Tag: ppaca

Washington Post: Democrats Are Abandoning Obamacare

From The Washington Post’s The Fix:

Moderate Democrats are quitting on Obamacare

By Scott Clement, Published: July 23 at 9:00 am

The landmark health-reform law passed in 2010 has never been very popular and always highly partisan, but a new Washington Post-ABC News poll finds that a group of once loyal Democrats has been steadily turning against Obamacare: Democrats who are ideologically moderate  or conservative.

Just after the law was passed in 2010, fully 74 percent of moderate and conservative Democrats supported the federal law making changes to the health-care system. But just 46 percent express support in the new poll, down 11 points in the past year. Liberal Democrats, by contrast, have continued to support the law at very high levels – 78 percent in the latest survey. Among the public at large, 42 percent support and 49 percent oppose the law, retreating from an even split at 47 percent apiece last July.

2013-07-22 hcare among Democrats

The shift among the Democratic party’s large swath in the ideological middle– most Democrats in this poll, 57 percent, identify as moderate or conservative – is driving an overall drop in party support for the legislation: Just 58 percent of Democrats now support the law, down from 68 percent last year and the lowest since the law was enacted in 2010. This broader drop mirrors tracking surveys by the non-partisan Kaiser Family Foundation and Fox News polls, both of which found Democratic support falling earlier this year.

Read the whole thing.

This news comes on the heels of a significant fissure among House Democrats over Obamacare.

It also deflates an already weak talking point Obamacare supporters have used to pooh-pooh the law’s persistent unpopularity. As Henry Aaron of the Brookings Institution once put it:

Of [the] 51 percent [who oppose the law], somewhere between a quarter and a third oppose the bill not because they are against it, but because they don’t think it went far enough.

They can’t use that excuse here. If Democratic support for Obamacare fell because more Democrats suddenly wish the law went farther, that drop would occur first and primarily among left-wing Democrats, not moderates and conservatives. It’s hard to come up with a story that explains why that dynamic would cause a drop in support only among moderates and conservatives. 

(HT: Veronique de Rugy.)

Aside From That, Mrs. Lincoln, How’s ObamaCare Implementation Going?

The Washington Post has published a remarkable exposé on the Obama administration’s foundering efforts to implement ObamaCare.

The article paints a picture of a White House that did not know what it was getting into, either in terms of public opposition or the technical challenges of implementation. It likens the task of getting young adults to buy ObamaCare’s health plans to getting young adults to vote, despite a glaring difference between those challenges. (Hint: one of them requires young adults to shell out hundreds of dollars per month.) But this exposé is most remarkable for not exposing two lawsuits that by far pose the greatest challenge to ObamaCare’s survival.

One indication that implementation is not going well is what the Post quotes ObamaCare’s supporters as saying:

“In 2011, there was this ‘we’re going to save the world’ mentality. In 2013, it focuses more on how do we deliver on the requirements of the law.”

“It’s pretty much a black box.”

“They tell us, ‘It’s freakishly on schedule.’ They use those exact words. But only the people who work in this can tell you if it’s actually running on time.”

“Advocates on the ground are really struggling with that group. They want to have a positive message but don’t know what to say.”

“We’re in an environment [now] where 40 percent are against it, 35 percent are for it and neither side knows what’s actually in it.”

“How hard does the insurance department or Medicaid department in a red state [that opposes the law] make it to implement this?”

“Everybody is having sleepless nights given the magnitude of the effort and the short amount of time.”

“It’s like building a bridge from both ends and hoping, in the end, they connect.”

“I read [the delay of the employer-mandate] as an admission that not all of the components of the [data] hub are working.”

“Some of the guidance from the federal government is still coming. That means we can’t get to our wishlist.”

As bad as these evaluations are, things are actually quite a bit worse.

For one thing, the HuffingtonPost/Pollster.com polling aggregator currently shows that 52.5 percent of Americans are against ObamaCare, compared to 40.5 percent are for it. That’s a 12-point gap, not a five-point gap. It’s also the largest gap that aggregator has ever measured.

For another, the Washington Post acknowledges that if young adults don’t sign up for ObamaCare’s over-priced insurance “the law will fail,” and acknowledges the difficulty of getting young adults to over-pay for insurance. But it still downplays that challenge:

When…asked in a recent survey whether a $210 premium was affordable, only 29 percent of likely marketplace enrollees said yes. [Marketers then told] participants that, with their tax credits, they would save “$1,908 a year compared to what you would pay on your own.”

All of a sudden, 48 percent of the participants thought that insurance was affordable. But 48 percent is still less than half.

That number will turn out to be even lower when young adults realize they’re still shelling out that $210 they already said they cannot afford.

But the Post neglects to mention the greatest threat to the law’s survival: those tax credits may not even be there in two-thirds of the country.

The attorney general of Oklahoma, and a group of small employers and individuals from various states, have each filed lawsuits challenging the Obama administration’s plans to issue those tax credits in the 34 states that have opted not to establish one of ObamaCare’s health insurance “exchanges” themselves. The statute quite clearly authorizes those credits (and related subsidies) only “through an Exchange established by the State.” Nowhere, and in no way, does federal law allow the administration to issue entitlements through the 34 state-based Exchanges established and operated by the federal government. Yet the White House is trying to spend an estimated $700 billion over 10 years in those states without congressional authorization.

Both the non-partisan Congressional Research Service and Harvard Law Review have acknowledged these lawsuits are credible. Plaintiffs in one of the suits have asked the court to block that illegal spending before it begins in 2014. Supporters of the law admit that if that happens, ObamaCare doesn’t just fail, it collapses.

So the question this supposed exposé really answers is: aside from that, Mrs. Lincoln, how’s ObamaCare implementation going?

Obama to Congress: Only I Can Amend ObamaCare

Today the House of Representatives will vote on two bills. One would codify President Obama’s unlawful one-year repeal of the employer mandate and the related reporting requirements. The second would do the same for the individual mandate, effectively delaying its start date until 2015 as well.

I was initially skeptical that these votes would do much to build support for reopening, delaying, or repealing ObamaCare. I wrote last week that they seemed designed mainly to help partisan Republicans build their House majority by “embarrass[ing] House Democrats by forcing them either to support relief for employers but not families or to break ranks with their president on Obamacare.” Two things have changed my mind.

First, if these bills were to pass, it appears the insurance industry would join the coalition demanding that Congress delay ObamaCare. The industry appears very afraid of delaying the individual mandate. An item in today’s Politico Pulse titled, “Would Mandate Delay Mess With Exchanges?” explains:

[A]n insurance industry official makes the case that delay of the individual mandate…would also mean delay of exchanges since all of the 2014 premiums were filed assuming the mandate would be in place. “If the mandate is delayed, the rates will need to be modified to reflect the likely impact on the risk pool,” the official said. “There is not enough time for plans to re-configure their bids, submit them to regulators for approval, and have those new bids reviewed and approved by the time open enrollment begins on October 1.”

Second, these votes have forced President Obama into an untenable position. Yesterday, he threatened to veto both bills. Think about that. President Obama has threatened to veto a bill that would codify his own policy of repealing the employer mandate for one year. He supports rewriting federal law – but only if he does it. Not if Congress does it.

I’d wager lots of congressional Democrats are pretty angry at President Obama today.

The individual mandate is ObamaCare’s least popular provision. Just 34 percent of Americans support it. Only 12 percent support letting it take effect while employers get a pass. When he unilaterally delayed the employer mandate, President Obama put House Democrats, and potentially Senate Democrats, in the position of having to cast their most unpopular pro-ObamaCare vote, ever. The attack ads practically write themselves. ”Congressman X voted against giving families the same breaks as big business.

On top of that, Obama’s threat to veto the bill codifying the employer-mandate delay marginalizes all of Congress, Democrats included. It also puts Democrats in an impossible situation. If Democrats vote against the president on the employer mandate – by voting for the bill codifying his policy (are you confused yet?) – then they are breaking ranks with their party’s leader. If they vote with the president – by voting against the bill codifying the president’s policy – they would be participating in their own marginalization.

All told, these votes appear to maximize the likelihood of exposing fissures among ObamaCare supporters. Maybe they will do more to wear down the opposition to reopening ObamaCare than I thought.

UPDATE: This post originally claimed that only 17 percent of Americans support the individual mandate. The actual figure in the poll cited was 34 percent, split evenly between “very favorable” and “somewhat favorable.” I regret the error, and thank Robert Dible for catching it.

Fourth Circuit’s Liberty Ruling Deals a Hidden Blow to Obamacare

Obamacare had a rough day in court yesterday. In Liberty University v. Lew, the Court of Appeals for the Fourth Circuit ruled against Liberty University’s challenge to various aspects of the law. One might think, as SCOTUSblog reported, this was a victory for the Obama administration. 

In the process, however, the Fourth Circuit undercut three arguments the administration hopes will derail two lawsuits that pose an even greater threat to Obamacare’s survival, Pruitt v. Sebelius and Halbig v. Sebelius

The plaintiffs in both Pruitt and Halbig claim, correctly, that Obamacare forbids the administration to issue the law’s “premium assistance tax credits” in the 34 states that have refused to establish a health insurance “exchange.” The Pruitt and Halbig plaintiffs further claim that the administration’s plans to issue those tax credits in those 34 states anyway, contrary to the statute, injures them in a number of ways. One of those injuries is that the illegal tax credits would subject the employer-plaintiffs to penalties under Obamacare’s employer mandate, from which they should be exempt. (The event that triggers penalties against an employer is when one of its workers receives a tax credit. If there are no tax credits, there can be no penalties. Therefore, under the statute, when those 34 states opted not to establish exchanges, they effectively exempted their employers from those penalties.)

The Obama administration has moved to dismiss Pruitt and Halbig on a number of grounds. First, it argues that those penalties are a tax, and the Anti-Injunction Act (AIA) prevents taxpayers from challenging the imposition of a tax before it is assessed. Second, the administration argues that the injuries claimed by the employer-plaintiffs are too speculative to establish standing. Third, shortly after announcing it would effectively repeal the employer penalties until 2015, the administration wrote the Liberty, Pruitt, and Halbig courts to argue that the delay should (at the very least) delay the courts’ consideration of those cases. In Liberty, the Fourth Circuit rejected all of those claims.

In discussing whether the “assessible payment” that the employer mandate imposes on non-compliant employers falls under the AIA, the court writes:

You’ve Come a Long Way, Baby: Barack Obama on Health Care Fraud

Last week, President Obama approved a one-year, unilateral (and thus illegalrepeal of ObamaCare’s requirements that the federal government verify the incomes and insurance options of people applying for the law’s new subsidies—a move that eviscerated the law’s anti-fraud protections. Rescinding anti-fraud protections is nothing new (or defensible). There is a very powerful fraud lobby in Washington, D.C. Normally, such steps just mean an increase in fraudulent and improper payments from the federal treasury, and a few more ignored reports from the Government Accountability Office and HHS Inspector General. Obama’s move, however, is so sweeping that he effectively expanded the eligibility criteria for ObamaCare’s new entitlements without so much as consulting Congress. Indeed, the law Obama is implementing did not and could not have passed Congress.

Barack Obama wasn’t always part of the health-care fraud lobby. Oh, no: time was, he railed against health care fraud. When he pleaded for his health care plan before a joint session of Congress in 2009, he promised that with his plan:

We will root out the waste and fraud and abuse in our Medicare program that doesn’t make our seniors any healthier…I’ve appointed a proven and aggressive inspector general to ferret out any and all cases of waste and fraud.

Any and all cases! So inspiring. And in his final push for ObamaCare’s passage, he promised the law would reduce fraud and improper payments. Here are excerpts from a strident speech he gave in Missouri on March 10, 2010:

I believe that in everything government does, we’ve got a special responsibility to be wise stewards about how Americans’ hard-earned tax dollars are spent. And I know you agree with that, too. Doesn’t matter whether you’re a Democrat or a Republican, you don’t like seeing your money wasted — or an independent, don’t like seeing your money wasted.

That’s a responsibility my administration is seeking to fulfill every single day…

Washington is a place where tax dollars are often treated like Monopoly money — they’re bartered and traded, and they’re divvied up among lobbyists and special interests, and where waste — even billions of dollars of waste — is accepted as the price of doing business…

The health care system has billions of dollars that should go to patient care and they’re lost each and every year to fraud, to abuse, to massive subsidies that line the pockets of the insurance industry.

Let me just give you one example — this is a long recognized but long tolerated problem called “improper payments.” That’s what they call them. Washington always has a name for these things. “Improper payments.” And as is often the case in Washington, the more innocuous the name, the more worried you should be. So these are payments mostly made through Medicare and Medicaid that are sent to the wrong person, sent for the wrong reason, sent in the wrong amount. Sometimes they’re innocent errors. Sometimes they’re because nobody is bothering to check to see where the money is going and they’re abused by scam artists and fly-by-night operations…

If we created a “Department of Improper Payments” it would be one of the largest agencies in our government…

Now, for the past few years, there has actually been a pilot program that uses a system of tough audits to recover some of this lost money. And even though these audits, they were just operating mainly in three states, they already found a billion dollars in improper payments. So these results were both disturbing and encouraging. They’re disturbing because it shows you how much waste there is out there in the health care system. But it’s encouraging because we can do something about it.

So earlier today, with [U.S. Sen.] Claire [McCaskill, D-Mo.] looking over my shoulder — one of our auditors-in-chief — I signed an order calling on all federal agencies to launch these kinds of audits all across the country. All across the country. (Applause.) So agencies would hire auditors to scour the books, go through things line by line. Auditors are paid based on how many abuses or errors they uncover. So it’s a win-win. The auditor, if they do a good job they get a small percentage as a reward. And the taxpayer wins by getting huge sums of money that would otherwise be lost that we can then spend to provide care to people who really need it, or we can use to reduce the deficit.

Now, through this effort, we expect to more than double the amounts we would’ve otherwise recovered — a couple of billion dollars over the next few years. And I’m announcing my support for the Improper Payments Elimination and Recovery Act — that’s a mouthful — but this is a bipartisan bill — (applause) — is a bipartisan bill to expand our ability to do these audits, so we can prevent even more fraud and abuse and waste.

Now, the reason I’m bringing all this stuff up is because there’s been a lot of talk about health care lately. And look, I’ll be honest, a lot of people, they’re confused, they’re saying, well, how can you help people get insurance who don’t have it without it adding to our deficit? It’s a legitimate question.

Well, the reason is, is because so much of the money currently in our health care system is being misspent.

Barack Obama used to oppose health care fraud—up until the moment that opposing fraud conflicted with his goal of preserving ObamaCare.

And why not? It’s just other people’s money.

Obama Administration Tries to Use Its Illegal Delay of the Employer Mandate to Block Legal Challenges

Within hours of announcing its illegal decision to delay the employer mandate, the Obama administration on July 3 asked a federal court to block a legal challenge to the mandate, Liberty University v. Geithner, based on that delay. Today, the administration filed similar requests in Pruitt v. Sebelius and Halbig v. SebeliusThese actions confirm speculation that blocking these lawsuits—and especially Pruitt and Halbig—may have been the whole purpose of the delay.

I don’t have links yet, but the administration’s argument is weak and would not appear to impede any of the three cases. I hope to have more to say about this development soon. 

Yes, Delaying Obamacare’s Employer Mandate Is Illegal

Last week, when most Americans were starting their Fourth of July holiday, the Obama administration announced it will wait until 2015 to implement Obamacare’s penalties against employers who fail to offer “affordable” and “minimum value” coverage to their workers, rather than impose this “employer mandate” in 2014, as the statute requires. The administration’s stated rationale is that, despite nearly four years of lead time, it still won’t have the capacity to collect from employers the information required to determine which employers will be subject to penalties in 2014. As a result, the administration also announced it would not require employers to report that information until 2015, though (again) the statute requires employers to furnish that information in 2014.

Nicholas Bagley, a professor of law at the University of Michigan, suggests that maybe there is a legal rationale for the Obama administration’s delaying these provisions. So let’s take each provision in turn.

1) Has Congress given Treasury the authority to waive the penalties? The answer is no. The employer-mandate penalties unequivocally take effect on January 1, 2014, and the PPACA gives the Treasury secretary no authority to postpone their imposition.

Every element of the employer mandate demonstrates that it takes effect in 2014.

  • If any worker at a firm with more than 50 full-time-equivalent employees receives a tax credit through a health insurance “exchange,” then “there is hereby imposed on the employer an assessable payment.” Those tax credits become available on January 1, 2014. Thus that is also the date on which the penalties take effect.
  • The statute specifies penalty amounts that apply specifically in 2014, and provides that those penalties shall be adjusted for inflation in years after 2014.
  • The section creating the employer mandate even contains an effective date: “The amendments made by this section shall apply to months beginning after December 31, 2013.”

The statute gives the Treasury secretary the authority to collect these penalties “on an annual, monthly, or other periodic basis as the Secretary may prescribe.” It does not allow the secretary to waive the imposition of such penalties, except in one circumstance: Section 1332 authorizes the Treasury secretary to waive the employer mandate, but only as part of a state-specific waiver, and only if the state enacts a law that would provide equally comprehensive health insurance to as many residents, and only if that law would impose no additional cost to the federal government, and only if there is a “meaningful level of public input” over the waiver and its approval, and even then not until 2017. In other words, Congress spoke to the question of whether and when the executive should be able to waive the employer mandate, and Congress clearly did not want the administration to waive it unless certain specified conditions were met.

Nevertheless, Treasury claims it has the authority to waive those penalties without following Congress’ instructions: “[T]he employer shared responsibility payments…will not apply for 2014. Any employer shared responsibility payments will not apply until 2015.”

2) Has Congress given Treasury the authority to waive the reporting requirement? Again, the answer is no.

The PPACA added two sections to the Internal Revenue Code (sections 6055 & 6056) that require employers to report certain information on their health benefits and the workers who enroll in that coverage, in order to help the IRS determine whether those workers are eligible for tax credits and whether the employer is subject to penalties. Again, the statute is clear: those reporting requirements take effect in “calendar years beginning after 2013” and “periods beginning after December 31, 2013.” The statute contains no language authorizing Treasury to waive those requirements.

Bagley argues the statute does contain language that might enable Treasury to delay the imposition of these reporting requirements. Sections 6055 & 6056 state that employers must furnish this information “at such time as the Secretary may prescribe.” He writes, “Delaying the reporting requirements until 2015 is arguably just a specification of the ‘time’ at which the reports must be submitted.”

This theory reflects a misunderstanding of what an effective date is. When Congress imposes an obligation on some party, that obligation becomes effective on the effective date. The secretary’s discretion to prescribe the time at which the affected party must discharge that obligation neither affects the existence of the obligation, nor empowers the secretary to repeal it.

One might argue that Treasury has the authority to say employers need not report the required information regarding their 2014 health benefits offerings until, say, the next year, when they report the same information for their 2015 offerings. Yet that is not what Treasury is doing. Treasury claims it can altogether eliminate the obligation to report the 2014 information: “The Administration…will provide an additional year before the ACA mandatory employer and insurer reporting requirements begin.”

Moreover, if the language Bagley cites were interpreted to permit Treasury to waive the mandate and reporting requirements for 2014, is there any reason why that interpretation would not empower Treasury waive those provisions indefinitely? Could the secretary determine employers need discharge these obligations every 1,000 years? If not, why not?

Finally, Bagley concludes no one would have standing to challenge these actions in court. Thus even if the administration’s actions are illegal, he writes, “So what?”

Let’s assume for the moment that Bagley is correct on the standing issue. Here’s “what.” The law is a mutual compact between the government and the people. The more the government acts as though it is not bound by that the law, the more widespread will be the belief among the people that they are not bound by the law, either. That would be a very bad situation. There are already enough people out there who believe the government is not bound by the law that President Obama feels it is worth his time to counsel Americans to “reject these voices” – even as his actions lend credence to them, and further diminish respect for the law. That’s a “what” that I figured law professors understood.