues the ACA Individual Mandate is unconstitutional.

Supreme Court has already ruled the Individual Mandate constitutional.

(Having said that, the Supreme Court now has a few different judges than it had during that ruling. So a different ruling is possible.)

 

[LRDave]

My specific concern is that come July, I've got to pick a horse to ride. I will come off of employer-sponsored health insurance. My two options are:
1) ACA marketplace
2) Join DW's state retirees health care plan.

Option 2 sounds like it would be great, but it isn't. Until DW turns 60 (July 2020) the rate is basically COBRA rates - very high for a pretty sorry plan. Add me to the mix and it is VERY high. Even the reduced rates for both of us once she turns 60 are just OK.

With option 1, I think we can manage MAGI nicely until I turn 65. Currently ACA quotes are FAR cheaper for me.

I only get one chance to join DW's plan, I think, because I don't see any qualifying events for me between now and me turning 65.

The numbers say ACA, but I was wondering what sort of risk factor we'll have. Wonder if loss of ACA in my state would be a "qualifying event"?

 

[BuysToys]

The current lawsuit states the mandate is unconstitutional because the requirement to purchase medical coverage has been removed. ACA was changed, so whether or not the individual mandate is still constitutional will have to be tried, likely bumping up to the SC.


I'll be off of ACA plans soon, so I don't have a dog in this race. Having said that, the ACA was poorly written and badly enacted. Setting up the early years as easy to default hurt the program as it was less expensive for the healthiest folks to not participate. Insurance rates got out of hand. Something needed to change. We won't know if this is a positive or negative more until it's happened and we've lived with it for a couple of years.

 

[footenote]

If nothing substantive has happened by July, if I were in your shoes, I'd go with ACA under your circumstances.

Worst case (and even then, litigation would have to progress in a BIG hurry), ACA would not be available Jan 1, 2020, not mid-year 2019. (Not a lawyer; just how I would assess the risks.)

 

[MRG]

I'm 62, only 3 more years of this madness for me. I don't know what will happen but it's very sad to see 20 million people held in limbo.

Unthinkable when you want to purchase something at an exorbitant price and they won't let you buy it.

 

[joeea]

Without getting "porky", what do you think the chances are that ACA - particularly the subsidies - is at risk of disappearing?

Just the likelihood of elimination, possible program changes, etc.,. No politics please.....


(question spurred by recent Justice Dept. ruling...)

It will likely go to the Supreme Court (again).

The makeup of the court has changed since the last go round. But I suspect the outcome will be the same.

I put the chances of the ACA disappearing at 13.76%

I'm biting my lip very hard right now, so as to avoid discussing the obvious politics at play here.

 

[joeea]

The numbers say ACA, but I was wondering what sort of risk factor we'll have. Wonder if loss of ACA in my state would be a "qualifying event"?

I would anticipate delays in any potential changes to the ACA, probably for years. (Has the Supreme Court already determined all the cases they will hear this year?)

And I would anticipate that it would be deemed a qualifying event in the unlikely case that the ACA just disappears.

I think you are best served by going with the past that seems best under the current laws and not trying to guess when/if the laws will change.

 

[imoldernu]

Have you heard anything at all about what might replace ACA?

 

[scrabbler1]

While the Court's composition has changed since the 2012 ruling, the 5 justices in that year's 5-4 majority ruling have not. This leaves me optimistic that the ACA won't go down.

 

[easysurfer]

Too early to say anything. This is like the pre-game show before the first inning. Did watch on the morning news yesterday that anything for deciding moving up in the courts wouldn't happen until around a year or so.
As usual, with the ACA, I'm biding my time with a wait and see .
Approaching as the ACA is the land of the law until it is not.

 

[gstillson]

The ACA is here to stay. Social programs don't go away.

Why is everything rhyming?

 

[Dtail]

While the Court's composition has changed since the 2012 ruling, the 5 justices in that year's 5-4 majority ruling have not. This leaves me optimistic that the ACA won't go down.

Beat me to this important point.
It would also take a decent amount of time for it to be heard in the SC.
Need 5 more years of this coverage.

 

[joeea]

Have you heard anything at all about what might replace ACA?

There are no bills in Congress for any replacements. And the court ruling cannot impose any replacement at all.

So we can all guess what might eventually happen as far as eventual replacement. But this forum doesn't encourage such speculation.

 

[Dtail]

Have you heard anything at all about what might replace ACA?

Nothing coz there is nothing right now, except a theoretical reversion to a pre ACA environment.

 

[Smitty700]

Let's assume that the Supreme Court will declare the ACA unconstitutional. (I'm not saying that will happen, only assuming that for this post.) The case needs to work through the lower courts, with reports saying that it would reach the Supreme Court no earlier than fall of 2020. That means a decision would not be rendered until spring of 2021. That unconstitutional declaration would not take effect for the current ACA plan year, and it's likely that the court would allow the system to stay in place through the next plan year because of the impact to millions and to give congress time to come up with an alternative.

So even in the case in which the ACA is declared unconstitutional, the ACA will be here through 2022. It's way, way early to begin wondering about alternatives.

 

[Teacher Terry]

This won’t affect us but I really feel for people that need it. I really wish we would just do what Europe does and have single payer.

 

[Marc]

Maybe the law can be changed to incorporate a "wealth" test instead of the current MAGI test; then I think the costs might become more bearable to the public (i.e., taxpayers) and the system (i.e., exchanges) can stay.

Marc

PS I am still smarting from the SS changes that are going to really hurt me so I might be a little too unsympathetic.

 

[samclem]

Maybe the law can be changed to incorporate a "wealth" test instead of the current MAGI test; then I think the costs might become more bearable to the public (i.e., taxpayers) and the system (i.e., exchanges) can stay.

Marc

PS I am still smarting from the SS changes that are going to really hurt me so I might be a little too unsympathetic.

I'm not sure that just modifying who pays the bill ("the government," the risk-pool participants, or the individual receiving the services) gets to the nub of the problem. It is the >cost of the medical services< that is the root of the cost issue. The money kept by insurers (whether private or public) accounts for a fairly small portion of the total costs.

 

[ziggy29]

Have you heard anything at all about what might replace ACA?

No. My understanding is that at least some of the senators who voted to end the individual mandate (I know Sen. Collins is one) were more or less promised by leadership that there would be a significant ACA replacement bill in the works, but that has not happened. I don't see anything to discuss here in terms of policy changes that have gone through the sausage-making process.

As for the Supreme Court, it's hard to say. Remember that Roberts was the swing vote in the original decision (Kennedy voted with the minority, so his retirement changes nothing per se), and Roberts upheld it by calling the individual mandate a "tax". Now that the tax has been repealed, it's anyone's guess. Will he find another justification to keep the law on the books? It's hard to say.

That said, this all really sucks for people who retired early planning on this to be their bridge to Medicare. It must feel like Lucy holding the football for Charlie Brown, only to have it yanked away before he could kick it (i.e. reach Medicare age). And I suppose anything is possible, but will that impact have any sway on what happens from here on out? My crystal ball is broken.

 

[explanade]

The current lawsuit states the mandate is unconstitutional because the requirement to purchase medical coverage has been removed. ACA was changed, so whether or not the individual mandate is still constitutional will have to be tried, likely bumping up to the SC.

Actually the ACA was not changed.

It was the tax bill where they changed the individual mandate tax to $0.

That is what made state attorneys general in conservative states file this suit and a Texas district court judge ruled all of the ACA unconstitutional, a decision that most people expect won't stand in appeal.

But the DOJ on Monday wrote a letter to the Appeals Court considering the case that the lower court ruling should be upheld in its entirety.

They are expected to submit a detailed brief later.

Meanwhile there's an article that two cabinet members, Alex Azar of HHS and Bob Barr of DOJ both opposed the administration taking this position, to have all of the ACA ruled unconstitutional.

Azar was against it because they had no replacement policy.

Barr was dubious of the case and the ruling and don't think the Appeals Court will uphold the lower court ruling.

But the White House overruled them and went with the push by Mick Mulvaney, who has a long history of opposing the ACA. For instance, when he was in Congress, he supported a govt. shutdown to try to stop the ACA.

 

[Dtail]

Maybe the law can be changed to incorporate a "wealth" test instead of the current MAGI test; then I think the costs might become more bearable to the public (i.e., taxpayers) and the system (i.e., exchanges) can stay.

Marc

PS I am still smarting from the SS changes that are going to really hurt me so I might be a little too unsympathetic.

The amount of tax subsidies which are being given to "wealthy" users is very small as a portion of the overall costs.
Do you have the ACA coverage?