Discussion for article #225546
Yes, a LITTLE weird, but it was never a secret that the plan was to have the states do the exchanges. The Fed exchange was only there as a back-up as Gruber says. So yes, not granting tax credits to folks who sign up with the Fed is a way–sort of–of squeezing the states to do it. But a very ineffective way.
For one, the assumption was never that the states would simply refuse to set up an exchange in order to sink the law, even at the risk of screwing their people out of a tax credit and, more importantly, coverage. If state leaders don’t care, then they are unlikely to feel this pressure.
And the average person is so out of it that he’s unlikely to know or care that folks in a neighboring state are getting a tax credit he’s not getting–and thus put pressure on his state to get with the program. His biggest concern is getting insured at a reasonable price. And it would be cruel for the Feds to withhold coverage because a state refused to set up an exchange for political reasons. And the whole thing doesn’t work for a lot of people UNLESS they get a tax credit.
Okay, another misleading take on this. Sure, Gruber brings up the issue of tax subsidies, but the point he was making is that it puts pressure on states to make the tax credits available to their citizens. It you want to take this as an endorsement of the recent SCOTUS decisions, then you enjoy stretching your arguments whisper thin. That kind of distortion is best left to the fascists on the right.
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The whole PP&ACA appears to be “just a typo”.
Basically Congress was attempting to force the States into running the exchanges, buying them off with tax credits. Tax credits are also unavailable to territories like Puerto Rico and States that did not have their exchange operating by a certain date. They tried the same thing with the expansion of Medicare by denying any Medicare funds to States that did not expand.
Congress was using the citizens of the States, knowing full well that the subsidies will decrease over time and the States will be left holding the expense.
“I hope that that’s a blatant enough political reality…”
In these times, the laws of political reality have been revoked. So what would normally work–say, pressure from the center–no longer works. Bagger Nation simply doesn’t care.
No. The STATES are using their citizens and screwing them.
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If I understand correctly, tax credits are basically an expansion of Medicare for low income people (non-Medicare eligible). And the federal tax credits are reduced over the next several years, leaving the States to foot the bill.
The interesting thing is that lower income people are paying the same that they would have paid under the previous health insurance schemes, even more if they had just purchased catastrophic insurance and paid for basic doctor visits.
“Congress was using the citizens of the States…”
If by “using” you mean encouraging people to have, or have better, insurance in order to decrease, or at least limit the increase of, health care costs, I’m in complete agreement.
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No. The federal government are using the citizens and screwing them.
It was very easy to write in that the federal exchanges could offer tax credits however Congress (i.e. the Senate) did not allow credits for territories, States that did not start exchanges by a certain date, nor the federal exchanges.
This is what happens when Congress tries to pull a “fast one” over the citizens. We all remember Speaker Pelosi saying, paraphrased, “we have to pass the bill to see what’s in it”.
Using the people to force their States to accept the additional burden of the tax credits which will force tax increases in the States to cover the credits as the federal government reduces them.
The only reason for an increase in participation in healthcare insurance is the individual mandate, without which the same people would not have purchased healthcare insurance. The mandate alone would have increased participation in the previous method without the increase in healthcare insurance pricing.
BTW: Those not eligible for Medicare pay the same under the ACA as they would have paid prior to the ACA while those not eligible for credits have seen a dramatic increase in healthcare costs. There has also been an increase in basic living costs because of the increase in healthcare costs for the employees involved in the production, transportation, and distribution of necessities.
“CBO estimates show that the federal government will bear nearly 93 percent of the costs of the Medicaid expansion over its first nine years (2014-2022). The federal government will pick up 100 percent of the cost of covering people made newly eligible for Medicaid for the first three years (2014-2016) and no less than 90 percent on a permanent basis.” (Emphasis added.)
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For some reason, that didn’t post the link. Here.
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Where do you see that the Federal Government will reduce subsidies for insurance purchased through the exchanges? There’s a reduction over time in the federal money for expanding Medicaid, but we’re talking about 90% Federal coverage by 2020.
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Imposing a mandate under “the previous method” would have been a complete travesty because there would still have been lifetime limits on coverage and exclusions based on pre-existing conditions. People would have had to buy insurance that didn’t cover ongoing conditions. The ACA changed “the previous method” to do away with lifetime limits and pre-existing conditions–and thank goodness for that.
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What dramatic increase in healthcare costs? You mean like from 2000-2005, when annual premium increases never averaged below 8%?
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You don’t understand correctly. The Medicaid (not Medicare) expansion is a separate issue, bringing in working poor whose incomes are somewhat higher than the original maximum eligibility level. The Federal contribution for that does decline over time, from 100% all the way down to 90%. The subsidies, which are the item at issue here, are for working people who make too much to qualify for even the expanded Medicaid, up to 400% of the poverty level (ie, hitting the middle class); they’re Federally funded, at a level determined by income, and are a permanent, integral part of the law. And no, most people are definitely not paying more; most are paying a fair amount less for better coverage.
Unfortunately, that’s precisely the argument the fkers who brought the case are making. Gruber’s great, but he does get flip now and then; but everything in the Congressional record re this legislation, and even within it, makes clear that this wasn’t Congress’ intent. Sheesh, without the subsidies the market falls apart, which Congress obviously wouldn’t have intended. But that’s precisely the intent of the fkers who brought the case. Soulless fkers.
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The subsidies don’t decrease over time; and it’s Medicaid, not Medicare.
Your mastery of misleading, inaccurate and out-of-context right-wing talking points is a marvel.
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As I remember at that time, lots of ideas were being thrown against the wall to solve successive problems in getting the Congress to a majority. It’s not surprising seeing various ideas that were floated at the time, or entertained as legislation formed. But it is obvious that the structure of the PPACA requires virtually universal access to program subsidies.