King v Burwell (ACA Subsidies) Decision Announced

[MichaelB]

that's certainly an issue for employers to consider, I was talking about individual plans on the exchanges

if someone jumps the company ship and goes to an exchange to get a subsidy then there is a penalty involved

In my state anyways, individual insurance was always charged in relation to age. Compared to group plans I imagine you are correct. Especially if your company was all 50 year olds and you were the only 25 year old.
But in the individual market pre ACA you were always charged in relation to your age band. I am going off total memory and could be faulty. But there was a minor uproar when rules were being set that the young were in effect subsidizing the older at 3-1. I could have sworn in traditional pre ACA individual market the ratio difference was closer to 5-1.

Most insured 30 year olds in the US were, and still are, in group plans. The rate for them is higher than in the individual market. It doesn't matter who pays, the rates are still higher.

Individual policy premiums for some 30 year olds in the pre-ACA days were lower. That is an artificial point of comparison, however, because so many were excluded and insurers regularly rescinded policies after the fact.

Introducing age into insurance pricing was, and still is, a way to exclude individuals from groups and keep costs artificially low.

 

[Big_Hitter]

I do not think you qualify for a subsidy if you are working and offered a plan....

OR, do you mean actually quitting a job just to get on an exchange to get a subsidy That does not make much sense to me....

I think you can still qualify if your employer coverage isn't "affordable" (exceeds 9.5% of agi) and you are under the 400% fpl

 

[Mulligan]

Most insured 30 year olds in the US were, and still are, in group plans. The rate for them is higher than in the individual market. It doesn't matter who pays, the rates are still higher.

Individual policy premiums for some 30 year olds in the pre-ACA days were lower. That is an artificial point of comparison, however, because so many were excluded and insurers regularly rescinded policies after the fact.

Introducing age into insurance pricing was, and still is, a way to exclude individuals from groups and keep costs artificially low.

Not really disagreeing with you, just commenting. If we are talking insurance, age is prevalent in many forms of insurance so it isn't that unusual. It can also work the opposite way such as auto. Mentally I am still caught in the middle. If we are going to call it insurance its cost is usually based on age, usage factor, and sometimes financial condition. Make the system "national healthcare" instead of insurance and I can clear my brain of the confusion!


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[NW-Bound]

Most insured 30 year olds in the US were, and still are, in group plans. The rate for them is higher than in the individual market. It doesn't matter who pays, the rates are still higher...

This is a valid point. Group insurance has to provide coverage without individual underwriting, so they have to make it up somehow.

The healthy people always pay for the sick. I guess that's what it boils down to.

 

[utrecht]

Dont take this as meaning I want subsidies taken away or anything, but...

This Supreme Court decision seems like its kind of bogus to me. The Supreme Court is supposed to look at issues and decide the case on its merits. In this case it seems to me that they said "Hmmm...there's no way we can overturn the ACA. Its too big and too important to too many people. If we overturn it, it will take forever for those lawmakers to come up with a new plan that satisfies everyone, so lets dig thru it and find a way to interpret the wording to make the law able to stay in effect". That bothers me a bit, although I agree that overturning it would've been a nightmare.

 

[travelover]

Dont take this as meaning I want subsidies taken away or anything, but...

This Supreme Court decision seems like its kind of bogus to me. The Supreme Court is supposed to look at issues and decide the case on its merits. In this case it seems to me that they said "Hmmm...there's no way we can overturn the ACA. Its too big and too important to too many people. If we overturn it, it will take forever for those lawmakers to come up with a new plan that satisfies everyone, so lets dig thru it and find a way to interpret the wording to make the law able to stay in effect". That bothers me a bit, although I agree that overturning it would've been a nightmare.

Unlike some constitutional interpretations, the people that wrote the ACA were on hand to explain what their intention of the law was.

 

[brewer12345]

Dont take this as meaning I want subsidies taken away or anything, but...

This Supreme Court decision seems like its kind of bogus to me. The Supreme Court is supposed to look at issues and decide the case on its merits. In this case it seems to me that they said "Hmmm...there's no way we can overturn the ACA. Its too big and too important to too many people. If we overturn it, it will take forever for those lawmakers to come up with a new plan that satisfies everyone, so lets dig thru it and find a way to interpret the wording to make the law able to stay in effect". That bothers me a bit, although I agree that overturning it would've been a nightmare.

Frankly, who knows what they really thought. And aside from what the ruling actually says, who cares? We live in a country that is well into the transition from a republic (SPQR, represent) to an imperial kleptocracy. The big boys do as they please and the rest of us like it or lump it.

 

[easysurfer]

I don't use a subsidy for my HI. But next year, I may have to go back to a cheap bronze plan where my doctor is not even covered. At least there's a 6K deductible per year limit.

 

[NW-Bound]

Unlike some constitutional interpretations, the people that wrote the ACA were on hand to explain what their intention of the law was.

Are they still all there? I thought some got voted out.

 

[utrecht]

Lots of people have been charged with crimes or sued for things that judges have acknowledged weren't the intention of the laws and the judge says "Im sorry my hands are tied".

How about someone who gets life in prison for a drug charge and then 2 months later the penalty for the same charge is changed to a max of 2 yrs? The lawyer files for an appeal or a hearing before a judge to lesson the sentence and the judge says "I agree your clients sentence is excessive but that was the law at the time. My hands are tied". There are all kinds of injustices like this in our country, but this time the Supreme Court searched high and wide to find to find a way to interpret the law the way they wanted to fit their predetermined outcome. That's my opinion, although like I said I agree with the result.

 

[NW-Bound]

From Through the Looking Glass by Lewis Carroll:

"When I use a word," Humpty Dumpty said in rather a scornful tone, "it means just what I choose it to mean -- neither more nor less."
"The question is," said Alice, "whether you can make words mean so many different things."
"The question is," said Humpty Dumpty, "which is to be master - - that's all."

 

[brewer12345]

Lots of people have been charged with crimes or sued for things that judges have acknowledged weren't the intention of the laws and the judge says "Im sorry my hands are tied".

How about someone who gets life in prison for a drug charge and then 2 months later the penalty for the same charge is changed to a max of 2 yrs? The lawyer files for an appeal or a hearing before a judge to lesson the sentence and the judge says "I agree your clients sentence is excessive but that was the law at the time. My hands are tied". There are all kinds of injustices like this in our country, but this time the Supreme Court searched high and wide to find to find a way to interpret the law the way they wanted to fit their predetermined outcome. That's my opinion, although like I said I agree with the result.

Those are all matters involving little people without money. Of course they get screwed over; they cannot buy politicians.

 

[rbmrtn]

but this time the Supreme Court searched high and wide to find to find a way to interpret the law the way they wanted to fit their predetermined outcome.

I don't think they had to search much at all. In a thread earlier this year, I posted why I thought the plaintiffs case was weak and had no standing.

http://www.early-retirement.org/for...orrow-on-aca-subsidy-76235-4.html#post1565586

Roberts agreed with me and quoted the same parts in his opinion ( from pg 10 of the opinion )

By using the phrase “such Exchange,” Section 18041
instructs the Secretary to establish and operate the same
Exchange that the State was directed to establish under
Section 18031. See Black’s Law Dictionary 1661 (10th ed.
2014) (defining “such” as “That or those; having just been
mentioned”). In other words, State Exchanges and Federal
Exchanges are equivalent—they must meet the same
requirements, perform the same functions, and serve the
same purposes. Although State and Federal Exchanges
are established by different sovereigns, Sections 18031
and 18041 do not suggest that they differ in any meaningful
way. A Federal Exchange therefore counts as “an
Exchange” under Section 36B.

 

[pb4uski]

I think you can still qualify if your employer coverage isn't "affordable" (exceeds 9.5% of agi) and you are under the 400% fpl

True, but this drives me crazy. DS was working for a temp agency that did not offer health insurance so he had a HDHI ACA policy that he paid ~$35/month after a $115/month subsidy based on his income.

The company he was doing work for offered to put him on payroll (actually pretty much insisted). Their plan, which is somewhat better than the HDHI ACA plan DS has, is $35/WEEK and is still "affordable" so he'll no longer qualify for the ACA plan and loses the $115/month subsidy.

It seems odd that ACA pushes employed people with the same income into very different health insurance cost situations simply based on whether or not the employer offers health insurance.

So while his risk of getting laid off is lower since the company lays off temp people first when work slows down, he is paying more for health insurance (albeit a better plan but he gets little benefit from it since he is healthy).

 

[travelover]

Are they still all there? I thought some got voted out.

I believe that people that have been voted out are no longer executed on departure. Therefore, they would be available to testify in a court room.

 

[brewer12345]

I believe that people that have been voted out are no longer executed on departure. Therefore, they would be available to testify in a court room.

A damn shame. Although I would happily agree to a mandatory jail sentence in a Pound Me In The Umm... Federal Penitentiary that ran concurrent with time in office for Congress, the Supreme Court and the President down through the cabinet.

 

[NW-Bound]

Calling all 435 of them before the court? It takes a while, and they will be fighting this all over again.

And I doubt if any of them in Congress, whether they voted Yay or Nay, bothered to read the entire 2,400 pages of the act. Better to ask their aides who actually worked on this on their laptops. Or maybe the interns?

 

[travelover]

Calling all 435 of them before the court? It takes a while, and they will be fighting this all over again.

And I doubt if any of them in Congress, whether they voted Yay or Nay, bothered to read the entire 2,400 pages of the act. Better to ask their aides who actually worked on this on their laptops. Or maybe the interns?

Good point. I think that is why lobbyists do the actual writing of most bills these days.

 

[Big_Hitter]

"When the Affordable Care Act was conceived and drafted, did its creators mean to withhold health care subsidies from people living in states that refused to set up their own exchanges?"
__________________


Here’s what Obamacare’s authors said they actually meant - The Washington Post

 

[MichaelB]

Here’s what Obamacare’s authors said they actually meant - The Washington Post

How about a snippet or short summary for the link...

 

[Big_Hitter]

How about a snippet or short summary for the link...

sorry - I edited the post above - the article is somewhat long

 

[utrecht]

Basically it says that the authors worded it that way to incentivize states to set up their own exchanges but didnt want low income people excluded from getting a subsidy. If you think about it that makes no sense. The authors were basically bluffing. They said to the states..."If you dont set up an exchange, your low income people wont get a subsidy....but we dont want any low income people excluded for getting a subsidy". Bluffing doesnt work if you aren't willing to be called on your bluff which is what happened.

 

[MichaelB]

sorry - I edited the post above - the article is somewhat long

Thanks.

It's a good thing there's no longer any need to continue trying to determine or debate what was intended when the ACA was drafted and passed into law. The US Supreme Court did that for us and the matter has been settled. Now we can move on to other things.

 

[samclem]

Introducing age into insurance pricing was, and still is, a way to exclude individuals from groups and keep costs artificially low.

If age is considered during the underwriting and policies priced accordingly, then the pricing and the costs are in line with the risk, not artificially low. I suppose it is "artificially low" if the beginning assumption is that the "group" should be priced to include risks of the general population of potential members.

It's a strange setup as we have it now in the exchanges. We are shifting costs off the old to the young. We are shifting costs off women to men. We are shifting costs off low income people to higher income people. The only place where something close to rough underwriting is allowed is tobacco use. But underwriting is not allowed for many other voluntary decisions and behaviors that increase health costs.

I think Justice Roberts is very concerned that the Supreme Court be popular. I think he wants he and the court to be viewed as "above the fray." I wish his priorities were different.

 

[Texas Proud]

Thanks.

It's a good thing there's no longer any need to continue trying to determine or debate what was intended when the ACA was drafted and passed into law. The US Supreme Court did that for us and the matter has been settled. Now we can move on to other things.

Well, it settles at least that the ACA is current law.... but I doubt it settles if it will stay law... or what fixes will ever be made to fix the problems...

I do not want to side track this thread with a discussion on any merits either way... just saying, like abortion, having the SC make a decision does not always make a final decision on any matter....