“We are about to witness, for the first time, the power of a fully operational Affordable Care Act (ACA).
The American Rescue Plan made 3.7 million more people eligible for the ACA’s premium subsidies. The Biden administration had already opened up enrollment after taking office, and 200,000 Americans signed up in the first two weeks. Now the administration is extending enrollment until August 15, backed by millions of dollars in advertising.
Insurers are expanding into new markets, and some who abandoned it long ago in the law’s fraught early years are now reentering. The individual mandate is gone, but, as it turns out, it may not be as important to the law’s long-term viability as originally thought. The law had been weakened since its passage by the Supreme Court and Republican opposition. So this is a new beginning of sorts.
“The ACA is right now much closer to what its advocates hoped it would be from the start,” Larry Levitt, executive vice president at the Kaiser Family Foundation (KFF), told me. “This is a true test of how effective a juiced-up ACA can be at getting us closer to universal coverage.
Taken together, come Labor Day, the country should have the clearest idea yet of how the ACA functions at full strength — and where holes in the US health system remain.”
Optimistic View: What Trump will do. Lone Candle. 11 11 2016. https://www.youtube.com/watch?v=ttw8tSXNesk&feature=youtu.be The biggest problem with Donald Trump as president Lone Candle. 7 22 2016. https://www.youtube.com/watch?v=PexQGJj3C8w&feature=youtu.be More pain than gain: How the US-China trade war hurt America Ryan Hass and Abraham Denmark.
“The US Supreme Court issued its ruling in Little Sisters v. Pennsylvania Wednesday, holding the Affordable Care Act gives the Trump administration broad authority to grant exceptions to a federal regulation requiring employers to provide birth control coverage to their employees.
On the surface, Justice Clarence Thomas’s majority opinion appears to be focused exclusively on birth control, and it also endorses a policy that could cease to exist in less than a year.
The immediate upshot of Little Sisters is to let stand Trump administration rules allowing employers opposed to birth control to refuse to provide contraceptive coverage to their employees. If presumptive Democratic nominee Joe Biden becomes president next year, however, his administration could repeal the Trump administration’s policy and implement a new policy more favorable to contraception coverage.
But dig just one inch below the surface of Justice Thomas’s opinion, and it has deeply radical implications: Little Sisters opens up a new front in the seemingly endless judicial war on Obamacare. And it gives Republicans a new weapon it can use to attack the landmark legislation President Obama signed more than a decade ago.
Thomas’s opinion does not simply allow the Trump administration to limit many individuals’ access to birth control, it could also allow courts to dismantle a key provision of Obamacare that ensures patients receive preventive care without having to pay out-of-pocket costs.”
“At the end of 2019, Congress repealed three significant tax components of the Affordable Care Act, a.k.a. Obamacare. Each of them had been included in the initial legislation to raise the revenue required to pay for the new spending the law called for.”
“What’s the problem with the repeal of a bunch of taxes no one ever really liked? That’s probably what the lawmakers who voted to end the taxes were thinking too. The main effect will be to increase the deficit by a little more than $373 billion over the next decade—and, in the process, to further weaken a central argument made by supporters of the legislation.
Obamacare was passed on a promise that it would be deficit-neutral or even reduce the deficit slightly. The Congressional Budget Office estimated that the law would reduce the deficit during its first decade, provided that all of its provisions were enacted as the statute called for. As The New York Times noted last summer, the Cadillac tax “was expected to be a key cost-containment provision in President Barack Obama’s signature health law and one of the main ways it was supposed to pay for itself.”
There are obvious lessons here about what we might expect from various plans to “pay for” Medicare for All now being touted by various Democratic presidential hopefuls. If nothing else, this episode is a reminder of how Washington works: First, Congress passes a law setting up an expensive new program along with (if we’re lucky) a system to pay for it. Years later, amid a bipartisan spending binge, those taxes are repealed while the rest of the program remains on the books. The public barely notices, and the lawmakers involved shrug and move on.”