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Illinois’ Obamacare plan can continue

Thursday, Jun 25, 2015

* This ruling means Illinois doesn’t have to change any laws, which, among other things, gets our GOP governor out of a potential jam

The Supreme Court ruled on Thursday that President Obama’s health care law may provide nationwide tax subsidies to help poor and middle-class people buy health insurance.

Chief Justice John G. Roberts Jr. wrote the majority opinion in the 6-to-3 decision. The court’s three most conservative members — Justices Antonin Scalia, Clarence Thomas and Samuel A. Alito Jr. — dissented.

The case concerned a central part of the Affordable Care Act, Mr. Obama’s signature legislative achievement. The law created marketplaces, known as exchanges, to allow people who lack insurance to shop for individual health plans.

Some states set up their own exchanges, but about three dozen allowed the federal government to step in to run them. Across the nation, about 85 percent of customers using the exchanges qualify for subsidies to help pay for coverage, based on their income.

The opinion is here.

…Adding… The IHA explains…

The Illinois Hospital Association (IHA) applauds today’s U.S. Supreme Court decision upholding the legality of subsidies for hundreds of thousands of Illinoisans and millions of Americans that have enabled them to obtain health insurance coverage under the Affordable Care Act (ACA).

Because of these subsidies, more than 230,000 low- and moderate-income Illinoisans are able to afford health insurance, ensuring that they have access to the health care they need when they need it. These Illinoisans now receive more than $49 million a month in subsidies (nearly $600 million on an annualized basis).

The subsidies also help stabilize the overall cost of health insurance premiums in the state so that even those who do not currently receive subsidies have affordable premiums in the individual health insurance market. With health insurance, patients are able to seek care for serious health conditions at the right time in the right setting, leading to better health outcomes and lower costs for the health care system.

IHA and the Illinois hospital community have been long-time supporters of health insurance coverage. We are strongly committed to working every day to continue transforming the health care delivery system to ensure and maintain access to quality health care for all Illinoisans.

* Illinois State Medical Society…

In reviewing the U.S. Supreme Court’s decision, the Illinois State Medical Society is primarily concerned with the interests of our patients and their ability to access care. The Court’s decision validating subsidies for low-income patients who buy insurance through the federal marketplace provides important peace of mind for thousands of Illinois patients insured under Affordable Care Act plans. This decision does not represent the final word on accessing health care in Illinois. ISMS remains committed to addressing other crucial challenges, such as advocating for adequate financial resources for our Medicaid program and promoting a robust physician workforce to treat Illinoisans.

* Sheriff Tom Dart…

Today’s ruling allows people in Illinois to continue receiving both physical and mental health care.

Since Illinois’ Medicaid expansion went into effect, we have enrolled more than 11,000 detainees who came through the Cook County Jail. These detainees, with their new insurance cards, are now being treated for their physical and mental health problems and are less likely to be coming back to the jail as guests of Cook County taxpayers.

Too often in recent years we have seen detainees with mental health challenges re-offend soon after being released because they tell us the Cook County Jail is the only place they can get help. That is wrong on many levels and the new health care plan – combined with our own ground-breaking efforts to arrange mental health after-care for our detainees who are released – should help change that dynamic in the long run.

Now that these 11,000 people can rest assured that their insurance will not be abruptly taken from them, state and local legislators should focus their energies on appropriately funding mental health services and providing forums where these individuals can apply that insurance for the treatment they badly need. Until government gets it right on this issue, the shameful criminalization of mental illness will persist within our community.

- Posted by Rich Miller        

66 Comments
  1. - Amalia - Thursday, Jun 25, 15 @ 9:27 am:

    Scalia wants to call it SCOTUSCare. hilarious. Roberts proves himself to be the balancing act once again.


  2. - Flava Dave - Thursday, Jun 25, 15 @ 9:28 am:

    Good news for the United States - now the boys and girls in DC need to get more folks enrolled and reduce costs - those go hand in hand.


  3. - Team Sleep - Thursday, Jun 25, 15 @ 9:35 am:

    Wow.

    For all the talk about how SCOTUS leans, they have handed President Obama two major wins on this issue. If they rule in favor of same sex marriage rights, then that is a third. There are surely more, although nothing pops into my noggin right now. And, for all the bluster against the “Citizens United” ruling, nothing was stopping President Obama from pushing for campaign finance reform in 2009 and 2010.


  4. - A guy - Thursday, Jun 25, 15 @ 9:35 am:

    Obamacare would not exist without Chief Justice Roberts. He has plenty of equity in ensuring they discover methodology to make it work. 6-3 is a lot better than 5-4 on this. Time to move on.


  5. - Grandson of Man - Thursday, Jun 25, 15 @ 9:37 am:

    Great news. I read previously that one of Kennedy’s concerns was that the federal government should not have the power to damage states–in this case, states’ insurance markets and massive loss of insurance coverage for individuals–if subsidies were cut off.

    I have to read more about today’s ruling. I thought it would be 5-4 or 6-3 in Obama’s favor. It’s a great day for Obama and his legacy .


  6. - Streator Curmudgeon - Thursday, Jun 25, 15 @ 9:39 am:

    Common sense rules in the SCOTUS–but not unanimously.


  7. - Just Me - Thursday, Jun 25, 15 @ 9:41 am:

    To any conservatives who hate this ruling: Rauner’s introduced budget totally depended on Obamacare remaining law. He shorted a ton of incredibly popular healthcare programs with the assumption that folks would have insurance through Obamacare.


  8. - Federalist - Thursday, Jun 25, 15 @ 9:48 am:

    @Just me,

    Insightful comment!

    If the Republicans want to eliminate ACA/ObamaCare
    they will have to take the White House and Congress in 2016.

    It is interesting that c. 10 million are enrolled when the backers of this legislation talked of 47-50 million uninsured.


  9. - Sheesh Hecuka Cupajava - Thursday, Jun 25, 15 @ 9:52 am:

    But, but…the conservative right-wing court!


  10. - Amalia - Thursday, Jun 25, 15 @ 9:53 am:

    the Scalia dissent is a great source of wonderful quotes with phrases that should be applied elsewhere. Among my faves: interpretive jiggery-pokery, pure applesauce, and next defense of the indefensible. While I may not agree with his logic or politics, I do like his style! no wonder Notorious RBG goes to the opera with Scalia


  11. - Cassandra - Thursday, Jun 25, 15 @ 9:56 am:

    The Republicans must be happy when they’re at home. Cutting off millions of citizens, even if a workaround were found in some states, would have been disastrous for their already shaky 2016 prospects. Sometimes you win for losing.


  12. - Team Sleep - Thursday, Jun 25, 15 @ 9:57 am:

    Amalia - hilarious! Thanks for some morning chuckles. I’m picturing Justice Scalia sitting on his porch, smoking his Benson & Hedges cig and hammering out rhymes and clever retorts.


  13. - walker - Thursday, Jun 25, 15 @ 9:59 am:

    The Court found for the obvious legislative intent of the law, rather than quibble over some incomplete language. Good for them.

    Republican governors all over the country have defended cuts in their own state budgets by pointing to the ACA as their back up, while still politically criticizing it.

    Rauner, to his credit, acknowledged ACA’s help to his budget, without getting on the national party’s anti-Obamacare bandwagon.


  14. - pundent - Thursday, Jun 25, 15 @ 10:02 am:

    Federalist - The Republicans don’t want to eliminate Obamacare because they have no alternative to replace it. And whether the amount of uninsured is reduced by 50M or 10M the Republicans will not want to take their insurance away. A lot of those people vote too.


  15. - ZC - Thursday, Jun 25, 15 @ 10:05 am:

    Re the Supreme Court, Scotusblog (to the Supreme Court, what Capitol Fax is to IL politics) had an interesting point today: part of the “liberal lean” to this year’s rulings, is the Supreme Court at least took up and heard challenges that, in a previous era, would have been seen as fait accomplis for the liberal side.

    But let’s forestall any full discussion of the “conservative” or “liberal” Supreme Court these days, until we find out what they ruled on gay marriage …


  16. - MrJM - Thursday, Jun 25, 15 @ 10:09 am:

    Scalia dissent tl;dr - http://i.imgur.com/XPpoZ8F.gif

    – MrJM


  17. - Demoralized - Thursday, Jun 25, 15 @ 10:10 am:

    Until they manage to get a President to sign a repeal of the law (assuming they maintain their majority in Congress), the Republicans need to move on from the ACA. The Court has clearly indicated (twice now) that they are in no mood to assist them in dismantling the ACA.


  18. - Grandson of Man - Thursday, Jun 25, 15 @ 10:13 am:

    I wonder how many Republicans are secretly breathing a sigh of relief, now that millions of people won’t lose their health insurance subsidies. We know how upset people get when they lose their insurance coverage…

    I read one or another study that states around a net 17 million gained coverage under Obamacare. We have also seen surveys that show big drops in uninsured rates. This ruling has huge implications.

    I believe that Obamacare may be only the beginning of health insurance/healthcare reform. From what I saw, we can do better in negotiating drug prices with big drug-makers. There are great new medicines, but some are so expensive.


  19. - Todd - Thursday, Jun 25, 15 @ 10:24 am:

    while many of my conservitive friends are nashing their teeth and condeming the ruling, a simple question pops to mind:

    The Second Amendment says — “A well regulated militia being necessary to the security of a free state, the right of the people to keep and bear arms shall not be infringed”

    In this the Court has ruled that the term State applies to the federal governement, state government and even local government.

    Given that, is this ruling that out of whack?


  20. - Apocalypse Now - Thursday, Jun 25, 15 @ 10:24 am:

    Based on this ruling and precedent, language in laws or contracts mean nothing. Sad legal ruling for the country.


  21. - a drop in - Thursday, Jun 25, 15 @ 10:28 am:

    I just got around to watching the series on FDR (PBS). When the Supremes starting declaring much of the New Deal legislation unconstitutional, he came back with an idea to pack the court with his appointees. Suddenly, the remaining legislation was somehow determined to be constitutional.

    Judge Roberts was highly criticized in having a conservative agenda and the court seems to have reacted to that. It has been said this term’s Court is the most liberal deciding since the Warren Court.


  22. - walker - Thursday, Jun 25, 15 @ 10:29 am:

    Federalist: The number of uninsured has dropped 16M due to ACA. The number of enrollees impacted by this court decision was just under 9M. At least that’s what I could find thru May this year.


  23. - Amalia - Thursday, Jun 25, 15 @ 10:29 am:

    @ Team Sleep, do read his dissent. my pulled out bits do not do him justice. love your picture of him while writing. Benson and Hedges!


  24. - How Ironic - Thursday, Jun 25, 15 @ 10:34 am:

    @Apocalypse Now:

    “Based on this ruling and precedent, language in laws or contracts mean nothing. Sad legal ruling for the country.”

    Oh please. Cue the victim music now. You don’t gut an entire program, and throw millions of needed insurance because of a misconstrued phrase, that BTW no one really thought meant anything other than the way the law had been enacted.

    This was a hail-mary of a hail-mary, last ditch effort by a marginal few. Even the GOP is relieved that this was the ruling. Chaos would have ensued.


  25. - Shoe Searer - Thursday, Jun 25, 15 @ 10:35 am:

    =Scalia dissent tl;dr==

    Did you read it? Or did you run out of time searching for a killer gif?


  26. - Amalia - Thursday, Jun 25, 15 @ 10:38 am:

    @Todd, anything of interest which you anticipate from
    Johnson v US?


  27. - Amalia - Thursday, Jun 25, 15 @ 10:42 am:

    http://ethanklapper.tumblr.com/post/27575682612/antonin-scalia-in-gif-form

    sadly, no Benson and Hedges….


  28. - MrJM - Thursday, Jun 25, 15 @ 10:43 am:

    “Did you read it?”

    I did. Typical melodramatic argle-bargle.

    “Or did you run out of time searching for a killer gif?”

    I didn’t search for that killer gif. I made it.

    – MrJM


  29. - Shoe Searer - Thursday, Jun 25, 15 @ 10:46 am:

    ==You don’t gut an entire program, and throw millions of needed insurance because of a misconstrued phrase, that BTW no one really thought meant anything other than the way the law had been enacted.==

    (At least) three supreme court justices did and wrote a painfully detailed explanation why. But don’t let that get in the way of what cable news said.


  30. - MrJM - Thursday, Jun 25, 15 @ 10:58 am:

    Keep banging your drum, Shoe Searer!

    You’ll drive out that Obamacare demon yet!

    – MrJM


  31. - Birdseed - Thursday, Jun 25, 15 @ 10:59 am:

    Solid.

    The somersaults of statutory interpretation they have performed (“penalty” means tax, “further [Medicaid] payments to the State” means only incremental Medicaid payments to the State, “established by the State” means not established by the State) will be cited by litigants endlessly, to the confusion of honest jurisprudence.


  32. - downstate - Thursday, Jun 25, 15 @ 11:02 am:

    Tortured logic from the majority.

    No doubt it would’ve created an appreciable amount of chaos if the ACA was overturned but I still (perhaps naively) thought the Court was supposed to insulate itself from the politics of an issue and focus on the issue itself.

    Scalia’s dissent, while fun, is chock full of hyperbole; but he does correctly point out that the majority decision sets a potentially dangerous precedent.

    It’s been a strange couple of years for SCOTUS.


  33. - 47th Ward - Thursday, Jun 25, 15 @ 11:20 am:

    ===It has been said this term’s Court is the most liberal deciding since the Warren Court.===

    Who said such nonsense? Glenn Beck? Sarah Palin? Donald Trump?


  34. - Shoe Searer - Thursday, Jun 25, 15 @ 11:27 am:

    ==Keep banging your drum==

    My drum banging had zero to do with the law, its merits, or my personal views. Rather, it was your unwillingness (surely not inability, right?) to engage any of the arguments in the dissent with something more than a gif and “argle-bargle”. Strikes me as a reaction of one who has either not read a word of the text, or, in skimming through it, paused periodically to reflect on how bad Jon Stewart and Vox are going to destroy Scalia.


  35. - Demoralized - Thursday, Jun 25, 15 @ 11:30 am:

    It’s interesting to watch people’s reactions to Supreme Court decisions. If you agree with it the Court is the greatest thing since sliced bread. Disagree with it? The Court is a bunch of lunatics who are destroying the Constitution.


  36. - Mokenavince - Thursday, Jun 25, 15 @ 11:34 am:

    Good news on ACA, this should but won’t stop all the nonsense on Fox. Now congress should work to correct the flaws in the law.


  37. - Carroll County - Thursday, Jun 25, 15 @ 11:34 am:

    One industry gets to continues its pillage of the rest of the economy, see Hospital Assoc. above, and the rally in these stocks today on Wall Street.

    http://www.cnbc.com/id/102788551

    20% of GDP to healthcare. How high can it go before the rest of us can’t continue to tighten our belts to feed this monster?

    I only hope this is a not-yet-revealed path to single payer and that the sick can quit having fundraisers to pay medical bills someday soon.


  38. - One of the 35 - Thursday, Jun 25, 15 @ 12:00 pm:

    Poorly worded legislation is salvaged by SCOTUS.


  39. - Wordslinger - Thursday, Jun 25, 15 @ 12:22 pm:

    Todd, it’s common usage to refer to various levels of government as “the state.” Interpretation in law should reflect legislative intent, as this majority ruling does.

    In federal courts, everyone refers to the Justice Department, representing the United States, as “the state.” The United States is a “nation-state.”

    Justice Scalia no-likey obvious legislative intent when it doesn’t suit his purposes. When it does, he’s cool with it.


  40. - Todd - Thursday, Jun 25, 15 @ 12:46 pm:

    Amilia, Not really. Waiting on the SSM ruling actually. think it could be more important

    Word, I just looked to that use of it and found the idea plausable. I understand the use of State in criminal charges and other pleadings. I just rtry to be somewhat consistant in how a veiw things. and I think picking and choosing things like this definition does conservitives no good


  41. - Southwest - Thursday, Jun 25, 15 @ 12:52 pm:

    wordslinger, what are some examples of Scalia’s opinions regarding legislative intent?


  42. - How Ironic - Thursday, Jun 25, 15 @ 12:53 pm:

    - Shoe Searer - Thursday, Jun 25, 15 @ 10:46 am: “At least) three supreme court justices did and wrote a painfully detailed explanation why. But don’t let that get in the way of what cable news said.”

    Sure, and don’t let the fact that 6 Judges disagreed with the 3 losing judges.

    I’ll bank on the winners, you console yourself with the tears and impotent rage of the remainder.

    It’s like saying the Patriots of ‘85 were better than the Bears, score not withstanding.


  43. - A guy - Thursday, Jun 25, 15 @ 12:54 pm:

    === Demoralized - Thursday, Jun 25, 15 @ 10:10 am:

    Until they manage to get a President to sign a repeal of the law (assuming they maintain their majority in Congress), the Republicans need to move on from the ACA. The Court has clearly indicated (twice now) that they are in no mood to assist them in dismantling the ACA.====

    Demo, that’s precisely where we are. ACA is a lousy collection of legislation. This conservative (me) believes any approach to National Health Care would be characterized the same way.

    We can continue to fight about it, or we can try to amend it, fix it, and make it work to it’s best potential. Pragmatic conservatives get that.


  44. - Wordslinger - Thursday, Jun 25, 15 @ 12:59 pm:

    SW, google “Scalia legislative intent.” It will keep you occupied for a while.


  45. - How Ironic - Thursday, Jun 25, 15 @ 1:04 pm:

    @A Guy:
    “We can continue to fight about it, or we can try to amend it, fix it, and make it work to it’s best potential. Pragmatic conservatives get that.”

    I can only imagine the looks had this case prevailed. The GOP presidential contenders would have all looked like dogs that managed to catch the car they were chasing. And all saying ‘now what’?

    The repeal crowd is content to talk big, but they’ve not actually advanced any sort of counter-program had the ACA been gutted.

    I think it’s a lot more about resisting anything Obama stands for, than actually formulating a program that is ‘better’ than what the ACA is.

    From a hospital perspective, the ACA has been good. Our non-insured patient base is way down, and revenues are going up. Seeing much less traffic in the ED from patients that have no where to go. Certainly it’s not been eliminated, but it’s much, much better than pre-ACA.


  46. - Wordslinger - Thursday, Jun 25, 15 @ 1:05 pm:

    ACA was a swell conservative, market-place idea when the Heritage Foundation drew it up and Sen. Grassley pushed it in the Senate.

    Then something happened in 2009. Don’t know what.

    Guy, are you down on all national healthcare, like Medicare and prescription drug benefits, too?


  47. - Federalist - Thursday, Jun 25, 15 @ 1:13 pm:

    Was the ACA that Obama advocated different, and if so how different in both operational and financial costs, that what the Heritage Foundation advocated?

    Would not be surprised to find out that they were but I certainly do not know the history of this issue.


  48. - Southwest - Thursday, Jun 25, 15 @ 1:15 pm:

    Wordslinger, I already have googled it. Scalia’s book says he is a “textualist.” That laws should be read based on the fairest meaning.

    “Judges should not be using such extrinsic factors as, ‘What is the general purpose of the statute?’ Or ‘What did the Senate committee say when the statute was enacted?’” I’m just looking for examples of cases that prove he doesn’t follow this if it does not suit his purpose.


  49. - Federalist - Thursday, Jun 25, 15 @ 1:16 pm:

    @Walker,

    Can you explain to me how the number of uninsured dropped by 16 million when about 9 to 10 million were enrolled? Where did the c. 6 million go?

    Thanks.


  50. - Federalist - Thursday, Jun 25, 15 @ 1:20 pm:

    pundent - Thursday, Jun 25, 15 @ 10:02 am:

    Federalist - The Republicans don’t want to eliminate Obamacare because they have no alternative to replace it. And whether the amount of uninsured is reduced by 50M or 10M the Republicans will not want to take their insurance away. A lot of those people vote too.

    That’s the way I see it also. Besides they want to gripe about it and use it for fund raising. And I say that even though there are many aspects of this legislation I do not like.


  51. - Threepwood - Thursday, Jun 25, 15 @ 1:42 pm:

    Federalist:

    I’m struggling to quickly find the specific statistics in question, but I know that 10 million figure refers specifically to the people who enrolled through the exchanges set up under the ACA. You don’t necessarily have to use the exchanges, and the law has other incentives and prods to encourage people to sign up, and employers to provide coverage. So that is likely the difference between the numbers.


  52. - ZC - Thursday, Jun 25, 15 @ 1:43 pm:

    I took up the “Scalia challenge” and Googled around - a bit. Overall I’d say this isn’t a marked departure from Scalia’s normal approach to law. He usually scorns “legislative intent” as a source for determining the meaning of a statute, and legislative intent was always the strongest trump card the ACA supporters had going for them. The record was fairly overwhelming that nobody writing the law intended for state-created exchanges to get shafted. (There have been some conservative dissenters to this point, to be sure, but they strike me mostly as johnny-come-latelys who jumped on this particular bandwagon, when they realized it might help sink the ACA).

    But while Scalia takes this position, it’s hardly the only nor the dominant interpretative position on the Court (obviously). Plenty of other justices believe that factoring in legislative intent is an important part of their jobs - perhaps especially when the evidence here is as one-sided as it is.

    Maybe the best critique here is that when Scalia spurns “what did lawmakers think they were up to,” he goes to some strange places. For me the weakest part of his dissent is where he does reason backwards and put it out there, “Well based just on these -words-, it seems very plausible that Congress really did intend to deny subsidies to state exchanges.” In other words, based on his reading of the statute and his dictionary, he projects an interpretation of what he thinks the lawmakers (might) have really intended to do, in their heads. Whatever else is right or wrong about his dissent, that part is odd.


  53. - Joe Bidenopolous - Thursday, Jun 25, 15 @ 1:50 pm:

    Federalist,

    Targeting an absolute number is almost futile. For instance, not all people who are now receiving subsidies, or who are enrolled in exchanges, were without insurance prior to the ACA. Many, perhaps most, were, but not all.

    According to Kaiser, Medicaid enrollment nationwide grew by 11.2 million people between 2013 and 2015. Most of that increase was due to Medicaid expansion in states that accepted expansion dollars. Some of those people had insurance before expansion, many didn’t.

    In sum, there are several ways in which people who were uninsured pre-ACA might be insured today. Some (few) people who were insured pre-ACA are now uninsured, some who were insured pre-ACA are now either on Medicaid or enrolled in exchanges and receiving subsidies.

    Bottom line is that the number of uninsured Americans was reduced by about 9 million as of the end of 2014, the first year that coverage was required, and likely has decreased further in 2015, though those numbers won’t be available for some time. Since the ACA was implemented in 2010, there are roughly 14 million fewer uninsured Americans. That’s about as precise as you can get.

    And 14 million ain’t nothing. Just ask them and their families.


  54. - Anon. - Thursday, Jun 25, 15 @ 1:52 pm:

    ZD @ 1:43 pm ==Whatever else is right or wrong about his dissent, that part is odd.==

    What is odd about saying that the best evidence of what Congress intended the law to mean is what the law they drafted actually says?


  55. - A guy - Thursday, Jun 25, 15 @ 1:52 pm:

    Slinger, read my comments again. I don’t know what you mean by “Are you down…”

    And to suggest the Grassley version and Obamacare are the same is more than a little off dude.

    ACA is the law of the land. I never thought there would be votes to overturn it. That bridge was crossed when the Chief Justice weighed in the first time.

    I’m in the camp that says let’s improve it and remove some of the problems.

    Prescription drug benefits may have inadvertently saved Medicare really. It presented the first opportunity for comprehensive review since the entitlement began. If down on it means I don’t like it, I am not down on it.


  56. - Joe Bidenopolous - Thursday, Jun 25, 15 @ 1:57 pm:

    Adding…

    And part of the reason that the ACA hasn’t hit the benchmarks for reducing the uninsured is the SCOTUS ruling on Medicaid expansion and the states that have not expanded Medicaid as a result, notably Florida and Texas, which has the highest uninsured population in the nation.


  57. - ZC - Thursday, Jun 25, 15 @ 2:13 pm:

    >> What is odd about saying that the best evidence of what Congress intended the law to mean is what the law they drafted actually says?

    Because when you go back and talk to all of them, the people who actually wrote it and all of the existing floor debates (which they can’t retroact, including all the public comments of the critics of the law, too, with the possible exception of one Attorney General in Oklahoma) nobody seems to call attention to this structural flaw that would demolish all of the state-run exchanges. You’d think it would have occasionally come up, if this is what they intended for the law to do.

    It’s like Democrats spent the greater part of two years building something to intentionally not have it work? That’s the part that’s odd to me. And yes the contrary interpretations start sounding really conspiracist and paranoid, sorry.

    Now if Scalia had just stopped his dissent before then, just sort of said, “Eh, whatever they meant, it’s a screwed-up phrasing, and I follow the words,” then I wouldn’t agree, but I could see where he’s coming from.


  58. - Rich Miller - Thursday, Jun 25, 15 @ 2:16 pm:

    ===That’s the part that’s odd to me===

    Extremely.

    This suit should never have risen to such a high level.


  59. - wendy - Thursday, Jun 25, 15 @ 2:22 pm:

    Federalist:

    There are approximately 11.7 million people who got health insurance through the marketplaces. Almost 8.9 million of them got insurance through the federal marketplace (because they live in states that chose not to run their own. Illinois is one of those states.) Almost all of those 8.9 million — approximately 7.7 million people — are getting subsidies that would have ended if King had been decided differently.

    Other ACA provisions also increase coverage. Since 2010, more than two million young adults have been able to stay on their parents’ health insurance. Additional Medicaid enrollments in the Medicaid expansion states (even as an improving economy and lower unemployment would have meant fewer people with Medicaid,) leads to the total of about 16 million more people with health insurance. The percentage of people in the United States without health insurance has gone down by more than one third. The reduction in the number of people in the expansion states, whose incomes are just above the poverty line and now have health insurance is, I think, especially moving.

    You can get more information about the impact of the ACA here http://www.hhs.gov/news/press/2015pres/03/20150310a.html
    and here http://aspe.hhs.gov/health/reports/2015/uninsured_change/ib_uninsured_change.pdf


  60. - Federalist - Thursday, Jun 25, 15 @ 2:22 pm:

    Joe Bidenopolous

    Any large government program is difficult to define and explain in absolutes.

    It is obvious you are a big supporter of this legislation but I thank you for your explanation.
    It helped a little.


  61. - Wordslinger - Thursday, Jun 25, 15 @ 3:45 pm:

    Guy, I did read your comments.

    –…ACA is a lousy collection of legislation. This conservative (me) believes any approach to National Health Care would be characterized the same way.–

    I’m pretty sure Medicare and prescription drug are national health care programs. In your mind, they’re “good” lousy collections of legislation?

    Tne other stuff you wrote about Grassley and prescription drug saving Medicare made about as much sense.


  62. - walker - Thursday, Jun 25, 15 @ 4:34 pm:

    Federalist: Wendy’s outline above agrees with the best info I could find, that explains the 16M+ reduction in uninsured. The largest impacts other than “enrollment” came from expanded Medicaid and the 26 yr. old inclusions, both of which are part of the ACA as well.

    Would agree with you it did not meet all its initially touted objectives, for many reasons. It certainly boosted profits in the private healthcare sector dramatically.


  63. - Grandson of Man - Thursday, Jun 25, 15 @ 4:52 pm:

    I agree with those who say health insurance reform is a work-in-progress, with more work to do for improvement.

    Still, I don’t recall any recent law that has gone through so much rigor and strain, and withstood so many attacks–two SCOTUS victories and 50 or more legislative attacks. Obamacare is a battle-tested survivor. When will the frothing-at-the-mouth attacks end, or will they? Will the GOP push repeal in 2016? When will the returns finally diminish to end the attacks, or are certain voters so angry still that politicians will milk their anger for votes?


  64. - Wordslinger - Friday, Jun 26, 15 @ 7:35 am:

    Today’s Washington Post points out that Roberts in his majority draws on Scalia’s dissent in the 2012 ACA case.

    Back then, Scalia thought his interpretation of legislative intent was critical. This time, not so much. His politics are consistent, at least.


  65. - Mister M - Friday, Jun 26, 15 @ 8:52 am:

    For the “established by the state” phrase, what is the full sentence. It can mean one thing in one context, and a differentthing in another context. If the rest of the sentence has a singular reference to a state exchange, then there really is no ambiguity and “state” means one of the fifty (how do they reference DC, Peurto Rico, etc?). If the full sentence does not have such a context, some ambiguity could be read into it.


  66. - Logic not emotion - Friday, Jun 26, 15 @ 11:09 am:

    What is the status of the state’s In Personal Counselor grants to help people navigate through the exchange?


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* GOMB: State needs another $3+ billion a year to stay even
* Raoul announces transition committee
* The Democrats' vote-by-mail juggernaut
* Why the Firearms Restraining Order Act is so important
* Pension benefits are not cut in the abstract
* The way forward
* Yes, something can be done
* Monday's heroes
* *** LIVE COVERAGE ***
* Yesterday's stories

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