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This just in…

Thursday, Jun 28, 2012

* 9:37 am - As you’re probably seeing around the Web, the US Supreme Court has upheld most of the “Obamacare” law. From the SCOTUS Blog

In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional.

There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters.

Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding.

The full opinion is here. [Fixed link.]

* 10:33 am - State react is coming in. Sen. Bill Brady…

State Senator Bill Brady issued the following statement following the U.S. Supreme Court’s decision to uphold key provisions of the federal Affordable Health Care Act, commonly referred to as “Obamacare”:

“Unfortunately, the court’s ruling will have tragic consequences that will spread well beyond the issue of mandatory insurance and health care services. It will drive up health care costs and put yet another financial burden on our already struggling small businesses. We in Illinois will be exploring avenues available for implementing this sweeping law and still providing the greatest options and lowest cost for our families and businesses.”

Brady (R., Bloomington) co-chaired a legislative study committee on the formation of a state health insurance exchange as part of Illinois’ implementation of the law.

* 10:39 am - Cook County Board President Toni Preckwinkle…

“I applaud today’s decision by the United States Supreme Court upholding the Affordable Care Act.

“In accordance with this historic ruling, the Cook County Health and Hospitals System will continue to seek a 1115 Medicaid Waiver from the work Centers for Medicare and Medicaid Services. This waiver, if approved by the federal government, would permit CCHHS to receive federal reimbursement for the costs of treatment provided to the tens of thousands of our patients who currently have no medical coverage but will gain access to Medicaid on January 1, 2014.

“CCHHS is the foundation of the safety-net health network in northeastern Illinois. Today’s decision by the Supreme Court will allow our system to proactively prepare for Affordable Care Act implementation in 2014.”

* Illinois Hospital Association…

The Illinois Hospital Association (IHA) applauds the United States Supreme Court decision to uphold the Affordable Care Act. Illinois hospitals have long supported the expansion of coverage for the uninsured and reforms to eliminate exclusions for pre-existing conditions and coverage caps to improve the health and well-being of Illinoisans.

Strong communities start with healthy communities. Because of this legislation, people in Illinois will no longer have a diminished quality of life, be at risk of dying merely because they lack health insurance, or be forced into bankruptcy because of a devastating diagnosis.

While many organizations have been waiting for this ruling to act on health care reform initiatives, Illinois hospitals already have been working to transform health care by being more accountable and transparent. Through the IHA Quality Care Institute, Illinois hospitals are implementing quality improvement programs, improving patient safety and infection control, and reducing unnecessary utilization and readmissions. The goal is to create new and efficient models of health care delivery to improve outcomes and lower costs.

In partnership with Governor Quinn and the General Assembly, IHA will continue to help guide Illinois hospitals through the intricacies of health care reform including the implementation of the Illinois Health Insurance Exchange. With the health care reform law upheld, we urge the General Assembly to pass legislation authorizing and establishing the insurance exchange.

* Congressman Quigley…

“I applaud the Supreme Court’s decision to uphold health care reform and protect millions of our most vulnerable Americans. Now it’s time to put labels and political rhetoric aside and remember what this is about. An insurance company can no longer deny coverage to the 17 million children with a preexisting condition. Seniors no longer have to choose between paying the rent or buying their prescriptions. And college students will no longer lose their insurance on graduation day. It is our responsibility to provide access to affordable health care to Americans, and today’s victory should bring peace of mind to families across our country.”

* Campaign for Better Health Care…

“Today’s Supreme Court decision helps to strengthen our nation’s tattered social fabric and provides hope that constitutional law and democracy matters,” commented Jim Duffett, Executive Director of the Campaign for Better Health Care.

Duffett continues, “It is time for the obstructionists in the Republican Party in Congress and in Springfield, and a handful of insurance industry backed Democrats in Springfield to stop their crusade against Obamacare. It is time to put America and Illinois first, act like adults, and do something positive for a change that will help small businesses and hard working Americans by implementing Obamacare. Meanwhile, we are urging Governor Quinn to immediately sign an Executive Order and begin implementing the new insurance Marketplace (exchange) so Illinois’ hard working families and small businesses will continue to enjoy the benefits of access to affordable, quality health care.”

Duffett concludes, “Thank you Obamacare and thank you President Obama for keeping your word and delivering for the American people. The United States can now join the rest of the sane western industrial world that provides affordable, accessible and quality health care to its people.”

* 10th CD Democratic nominee Brad Schneider…

“Today’s decision affirmed that all Americans should and will have access to quality and affordable healthcare. After nearly two decades working with family-owned companies, I know we still need to improve the law, working to lower costs for small businesses and their employees. But we can’t afford to go backwards as some Tea Party Republicans in Washington are threatening to repeal the health care law and give insurance companies free reign to abuse consumers. In Congress, I will work to ensure that small businesses can receive tax credits for covering their employees, that young adults can stay on their parent’s health plan, and that denial of coverage for preexisting conditions is a thing of the past.”

* Congressman Schilling…

“Like many folks throughout Illinois’ 17th Congressional District I’m disappointed by today’s ruling, but the fact is that the President’s health care law will cost trillions of dollars while doing absolutely nothing to address the rising cost of health care,” Schilling said. “The opportunity remains for folks in Washington to come together in support of policies that address the rising cost of health care and put patients and their doctors back in charge of health care decisions, without this tax. I will continue working to roll back the harmful parts of this law so we can get health care reform done right. We can start over and in a transparent fashion work to enact bipartisan, step-by-step reforms that guarantee folks in Illinois and throughout the country are able to access health care that is affordable, convenient, and high quality.”

* 10:55 am - Illinois State Medical Society…

After months of uncertainty the U.S. Supreme Court has today affirmed the Affordable Care Act. It is good news that Illinoisans will have the responsibility and tools for obtaining health insurance coverage. It is also positive to note that important coverage provisions, such as the protection against denial for pre-existing conditions, remain in place. However, much work is needed before we can truly call our health system “reformed.”

Among the significant remaining challenges are:

    Medicare Payment Reform – Our Medicare program’s financial health edges closer to a cliff each day Congress fails to enact reform. Currently, physicians face an across-the-board reimbursement cut of about 30% on January 1, 2013. Without Medicare payment reform, our Medicare patients’ access to care is in peril.

    Medicaid Reform – We are still reviewing the section of the opinion that deals with Medicaid. The Affordable Care Act builds coverage through significant Medicaid expansion. This is not a sensible policy in states such as Illinois with struggling Medicaid programs. Patients already receiving care through Medicaid face hurdles that those with other forms of insurance do not. Illinois’ current Medicaid reimbursement levels rank behind 40 states when compared to the Medicare fee schedule. The ACA provides for a temporary and limited Medicaid reimbursement increase, but more must be done to fix this program.

    Medical Liability Reform – Despite a dire need for reform, Illinois courts have struck down strong medical liability protections here on more than one occasion. Federal reform is needed to help Illinois with our medical workforce recruiting. Currently, half of physicians who train here leave after residency. Two-thirds of those who depart cite our liability climate among their chief reasons for leaving. National physician supply projections suggest we will soon have an inadequate number of doctors to meet the needs of our patients. Illinois needs medical liability reform as a component of a comprehensive policy to address our medical workforce needs.

Until we address these issues, our journey toward a sensible and cost-effective health care system is far from over. ISMS has developed our Health Care Reform Principles to assist Congress in crossing the finish line with health reform. We urge them to roll up their sleeves and finish the job.

* Congressman Dold…

“While this ruling speaks to the constitutionality of the ACA, the real question is whether the 2010 law makes for good public policy,” said Congressman Dold. “The American people missed a golden opportunity with health care reform when Congress rushed it through on a partisan basis. I believe that properly confronting the big issues and challenges in this country requires input from both sides and bipartisan support. There are positive provisions in the ACA that should remain as law, but there is more we can do to increase quality and access to care, while reining in skyrocketing costs to the health care system. As health care reform continues to take shape, I am committed to working in a bipartisan way to find positive solutions to the rising costs of health care.”

* Where the states stand, via the AP


NUMBER OF UNINSURED: 1,914,000 state residents are uninsured, or about 15 percent.

WHERE THE STATE STANDS: Illinois has received three federal grants to study and start building its health insurance exchange, but the Legislature has failed to pass a law establishing it. Gov. Pat Quinn, a Democrat, has considered an executive order to do that, but now may pursue a federal-state partnership instead.

* 11:20 am - US Sen. Mark Kirk…

“While I respect the Court’s decision, the health care law threatens our economic recovery by raising taxes, imposing new regulations and creating a drag on the economy,” said Senator Kirk. “Congress should repeal the health care law and replace it with common sense, centrist reforms that give Americans the right to buy insurance across state lines and expand coverage without raising taxes, while blocking the government from coming between patients and their doctors.”

* 12th CD Republican candidate Jason Plummer…

“The Supreme Court’s decision today does not change the fact that Obamacare is an unworkable and unaffordable piece of legislation that is not right for the American people,” Plummer said. “The Court’s ruling that the individual mandate is unconstitutional and a tax goes against everything the President and his allies said as they were trying to pass the law, and puts an increased burden on working families.

“This bill must be repealed before it causes any more damage to the economy. Not only does it cut $500 billion from the Medicare program, but it also raises taxes on the middle class in the midst of a recession,” Plummer added. “Estimates from the Congressional Budget Office have even shown that the legislation could reduce employment by 800,000 workers.

“The American people need true healthcare reform, not government-run healthcare. Doctors and families need to be in charge of making healthcare decisions, not unelected bureaucrats. We need to continue the fight to repeal this law and then work together to pass true healthcare reform in a transparent manner than helps improve individuals’ coverage and gets costs under control for all Americans.” [Emphasis added.]

* 11:26 am - The NCSL has a great summary of the decision. Click here to see it.

* Sun-Times

Gov. Quinn is “thrilled” with the Supreme Court’s ruling upholding President Obama’s health care law, his aides said Thursday.

The governor is expected to hold a news conference this afternoon and provide further reaction.

* Congressman Roskam

“The Supreme Court’s ruling examined the Constitutionality of the health care law, but the Justices could not take into account the practicality or effectiveness of a government takeover of our health care system and one-sixth of our economy—on that score, the verdict was in long ago.

“The American people are disappointed in this law and fearful of its full effects because so far, the rhetoric does not match up to the reality. Remember when the president said, ‘If you like what you have, you can keep it?’ Some estimates say up to 30 percent of employers will definitely drop their employee health coverage, forcing many into state exchanges.

“Remember when we were promised the law would lower costs? Family premiums have already increased by 9 percent, with costs predicted to rise for years to come. And what of the promise that the law would bend the cost curve down? Recent studies show that government spending is expected to explode to half of all health care spending in the United States. One of the few promises that came true was when then Speaker Nancy Pelosi said, ‘We have to pass the law to find out what’s in it.’

“President Obama’s takeover not only made our health care system more complex and expensive, but stalled our already tepid economic recovery by creating tremendous uncertainty for job creators and small businesses.

“The House of Representatives is as committed as ever to full repeal of the disastrous health care law, and replacing it with common-sense, patient-centered solutions that families can afford. The American people deserve better than what President Obama’s health care law provides. We can do better and we will do better.”

* More from the Right

John Tillman, executive director of the Illinois Policy Institute, a right-leaning think tank, disagreed, saying the Affordable Care Act will strain the health-care system as the federal government struggles to come up with the money to pay for it. Tillman said the law as is will force “children with throat cancer or other serious conditions to compete with even more people for fewer and fewer doctors.” […]

“The Supreme Court’s decision to uphold ObamaCare – and specifically the individual mandate – was a severe blow to restoring Constitutional limits on federal power,” Tillman said. “Congress must repeal all of ObamaCare and replace it with reforms that put patients first.”

Even if the law survives additional attacks, Thursday’s ruling was only the start.

“It is impossible to enact the act as written,” Robert Slayton, president of the Illinois State Association of Health Underwriters, which lobbies on behalf of health insurers, said. Congress “will spend the next 10 years modifying the act to make it work the way it needs to work.”

* Excerpted from an SEIU Healthcare release…

Now that the court – in an opinion authored by its conservative Chief Justice – has given its seal of approval to this law, the time has come for Republicans to put the economic interests of working families ahead of the political interest of their party. The time has come for a bipartisan commitment in Washington to fully implement the Affordable Care Act, so we can help cure the ailing U.S. economy.

We call on Illinois’ Republican Congressional delegation to join in that commitment. Any energy spent on a futile and time-consuming effort to repeal the Affordable Care Act will only divert attention away from the issue foremost on the minds of Illinois residents: our state’s economic recovery.

And the Affordable Care Act will be instrumental in aiding the state’s economy by making health care more affordable and accessible. For instance, in Illinois alone, the law as already generated the following rewards:

    Ø More than 3.6 million residents became entitled to preventative medical services, such as mammograms and colonoscopies, without having to pay deductibles or co-pays.

    Ø More than 100,000 uninsured young adults under the age of 26 became eligible for coverage under the parents’ health insurance.

    Ø More than 150,000 seniors with Medicare received a $250 rebate to cover the cost of their prescription drugs once they hit the so-called donut hole.

* 11:56 am - Congressman Joe Walsh…

“Today, I, along with most Americans, am disappointed with the Supreme Court decision. It is now clear that the only way to repeal this law is legislatively,” Walsh said. “Today’s decision only affirms what we have known all along - the President’s health care plan is a massive tax increase. The President insisted that his health care plan would not cost the American people anything, but that is just untrue. To be clear, this is not a tax on wealthy Americans who already have insurance. This tax hits the 44 million uninsured Americans, who are already struggling and cannot afford to pay more hard-earned income in taxes.

“The American people deserve a choice in their health care plans, not government mandates. The President’s health care plan is an unworkable mega-bill that will destroy small businesses, kill jobs, stunt economic growth, and bankrupt the nation.

“My opponent, Tammy Duckworth, a true tax-and-spend liberal, supports this new tax on the Middle Class. In fact, not only does Tammy support the President’s current tax and spend health care plan, but she is on record supporting a single-payer socialized system. I, however, will make it my top priority to repeal this massive tax increase and the President’s entire health care plan.

“As a new member of Congress, I turned down my gold-plated Congressional health care plan. Instead, I chose to buy my insurance on the open market, and I know firsthand how difficult it is to find affordable, quality health insurance. The Supreme Court’s decision has finally ended the debate in Washington. The American people will decide where we get from here.”

* 12:36 pm - Comptroller Topinka…

Illinois Comptroller Judy Baar Topinka warned lawmakers on Thursday that the Supreme Court’s ruling on the federal Affordable Care Act could lead to hundreds of thousands of new residents enrolling for Medicaid coverage, and cost the state up to $2.4 billion over the next six years.

The forewarning from the state Fiscal Officer comes after the Court ruled that the federal government can tax residents that do not have health insurance. Given the decision, uninsured residents that qualify for Medicaid are expected to increasingly enroll in the program, and cost the state up to $2.4 billion over six years in the process.

“There is no doubt that this will cost the state, the only question is how much?” Topinka said. “We have thousands of residents around the state that are eligible for Medicaid but have never enrolled for one reason or another. We expect they will increasingly come forward, and I urge lawmakers to start saving now for those added costs.”

Medicaid currently accounts for more than 20 percent of the state budget and continues to grow. Underfunded, the program will end the fiscal year June 30 with an estimated $2 billion in unpaid bills. In an attempt to address those realities, members of the General Assembly this Spring voted to limit services and cut an estimated $2 billion from the program.

“Illinois is a textbook example of what can happen if financial challenges are not proactively addressed,” Topinka said. “The state needs to learn from experience, and take steps today to address the increased Medicaid costs that will occur in coming months and years.”

* 2:23 pm - I’m just getting back from a late lunch, but this came in around 1:30. Democratic congressional candidate Tammy Duckworth…

“As someone who survived a serious health crisis I understand how important it is to have affordable and quality healthcare. The ruling today is a victory for children with preexisting conditions who can’t be denied coverage, women who can’t be charged a higher premium, seniors who won’t suddenly find themselves without coverage, and young adults who will be covered under their parents until they are 26. However, I’m still concerned that ACA places an unfair burden on employers, especially our small businesses. We will need to evaluate these provisions as we move forward. I look forward to getting to Washington, rolling up my sleeves and getting to work.”

* Congresswoman Jan Schakowsky…

“Today is a historic day when the Supreme Court declared that the Affordable Care Act and the health security it brings is the law of the land. With President Obama’s leadership, Congress enacted the most significant law in half a century. The law ends insurance industry abuses in the health system, improves Medicare and Medicaid for seniors and the disabled, and covers millions of uninsured Americans. Today, Republicans need to finally put to rest the relentless, partisan attacks against a landmark law that is already working to provide affordable, high-quality care.

Over 86 million Americans have already received one or more free preventive services because of Obamacare, while 6.6 million young adults up to age 26 have taken advantage of the law to obtain health insurance through their parents’ plan. This positive decision by the nation’s highest court in the land should resolve any doubts that Congress can and should act to ensure that Americans get the health care they need at a price they can afford. It will allow us to move forward and maintain our commitment to real health care security.

Today’s Supreme Court decision is a victory for Illinoisans like 11-year old Olivia, who suffered a stroke at birth and no longer endures private insurance company abuses like pre-existing condition exclusions. Thanks to Obamacare, up to 17 million children nationwide with pre-existing conditions are no longer denied coverage by insurers and being a woman is no longer a pre-existing condition. Today is a victory for Illinois seniors like Ann, who is saving about $1200 this year because Obamacare is lowering her drug costs and closing the Medicare donut hole. Over 5 million American seniors in the ‘donut hole’ have saved $3.7 billion on their prescription drugs, including 152,170 Illinois seniors.

When Obamacare is fully implemented, exclusions for pre-existing conditions like cancer, heart disease, and AIDS will be a thing of the past. No longer will families be bankrupt because someone gets sick. People with mental illness will get the care they need.

Today is a day for celebration. Tomorrow we will get back to work ensuring that every American can take advantage of the benefits of Obamacare and have access to affordable, comprehensive and high quality health care. ”

* State Rep. ason Barickman (R-Champaign)…

“I stand with my colleagues at the Congressional level and here in Illinois in support of repealing Obamacare. The American people have in large part rejected the components of Obamacare and have repeatedly stated that they do not want their personal healthcare decisions to be dictated by Washington politicians. We need responsible health care reform that allows families to choose their own physician and have access to the care they need.

Obamacare has only acted to make our economic problems worse. The President’s health care initiative imposed burdensome regulations on our jobs providers, making it more difficult for small businesses to hire workers. We continue to see health care costs rise at unaffordable levels for Illinois families under Obamacare. This law will drastically limit our ability to manage state finances and implement the necessary cost controls to our health care programs that are needed to erase our multi-billion dollar budget deficit.

Today’s decision is another reminder that the best way to insure a limited and fiscally responsible government is at the ballot box this November.”


When Barack Obama ran for President, he promised no tax increases on the middle class. But the only way he could convince the Supreme Court to approve ObamaCare was to call it a new “tax.” Promise made – Promise Broken.

This comes as no surprise since Barack Obama spent his formative political years in Springfield being trained by Illinois Democrats like Mike Madigan, who through years of mismanagement, have led Illinois to having the worst budget deficit, credit rating, pension debt and business climate in the nation – and last year a 67% Tax Hike in the middle of the night on the last day of a lame duck session of the state legislature after many of his party members promised to oppose any such tax hike. Promise Made – Promise Broken.

It’s now up to us, the voters, to stop these reckless tax hikes and spending schemes that will lead to the implosion of our health care system, an explosion of our national and state debt and economic uncertainty for millions of job creators.

Here in Illinois, we are leading the fight by opening victory centers throughout the state to help elect more anti-tax Republicans to Washington and Springfield to keep Nancy Pelosi from becoming Speaker again and to end the decades-long rule of Mike Madigan, who is more interested in raising taxes and lining his pockets from his campaign contributors and law firm clients than he is in turning around our economy through fiscally conservative, pro-economic growth policies.

Our Victory Centers in 2010 led the nation in calls made and doors knocked on to reverse the Democratic tide right in Barack Obama’s own home state and we can continue the momentum in 2012 – with your help.

Please go to to make a quick, secure online donation to help stop the ObamaCare/Madigan Tax Hikes. For a long-term, sustaining commitment, you can become a member at

Please give whatever you can afford – every donation helps our cause!

Thank you!

* House GOP Leader Tom Cross…

“We have made tremendous efforts this year in Illinois to reduce our state run healthcare program, because we could no longer afford to provide the services that were once promised. Today’s Supreme Court decision affirms a federal law that has the potential to pile billions of dollars of additional expenses into our state budget that we cannot afford. We are encouraging Congress to repeal Obamacare at the federal level as soon as possible, and provide Illinois the ability to administer an efficient Medicaid program.”

* Senate Republican Leader Christine Radogno…

“While the U.S. Supreme Court has settled the legal argument, the debate over whether it is good policy or not will continue for months. We will be very carefully reviewing the decision for opportunities to reduce any negative impact of the Affordable Care Act and its tax on Illinois citizens. The Senate Republican Caucus has worked to cut costs in the state’s Medicaid program – targeting the waste, fraud and abuse that costs taxpayers hundreds of millions each year.”

* Gov. Pat Quinn…

“Today is a great day for Illinois and a great day for our country. This decision means that millions of working families across Illinois will continue to receive better healthcare.

“These historic reforms that are strengthening our healthcare system will continue to benefit young people, those with pre-existing conditions and care providers.

“We took a big step forward today as a nation and state, and I will continue to work with President Obama to help working families get the healthcare coverage they need.”

- Posted by Rich Miller        

  1. - Ronald RayGun - Thursday, Jun 28, 12 @ 9:44 am:

    Meanwhile, CNN is getting the thrashing of a lifetime on Twitter.

  2. - western illinois - Thursday, Jun 28, 12 @ 9:45 am:

    The medicade decsion looks interesting. It must be voluntary (I am sure Illinois will take it)
    Because the choice that congress gave the states was coercive. A choice is not a choice if it is coercive
    Does this bail us out since Illinois already provides medicaid to adults up to 133% of poverty?
    Arkansas applies it only to adults to 25% of poverty ie no one

  3. - Just the Facts - Thursday, Jun 28, 12 @ 9:46 am:

    Rich - appears to be a bad link to the opinion

  4. - PublicServant - Thursday, Jun 28, 12 @ 9:47 am:

    Thanks to the Supreme’s for allowing me to keep my son on my insurance while he’s in college. Thanks for not allowing people with pre-existing conditions to be denied insurance coverage by insurance companies. Thanks for not allowing lifetime caps on insurance. Now let’s get busy implementing the insurance exchanges.

  5. - hisgirlfriday - Thursday, Jun 28, 12 @ 9:48 am:

    Hands down best reaction I’ve seen to this decision:

    Ari Fleischer ‏@AriFleischer
    I miss Justice Harriet Miers.

  6. - Rich Miller - Thursday, Jun 28, 12 @ 9:49 am:

    Thanks for the heads up on the opinion link. Fixed.

  7. - PublicServant - Thursday, Jun 28, 12 @ 9:49 am:

    ===A choice is not a choice if it is coercive

    I’m hoping you’re right about that Western, since it’s definitely a coercive choice being offered to state employees with regards to pensions and insurance.

  8. - western illinois - Thursday, Jun 28, 12 @ 10:00 am:

    I was hinting at that Public Seravnt
    Rand Paul just claimed on CNBC that this would hurt Illinois because of medicaide expenses.
    I think the opposite Maybe? We can move higher income adults to the new benfits with better reimbursment?

  9. - Grandson of Man - Thursday, Jun 28, 12 @ 10:00 am:

    Romney is running against the ACA and said he wants to repeal it. The individual mandate stems from conservative thought and was enacted by Romney as governor. The idea is that people should pay for their own healthcare rather than getting medical treatment, not paying it and having it fall on taxpayers. Romney’s argument has been struck down, that the mandate is good only if states implement it on their own, and a federal law violates states’ rights. Now Romney will be running against the legal validation of his own plan (basically).

  10. - Slick Willy - Thursday, Jun 28, 12 @ 10:03 am:

    The irony is that when Obama was selling this to teh public, he was adamant that this was not a tax, yet the SCOTUS upholds it on that grounds that it is only legitimate because it is precisely that - a tax.

  11. - cassandra - Thursday, Jun 28, 12 @ 10:04 am:

    Well, this seems to mean that state employees, if forced to choose between Cola and state retiree health insurance, will have more options than before, even if they retire before reaching Medicare age.

  12. - Slick Willy - Thursday, Jun 28, 12 @ 10:04 am:

    Apologies for the bad grammar and spelling errors.

  13. - Grandson of Man - Thursday, Jun 28, 12 @ 10:10 am:

    “Apologies for the bad grammar and spelling errors.”

    Also apologies for myself for my hazy memory, If I remember correctly, Obama didn’t initially support the indivudual mandate, but he wanted to ensure that Americans have health insurance, so he compromised.

  14. - mark walker - Thursday, Jun 28, 12 @ 10:10 am:

    Just watched Fox News run a headline across the screen for the first 15 minutes of their reporting: “Individual Mandate Declared Unconstitutional”

    The Fox on-screen reporter had to tell the producer to stop it.

    Dewey didn’t really win.

  15. - Grandson of Man - Thursday, Jun 28, 12 @ 10:14 am:

    “Thanks for not allowing people with pre-existing conditions to be denied insurance coverage by insurance companies.”

    I have a family member with a serious pre-existing condition, and another who’s in remission from cancer, so I second the thanks.

  16. - Yellow Dog Democrat - Thursday, Jun 28, 12 @ 10:14 am:

    I can’t wait to read the opinion, especially the part where the Court says that Medicaid funding is a state entitlement.

    That seems like a huge gift to the insurance industry from Justice Roberts. If state’s cannot be compelled to provide coverage for the working class, but the working class can be compelled to have coverage, it really leaves them no choice but private carriers.

  17. - ZC - Thursday, Jun 28, 12 @ 10:15 am:

    I’m not sure what Justice Harriet Miers has to do with this. Her replacement was Alito, not Roberts.

    Also one of the sharpest observations I’ve seen on this decision so far came from David Bernstein over at Volokh Conspiracy, where he notes that Justice Roberts (the swing vote on this case) was extensively vetted by the Bush Administration - but mainly to make sure he was a “reliable vote” for the War on Terror, 9/11, civil liberties etc. He wasn’t vetted nearly so much on federalism questions.

    In a similar vein I don’t know if Miers would have been any different. We’ll never know.

  18. - johhnypizza - Thursday, Jun 28, 12 @ 10:20 am:

    Well, if we think that unfunded pensions and tax increases are killing us now, wait until this is fully implemented. On the other hand, this opens a lot more jobs for actuarians who will really be dictating who gets what health care services down the line. There is not enough tax money available from the 1% or savings from eliminating the military to make up the costs of this. What entitlements are going to be cut to fund this? None. Nothing like a big tax increase just before elections in a poor economy to stimulate interest in the election.

  19. - NIref - Thursday, Jun 28, 12 @ 10:22 am:

    Cue angry Joe Walsh press conference.

  20. - Anon III - Thursday, Jun 28, 12 @ 10:25 am:

    “It’s not a mandate, it’s a tax.” That seems to be a political poison-pill. It won’t be long before someone puts some dollar numbers on that tax and some real faces on the people who will pay it.

  21. - Ready To Get Out - Thursday, Jun 28, 12 @ 10:27 am:

    mark walker — pretty scary that you watched Fox for 15 minutes…ha! But great timing.

  22. - Grandson of Man - Thursday, Jun 28, 12 @ 10:30 am:

    “It won’t be long before someone puts some dollar numbers on that tax and some real faces on the people who will pay it.”

    But conservatives who supported the mandate wanted people to be financially responsible for their own healthcare. One or more people used the emergency treatment example, in which someone gets emergency medical treatment, can’t pay the bill and leaves the bill for the taxpayers. So how can they have it both ways?

  23. - Bigtwich - Thursday, Jun 28, 12 @ 10:31 am:

    Justice Thomas restricted his separate dissent to 179 words. Admirable.

  24. - Yellow Dog Democrat - Thursday, Jun 28, 12 @ 10:34 am:

    === It won’t be long before someone puts some dollar numbers on that tax and some real faces on the people who will pay it. ===

    Good luck putting together the Alliance of Americans for Personal Irresponsibility.

    My response: “They expect the rest of us to pay for their emergency room visits while they spend their money on lobbyists and t.v. ads.”

  25. - Aaron - Thursday, Jun 28, 12 @ 10:34 am:

    @Anon III
    If it’s a poison pill, then the Obama administration did it themselves. Don Verrilli, the Solicitor General, argued both the commerce clause and taxing provisions before the SCOTUS. His predecessor Neal Katyal argued as much in earlier courts.

  26. - The Doc - Thursday, Jun 28, 12 @ 10:34 am:

    ==Nothing like a big tax increase just before elections in a poor economy to stimulate interest in the election==

    Which tax increase would that be, exactly? I’m sure you’ve got a boatload of reliable data to support all of your talking points, but I’ll consider the CBO projections a touch more accurate nonetheless.

  27. - chuddery - Thursday, Jun 28, 12 @ 10:35 am:

    ==Justice Thomas restricted his separate dissent to 179 words==

    So what, that’s still 179 more words than he uses during oral arguments.

  28. - ZC - Thursday, Jun 28, 12 @ 10:38 am:

    Right, it’s a tax on irresponsibility. It’s the people who free-ride the system, could pay for health insurance and don’t, and count on all the other taxpayers to pick up much of their medical costs if they actually get injured - they now have to pay something. That saves money, not costs it. And all they have to pay is they might not get their income refund in April.

  29. - illinifan - Thursday, Jun 28, 12 @ 10:39 am:

    Medicaid for parents of children are covered up to 133% as of July 1, but single adults with no disability do not have the coverage so this is an expansion to this group. The big thing is for the new Medicaid eligibles under ACA the funding is 100% federal dollars reducing over time to 90% federal with the state having to do a 10% match. This was a no brainer. Also the exchange that will be set up is really great for consumers since you will be able to choose from multiple plans compared based on your own choice from keeping your primary care physician to affordability.

  30. - Southern Peggy R - Thursday, Jun 28, 12 @ 10:42 am:

    Whither federalism? Scalia forewarned us Monday.

    Some choice. So, if I don’t want to buy a Chevy Volt, O can tax me too? This is like the dhimmi taxes on non-Muslims in Islamic countries. Roberts is a horrid disappointment. It took wishy washy Kennedy to know the whole damn thing was an unconstitutional mess. Alas, dissents mean little.

  31. - Southern Peggy R - Thursday, Jun 28, 12 @ 10:45 am:


    Who says others pay your costs if you don’t have insurance? That would only be true for the poor who can’t pay bills. Hospitals have reduced rates for uninsured, payment plans,etc. Insured rates are inflated over costs. We should all pay our own way. Medicaid/care are for the poor who can’t. We already have programs. This was unnecessary govt expansion to put it mildly.

  32. - The Doc - Thursday, Jun 28, 12 @ 10:46 am:

    ==So, if I don’t want to buy a Chevy Volt, O can tax me too==

    No no no. Please take a breath and listen carefully.

    Your decision not to buy a Chevy Volt, or any other auto, has zero impact on other drivers and non-drivers.

    Your decision to forego insurance means that when (not if) you need medical care, there will be an adverse financial impact on the insured, and insurance companies, and hospitals, to name a few.

  33. - PublicServant - Thursday, Jun 28, 12 @ 10:51 am:

    Peggy, if your not buying a Chevy Volt cost me money, I’d want you to be forced to buy the Chevy Volt, but since it doesn’t, what has that got to do with forcing people who can afford it to buy insurance, when it would otherwise cost me money when they show up in the emergency room?

  34. - illinifan - Thursday, Jun 28, 12 @ 10:52 am:

    @southern peggy
    yes hospitals have programs to provide reduced or no costs but guess who pays for these programs, those of us who and are insured in higher costs, so we are paying for it through higher premiums, medical costs and taxes. It is time those who have no insurance get to contribute. I think this is called shared responsibility.

  35. - 47th Ward - Thursday, Jun 28, 12 @ 10:54 am:

    ===We already have programs.===

    Then why do 40 million Americans not have insurance? And Peggy, please google the phrase “free riders” to understand how those without insurance drive up the cost for everyone else. It’s a simple economic concept that this law solves via the free market.

    If this was “unnecessary government expansion” or a “government takeover” of health care, then it would be a single payer system. It’s not a single payer system, the entire law is predicated on a healthy and competitive private insurance system.

    Remember, the mandate was first offered by the Heritaga Foundation. This is hardly a big government approach to health care.

  36. - Southern Peggy R - Thursday, Jun 28, 12 @ 10:56 am:

    illinifan: Hospitals do not necessarily charge uninsured people BELOW cost, but insured people and their insurers are well ABOVE cost. Insurance, the guarantee of payment, causes higher retail prices. I am an economist who’s worked in regulation for 20 years.
    On Chevy Volt, 2 points. 1. It is a govt co. product right now. To support our govt I should buy it. 2. The environment is allegedly a “shared” concern. So, I could be taxed for not buying the govt’s own approved enviro-safe car and causing or not preventing pollution.

    Free stuff or freedom. That’s our choice.

  37. - Esquire - Thursday, Jun 28, 12 @ 10:57 am:

    The medical system needed reform, but this legislation was not the change that we needed nor is it change that we can believe in. As for Robert’s opinion, it looks to me that he punted by joining the majority. His words are lukewarm at best and it looks as if he would prefer to pass the buck back to Congress to clean up this mess. A stronger Chief Justice would have shouldered the burden and taken on the critics to do the right thing. The President publicly stated the individual mandate was not a tax. The Solicitor General’s last ditch argument was that it was a tax and that was the only winning argument as the Commerce clause defenses of the law failed.

    This decision may energize the Republicans and the Tea Partiers. It is premature to call the decision a victory for Obama on account of the unpopularity of the law. It might have better served Obama’s reelection interests if the law was invalidated — now he has to defend the merits of the law on the campaign trail and will not be able to play it both ways.

  38. - Colossus - Thursday, Jun 28, 12 @ 10:59 am:

    Peggy, let me just cut to the point here. If you don’t want to ever be held accountable to anyone else in any way shape or form, there’s a place you should be checking out. Here, I’ve done the primary research for you:

    Now, please, either live your rhetoric or shut up about it, but stop holding this country back from reclaiming its place in the world beause you are too selfish and scared to admit the world has changed and the last 30 years of “trickle down” theories and social engineering have failed miserably.

    The rest of us would like to get back to an America where young people can afford a house and to get married when they want to, instead of living in their parents basement because there are no jobs and the education system refuses to prepare them for the real world.

  39. - Aaron - Thursday, Jun 28, 12 @ 11:00 am:

    @Southern Peggy
    In case you can’t read the decision for yourself, or analysis like SCOTUSblog or somewhere like that, the IM is upheld under taxing power, and the majority decision of the court, under Roberts, held that the so-called “broccoli argument,” that Congress can make you buy anything, is unconstitutional. Reality would really let you see more than those blinders.

    From CJ RB himself: “The text of a statute can sometimes have more than one possible meaning. To take a familiar example, a law that reads “no vehicles in the park” might, or might not, ban bicycles in the park. And it is well established that if a statute has two possible meanings, one of which violates the Constitution, courts should adopt the meaning that does not do so.”


    “Although the payment will raise considerable revenue, it is plainly designed to expand health insurance coverage. But taxes that seek to influence conduct are nothing new. Some of our earliest federal taxes sought to deter the purchase of imported manufactured goods in order to foster the growth of domestic industry.”

  40. - A Modest Proposal - Thursday, Jun 28, 12 @ 11:00 am:

    I was unaware the Affordable Care Act was going to be ruled on by the Supreme Court.

  41. - wordslinger - Thursday, Jun 28, 12 @ 11:01 am:

    A resounding victory for the vision of Gov. Romney, the Heritage Foundation and GOP conservatives who first had the audacity to propose that able-bodied individuals of working age take all the responsibility they can for their healthcare costs and the burden it places on the rest of society.

    Congress passed, the president signed, the Supremes upheld. Game, set, match.

  42. - titan - Thursday, Jun 28, 12 @ 11:02 am:

    Something had to be done to deal with health coverage and access. This may not have been the better way to do it (particularly with the content packing of coverage requirements). People may be amazed at how much this is going to cost.

  43. - Southern Peggy R - Thursday, Jun 28, 12 @ 11:02 am:

    Funny how I never heard that the Heritage Found proposed a mandate in the 90s until a couple years ago. If so, I understand it was as a means to avoid the fed government becoming monopoly provider of mandatory insurance. It was by no means a desired approach I am sure. I do fault the GOP for squandering its time in power by not passing market based approaches to addressing market failures in insurance and medical services. Quite the opposite, the drug program was passed, an expansion of govt. The fed govt has “taken over” states’ jobs of regulating insurance. It is an expansion of the fed govt in role and size and taxes.

  44. - Rich Miller - Thursday, Jun 28, 12 @ 11:05 am:

    OK, people, I’ve let you guys go on and on with DC spin talking points, but let’s move along and try to comment on the stuff I’m posting above from Illinoisans. Some of the press releases are pretty thoughtful. You be the same way, please.

  45. - illinifan - Thursday, Jun 28, 12 @ 11:06 am:

    Bad word on my part to say cost….hospitals charge a different rate based on insurance and no insurance. I don’t think health care has any idea as to what the real cost of the services are. I have seen some studies that it is about 25% of what is billed. It all goes to how complex the whole issue is. Bottom line we need to pay for the service provided and usually when ill we do not have the luxury to shop for the best price unlike shopping for other products.

  46. - Colossus - Thursday, Jun 28, 12 @ 11:09 am:

    Well, to bring this back around to IL: Where’s Schock’s statement this morning? PJStar doesn’t have anything, and he’s not the kind of guy to avoid the opportunity to spew talking points everywhere. I’m curious to see how much “repealrepealrepeal” we’ll be hearing this summer/fall from the IL GOP delegation.

  47. - Rich Miller - Thursday, Jun 28, 12 @ 11:09 am:

    ===Funny how I never heard that the Heritage Found proposed a mandate in the 90s until a couple years ago.===

    As I often tell people, just because you don’t know something exists, doesn’t it mean it didn’t actually happen.

    Move along.

  48. - 47th Ward - Thursday, Jun 28, 12 @ 11:11 am:

    Rich, in fairness, most of the Illinoisans quoted above go on and on with DC spin talking points.

    Whether this ruling is good politically for Obama or bad politically for Romney, the most important win today was for the 1,914,000 Illinois residents who will now get health insurance. And it’s also good for all of us who no longer have to fear going bankrupt because we got sick.

    Let’s keep that in mind when discussing winners and losers today.


  49. - Southern Peggy R - Thursday, Jun 28, 12 @ 11:15 am:

    Aaron, Yes, I know the taxing rationale used by Roberts, but it is effectively coercion. Yes, the commerce clause was not considered operative. I have read scotus blog and other sites.

  50. - Tommydanger - Thursday, Jun 28, 12 @ 11:16 am:

    Unless there are other press releases from major players out there that Rich has not posted, I guess I would say that I’m surprised that most everyone did not have multiple press releases prepared that anticipated various outcomes that with just a little fine tuning should have already been released. Unless of course they are waiting on getting their talking points from Washington.

  51. - PublicServant - Thursday, Jun 28, 12 @ 11:18 am:

    OK Rich, I’ll bite. Per Bill Brady, the failed republican candidate for Illinois Governor
    ===It will drive up health care costs and put yet another financial burden on our already struggling small businesses.===

    Can someone ask him to explain that statement, or would anyone else care to reply?

  52. - hisgirlfriday - Thursday, Jun 28, 12 @ 11:23 am:

    Interesting how IL GOP lawmakers are so out of sync with their benefactors on this issue.

  53. - Louis G. Atsaves - Thursday, Jun 28, 12 @ 11:26 am:

    Amazing. All of you have digested 193 pages of this decision and opinion and have opined on it already? I’m still reading it. Are the rest of you speed readers? There seem to be a lot of intricate findings on States rights that may impede federal mandates not only in this field but on other issues to the States in the future.

  54. - Grandson of Man - Thursday, Jun 28, 12 @ 11:26 am:

    U.S. House Representatives Schilling and Dold say they want to work in a bipartisan manner on healthcare reform. I don’t see how that is possible, with the Tea Party in the House. U.S. House Republicans sking for bipartisan cooperation at this point seems like the sirens asking for Ulysses to come near the shore and hear their enchanting songs, so they can eat him.

  55. - PublicServant - Thursday, Jun 28, 12 @ 11:33 am:

    Yeah but Daddy’s boy, Jason Plumber, is as clueless as usual…===The Court’s ruling that the individual mandate is unconstitutional…===

    Err…Umm…Before you issue a statement based on Fox news misstatements, tune into some real news dude!

  56. - Anonymice - Thursday, Jun 28, 12 @ 11:33 am:

    ==Your decision not to buy a Chevy Volt, or any other auto, has zero impact on other drivers and non-drivers.==

    That has precisely zero relevance to whether or not Congress has the power to tax you for not buying one. Southern Peggy is right on this point — this decision means the feds can tax you for not buying a Chevy Volt. Congress can tax anything they want, except exports, provided that the tax must be apportioned if it’s a direct tax (and the court held this was not a direct tax) or uniform throughout the country if it’s not direct, and it can’t violate any of the taxpayer’s constitutional rights (such as, for example, a tax on your religious practices).

  57. - Yellow Dog Democrat - Thursday, Jun 28, 12 @ 11:44 am:

    @Rich -

    To your point, I think the reaction from Illinois’ Republican Congresscritters is politically misguided.

    Based on their comments, you’d think the uninsured all live in Democratic Congressional districts in Chicago.

    In fact, according to NCSL, one in ten are uninsured in Dold’s district and one in nine are uninsured in Shilling’s.

    Heck, even Judy Biggert has a district where one in 11 are uninsured…the lowest in the state.

  58. - Wensicia - Thursday, Jun 28, 12 @ 11:45 am:

    ==U.S. House Representatives Schilling and Dold say they want to work in a bipartisan manner on healthcare reform.==

    I think Dold understands if he wants to be re-elected in today’s 10th district he can’t take the hard, tea party line of partisan politics.

  59. - Aaron - Thursday, Jun 28, 12 @ 11:52 am:

    3/4 of GM is not govt-owned. That hardly makes it a govt company. TVA is a govt-owned company.

  60. - Yellow Dog Democrat - Thursday, Jun 28, 12 @ 12:04 pm:

    @Anonymice, Peggy -

    The push for a national, universal healthcare plan began back in the 1920’s. It took 90 years. I wouldn’t fret too much about the government forcing you to buy a Chevy Volt.

    To your faulty analogy:

    Not everyone owns a vehicle. But the government does require everyone purchasing a vehicle to meet certain requirements.

    Everyone does, by fact, participate in the health care system.

  61. - Yossarian Lives - Thursday, Jun 28, 12 @ 12:15 pm:

    Western Illinois -

    Illinois currently only covers adults up to 133% FPL if they are caregivers for children or the disabled, if they are disabled, if they are over 65, or if they have certain chronic conditions (hemophilia is one, I think). The ACA will allow us to expand our coverage to ALL adults with household incomes 133% FPL or lower, even if they do not fit in one of the above categories, with a 100% federal subsidy until 2017, when the subsidy will go down to 95%. (It will go to 90% and remain there indefinitely starting in 2020.) In practice, this will incorporate low-income adults ages 18-65 who do not have disabilities or young children at home in the Medicaid program.

  62. - Uncle Leo - Thursday, Jun 28, 12 @ 12:20 pm:


    Per The Beachwoodreporter, The Sun Times also got the news wrong.

    NEWS ALERT 6/28/2012

    BREAKING: Supreme Court strikes down individual mandate on health care law

  63. - western illinois - Thursday, Jun 28, 12 @ 12:23 pm:

    Thanks Yassarian. Nice to see some non DC spin.
    The NYT a couple of weeks ago reported the same adults we cover to 133% were only covered to 25% which means no one is covered who is an adult. I wonder if we could move them to the new 95% . That would help us some more

  64. - Grandson of Man - Thursday, Jun 28, 12 @ 12:26 pm:

    I am disappointed in Rep. Walsh’s statements. If he knows the difficulty of affording healthcare, why would he deny it to people who are not offered heatlh insurance by their employers and may not earn enough to afford it?

  65. - globalguy - Thursday, Jun 28, 12 @ 12:44 pm:

    I wonder if the SCOTUS recast of the ACA penalty as a tax will ultimately sink Obama in November. I had a feeling last night that upholding the constitutionality of ACA would ultimately galvanize GOP into defeating him and they love nothing more than a Straw Man Tax to bash about.

  66. - Anonymice - Thursday, Jun 28, 12 @ 12:44 pm:

    ==Everyone does, by fact, participate in the health care system.==

    Which, again, has zero relevance to the taxing authority of Congress. The analogy is perfectly valid.

  67. - Cook County Commoner - Thursday, Jun 28, 12 @ 12:46 pm:

    The Republicans are secretly ecstatic over the US Supreme Court’s decision because an invalidation of the law by the Court would have exposed the party as having no meaningful plan to immediately remedy a dysfunctional healthcare system.

  68. - Bruno Behrend - Thursday, Jun 28, 12 @ 12:53 pm:

    This is a masterful decision by Roberts.

    1. ObamaCare is a massive tax increase
    2. There was no real expansion in any Federal Power
    3. States can’t be forced into it

    “The Medicaid expansion thus violates the Constitution by threatening States with the loss of theirexisting Medicaid funding if they decline to comply with the expansion. Pp. 51–55.”

    4. The right is loaded for bear through November

    and most importantly…

    5. The Nec. and Proper power, and the Commerce power are expressly limited in a way that future cases will use this language to roll-back much of the decades-long expansion of Federal Power.


    This was masterful. He skewered Obama while constraining federal power.

    The right needs to stop its unsightly hysterical keening. It’s embarrassing. We won.

  69. - PublicServant - Thursday, Jun 28, 12 @ 12:56 pm:

    Yes, Anonymice, the US Supreme Court just clarified that the US Constitution allows the US Congress to institute a tax for not buying something. If that clarification bothers you, start working on amendment language. Until then, if you don’t have health insurance, and you otherwise could afford to buy it, but would prefer to stick other taxpayers with the bill, you’ll have to pay the tax.

  70. - It's All Good - Thursday, Jun 28, 12 @ 12:57 pm:

    In his haste to get out there and sound informed and in touch, Plummer and his campaign–again–sound completely uninformed and out-of-touch.
    Speaking of Plummer, did you see the quote he gave this week to a St. Louis paper? Commenting on the appointment of his Democratic opponent, Bill Enyart, he said, “These are serious times that call for serious leaders to provide serious solutions.”!/content/25725/enyart_nominated_12thdistrict
    Besides this almost being a direct quote from Michael Douglas’ character in the movie “The American President”, 29-year old Jason doesn’t seem to get that he just described his opponent, an attorney and a retired major general.

  71. - too obvious - Thursday, Jun 28, 12 @ 1:01 pm:

    Probably worth noting that Bill Brady is in the insurance business, if I’m not mistaken.

  72. - Yellow Dog Democrat - Thursday, Jun 28, 12 @ 1:04 pm:

    @Bruno -

    Good luck redefining ObamaCare as a “massive tax increase.”

    The Right has spent months and millions convincing Americans it was an unconstitutional power grab by the federal government that infringed on personal liberty.

    Now you want to change your storyline? Good luck.

    Moreover, if ObamaCare is a massive tax increase, then what was RomneyCare? The penalty for not purchasing insurance under Obama’s plan is $695. Under Romney’s, its $1200.

    Romney can hardly accuse Obama of a tax increase now without shooting himself in the face.

    Besides, the Republicans already have all of the rabidly anti-tax, rabidly anti-Obama, rabidly anti-government votes in their corner.

  73. - wishbone - Thursday, Jun 28, 12 @ 1:12 pm:

    The tax only applies to those who expect the rest of us to pay their emergency room fees i.e. freeloaders. Getting rid of freeloaders used to be the conservative approach to government. How they’ve changed.

  74. - Cheswick - Thursday, Jun 28, 12 @ 1:13 pm:

    Sen. Mark Kirk should always end his “blocking the government from coming between patients and their doctors” talking point with something like: Too bad for you, but good for me, I am living proof of just what government health insurance can do.

  75. - Freeman - Thursday, Jun 28, 12 @ 1:22 pm:

    I’m nearly through reading the entire opinion, and re-reading Roberts’ opinion. I see nothing that limits this strictly to health care, etc.

    As SCOTUS Blog summarized in their plain English live postings earlier today “The Court holds that the mandate violates the Commerce Clause… However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding.”

    I find nothing limiting the Government’s powers to levy such taxes anywhere in the opinions. Nothing appears to limit the scope of this judgment strictly to the health care situation.

    Southern Peggy R is correct in that the government can now offer you the choice between buying something, paying a tax, or doing neither and facing the consequences. This includes a Chevy Volt or any other inane thing one wants to substitute. While that is highly unlikely in practical terms, that is the ruling.

    I encourage everyone to read the ruling when they have a chance. Interesting arguments on all sides.

  76. - Inactive - Thursday, Jun 28, 12 @ 1:34 pm:

    ===getting rid of freeloaders===

    So…… to collect from those freeloaders? Fee/fine after fine after fine…….jail? What about illegals? Deny care in the ER?

  77. - cover - Thursday, Jun 28, 12 @ 1:40 pm:

    I have what I believe is a pertinent question regarding Toni Preckwinkle’s statement. Since SCOTUS did overturn the portion of ACA that would withhold existing federal matching funds if states don’t expand Medicaid in 2014, what happens to Cook County’s waiver program if Illinois chooses not to expand eligibility to childless adults up to 133% of poverty? Would that invalidate Cook’s program, or would the feds allow the state to essentially have two different eligibility standards, one for Cook County and one for the rest of the state?

  78. - cover - Thursday, Jun 28, 12 @ 1:44 pm:

    To clarify, I’m not predicting what Illinois will decide to do about the Medicaid expansion - that will likely be determined during the spring 2013 legislative session - I’m just wondering about the implications if the state chooses not to expand eligibility statewide.

  79. - Palos Park Bob - Thursday, Jun 28, 12 @ 1:45 pm:

    It’s interesting how so many of the liberal ilk think “choice” is such a vital component of health care, yet the “choice” to self insure will be prohibited and penalized by the government.

    There are apparently 1,914,000 people without health insurance in Illinois. How many CHOOSE not to pay for health insurance and instead spend their money elsewhere?

    The truly “poor”, and then some, have in modern times been protected by Medicaid. How many of those in that 1,914,000 would be covered by Medicaid should they have a medical need?

    Personal freedom, liberty and choice died a little bit today, and the power of the government bureaucracy to dictate how we eat, what we do that affects our health (in their tyrranical opinion), and how we direct our personal resources took a quantum leap.

    Thank God that our system allows us to change this usurpation next November, if we have the will and the strength.

  80. - Cheryl44 - Thursday, Jun 28, 12 @ 2:01 pm:

    You’d think Mark Kirk would have something thoughtful to say about healthcare reform. I guess he thinks we all get the level of care he is currently receiving whether we can afford insurance or not.

  81. - Rich Miller - Thursday, Jun 28, 12 @ 2:29 pm:

    ===The Right has spent months and millions convincing Americans it was an unconstitutional power grab by the federal government that infringed on personal liberty.

    Now you want to change your storyline? Good luck.===

    Parties turn on a dime all the time.

  82. - Slick Willy - Thursday, Jun 28, 12 @ 2:41 pm:

    ===The Right has spent months and millions convincing Americans it was an unconstitutional power grab by the federal government that infringed on personal liberty.

    Now you want to change your storyline? Good luck.===

    Didn’t the SCOTUS opinion just do that for them?

  83. - Pot calling kettle - Thursday, Jun 28, 12 @ 2:44 pm:

    ==Probably worth noting that Bill Brady is in the insurance business, if I’m not mistaken. ==

    You are mistaken, he builds houses. That said, Bloomington-Normal is, to a large extent, and insurance company town. He represents their interests and was a major drag on Illinois legislative group that was supposed to create a health care exchange but decided to wait because the Republican members hoped this decision would go the other way. Thanks to their foot-dragging, Illinois is now on track to miss out on a nice chunk of Federal funds, something that does not seem to be particularly fiscally responsible.

  84. - ZC - Thursday, Jun 28, 12 @ 2:57 pm:

    Agreed that parties turn on a dime all the time, but pivoting to the tax increase narrative still has that other problem that Yellow Dog outlined.

    I can see the debate question, “So Governor Romney, are you then in fact the biggest tax-hiker in the history of Massachusetts? And do you now believe that tax hike should be repealed?”

  85. - capncrunch - Thursday, Jun 28, 12 @ 3:10 pm:

    Congresswoman Jan Schakowsky…

    “…Today is a day for celebration. Tomorrow we will get back to work ensuring that every American can take advantage of the benefits of
    Obamacare …..”

    Translation: Find the $1 trillion required to fund these new entitlements over the next 10 years.

  86. - Grandson of Man - Thursday, Jun 28, 12 @ 3:18 pm:

    >>I wonder if the SCOTUS recast of the ACA penalty as a tax will ultimately sink Obama in November. I had a feeling last night that upholding the constitutionality of ACA would ultimately galvanize GOP into defeating him and they love nothing more than a Straw Man Tax to bash about.

  87. - Grandson of Man - Thursday, Jun 28, 12 @ 3:21 pm:

    I’m sorry about the above post. I made a comment on the tax sinking Obama in November. Something went wrong when I posted, and the comment didn’t take.

    I said that the tax could sink Obama if someone other than Romney was the candidate. But Romney, who’s already not that likeable in polls, would flip-flop against his plan on the big debate stage against Obama. Didn’t Romney praise Obama for listening to his people on crafting the healthcare legislation?

  88. - wordslinger - Thursday, Jun 28, 12 @ 3:31 pm:

    No one ever cared about the individual mandate as an issue, per se. It was a conservative GOP idea, for crying out loud.

    It was a Fox and Tea Party rallying point for opposition to Obama, nothing more (did anyone really think their “freedoms” were at stake if deadbeats had to buy health insurance? LMAO).

    Now that it’s gone, a new shiny thing will emerge as a rallying point. Choose wisely.

  89. - zatoichi - Thursday, Jun 28, 12 @ 3:57 pm:

    Most of the talk is focusing on the ‘tax’ aspect. Nice for the political speak. What about the other parts of the plan? There are millions of people who do not qualify for Medicaid. They have to stay in the private market or have nothing.

    I work for a small employer and our BCBS rates are killer with hefty annual increases. I would love to be part of a large exchange where several thousand companies like ours could be considered a bigger group equal to CAT, Sears, ADM, or state of Illinois. There will be companies who will want that business. Health Alliance would be fighting BCBS for that volume. When my wife worked for a national corp with 24,000 employees our portion of insurance was $200 a month. That same coverage through my place is $1,000 at a much higher deductible. The actuarial stuff gets spread over a very small group so we pay far more. Get me in some group with 20,000 others and it should drop.

    Tax, schmax. You help me drop my health insurance cost by $6,000 a year, with good coverage, no pre-existing, no life-time, and I am listening and willing to pay.

  90. - Yellow Dog Democrat - Thursday, Jun 28, 12 @ 4:03 pm:

    === Parties turn on a dime all the time. ===

    Not very successfully when it comes to major public policy.

    Public will campaigns — those that attempt to elevate an issue into one of the top two slots in citizens’ brains — take a long time to burn their messaging into people’s brains.

    Once you’ve burnt a message in — which I give conservatives credit, they’ve done a decent job of doing on Obamacare — its tough to erase that message and burn a different one in.

    Few will forget the analogy about “forcing people to buy broccoli.”

    “Taxing people for refusing to buy broccoli” just doesn’t seem to stick.

    @Wordslinger -

    Eh, I think people cared not about the Individual Mandate per se…but the question of whether you trust the federal government to do anything right, especially something as personal to most Americans as their health care choices, is pretty core.

    Republicans should have stuck with Death Panels.

  91. - Judgment Day - Thursday, Jun 28, 12 @ 4:05 pm:

    Most likely meaningless for Illinois.

    It expands demand, so we drive more providers to the sidelines.

    Not that it matters, as we don’t pay them anyway (at least not anything close to on time).

    But, hey, sounds good. Just not in practice.

  92. - amalia - Thursday, Jun 28, 12 @ 4:20 pm:

    screaming with joy at the news. it is vital that citizens play a part in the health care system for the good of self and all. pay in, stop visiting the er for care, get that annual checkup, and you can avoid something bigger, perhaps. those of us with big health problems that could not be avoided know the dread of not having the doc we want or the threat that the health care will go away. many conditions are indeed preventable, or caught in time can be handled. get your health care and take care of yourself so the cost for all can be lower.

  93. - cassandra - Thursday, Jun 28, 12 @ 4:51 pm:

    Illinois will choose to expand Medicaid and although the feds will pick up the costs of the expansion over the short run, Illinois taxpayers will have to cover some of them over the long run. Let’s hope somebody is thinking about these additional costs not so far down the road as they do fiscal planning not just for next year but for the next decade.

  94. - Pot calling kettle - Thursday, Jun 28, 12 @ 4:57 pm:

    My favorite bit from today is no Buzzfeed: “People Who Say They’re Moving To Canada Because Of ObamaCare” Just reading a few of the posts they collected makes me glad I stick to this blog where people at least know what they are talking about.

    Worth it for the chuckles:

  95. - Katiedid - Thursday, Jun 28, 12 @ 5:04 pm:

    Barickman’s statement was backwards. The American people have in large part SUPPORTED the components of the ACA, not rejected them. When asked if they support or oppose the ACA, the majority opposes it. But when the individual components are separately listed and people are asked if they support or oppose them individually, the majority (by far) support them. In other words, people do like the law, when the politics of it is taken out.

  96. - RNUG - Thursday, Jun 28, 12 @ 5:20 pm:

    Nobody is talking about this angle. Now that the ACA has been upheld, I think it might have some impact on the retiree health insurance issue, both SB-1313 and the other pending bills. And not just in terms of finding replacement coverage.

    As I’ve noted before, ACA has some pretty low limits, like 5% or so, on changing existing grandfathered group plans right now in terms of premiums, co-pays, etc. SB-1313 may run afoul of those limits. The only way around those limits that I saw was the loophole where that rule didn’t apply if the insurance ‘group’ was all retirees; then there was no limit.

    When I read the various pending Senate bills re COLA / Health Insurance trade-off a month or so ago, I found language talking about CMS or a successor trust (it was trust, not agency, but I can’t find the appropriate amendment at the moment to cite the exact language) being responsible for paying the retiree insurance. If that kind language is included in the final trade-off bill, it could let the State do an end-run around the ACA change limits by dumping all the retirees in a group separate from the employees … not that anyone at the State would think of shortchanging the retirees (snark intended)..

  97. - western illinois - Thursday, Jun 28, 12 @ 6:01 pm:

    I think with the ACA it means no one would take the COLA and since the supreme court doesnt like coercian I think they had better look at retiree health care and pesniona allover again.
    It would make most sense to off some sort of real incentive to leave the states plan for the ACA exchanges

  98. - RNUG - Thursday, Jun 28, 12 @ 6:14 pm:

    western illinois,

    Did you lose a word there? Didn’t you mean to say no one would take the COLA trade-off?

    I agree, given some of the SCOTUS statements, the IL GA needs to revisit the whole issue re coercion …

  99. - cassandra - Thursday, Jun 28, 12 @ 6:17 pm:

    If I were in that situation (of state retirees choosing between cola and staying on the state retiree plan), I’m pretty sure I’d take the Cola if ACA were in place. Since the Cola is what is costing the state money, per some pols anyway, this could affect plans to reduce retiree costs to the state and accelerate the push to shift costs to the local school districts going forward.

  100. - RNUG - Thursday, Jun 28, 12 @ 7:28 pm:


    I was mostly likely going to take the COLA even w/o ACA because I was one of the early retirees that is being heavily targeted in the cost formula and I have a lot of years remaining.

    I’m betting the State is going to do an ‘all of the above’ on pensions. I think that teacher pension cost shift is a done deal; it just won’t happen until after the November elections. All the other proposals will get passed too and the state will be smart enough to include a severability clause so when most the other parts are found unconstitutional, what remains will survive.

  101. - Capitol View - Thursday, Jun 28, 12 @ 9:11 pm:

    this decision was more than about health care costs and the upcoming election. It was about reasserting the US Supreme Court as an independent government body above or beyond politics. The Roberts Court was already tainted by the Bush v Gore decision. If the Obama implemented (Republican conservative) health care reforms were thrown out, the Roberts Court would be considered the most political highest court in the history of our country.

    Actually, I expected a unanimous or near unanimous ruling to either accept the health care financing law in total, or to remand it to a lower court for further review prior to the election. A 5-4 decision with the Chief Justice with the liberals on the court surprised me.

  102. - western illinois - Thursday, Jun 28, 12 @ 10:12 pm:

    Yes RNUG I miswrote.
    I am very suprised it made it.
    The Daily Show is hillarious”obama is strolling down bin Ladin lane”
    “its very complicated reasoning (referring to the Fox /CNN screw ups) until you get to Roverts clear explanation on page 4″

  103. - A Modest Proposal - Thursday, Jun 28, 12 @ 10:46 pm:

    Katiedid - I agree with you that Americans like some of the measures such as children 26 and younger staying on insurance, and the pre-existing condition. I don’t think everyone knows exactly whats all in this bill. I know they don’t like the major portions like the expansion of medicaid and the ‘’mandate.'’ Can you show what exactly they like, and what they don’t like?

  104. - Yellow Dog Democrat - Friday, Jun 29, 12 @ 7:25 am:

    @A Modest Proposal -

    I can’t speak for all “Americans”, but Illinoisans across the political spectrum broadly support Medicaid spending, as well as education spending and human services spending.

    At the same time, a slight majority have opposed tax increases, although majorities say they would personally be willing to pay more in taxes to protect the above three.

    Whether the American people…or more pointedly Independents in swing states and targeted Congressional races…will buy into the Republican argument that they misspoke when they said that Obamacare was unconstitutional is a matter that Rich and I disagree on, but will play out soon enough.

    Arguing that Obamacare is a “massive tax increase” is problematic. Its a “tax” that something like 1 percent of Americans will pay, and then only if they choose not to buy health insurance. In that regard, its much more like a parking ticket.

    Then of course, there’s the problem that Mitt Romney’s “State’s Rights” argument has been completely obliterated by the Court.

    As I pointed out elsewhere, around 2014 there is the potential problem that Red States will choose not to expand their Medicaid problem, having been relieved of that obligation.

    I find that highly doubtful. Medicaid expansion is strongly favored by health care providers, who have strong ties to and largely fund the GOP. Doctors will revolt against the GOP if they turn away federal Medicaid dollars in Texas, Florida and other Red States.

    If they are smart, Democrats will seize this issue now in Red States to force the GOP hand.

  105. - western illinois - Friday, Jun 29, 12 @ 9:07 am:

    Local dems in red states are even more hopeless than ours.the Doc lobby may force them but not red state dems who surrender at the word NRA and melt like ice in this heat.
    I really hope Illinois and the big Blues play it to max out federal money for a change. We have only done that on highways in the past

  106. - Double Down - Friday, Jun 29, 12 @ 10:03 am:

    Its a “tax” that something like 1 percent of Americans will pay, and then only if they choose not to buy health insurance. In that regard, its much more like a parking ticket.==

    Politico addressed this issue
    The penalty starts at $95 or 1 percent of an individual’s income, whichever is greater. That’s in 2014, when the mandate takes effect. By 2016, when it’s fully phased in, the penalty will be either $695 or 2.5 percent of income. That’s compared to the thousands of dollars a legally acceptable insurance policy would cost if you were to go out and buy one.

    So when Roberts said from the bench that “it is indeed likely that many [more] Americans will choose to pay the IRS than buy insurance,” he might have been right.

    And if the mandate doesn’t bring in enough young and healthy people, the danger is that the pre-existing condition coverage that’s also in the law — guaranteed coverage for people with health problems — would force insurers to raise their premiums to cover their costs.

Sorry, comments for this post are now closed.

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