Bacon's Rebellion

Democracy Thrives in Sunlight

In the “If Your Like Your Health Care Plan, You Can Keep It” Department…

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by

James A. Bacon
in , ,

then-i-said

From the Times-Dispatch: “After a year’s reprieve, up to 250,000 Virginians will receive notice by the end of November that their health insurance plans will be canceled because the plans do not comply with the Affordable Care Act and accompanying state law.”

Now those Virginians will have to buy new, Obamacare-compliant plans, which means they will have more benefits they may or may not want… and will cost more.

The Virginia Association of Health Plans, which has become a wholly owned subsidiary of the Obama administration, defended the forced switch. Said Executive Director Doug Gray: “I don’t call that cancellation – I call that an adjustment to the new law.”

I call it a cancellation. I’ll be that the people affected by the law call it a cancellation, too.

— JAB

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54 responses to “In the “If Your Like Your Health Care Plan, You Can Keep It” Department…”

  1. larryg Avatar
    larryg

    well , can you tell me that your current health insurance is for longer than one year and at the end of the year you receive a statement for the coming year – and plan changes ?

    every seen that? Most people get the letter but don’t read it but that letter often will have a premium increase or changes to co-pays or deductibles and limitations of coverage, etc.

    they can – and have sent letters that they no longer offer the plan you have and sometimes offer you others or if they are these companies that offer bare-bones catastrophic – they have a reputation of just refusing to renew at all if you’ve had claims.

    the statement made about keeping your insurance was wrong – stupidly wrong and damaged the POTUS – as it should have.

    but in the real world of insurance, most people do not get guaranteed insurance anyhow. It’s usually year-to-year and changes are made – or they can just refuse to offer you the insurance at all.

    I’m not saying this is better or worse than Obamacare but I’m saying the truth here is being shaded… as to your “right” to keep your policy.

    you have no such right at all – the company is free to dump you or double your premiums or cut out the benefit you depended on.

    let’s be truthful… about “keeping your plan”.

    the truth is – you don’t have a right to keep your plan. Never did.

    Now if you have employer-provided insurance – you DO have that right but you are still subject to plan changes that you have no control over.

    and the reason why you are guaranteed the right to have employer-provided insurance – is not the free market – it’s the govt.

    just as it’s the govt that lets you get that insurance – tax free.

  2. NoVaShenandoah Avatar
    NoVaShenandoah

    I must say that I don’t understand this obsession with the statement about not losing your health plan. Plans have been getting canceled and redefined for as long as I can remember. One year, my employer moved me through 3 different health plans.

    So it seems to me that those who keep harping on the point are doing so for perfectly dishonest reasons. Another way to put it is: ObamaCare is here (fortunately since before I was uninsurable … DEAL WITH IT!)

    Grow UP already. You lost the elections, and the country still disagrees with you.

    1. larryg Avatar
      larryg

      there where actually two big mistakes.

      the second one was the POTUS statement -but the 1st one was going one step beyond the exchanges and requiring other non-exchange insurance to offer plans with specific things covered.

      That gave those insurance companies the perfect excuse to not renewing people or increasing the premiums ..

      had they not done that – the difference between the exchange insurance in terms of guaranteed access and guarantee to keep it – and the ‘market’ insurance which has always been free to deny coverage, cancel, not offer it in the first place, increase premiums, kick you off.. would have been stark.

      If person that they kicked off – for their various reasons would have found an alternative in the exchanges.

      In addition to the Market insurance, there is the gross inequities with employer-provided.

      first – it is tax-free whereas those that buy insurance on the market are buying it with taxed-dollars. That’s a huge subsidy to employer provided in addition to guaranteed access … Next – there is the employer contribution when those who buy market insurance don’t even get a refundable credit for their outlays.

      what justifies employer-provided to be so inequitable to those who have to get insurance on their own?

      what was there not a level playing field where people who bought insurance – would get a tax refund so they would be getting health insurance tax free also? what justified employer-provided to do this and not – non-employer provided to enjoy the same tax policy?

      The GOP had and has had with their bogus “repeal and replace” – EVERY OPPORTUNITY to propose an approach that would level the playing field for everyone but they have done nothing.

      why not get rid of employer-provided tax advantages all together and let people buy their own insurance with their own taxed dollars and if there are going to be tax-advantages – give it to everyone.

      The problem with the critics – is that they enjoy being a critic so much that they offer no real alternatives – specific alternative other than their general hand-waving “market principles” blather. When push comes to shove, they refuse to actually propose real market alternatives.

      It’s fine to be a critic but it’s not fine to criticize and not offer a real alternative. At that point, you become a partisan.

      we have the same problem with immigration and same-sex – the critics don’t like either of the current policies but they have no alternatives to offer and any attempt to compromise results in legislative gridlock and hostage taking (i.e. we shut down the govt if we don’t like your approach).

  3. James A. Bacon Avatar
    James A. Bacon

    Wow, guys, I’ve got to hand it to you — your powers of rationalization are formidable!

    Sure, health care plans have never been static. They’ve always been in flux, as conditions change. If people didn’t like the new plans their insurers proposed, they could always opt for a cheaper one. The trouble is, with Obamacare, there are no cheaper plans. Obamacare dictates minimum standards. Most of these 250,000 people will wind up paying more for features that they either didn’t need, or didn’t value enough to pay for.

    1. larryg Avatar
      larryg

      re: ” they could always opt for a cheaper one.”

      really? do you mean the ones that pay almost nothing when you get sick then cancel you?

      ” The trouble is, with Obamacare, there are no cheaper plans. Obamacare dictates minimum standards. Most of these 250,000 people will wind up paying more for features that they either didn’t need, or didn’t value enough to pay for.”

      I think once again – you argue without the facts… you should go take a look at
      the choices available at the exchanges. Many, many people are getting BETTER coverage for LESS money that market insurance.

      again -you need to go look Jim – there are a wide array of plans available including HMOs and catastrophic plans…

      why do we have people whose only alternative to health insurance is to go without or buy these almost worthless policies at the same time you get subsidized with employer-provided? why do we have subsidies for some of us but not others who have no real options?

  4. NoVaShenandoah Avatar
    NoVaShenandoah

    To ‘James A. Bacon @ September 12, 2014 at 9:54 am’

    A couple of corrections:

    1. If you work for an employer who provides health coverage, you have absolutely no choice on the coverage you get: the employer selects the company and the options available to you as well as what you pay – period. It is only the federal government that provides any choice to its employees.

    2. Health plans, especially in the individual market (I know from personal experience) have rarely been in effect for more than 1 year at a time. Insurance companies, especially in the individual market, have been cancelling them and redefining them as a matter of course, with hardly any notice. It is nothing new.

    Stating these is not a rationalization. As has been said: You are entitled to your opinion but not to your facts.

    That is why I find this obsession with that 1 statement to be a canard by folks who still have not accepted that you lost the electionS, and the country, frankly, does not agree with you. That includes Virginia, by the way, which continues to elect people who want to expand health coverage. It is through the power of gerrymandering that we are deprived of it.

    1. larryg Avatar
      larryg

      let me add more…

      Medicare, Social Security, and Medicaid have bee changed dozens of times over time to correct/change flaws and improve it.

      that’s not the case with ObamaCare. The critics have complaints but they don’t want to fix it… the complaints are just opposition – and worse than that – they have no real alternative proposals except “ideas” that – as a group – they cannot support as a true alternative for the critics to vote for.

      so the same old canards get brought up – not as something to fix or change but as continuing opposition without real alternatives other than the prior system where people were denied coverage, kicked-off and every year changes made on a “take it or leave it basis” – and that includes both market and employer provided.

      the net result was/is millions of people who taxpayers foot the bill for them to get their care at ERs instead of primary care doctors and this includes the people who could “keep their insurance” but went to the ER when their insurance did not cover them.

      there is no virtue in the opposition. It’s basically political vandalism from folks who don’t give a rip about the real issue or else they’d be in the game with real alternatives.

    2. larryg Avatar
      larryg

      Another aspect alluded to by NoVaShenandoah on employer-provided – not only do you get what they decide to give you – but if you take single coverage instead of family -you get less tax-free compensation.

      and if your spouse works – and they elect family coverage at their employer – you get nothing unless you want to also get single or family coverage.

      why do you not get the same subsidy regardless of whether you are married or single or have insurance somewhere else?

      what would happen if people got the same subsidy? would they take that money and go out into the market to get exactly what they wanted?

      not likely – because the employer is required to offer you the insurance and cannot cancel it on you.

      what justifies the employers to be able to offer it’s employees what the market does not – guaranteed insurance? what enables that? What if employer provided insurance was able to function like the market and dump anyone who they pleased or charge whatever price on an individual basis they determined?

      what I’m pointing out here is that the counter-point to Jim and his fellow critics lament about “keeping your insurance” is – only true for employer-provided not because it’s a superior insurance – but because the law restricts them to do that and yet I don’t hear Jim Bacon complaining about the govt “interfering” with the free market of employer-provided insurance.

      employer-provided insurance would be far cheaper if they were not required to cover the sicker employees – no question about it – the others in the employee pool are essentially subsidizing the sicker ones instead of letting each person as an individual face the free market on their own merits.

      what justifies this special treatment which is imposed by the govt instead of letting the employer and their insurance company use a free-market approach for employee insurance?

    3. LifeOnTheFallLine Avatar
      LifeOnTheFallLine

      Remember, when entities in the private sector act like conscienceless sociopaths it’s fine because they have no social responsibility nor should we ask them to have any. So if insurance companies can play three card monte with individual plans that’s fine, the free market probably demands it or something.

      But if the government enacts policies that force insurance companies to drop plans that only cover people if their legs fall off and only provide three doctors visits a lunar year then it’s the most horrendous behavior ever.

      1. larryg Avatar
        larryg

        what if govt forces employer-provided insurance to not use the same free-market principles that market based insurance uses?

        what justifies the govt requiring employers to cover people that the free market will not and to make others in the employer insurance pool pay higher premiums to cover them?

        what gives the employers the right to not give you the insurance money instead of the insurance so you can go by exactly what you want and not be forced to take the employer insurance?

        where do these rules come from and why are they there?

    4. TooManyTaxes Avatar
      TooManyTaxes

      “If you work for an employer who provides health coverage, you have absolutely no choice on the coverage you get: the employer selects the company and the options available to you as well as what you pay – period. ”

      That statement is not universally true. I’ve worked for several employers that have offered multiple health care plans – some with broader coverage and higher premiums and others with less coverage and lower premiums. A good example is a choice between a traditional plan and an HMO. When I worked for a large company, I had the former, but a sister-in-law who worked for the same company, chose the latter.

      This is not universal, I will fully agree. But a lot of companies offered options at least prior to the ACA. At this point in time, I am insured through the federal government where my wife is employed and reimburse her for half the premiums. Full disclosure.

  5. Andi Epps Avatar
    Andi Epps

    Someone might have mentioned this, but part of it is because of state law. At least that’s what the paper said.

    1. larryg Avatar
      larryg

      but what’s the justification for the state or the Feds requiring employers to cover people while not requiring the same of market insurance?

      bonus question – why does the right wing and Jim Bacon and friends not complain about the govt regulation of employer-provided health care that inhibits free-market principles when they complain about “keeping your insurance”?

  6. Richard Avatar
    Richard

    Actually it’s not the government that is dropping these grandfathered plans, but the insurance companies that have decided they don’t want to provide them anymore. In other words the insurance company has made a business decision that these grandfathered plans aren’t worth supporting anymore. Here’s the explanation of the deadline for grandfathered plans from Obamacarefacts – a website you might consider consulting in the future:

    “SPECIAL UPDATE: You can now keep your plan until 2017 in some states!
    The Department of Health and Human Services (HHS, i.e. the department in charge of ObamaCare) has announced that health insurance plans that were supposed to be canceled by Obamacare by 2014 may be sold through October of 2016 in states that approve of the extension. This essentially extends some non-compliant non-grandfathered plans until 2017 (a plan renewed in 2016 is good for one year, the latest date to renew your plan is October 2016).”

    Your article is another example of the lengths that opponents will go to mischaracterize Obamacare. News flash – it’s not working anymore.

    1. James A. Bacon Avatar
      James A. Bacon

      Mischaracterizing Obamacare? Yikes, I’m just quoting from the TImes-Dispatch article.

      Sez the T-D: The plans are being canceled “because the plans do not comply with the Affordable Care Act and accompanying state law.”

      1. larryg Avatar
        larryg

        re: ” Mischaracterizing Obamacare? Yikes, I’m just quoting from the TImes-Dispatch article.”

        would you consider the TD to be a neutral player in Obamacare?

        “Sez the T-D: The plans are being canceled “because the plans do not comply with the Affordable Care Act and accompanying state law.””

        like they don’t cancel policies for all manner of reasons already?

        do you think they don’t offer Obamacare compliant policies and they just got our of the business all together ?

        or do you think they also “no longer offer” policies but instead offer different ones?

        the narrative you have latched onto is disingenuous because it implies that these policies would have been always offered – into the future and that these companies don’t change their policies anyhow, year to year.

        but why don’t you complain about how the govt puts regulations on employer-provided health insurance the same way it does the market insurance?

        Never once heard you complain that the govt puts regulations on employer-provided that cause the price to go up and limit people’s ability to get the insurance they want – or force them to subsidize those who are sick.

        why do you only focus on one side of the equation when it comes to free market and accept the employer-provided side as fine?

        are you really fine with the govt creating employer provided regulations and rules but not with other insurance?

      2. Richard Avatar
        Richard

        Jim. You’re being disingenuous. The title of your article repeats the completely misleading claim that your buddies made in the last Presidential election. Obamacare is doing what was promised and everyone is the better for it.
        Richard

  7. Andi Epps Avatar
    Andi Epps

    I have an honest question that is well suited to this group. There is NO sarcasm intended.

    If I allow my car insurance to lapse, I loose my license. If government can mandate on insurance why can’t they mandate all?
    OR
    If Obamacare isn’t constitutional (as some would argue) than how is car insurance (especially based mostly on credit rather than driving record) OK?

    1. larryg Avatar
      larryg

      good questions Andrea – and why can the govt decree that employer-provided insurance is tax free or that it must cover all employees instead of the company using free market principles to set rates according to individual risk?

      you never hear Jim complain about that govt influence.. never..

  8. Andi Epps Avatar
    Andi Epps

    My problem with that is the “individual risk”. I think everyone should be covered. I realize I would need to close a few government agencies to pay for it, but I happen to believe that the governments most important function should be HEALTH, safety and welfare of citizens.
    But I am not trying to open a can of worms.
    I just don’t understand the difference in attitudes between the mandate for auto insurance and health insurance.

    1. larryg Avatar
      larryg

      Andrea – you can drive uninsured…

      http://www.dmv.virginia.gov/vehicles/#uninsured_fee.asp

      there is a substantial fee…

      but in theory you do not have to buy a car and use the roads.

      I try to play the free-market game that folks like Jim say they support but

      I point out that we really don’t have a level playing field and that if we did – he would find it not to his liking at all because he’d be at risk for not being able to afford insurance for himself or family.

      he (i think) depends on employer-provided insurance which is subsidized by the govt – at the same time he espouses opposition to others getting subsidies.

      Medicare provides full coverage insurance to people who have 85K in income for 105.00 a month and you and I and Jim pay for it.

      what justifies giving someone who makes twice or 3 times the income that a full time worker makes – insurance for 105.00 a month while denying anything even close to that for a full time worker?

      employer provided insurance is essentially govt subsidized insurance because the money that pays for it – is not taxed and if it were – many who have it would owe thousands of dollars in additional taxes… if it were taxed.

      what justifies giving one person subsidized insurance and denying it to others?

      what I say is that if the faux libertarians really have scruples – they admit the existing disparate subsidies and if they oppose them – they oppose ALL of them not just cherry-pick opposition to subsidies for some while being okay with it to others.

      I ask – what justifies this disparate treatment by govt?

      If you support market insurance -you should be a person of integrity and support it across the board … stand up – be honest – and truly stand on your principles otherwise admit the hypocrisy.

      1. TooManyTaxes Avatar
        TooManyTaxes

        Larry, you understanding of the US Constitution and the law-making process simply doesn’t make sense, with all due respect. There is no obligation to treat everyone equal or tax everyone the same unless the treatment violates the equal protection clause. People who are similarly situated must be treated alike. If they are not similarly situated, discrimination is permitted.

        For most situations, the test is: Whether there is a rational basis for the differing treatment. In 1993, the Supreme Court stated the rational basis test is satisfied if “there is any conceivable state of facts that could provide a rational basis for the classification.” Is the classification rationally related to a legitimate goal.

        Discriminations affecting suspect categories, such as race, must satisfy a stricter standard. Hence, Virginia’s prohibition against mixed race messages was struck down, but FDR’s program to inter Japanese Americans during WWII was not. Other suspect classifications include national origin and religion.

        The courts also provide stricter review when a classification involves a fundamental right — such as the right to vote, the right to travel between states, and access to courts. There is also a fuzzy area that sometimes gets stricter scrutiny and sometimes does not – gender and illegitimacy.

        Can something survive equal protection review and still be viewed by many as unfair? Yes. But you or I thinking something is not fair is immaterial.

        Look at taxes – a highly compensated person can claim he/she is not being treated equally because some of their income is being taxed at a higher rate than is income earned by others. But this doesn’t violate equal protection. Similarly, a lower income person can complain they pay the same sales tax rate as the wealthy. This too is constitutional./ There is a rational basis for this disparate tax treatment. Now if we have Peter making a $10,000 purchase of a boat and Larry making the same purchase, but Peter pay as only a 1% sale tax rate, while Larry pays 5%, Larry has a claim. Why? Because they are similarly situated. But Larry cannot complain if he must pay a 5% sales tax on a boat, when Peter is only required to pay 3% on groceries, and Andrea pays no sales tax on medicine. Even though they are all making purchases, Larry, Peter and Andrea are simply not similarly situated.

        The analysis for tax free treatment of employer-paid health insurance is: Does the law treat all similarly situated employees the same? Do people in Michigan get treated the same as people in Maryland vis a vis employer paid health insurance? If so, the test is satisfied. The law does not ask whether Jim as a self-employed person get the same tax treatment as an employed person? The tax code can discriminate between employees and self-employed. For example, since I am self-employed, I can deduct certain business expenses that I could not deduct when I worked for a corporation or for law firms. Employees and the self employed are not similarly situated.

        Congress has not declared that there is a right to access to health insurance. Courts have never found that a person’s right to tax free health insurance is a fundamental right similar to my right to travel to NC to visit my daughter. You may think it’s unfair, but it is the law in the United States. So Employer A can give employees health insurance, and employer B need not because A employs 1000 people and B employs 6.

        There may be countries that provide a right to health care. But the United States is not one of them, with or without the ACA.

        I’ve posted many times that it is hard to take away a benefit. Some researcher in a tax exempt think tank writes a paper that concludes the federal government should eliminate the deduction for mortgage interest. The realtor start a PR blitz and any member of congress thinking of eliminating the deduction runs for the hills. It’s politics. And it’s not unconstitutional to allow this deduction while denying a renter a deduction on his car payment interest. Rational basis. Can some think it’s unfair? Yes. But it sure doesn’t violate the Equal Protection Clause.

        The same holds true for not taxing employer health insurance premiums. It does not violate the Equal Protection clause to allow this treatment while not transferring an equivalent sum of money to someone who does not have insurance. You may think it’s not fair, but it is not unconstitutional. There is a rational basis for the disparate treatment.

        1. larryg Avatar
          larryg

          TMT –

          “Larry, you understanding of the US Constitution and the law-making process simply doesn’t make sense, with all due respect. There is no obligation to treat everyone equal or tax everyone the same unless the treatment violates the equal protection clause. People who are similarly situated must be treated alike. If they are not similarly situated, discrimination is permitted.”

          this sounds subjective.. in the eyes of the beholder

          “For most situations, the test is: Whether there is a rational basis for the differing treatment. In 1993, the Supreme Court stated the rational basis test is satisfied if “there is any conceivable state of facts that could provide a rational basis for the classification.” Is the classification rationally related to a legitimate goal.”

          do you think different folks would have differing views of what is or is not ‘rational’? like for same sex marriage?

          “Discriminations affecting suspect categories, such as race, must satisfy a stricter standard. Hence, Virginia’s prohibition against mixed race messages was struck down, but FDR’s program to inter Japanese Americans during WWII was not. Other suspect classifications include national origin and religion.”

          again – are there truly objective standards?

          “The courts also provide stricter review when a classification involves a fundamental right — such as the right to vote, the right to travel between states, and access to courts. There is also a fuzzy area that sometimes gets stricter scrutiny and sometimes does not – gender and illegitimacy.”

          the right to get special treatment if you are in a class – like getting married?

          “Can something survive equal protection review and still be viewed by many as unfair? Yes. But you or I thinking something is not fair is immaterial.”

          Oh I completely agree… it’s a political issue – we have a grossly inequitable system.

          “Look at taxes – a highly compensated person can claim he/she is not being treated equally because some of their income is being taxed at a higher rate than is income earned by others. But this doesn’t violate equal protection.”

          because TMT – ALL taxpayers are subjected to the SAME RULE –

          “Similarly, a lower income person can complain they pay the same sales tax rate as the wealthy. This too is constitutional./”

          now tell me why Fairfax cannot charge you a different tax rate than your neighbor.

          ” There is a rational basis for this disparate tax treatment. Now if we have Peter making a $10,000 purchase of a boat and Larry making the same purchase, but Peter pay as only a 1% sale tax rate, while Larry pays 5%, Larry has a claim. Why? Because they are similarly situated. But Larry cannot complain if he must pay a 5% sales tax on a boat, when Peter is only required to pay 3% on groceries, and Andrea pays no sales tax on medicine. Even though they are all making purchases, Larry, Peter and Andrea are simply not similarly situated.”

          again – if the SAME RULES apply to Larry and Peter for the same kind of purchases.. but if you try to tax Peter a different rate on a boat than Larry you mess up.

          “The analysis for tax free treatment of employer-paid health insurance is: Does the law treat all similarly situated employees the same? Do people in Michigan get treated the same as people in Maryland vis a vis employer paid health insurance? If so, the test is satisfied. The law does not ask whether Jim as a self-employed person get the same tax treatment as an employed person? The tax code can discriminate between employees and self-employed. For example, since I am self-employed, I can deduct certain business expenses that I could not deduct when I worked for a corporation or for law firms. Employees and the self employed are not similarly situated.”

          I would agree with you on this.

          “Congress has not declared that there is a right to access to health insurance. Courts have never found that a person’s right to tax free health insurance is a fundamental right similar to my right to travel to NC to visit my daughter. You may think it’s unfair, but it is the law in the United States. So Employer A can give employees health insurance, and employer B need not because A employs 1000 people and B employs 6.”

          what I challenge is your assertion that if it’s not in the Constitution – it’s not legal.

          “There may be countries that provide a right to health care. But the United States is not one of them, with or without the ACA.”

          do you not think that retired people in this country to not have a RIGHT to Medicare?

          explain why they do not.

          “I’ve posted many times that it is hard to take away a benefit. Some researcher in a tax exempt think tank writes a paper that concludes the federal government should eliminate the deduction for mortgage interest. The realtor start a PR blitz and any member of congress thinking of eliminating the deduction runs for the hills. It’s politics. And it’s not unconstitutional to allow this deduction while denying a renter a deduction on his car payment interest. Rational basis. Can some think it’s unfair? Yes. But it sure doesn’t violate the Equal Protection Clause.”

          Oh I agree – now tell me they have not changed deductions.. or credits.. they do all the time.

          “The same holds true for not taxing employer health insurance premiums. It does not violate the Equal Protection clause to allow this treatment while not transferring an equivalent sum of money to someone who does not have insurance. You may think it’s not fair, but it is not unconstitutional. There is a rational basis for the disparate treatment.”

          do you think it’s wrong to tax Social Security benefits – I mean wrong in terms of illegal and disparate and violating the equal protection clause?

          how about charging people different rates for Medicare?

          Do you think it was wrong/illegal/irrational to change the deduction for out-of-pocket health costs from 7.5% of AGI to 10%?

          Do you think it would be that different to put a limit to what is tax free for insurance like they do right now for HSAs?

        2. larryg Avatar
          larryg

          TMT – you say that Congress can unfairly benefit people and that’s legal but you complain about ObamaCare and expanding MedicAid.

          why do you have two different views about this -where you say it’s okay to unfairly benefit those with employer-provided health insurance but it’s not okay to do something similar for Obamcare and the MedicAid expansion?

          please explain your ‘rational’ basis for this seemingly arbitrary view.

  9. Andi Epps Avatar
    Andi Epps

    I support health coverage as one of the few true functions of government. Cut the unnecessary and provide health coverage for everyone, equally. And you can still get a ticket, even if you pay the fee for uninsured driver. Not to mention someone suing you for dinging a steel bumper, even if you didn’t do it.

    1. larryg Avatar
      larryg

      well Andrea – folks like Jim Bacon do not agree. Most Republicans do not agree.

      it’s a kind of kabuki theater… you have to earn healthcare -you’re not entitled to it and if you are an uneducated lower run person – you deserve to not have it… because if you were a real good person -you’d have it.

      understand?

      are you fired up yet?

      😉

    2. TooManyTaxes Avatar
      TooManyTaxes

      Andrea, I respect your view, but have a serious question. Where, when and how did the provision of health care on a universal basis become one of the true functions of government? For most of this Nation’s history, people and courts would have given you a puzzled look if you made that statement.

      I believe the Constitution could be amended to guarantee such right. Or, perhaps, Congress could pass a statute giving everyone a statutory right to health care access. But I don’t believe that has ever been done.

      There is a big difference between some people believing this should be the case and it actually being the case. In a constitutional government of laws and not fiats, there must be some provision in a law or constitution that gives rights or imposes duties. Lincoln and Congress imposed an income tax, but since it was not apportioned, the courts struck it down. Only after the Constitution was amended could today’s income tax be adopted. Similarly, for a significant portion of American history, women did not have a right to vote that overrode state law to the contrary. But the Constitution was amended to outlaw contrary state laws. Our founders felt the need for free speech was so important that the First Amendment to the Constitution was adopted.

      Where is the source of a constitutional or legal right to health care? If there is no source, why can’t any groups invent any right? And why can’t any new president/congress invent or take away rights?

      1. larryg Avatar
        larryg

        TMT – what gave Congress the Constitutional power to allow health care to be taxfree or to give it to people who make 85K a year for 105.00 or for that matter to pass EMTALA?

        Do you think the employer-provided insurance that you enjoy is Constitutional?

        1. TooManyTaxes Avatar
          TooManyTaxes

          Larry, you keep muddling the issue. You make a “fairness” argument. I understand that. But my point is: What is the source of the alleged right to access to health care? I hear people make the claim, but have never seen the source of the right. Can we just pluck rights out of the air? Who decides?

          Now people can debate the fairness of darn near anything. I object to the Ford Foundation being tax exempt. If big foundations had limits on their tax exempt status, the deficit would be smaller. The IRC doesn’t recognize differences in cost of living or housing. That benefits people in lower cost states. There are many laws and regulations that people can argue are unfair. But unless they violate the Constitution or an underlying statute, they are permissible.

          As far as your questions are concerned, these tax discriminations are permissible so long as they have some rational basis. As we all know, non-taxable health care grew out of the political need for employers to give some additional compensation to workers under wage freezes during WW2. And this brought such a benefit to so many, it’s essentially a sacred cow. It’s not unlike the prohibition of fees/taxes on the Internet or the deduction for mortgage interest. Third rail – touch it at your own risk. Look at Dan Rostenkowski or some of the GOP senators who lost in 1986.

          Is there any arbitrariness to these results? Yes, but not so arbitrary that they violate the equal protection clause.

          But my original question remains unanswered: What is the source of a right to access to health care?

          1. larryg Avatar
            larryg

            re: ” Larry, you keep muddling the issue. You make a “fairness” argument. I understand that. But my point is: What is the source of the alleged right to access to health care? I hear people make the claim, but have never seen the source of the right. Can we just pluck rights out of the air? Who decides?”

            TMT – who gave you the right to tax-free employer-provided health insurance that forces the insurance to take you no matter your risk and only charge you what others pay?

            who gave you that right? Is that right Constitutional based on your view about what is or not?

            “But unless they violate the Constitution or an underlying statute, they are permissible.”

            do you think that employer-provided health insurance is Constitutional? where is it permitted?

            “As far as your questions are concerned, these tax discriminations are permissible so long as they have some rational basis.”

            who decides what is “rational”? and you are essentially justifying arbitrary tax treatment that discriminates… isn’t that wrong?

            “As we all know, non-taxable health care grew out of the political need for employers to give some additional compensation to workers under wage freezes during WW2. ”

            why does that justify the govt being involved?

            “And this brought such a benefit to so many, it’s essentially a sacred cow.”

            but you you justify your sacred cow – as you also justify discrimination against others.

            “It’s not unlike the prohibition of fees/taxes on the Internet or the deduction for mortgage interest. Third rail – touch it at your own risk. Look at Dan Rostenkowski or some of the GOP senators who lost in 1986.”

            yes. you are saying that your subsidy is justified and others are not.. “because”…

            “Is there any arbitrariness to these results? Yes, but not so arbitrary that they violate the equal protection clause.”

            you thought that about mixed marriage too.. right?

            “But my original question remains unanswered: What is the source of a right to access to health care?”

            and what is your right to govt-subsidized employer-provided health care that requires the insurance company to provide you insurance no matter your risk and to charge you the same rate as others – no matter your risk.

            what justifies you benefiting from that policy while others are denied something equivalent?

            you say that’s the way it is.. I say that we’re not done… and you have an illegitimate argument that will ultimately be found to be in wrong – and fixed.

            when you say “right of access” why do you oppose it for others and justify it for you?

          2. larryg Avatar
            larryg

            TMT – is your view essentially that employer-provided is just as unConstitutional as ObamaCare but it’s grand-fathered in?

            that we cannot undo it and we cannot grant the same basis to ObamaCare?

            don’t you think at some point – people are going to see this as just as wrong as other kinds of discrimination that were ultimately -subsequently rolled back?

            for instance, if you filed a lawsuit against ObamaCare claiming it’s UnConstitutional – would the defense team bring up Employer-provided and ask what is the difference?

  10. larryg Avatar
    larryg

    if the govt got out of employer-provided healthcare – taxed it – and allowed the insurance companies to choose who they would insure – and set rates for each individual – like it is in the free market – you’d see a lot of folks who complain about ObamaCare and the Medicaid expansion -change their tunes pretty quick.

  11. Andi Epps Avatar
    Andi Epps

    my opinion that everyone should have access to healthcare is just that. It’s only my opinion. I know we could find enough waste to eliminate to cover the cost. But I understand your point. Personally, I don’t think the right to life can be equal without equal access to healthcare. And I could be off base here, and I am certainly no fan of Obamacare, but didn’t the SCOTUS uphold it?
    If I had to point to where it is a right, I would say right to life and SCOTUS decision.

    1. James A. Bacon Avatar
      James A. Bacon

      There are two kinds of rights. One kind is the rights enshrined in the Bill of Rights — free speech, freedom of religion, freedom to a jury trial, right to bear arms, etc. The exercise of those rights does not diminish anyone else’s rights. They are basic and fundamental.

      Then there are secondary rights. Sure, it is a reasonable goal of every affluent society to provide health care to all. But who pays for that health care? Inevitably, we are talking about a transfer of wealth from one group of people to another. Thus, the “right” of poor people to health care is accomplished at the expense of someone else. Implicit in the statement that I have a “right” to health care is the proposition that “I have a right to healthcare that you help pay for — in other words, I have a right to your money.”

      To my mind, that is not a right at all. That’s a public policy choice.

      1. larryg Avatar
        larryg

        re: ” Sure, it is a reasonable goal of every affluent society to provide health care to all. But who pays for that health care?”

        WE ALL DO – right now – it’s delusional to think otherwise. Right now you are paying to provide health care to people who make 85K a year in income for the price of 105.00 a month and nary a word from you on that “wealth transfer”. why not?

        ” Inevitably, we are talking about a transfer of wealth from one group of people to another. Thus, the “right” of poor people to health care is accomplished at the expense of someone else. Implicit in the statement that I have a “right” to health care is the proposition that “I have a right to healthcare that you help pay for — in other words, I have a right to your money.”

        you are subsidized by other taxpayers including the poor if you have employer-provided healthcare with it’s govt-provided “transfer” of tax-free compensation, regulations that require you be covered instead of letting the company decide and the govt rule that if you belong to an employee group – you cannot be charged more than others no matter the risk.

        this is a govt-provided wealth transfer to YOU!

        “To my mind, that is not a right at all. That’s a public policy choice.”

        we agree but you seem to favor an inequitable status-quo system where some get govt subsidies and others do not and you characterize those that do not – as undeserving as if the folks who do get subsidies like yourself – do deserve them.

        do you favor an equitable system or do you favor the current inequitable system?

        can’t have it both ways. If you hate ObamaCare why don’t you also hate employer-provided health care and Medicare and EMTALA for that matter?

        why would you oppose one and not the existing wealth transfers?

        1. TooManyTaxes Avatar
          TooManyTaxes

          Larry, I don’t think most people with health insurance believe they somehow got a special deal on it. People who have it from work or their spouse’s job see it as part of compensation. Taking it away means a pay cut. Taxing health care would be viewed as a pay cut. Few elected officials are going to vote for something that their constituents will see as a reduction in their compensation.

          For Medicare, LBJ sold it as a new social contract; pay higher taxes while you work and get health care funding when you are older and likely retired. Medicare was not created as a means-tested program. That was not part of the social contract. So means testing looks like a cut of promised benefits. And to raise any meaningful sum of money, Uncle Sam needs to dig deep into the middle class. What politician is going to call for this?

          The way I look at is my grandparents and parents received Medicare after paying taxes. My in-laws did the same. My wife and I are paying higher taxes and expect to receive the same Medicare our antecedents received. I don’t think we are alone. This is LBJ’s deal. It better be maintained or many of us Boomers will be voting people out of office.

          One of your problems is that your argument requires people who have been paying taxes their entire working life and subsidizing many others, including businesses, to believe that they somehow have been net recipients of tax subsidies. It won’t sell. People who have paid 40 years of taxes and then get Medicare just don’t see themselves getting a tax windfall. And for your argument to work, they need to believe that they are getting more than all the taxes they have paid for 40 years. It’s pretty hard to put the Boomers on a guilt trip.

          1. larryg Avatar
            larryg

            re: ” Larry, I don’t think most people with health insurance believe they somehow got a special deal on it. People who have it from work or their spouse’s job see it as part of compensation. Taking it away means a pay cut. Taxing health care would be viewed as a pay cut. Few elected officials are going to vote for something that their constituents will see as a reduction in their compensation.”

            but they did. it’s a govt-provided benefit. it’s not a free-market benefit. We have an economy now where employer-provided is more and more like a the obsolete company pensions. We have millions and millions of people who do not get employer-provided but they work just as long, just as hard and for their lives yet they don’t get what you get not because you earned it but because the govt (all taxpayers) gave it to you.

            tax-free health insurance .. rules that require the insurer to not deny access.. or cancel you, rules that the insurer can’t charge you more than others..in the same pool while other workers are not treated the same way. Their health care has to be paid for with taxed dollars. There is no govt regulation that requires the insurance company for regular workers to be treated the same as you are.

            you get these benefits – not from the Constitution – but from government – the same govt that you say – should not be providing health care benefits to those who would get Obamacare.

            How can you justify getting these benefits yourself while denying the same benefits to others?

            “For Medicare, LBJ sold it as a new social contract; pay higher taxes while you work and get health care funding when you are older and likely retired. Medicare was not created as a means-tested program. That was not part of the social contract. So means testing looks like a cut of promised benefits. And to raise any meaningful sum of money, Uncle Sam needs to dig deep into the middle class. What politician is going to call for this?”

            I thought you were opposed to govt fulfilling a “social contract”. no?
            Are you in favor of what LBJ did or not? It’s okay when you get LBJ”s social contract but not others? tsk tsk

            means-testing – you did not earn Part B Medicare – you did Part A. Part B is totally voluntary – fee for service health insurance sold at a tremendous loss – as it costs other taxpayers 5 times what you pay for it – more than you ever paid taxes for even if you say none of it was for other things like defense.

            “The way I look at is my grandparents and parents received Medicare after paying taxes. My in-laws did the same. My wife and I are paying higher taxes and expect to receive the same Medicare our antecedents received. I don’t think we are alone. This is LBJ’s deal. It better be maintained or many of us Boomers will be voting people out of office.”

            again – are you saying that if you pay income (rather than FICA) taxes when you work – that that entitles you to subsidies for employer-provided while you work AND Medicare after you retire? Who pays for the rest of Govt and DOD if you’re going to count all your taxes towards your healthcare?

            People receive hundreds of thousands of dollars of Medicare when they retire., far, far more than they every paid into it. There is no way they could have paid for all of it ahead of time unless they diverted that money from other things like National Defense…

            but what entitles you to it so you cannot be turned down, cannot be dumped when you exceed what you paid into it…etc.. what entitles you to more than you ever paid into it?

            we run a deficit and a 17 trillion debt .. from spending more than we paid in.

            do you believe we should be providing Medicare when it drives us into deficit?

            what would you do – if instead of Medicare you got a voucher – and were free to go out into the free market to buy your insurance – and that voucher was no more than what you paid into it?

            basically what I’m asserting here is that we have a grotesquely inequitable system when it comes to health care where some of us get far, far more benefits and subsides than others – and the “haves” resent the “have nots” getting their share.

            you mentioned “social contract”. Do you believe that whatever government does with regard to healthcare should be done equitably to all or do you support the govt essentially picking winners and losers?

            or do you believe the govt should not be involved at all – in anybody’s health care?

            so far it sounds like, you’re justifying the things that benefit you that have been benefiting you for some time and opposing the things that benefit others…if we try to catch them up to you – now.

            I just don’t think we have an equitable system and we pretend otherwise. It’s hypocrisy.

            I’m NOT saying the govt (which is really taxpayers) should pay for everyone’s health care but I am saying that all the other developed countries in the world – do just that – and it’s far more successful than our system – when we are honest enough to include not only those who are “covered” but those who are not.

          2. LifeOnTheFallLine Avatar
            LifeOnTheFallLine

            Actually, it looks like most people do get more of Medicare than they pay into it.

            http://www.politifact.com/truth-o-meter/article/2013/feb/01/medicare-and-social-security-what-you-paid-what-yo/

            And of course it’s hard to put Boomers on a guilt trip, they’re the same people who saw the amazing society that their predecessors had left them as a legacy – universal public education, top-notch state funded universities with low tuition, a modern transportation network, strong labor representation, and a dedication to eradicating the vestiges of racism – and then decided to toss it all away rather than pay the same taxes as the people who left it to them.

          3. larryg Avatar
            larryg

            there’s more irony also. Social Security and Medicare are, in fact, individual mandates…

            but I’ll accept TMT’s assertion that people pay into Medicare with FICA and income taxes – if he will explain to me why people with employer-provided health deserve the tax-free compensation and the rules that require the insurance companies to take them no matter their risk and charge them no more than others in the pool – while folks who work at other jobs – their entire lives don’t get some equivalent govt treatment of tax-free health insurance and insurance companies that must insure and cannot charge more than others.

            what exactly justifies these govt protections for those who get employer-provided health care?

            make no mistake – if the govt was not involved in employer-provided health care – it would look much more like market insurance. the govt would tax it like all other compensation – and there would be no guaranteed insurability nor comparability on costs via poolng. it would be virtually identical to market insurance where they turn you down or dump you when you get sick – and your family members.. and charge you whatever rate they set – with nothing to do with what they charge others.

            TMT says people don’t view it that way. I agree.

            but those same people view – giving that equivalent benefit to those who don’t have govt-assured employer provided as an unwarranted entitlement to those who do not deserve it.

            we have – a system of haves and have nots.. created by the govt – and the haves do not want to give the have nots the same thing they have.

      2. LifeOnTheFallLine Avatar
        LifeOnTheFallLine

        LOL at the idea that owning a killing machine is a basic and fundamental human right, but not access to health care. I guess your philosophy is more Hobbes and less Locke.

        The right of people to a jury trial is accomplished by taking wealth from someone and funneling it to others. There are people who go their whole lives without ever entering a courtroom who still pay for the building and maintenance of courthouses and the impaneling of a jury. So all the Bernie Madoffs of the world have a right to my money but some working mom at McDonald’s doesn’t?

        Is declaring war a basic and fundamental right of the people? When my tax dollars were going to enrich Halliburton contractors in Iraq to protect us all from a threat that couldn’t launch Tom Sawyer’s raft was that a right or a policy choice?

        1. larryg Avatar
          larryg

          being able to create hand-waving plausible narratives is considered a critical skill on the right…

          1. LifeOnTheFallLine Avatar
            LifeOnTheFallLine

            HA!

            I will say, I’ve learned more about the policy underpinnings of healthcare from you in this thread than I have other places. Well done.

          2. larryg Avatar
            larryg

            the right talks about how much ObamaCare “costs” ( $759B over 5 years) but if you look at how much the tax expenditure is for employer-provided -it is by far the largest tax expenditure of all of them exceeding a trillion dollars over the same 5 years and bigger than the mortgage deduction, charitable deductions, and earned income tax credits – combined.

            The question is why do folks who get employer-provided deserve that tax subsidy and folks who get Obamacare do not?

            what’s the difference?

            the best answer I’ve heard came from TMT who said “we got ours first and we can’t afford any more”. Tough cookies.

            😉

  12. TooManyTaxes Avatar
    TooManyTaxes

    Responding to many. A right needs a source. Some believe in the concept natural law; others don’t. But virtually all agree that a provision of the constitution, a law or a regulation is necessary before a right can be bestowed or a duty imposed. Otherwise we invite a Joe Stalin to take over and decide who gets rights and when.

    A simple example is the lifetime pass to national parks. Now a person 62 or over can pay $10 and obtain no additional charge access to national parks and the like. When my dad and father-in-law were each living, they got their passes for free. The right stems from a US Park Service regulation authorizing special rates for older Americans and likely a statute that authorizes the US Park Service to set entry fees for parks. Uncle Sam could abolish this right tomorrow by following appropriate rulemaking procedures.

    Someone could challenge the special deal given to older Americans as violating equal protection. Why does a person 65 pay a lower rate than a person 55 or 25 without regard to income? Because the equal protection clause merely requires a rational basis for this type of discrimination. The USPS presumably noted that most older Americans live on fixed incomes; many have low incomes; and it’s good to have older Americans active. A federal judge is not going to strike this down. Similarly, a person who has to pay $10 now could not get that requirement voided because the pass used to be free. Older Americans’ right to enter national parks a no or a low fee depends on the statutes and regulations.

    Now suppose we say everyone 62 or older gets a lifetime pass unless one of his/her grandparents were born in Italy (Ireland, South Africa) etc. Or that only women get the lifetime pass. There, a court will subject the discrimination to a tougher standard and likely demand a compelling reason to uphold the regulation. Race and gender are often suspect categories and, as such, receive stricter scrutiny.

    SCOTUS never declared Americans have a right to health care. It said the feds could not make people buy insurance under its power to regulate interstate commerce, but could require people refusing to buy insurance to pay a tax. It also said Congress did not have the authority to withhold all Medicaid funds unless the states expanded Medicare.

    There is no universal right to access to health care. Some may have rights given by statute or regulation. For example, I believe illegal aliens have been given a right to buy insurance from a pool, but cannot receive a subsidy. So if Juan has no legal status because he was born in Mexico and came the US illegally, he gets no subsidy even though his sister Rachel can get a subsidy because she was born in New Mexico. This result would likely stick if reviewed by a court.

    There simply is no universal right to access to health care. Some believe their should be such a right. But wishing does not make it so.

    1. larryg Avatar
      larryg

      is EMTALA a universal right to health care?

      is employer-provided health insurance a govt-provided benefit to you that is not in the Constitution .

      why are you entitled to tax-free health care?

      why are you entitled to be put in an insurance pool and others not?

      why are you entitled to pay the same price as everyone else in the group regardless of your individual risk while others do not have that govt-provided benefit?

      re: ” The way I look at is my grandparents and parents received Medicare after paying taxes. My in-laws did the same. My wife and I are paying higher taxes and expect to receive the same Medicare our antecedents received. I don’t think we are alone. This is LBJ’s deal. It better be maintained or many of us Boomers will be voting people out of office”

      you prepaid FICA for Medicare Part A but not Part B which you have to sign up for and pay $105 a month for. Why do you deserve that?

      if others are also paying taxes – that go to provide benefits to others, why are they not also entitled ?

    2. larryg Avatar
      larryg

      re: ” Responding to many. A right needs a source. Some believe in the concept natural law; others don’t. But virtually all agree that a provision of the constitution, a law or a regulation is necessary before a right can be bestowed or a duty imposed. Otherwise we invite a Joe Stalin to take over and decide who gets rights and when.”

      so trying to figure out how govt-enabled employer-provided health insurance fits into this conundrum.

      it’ s not in the Constitution…

      it’s therefore not a right…

      but the govt has decided to provide health care to some people and allow others to pay for it.

      The first example of this, by the way, was voted on by Thomas Jefferson one of the signers of the Constitution:

      http://www.forbes.com/sites/rickungar/2011/01/21/thomas-jefferson-also-supported-government-run-health-care/

      so we’ve agreed that it’s not a right – but then we can’t seem to agree on if the GOvt can grant certain rights to some people and not others – i.e. the equal protection clause.

      and what could be more illustrative of the equal protection clause than the govt protecting those with employer-provided insurance from market insurance practices while allowing those without employer-provided insurance to be at the mercy of market insurance.

      this is fair?

      this is the American approach to equal protection?

      for how many years did we pretend schools were separate but equal or that marriage was only valid between opposite sexes or for that matter that the Constitution only applied to people who were not slaves?

      At some point – someone is going to sue the govt over employee-provided health insurance and that too will fall like the others…had to – because they were fundamentally discriminatory.

  13. larryg Avatar
    larryg

    re: ” One of your problems is that your argument requires people who have been paying taxes their entire working life and subsidizing many others, including businesses, to believe that they somehow have been net recipients of tax subsidies.”

    nope. I think we ought to be honest about the subsidies we do get – First and not say that people “believe” they are entitled to them.

    People who work full time and don’t have employer-provided health insurance are subsidizing those who do have it – and your response is that they are probably net consumers of subsidies so it does not count?

    ” It won’t sell. People who have paid 40 years of taxes and then get Medicare just don’t see themselves getting a tax windfall. And for your argument to work, they need to believe that they are getting more than all the taxes they have paid for 40 years. It’s pretty hard to put the Boomers on a guilt trip.”

    how about the folks who have also worked 40 years and did not receive govt-subsidized employer-provided health insurance while you did and get Medicare to boot?

    you are benefiting not only from the tax-free health care – you are benefiting from being guaranteed access to insurance and at a price no higher than others -regardless of your own risk while those without what you have – have to go into the market where they are charged individual rates according to their individual risk.

    why do you merit different treatment than them on access to insurance?

    what entitles you to superior benefits and access to those that don’t have access to employer-provided?

    We’re talking about retail store clerks, waiters, tradesmen, independent contractors. – a huge segment of our economy – who work hard to make a living but do not enjoy the benefit the govt has given to you.

    so, here is the question to you:

    would you be opposed to the govt – providing the same benefits you get to people who don’t have employer-provided health insurance and get their own?

    So those folks could write off – get a tax credit on what they paid for health insurance and health care.

    that the insurance companies could not deny them coverage – just like you?

    that they could not charge them more than others – just like your benefit?

    why could we not have a large state-level pool for folks that don’t have employer-provided and it functions exactly like your employer-provided.

    what’s the argument against that?

    1. TooManyTaxes Avatar
      TooManyTaxes

      Larry, your claim that people without employer-provided insurance are subsidizing those with it is simply wrong. Let’s go back to the 2012 campaign – 47% of Americans don’t pay any income tax. They are not affected by the tax-exempt status of employer-paid health insurance. They only pay SS and Medicare – and they will receive those benefits in the future. SS and Medicare taxes are not affected by tax exemptions or deductions.

      How many Medicaid recipients pay FIT? Not many, if any. How many people who could be covered by a Medicaid expansion pay FIT? Not many, if any. Your suggestion that these people are subsidizing others via the tax system is simply incorrect. Any tax subsidy is paid by people who pay taxes; people who are more likely to have employer-paid health insurance. If the truth be known, it is that people with tax-exempt insurance pay for the exemption out of their other pocket. Only Obama and his Marxist army of true believers think that people who don’t pay income taxes are somehow subsidizing those who do. That’s simply absurd.

      I don’t regard employer-paid health insurance as a gift from the government. When I purchased it through my employer, the employer’s contribution was part of my compensation, just like my salary, merit and team bonuses, disability insurance, a pension and a 401K match. Did I have good benefit? Yes. But I also gave up several years of income by going to school and then working hard. I once spent a Christmas by myself writing a advocacy piece for my employer. I earned my compensation. So why am I supposed to split my benefits with others who didn’t earn them?

      Mark Warner made some good business decisions by forgoing legal fees in exchange for a piece of cellular licenses. And a boatload of money too. Does he have a duty to split his earnings?

      As I’ve written many times, I have no problem with the establishment of insurance pools for people without insurance. I don’t have a problem providing lower-income people with tax credits to buy insurance. My problem was with Der Leader Obama when he told people that, if they liked their existing insurance, they could keep it, when, all along, he knew that was false. I have a problem making a 25-year old male or a 55 year old woman being forced to buy maternity coverage.

      Democrats know that the public would not accept significant cuts in their health insurance or increases in taxes to expand coverage. That may be unfair, but it is true. Look at Obama’s attacks on McCain when he proposed taxing high-cost insurance provided by employers. The Democrats don’t want to touch the third rail. You seem to think the GOP has a duty to touch the rail first to protect Democrats. That’s crazy.

      1. larryg Avatar
        larryg

        @TMT:

        ” Larry, your claim that people without employer-provided insurance are subsidizing those with it is simply wrong. “Let’s go back to the 2012 campaign – 47% of Americans don’t pay any income tax. They are not affected by the tax-exempt status of employer-paid health insurance.”

        are you assuming that no one without employer-provided at not paying any Federal taxes?

        “They only pay SS and Medicare – and they will receive those benefits in the future. SS and Medicare taxes are not affected by tax exemptions or deductions.”

        how many work, pay federal taxes and don’t have employer-provided?

        do you know?

        for those folks – would you admit that they DO subsidize and what would you do for them even if not the others?

        “How many Medicaid recipients pay FIT? Not many, if any. How many people who could be covered by a Medicaid expansion pay FIT? Not many, if any. Your suggestion that these people are subsidizing others via the tax system is simply incorrect. Any tax subsidy is paid by people who pay taxes; people who are more likely to have employer-paid health insurance. If the truth be known, it is that people with tax-exempt insurance pay for the exemption out of their other pocket.”

        if your numbers are correct – are they? People without kids in Va do not qualify for MedicAid by the way.

        “Only Obama and his Marxist army of true believers think that people who don’t pay income taxes are somehow subsidizing those who do. That’s simply absurd.”

        what total blather. “marxist” army? Do you think John McCain or Mitt Romney or the Heritage folks are “Marxist armies”. Are you objective on this or partisan?

        DO you know what EMTALA is TMT? do you think it is universal health care? do you think you pay for it?

        Do you realize that Obamacare is NOT directly funded from general revenues but from earmarked taxes – like SS/Medicare are?

        do you know that the 47% pay those taxes also because those taxes are excise taxes on equipment and services….?

        If you killed ObamaCare today -you’d not save one penny on the deficit.

        “I don’t regard employer-paid health insurance as a gift from the government. When I purchased it through my employer, the employer’s contribution was part of my compensation, just like my salary, merit and team bonuses, disability insurance, a pension and a 401K match. Did I have good benefit? Yes. But I also gave up several years of income by going to school and then working hard. I once spent a Christmas by myself writing a advocacy piece for my employer. I earned my compensation. So why am I supposed to split my benefits with others who didn’t earn them?”

        I’ll concede your point here..if you admit that getting paid by the govt is not the private sector …right?

        would you have that benefit if it were not for the government? What did you do to earn tax-free compensation?

        “Mark Warner made some good business decisions by forgoing legal fees in exchange for a piece of cellular licenses. And a boatload of money too. Does he have a duty to split his earnings?”

        you take advantage of the tax code for the things you can – that does not mean that you earned any of them – just that the govt chose to give you a tax-break.

        if all tax breaks were discontinued – we would not only balance the budget, we would have a surplus and buy down the debt – and have money left over for a tax reduction for everyone – who pays.

        “As I’ve written many times, I have no problem with the establishment of insurance pools for people without insurance.”

        I missed that. how would you do that unless the govt required it?

        ” I don’t have a problem providing lower-income people with tax credits to buy insurance. My problem was with Der Leader Obama when he told people that, if they liked their existing insurance, they could keep it, when, all along, he knew that was false. I have a problem making a 25-year old male or a 55 year old woman being forced to buy maternity coverage.”

        oh Jezus H. Keeerist.. get off the Obama thing.. for gawd sake!

        he screwed up – no question – but you tell me just how many people REALLY get to keep their insurance – year to year with NO changes? How many? DOes your policy send you changes every year like mine does? did you get to KEEP your policy from last year? what total blather.. it’s the motto of the Obama-haters… nothing more.

        “Democrats know that the public would not accept significant cuts in their health insurance or increases in taxes to expand coverage. ”

        doesn’t that happen to many people’s policies every year right now?
        what about those who actually get dumped from their policies?

        “That may be unfair, but it is true. Look at Obama’s attacks on McCain when he proposed taxing high-cost insurance provided by employers. The Democrats don’t want to touch the third rail. You seem to think the GOP has a duty to touch the rail first to protect Democrats. That’s crazy.”

        I think the GOP has a responsibility to help solve the issue that they say Obama did wrong.

        what do you want – a return to the days when people cannot get insurance unless they have employer-provided?

        what gives you the right to guaranteed insurance – beyond you paying taxes to get it tax-free? why are you not subjected to the same risk rules as other people who work, pay Federal taxes and can be denied coverage? why do you deserve guaranteed coverage when others do not get it?

        would you support the govt making those rules the same for everyone?

        you oppose ObamaCare and essentially support the failed system that ObamaCare attempted to fix – badly according to you and others but if we repealed Obamacare today where would we be?

        You’d be happy as long as you were getting your health care – right?

        the problems do not affect you – but the solutions to them might affect you, right?

        I’m just saying you can’t stand by with satisfaction for own situation when there are gross inequities for others that will ultimately result in changes .. even if those changes are not ObamaCare and maybe come from Republicans and you will hate them just as much if they threaten what you have right now.

        you should want a more equitable system yourself – for no other reason that a purely selfish one that it will better secure your own benefits.

        the more people who do not have health care – the more your own benefits will be threatened.

      2. larryg Avatar
        larryg

        @TMT

        the 47%

        you may want to read this TMT:

        http://www.cbpp.org/cms/?fa=view&id=3505

        ” Moreover, low-income households as a group do, in fact, pay federal taxes. Congressional Budget Office data show that the poorest fifth of households paid an average of 4.0 percent of their incomes in federal taxes in 2007, the latest year for which these data are available — not an insignificant amount given how modest these households’ incomes are; the poorest fifth of households had average income of $18,400 in 2007.[6] The next-to-the bottom fifth — those with incomes between $20,500 and $34,300 in 2007 — paid an average of 10.6 percent of their incomes in federal taxes. ”

        and TMT – it’s not just who pays – it’s the fact that you have guaranteed coverage at a pool price… while others are not guaranteed coverage nor a pool price.

        the govt “protects” you from the free market while others are subjected to the full force of the free market.

        if the govt pulled back and let the insurance company for the employer-provided do to you – what they do to people in the free market – what would happen to you?

        you would not be guaranteed insurance nor would you be guaranteed to pay no more than others in the pool.

        you could be denied insurance or be charged so much you could not afford it.

        why do you deserve that protection and not others?

  14. James A. Bacon Avatar
    James A. Bacon

    I don’t have the time or inclination right now to get into a siege-warfare debate over health care. But I do want to correct one misconception that readers may conclude from Larry’s comments. I agree that the federal income tax break for health care insurance is one of the root problems of our health care system.

    Rather than building a Rube Goldberg contraption like Obamacare, we should start by fixing what’s wrong with the existing dysfunctional system. The very first thing we should do is scrap the tax break, and we should take employers out of the equation. People should buy health insurance directly from insurance companies. Insurance companies should design health policies for their patients, not for their patients’ employers. That one change wouldn’t fix everything, but it would fix a lot.

    1. larryg Avatar
      larryg

      we actually agree. we ought to have an equitable system – not one where some get benefits and others do not.

      I don’t think Obamacare is any more rube goldberg than the current employer-provided system – that is guided by complex Federal regulations that the average person is wholly unaware of but even if they knew would not understand.

      but I don’t think dumping employees onto the a “free market” where insurance companies can deny coverage and charge individual rates and not have insurance pools – is going to be to the liking of folks sent to the free market.

      and that’s the hypocrisy here – the folks with employer-provided KNOW they are protected from the free-market and they will not going willingly to the free market – no more than Medicare folks would.

      and Republicans know this – so their “solution” to date is to attack Obamacare and provide no real alternative.

      I always say – be loyal to your political philosophy but be man enough to stand in front of voters and be honest about your intentions.

      we have an entire political party right now that is essentially lying about their position on health care.

      I have not heard one elected person admit what Jim Bacon just said.

      not one – although Mitt Romney had made noises along those lines for a while but then went silent…

      I do not think the American people will support what Jim says. I think any elected official who says what Jim says – would get booted forthwith.

      if all Republicans said what Jim advocates – we’d have a majority of Democrats in Congress – no question.

      I give Jim credit – but the folks he herds up with have no such integrity on this issue. they are totally disingenuous and feckless.

    2. larryg Avatar
      larryg

      Obamacare will, if it survives – eventually kill employer-provided health insurance.

      We’re getting to the point where employers are going to find it easier to let their employees get Obamacare rather than continue the struggle in something that really is not part of their business – and, in fact, puts them at a competitive disadvantage against global companies that have no such costs layered on to their products.

      There is no reason why Virginia, the school systems and counties could not bail and let employees find their own healthcare from the health care exchanges.

      I’ve never understood why each school system and county in Va negotiates it’s own policy with small pools compared to if there was a statewide pool.

      One person with an expensive illness can cause premiums to go up in these small pools.

      why not have one large pool of school employees across the state?

      that’s what you already have with the Obamacare Exchanges – a statewide pool.

      so people are not going to go as individuals to get insurance on the open market. They’re going to go where larger pools are available.

      Would the free market create larger pools without the govt?

      They haven’t so far. They’ve not offered many if any statewide pools for schools nor for small businesses… and probably will not unless the govt requires them to or the govt creates a law that incentivizes companies to do it and those companies start taking business away from the individual insurance market.

      Health insurance without pools and without protections for denial of insurance is not going to be acceptable to people – even Republicans.

  15. larryg Avatar
    larryg

    In reading further about the issue – I learned even more about employer-provided health insurance in that not only is the money spent on health insurance not taxed (by the Federal AND state govt) – but the employer does not have to pay FICA taxes on it either.

    286 billion a year is NOT going into the social security trust fund basically starving it of money it needs to stay solvent as boomers retire.

    As the years have gone by and health care costs have increased – so have premiums of employer-provided health insurance – devoting more and more money into tax-free health insurance costs on average about 10-15K a year is shielded from being taxed – money not going into social security, money not paying down the deficit, and money not going to education in the states.

    In other words – employer-provided health insurance is sucking money from other needs also.

    Not well known, but In 2008, the Republican presidential nominee, Senator John McCain of Arizona, proposed to abolish the exclusion for health insurance and use the revenue to finance a $5,000 tax credit for families to buy their own health insurance. – Remember over 400 billion a year is currently deferred from taxes.

    There Heritage foundation said this : ” “There is a huge consensus that this is inequitable and unfair tax treatment,” said Robert E. Moffitt, a policy analyst with the Heritage Foundation, which has long supported changing the tax laws and contends this is an area that might have significant bipartisan support.” ( Heritage was saying this in 2009 when they thought Republicans would support that rather than Obamacare – which became law in March 2010).

    ” What is more, some economists and policy analysts say the current system encourages overly generous coverage, which they say helps drive up the cost of medical care by keeping patients insulated from the true costs. “One of the arguments for doing it is trying to achieve higher value through the health care system,” said Katherine Baicker, a health economist at the Harvard School of Public Health”

    Congress has, in the past – discontinued interest paid on car loans, taken away other credits and deductions such as limiting mortgage interest to a million and this year, reducing the amount deducted for out of pocket health expenses to 10% of AGI from 7.5%. They removed the ability to pay for over-the-counter drugs from HSAs… got rid of the new-house credit, etc, teacher expenses…reduce energy credits, etc.

    the point here is that the tax deductions and credits have never been sacrosanct and changes made every year and Congress – could – just as easily do what they’ve done with other deductions and credits – put a cap on what is tax-free just as they do with IRA and 401(k)s right now.

    Doing so would increase tax revenues to buy down the deficit and strengthen social security – and Medicare and or provide similar tax credits to those who buy their own insurance.

    the other point here is that there are a plethora of options – that have been and continue to be available to Republicans as alternatives to Obamacare and tell me just how many have you heard them support for the REPLACE part of “Repeal”?

    The Republicans are AWOL on the issue. They threaten repeal and gridlock instead of solutions.

    you can’t be in favor of nothing which is where the GOP – and their supporters and opponents of ObamaCare are at these days.

    they favor repeal of ObamaCare and retaining the status quo of employer-provided health insurance despite the massive damage it has done to the county, health care – and those without it.

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