Many decades ago, I majored in engineering. We had a little one credit course in which, in part, it was said that when a project was discussed, it was all right to propose alterations or even a new plan, but once a decision was made, everyone was to get together and make the plan work, even if you thought it wasn't the best plan or even if you thought it wouldn't work. So the question is, ACA (Obamacare) became the plan (became law, a decision was made) so what did Republicans do to try and make the plan work?
True, the ACA was passed by one political party although the plan was that of the opposing party; yet none of the opposing party voted for it. That is a big reason why the Republicans are having such a difficult time with repeal and replace for the ACA. It was really their plan.
A huge problem in our current politics is that there is never a real decision made. It sure makes it difficult for people to plan for the future. You have to plan for every eventuality.
When Republican Bush-43 proposed Medicare D (prescription drugs), Democrats voted for it. It was his fellow Republicans that gave Bush such a hard time, but it passed. Now there is no argument over Medicare D. President Reagan proposed that emergency rooms have to take all applicants, regardless of ability to pay. Democrats and Republicans both voted for it and there is no argument against it today. Come on Republicans, it is in your interest to propose some plan that Democrats can vote for or help fix the ACA.
Showing posts with label Obamacare. Show all posts
Showing posts with label Obamacare. Show all posts
Monday, July 17, 2017
Thursday, June 29, 2017
BIPARTISAN HEALTHCARE BILL
When Social Security got in trouble back in 1981, a bipartisan commission was formed (National Commission on Social Security Reform, informally known as the Greenspan Commission) that managed to come up with a plan that included increased in payments into Social Security. A bill was passed in 1983. Though there were lots of statements regarding overturning the law, it stuck.*
Then in 1986, President Reagan got a reconciliation bill passed that included a provision that Emergency Rooms must take all comers regardless of ability to pay. There we no provision for the Federal government to cover the costs of this. It was left up to hospitals to find a way. The law has doe not seem to be opposed today.**
President Bush (Bush-43) narrowly got Medicare D passed (1986) in a bipartisan vote that provided some relief on prescription drug purchases. This law still stands today unopposed Though I believe the famous "doughnut hole" where prescription costs were not covered began to be eliminated. (see ACA below)*** Again there was no provision for the government to pay for this benefit.
Democrats passed a bill in 2010 called the ACA (Patient Protection and Affordable Care Act also known as Obamacare.).**** It was tailored to appeal to conservatives though no Republicans voted for it in the end. This law has been strongly opposed by Republicans ever since. There was an attempt to pay for this this bill, but I believe that Republicans objected to every attempt to do so: from the individual mandate, the business mandate, the tax on stock trading by the wealthy, the tax on artificial limbs. The Republicans have said they were going to Repeal and Replace this law ever since.
Currently, Republicans are attempting to develop a replacement for the ACA without hearings or amendments (both of which were numerous on the ACA) and without Democratic votes. In view of the above it seems as if you want a permanent law, then it had been better be bipartisan, but as of this date, the Senate leadership is refusing such an attempt. People are probably going to object to any bill that is passed (because it won't be free and will entail some restrictions) on health care so a bipartisan bill helps spread the blame. The bipartisan nature helped the Social Security reform as everyone took the blame.
* https://en.wikipedia.org/wiki/Greenspan_Commission
** https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act
*** https://en.wikipedia.org/wiki/Medicare_Part_D
**** https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
Then in 1986, President Reagan got a reconciliation bill passed that included a provision that Emergency Rooms must take all comers regardless of ability to pay. There we no provision for the Federal government to cover the costs of this. It was left up to hospitals to find a way. The law has doe not seem to be opposed today.**
President Bush (Bush-43) narrowly got Medicare D passed (1986) in a bipartisan vote that provided some relief on prescription drug purchases. This law still stands today unopposed Though I believe the famous "doughnut hole" where prescription costs were not covered began to be eliminated. (see ACA below)*** Again there was no provision for the government to pay for this benefit.
Democrats passed a bill in 2010 called the ACA (Patient Protection and Affordable Care Act also known as Obamacare.).**** It was tailored to appeal to conservatives though no Republicans voted for it in the end. This law has been strongly opposed by Republicans ever since. There was an attempt to pay for this this bill, but I believe that Republicans objected to every attempt to do so: from the individual mandate, the business mandate, the tax on stock trading by the wealthy, the tax on artificial limbs. The Republicans have said they were going to Repeal and Replace this law ever since.
Currently, Republicans are attempting to develop a replacement for the ACA without hearings or amendments (both of which were numerous on the ACA) and without Democratic votes. In view of the above it seems as if you want a permanent law, then it had been better be bipartisan, but as of this date, the Senate leadership is refusing such an attempt. People are probably going to object to any bill that is passed (because it won't be free and will entail some restrictions) on health care so a bipartisan bill helps spread the blame. The bipartisan nature helped the Social Security reform as everyone took the blame.
* https://en.wikipedia.org/wiki/Greenspan_Commission
** https://en.wikipedia.org/wiki/Emergency_Medical_Treatment_and_Active_Labor_Act
*** https://en.wikipedia.org/wiki/Medicare_Part_D
**** https://en.wikipedia.org/wiki/Patient_Protection_and_Affordable_Care_Act
Monday, March 27, 2017
TRUMP'S BASE ESCAPES SILVER BULLET
Who would ever have thunk it. Obamacare was saved by the hard right (Freedom Caucus) of the Republican Party, a group that probably doesn't like any type of healthcare. By turning down the American Health Care Act (AHCA), the ACA (Obamacare) lives!
Why was Trump's base saved? It turns out that counties that favored Trump have a high percentage of people on Medicaid. Medicaid was cut back to pre-Obama days and the savings would have been given to the wealthiest who now pay a surtax of 3.8 percent on capital gains: Quotes follow:*
Among those hit the hardest under the current House bill are 60-year-olds with annual incomes of $30,000, particularly in rural areas where healthcare costs are higher and Obamacare subsidies are greater.
In nearly 1,500 counties nationwide, such a person stands to lose more than $6,000 a year in federal insurance subsidies. Ninety percent of those counties backed Trump, the analysis shows.
And 68 of the 70 counties where these consumers would suffer the largest losses supported Trump in November.*
(Click on figure to enlarge)
And the wealthiest would benefit the most from tax cuts:**
The single biggest tax cut included in the bill is the repeal of the 3.8 percent tax the Affordable Care Act applied to capital gains, dividend, and interest income for families with $250,000 or more in income ($125,000 for singles).
Repealing that tax is a change that, by definition, only helps the rich, or at least the affluent. If you’re part of a married couple and, like the vast majority of Americans, make less than $250,000 a year, or earn more than that but have little investment income, it doesn’t affect you at all.
..................................................................
By contrast, members of the top 0.1 percent, who each on average make more than $3.75 million annually, would get an average tax cut of $165,090.
...................................................................
Then there’s the 0.9 percent Medicare surtax, a hike on wage income in excess of $250,000 a year ($200,000 for unmarried people). The Republican bill would repeal this surtax and, in so doing, give everyone in the bottom 90 percent an average tax cut of $0, per the Tax Policy Center. The richest of the rich, the top 0.1 percent, would get an average cut of $30,520.**
* http://www.latimes.com/politics/la-na-pol-obamacare-trump-supporters-20170312-story.html
** http://www.vox.com/policy-and-politics/2017/3/7/14844362/ahca-ryancare-trumpcare-tax-cut-rich
Why was Trump's base saved? It turns out that counties that favored Trump have a high percentage of people on Medicaid. Medicaid was cut back to pre-Obama days and the savings would have been given to the wealthiest who now pay a surtax of 3.8 percent on capital gains: Quotes follow:*
Among those hit the hardest under the current House bill are 60-year-olds with annual incomes of $30,000, particularly in rural areas where healthcare costs are higher and Obamacare subsidies are greater.
In nearly 1,500 counties nationwide, such a person stands to lose more than $6,000 a year in federal insurance subsidies. Ninety percent of those counties backed Trump, the analysis shows.
And 68 of the 70 counties where these consumers would suffer the largest losses supported Trump in November.*
And the wealthiest would benefit the most from tax cuts:**
The single biggest tax cut included in the bill is the repeal of the 3.8 percent tax the Affordable Care Act applied to capital gains, dividend, and interest income for families with $250,000 or more in income ($125,000 for singles).
Repealing that tax is a change that, by definition, only helps the rich, or at least the affluent. If you’re part of a married couple and, like the vast majority of Americans, make less than $250,000 a year, or earn more than that but have little investment income, it doesn’t affect you at all.
..................................................................
By contrast, members of the top 0.1 percent, who each on average make more than $3.75 million annually, would get an average tax cut of $165,090.
...................................................................
Then there’s the 0.9 percent Medicare surtax, a hike on wage income in excess of $250,000 a year ($200,000 for unmarried people). The Republican bill would repeal this surtax and, in so doing, give everyone in the bottom 90 percent an average tax cut of $0, per the Tax Policy Center. The richest of the rich, the top 0.1 percent, would get an average cut of $30,520.**
* http://www.latimes.com/politics/la-na-pol-obamacare-trump-supporters-20170312-story.html
** http://www.vox.com/policy-and-politics/2017/3/7/14844362/ahca-ryancare-trumpcare-tax-cut-rich
Tuesday, July 19, 2016
AMERICAN ECONOMY - HEALTHCARE
Another area of discontent by many with the current economy seems to be the health insurance ACA or Obamacare. A problem has been that people want medical care, but they don't want to pay for it, and Republicans have gone along with this.
For example, President Reagan introduced a law that hospital emergency rooms must take all comers, whether they can pay or not. I'm all for that, but he left it up to the hospitals to find a way to pay for it. Thus paying for it was put on the shoulders of those who have health insurance. A part of the ACA is called the Individual Mandate where everyone is required to have health insurance or pay a small fine. This was a conservative approach (proposed by the conservative Heritage Foundation) to pay for the "free" emergency room costs. And people have rebelled against it. Their ire is such that it might decide an election, but I consider it unfair.
George W. Bush (Bush-43) worked hard to get through a drug benefit for Medicare (Medicare D), but he too didn't pay for it.
An attempt was made in Obamacare to pay for the benefits and nearly everybody rebels against paying for it. There are objections to most of the plans to pay for it, including the tax on artificial limbs, the individual mandate, the company mandate and perhaps others. Conservatives should applaud these attempts to pay for a medical plan that includes provisions for children up to 26 being on their parents medical plan and no exclusion for pre-existing conditions.
There was the plan in the ACA to have insurance companies bid against each other to provide health services, but this doesn't seem to work very well. Most states did not go along with this and, in North Carolina where I live, there is only one company in the Obamacare plan. Where is the competition? North Carolina is one of the states that refused to set up their own plan.
The reason Republicans have so much trouble coming up with an alternative plan is that the ACA IS the conservative health plan.
For example, President Reagan introduced a law that hospital emergency rooms must take all comers, whether they can pay or not. I'm all for that, but he left it up to the hospitals to find a way to pay for it. Thus paying for it was put on the shoulders of those who have health insurance. A part of the ACA is called the Individual Mandate where everyone is required to have health insurance or pay a small fine. This was a conservative approach (proposed by the conservative Heritage Foundation) to pay for the "free" emergency room costs. And people have rebelled against it. Their ire is such that it might decide an election, but I consider it unfair.
George W. Bush (Bush-43) worked hard to get through a drug benefit for Medicare (Medicare D), but he too didn't pay for it.
An attempt was made in Obamacare to pay for the benefits and nearly everybody rebels against paying for it. There are objections to most of the plans to pay for it, including the tax on artificial limbs, the individual mandate, the company mandate and perhaps others. Conservatives should applaud these attempts to pay for a medical plan that includes provisions for children up to 26 being on their parents medical plan and no exclusion for pre-existing conditions.
There was the plan in the ACA to have insurance companies bid against each other to provide health services, but this doesn't seem to work very well. Most states did not go along with this and, in North Carolina where I live, there is only one company in the Obamacare plan. Where is the competition? North Carolina is one of the states that refused to set up their own plan.
The reason Republicans have so much trouble coming up with an alternative plan is that the ACA IS the conservative health plan.
Saturday, August 1, 2015
EXPAND MEDICARE TO REPEAL OBAMACARE?
In the August 1 WSJ, conservative Peggy Noonan (a spech writer for President Reagan) says she thinks Obamacare will gradually be replaced by expanding medicare. What a surprise! Is there a liberal out there that wouldn't love that?
A reason that conservatives have such a hard time coming up with an alternative to the Affordable Care Act (ACA) or Obamacare is that Obamacare IS the conservative health care plan. It is not that liberals like the ACA, it is that it was the best plan that Democrats could get past. There are DINOs in the Democratic Party (Democrats In Name Only) that had to be catered to. So an attempt was made to appeal to DINOs and Republicans to vote for the plan. Republicans voted against it and oppose it only because it was proposed by a Democratic administration.
An unusual feature of the ACA is that an attempt was made to PAY FOR IT. Republicans don't like to pay for health care. President Reagan, for example, instituted the plan where hospitals with emergency rooms had to take all comers whether they could pay for it or not. But he left it up to the hospitals to find a way to pay for this service. Ditto President Bush (Bush-43) with Medicare D, the prescription drug plan where no attempt was made to pay for it. And Republicans seem to try to repeal all attempts to pay for Obamacare (e.g. the business mandate and the tax on artificial limbs and replacements). It is a disappointment that Republicans, supposedly the party of fiscal responsibility are so irresponsible on health care. It is as if Republicans don't want health care for the poor at all. This is strange because the Republican Party has been taken over by Evangelicals. They even criticize John Kasich, an evangelical with a small e, for accepting the Federal Medicaid money. He believes that Christians need to take care of the less fortunate among us. After all Poor and Poverty appear 446 times in the bible.*
* http://stopcontinentaldrift.blogspot.com/2014/03/poor-and-poverty-appear-446-times-in.html
A reason that conservatives have such a hard time coming up with an alternative to the Affordable Care Act (ACA) or Obamacare is that Obamacare IS the conservative health care plan. It is not that liberals like the ACA, it is that it was the best plan that Democrats could get past. There are DINOs in the Democratic Party (Democrats In Name Only) that had to be catered to. So an attempt was made to appeal to DINOs and Republicans to vote for the plan. Republicans voted against it and oppose it only because it was proposed by a Democratic administration.
An unusual feature of the ACA is that an attempt was made to PAY FOR IT. Republicans don't like to pay for health care. President Reagan, for example, instituted the plan where hospitals with emergency rooms had to take all comers whether they could pay for it or not. But he left it up to the hospitals to find a way to pay for this service. Ditto President Bush (Bush-43) with Medicare D, the prescription drug plan where no attempt was made to pay for it. And Republicans seem to try to repeal all attempts to pay for Obamacare (e.g. the business mandate and the tax on artificial limbs and replacements). It is a disappointment that Republicans, supposedly the party of fiscal responsibility are so irresponsible on health care. It is as if Republicans don't want health care for the poor at all. This is strange because the Republican Party has been taken over by Evangelicals. They even criticize John Kasich, an evangelical with a small e, for accepting the Federal Medicaid money. He believes that Christians need to take care of the less fortunate among us. After all Poor and Poverty appear 446 times in the bible.*
* http://stopcontinentaldrift.blogspot.com/2014/03/poor-and-poverty-appear-446-times-in.html
Tuesday, June 30, 2015
CONGRESS HAS ABROGATED THEIR RESPONSIBILITIES
There seem to be many (all or nearly all are Republicans) who are unhappy with the Supreme Court for their decisions on Obamacare and Gay Marriage. Some have even called for the elimination of the Supreme Court! You don't hear such cries when the Court makes a decision that they like, of course, such as on citizen's United.* The thing is that congress could (in theory) act on these matters, cut, since they don't, they push to have these matters decided by the Court. They have only themselves to blame if the court decides in a manner that displeases them.
Actually as some commentators have mentioned, these politicians yelling so loud now are secretly happy to have these issues taken off the table. Is it no wonder that congress is viewed so unfavorably by the public? In the meantime, recent polls suggest that Obama's ratings that he is doing a good job have risen to 50%* and even higher for his handling of the economy (52%).** I wondered when the public would wise up that the economy is doing pretty well.
* I consider this one of the all-time bad decisions by the Supreme Court (that companies are people) and presume that some year it will be fixed.
* http://www.cnn.com/2015/06/30/politics/obama-approval-rating-cnn-poll/
http://www.washingtonexaminer.com/obamas-approval-rating-grows-to-50-percent/article/2567295
Actually as some commentators have mentioned, these politicians yelling so loud now are secretly happy to have these issues taken off the table. Is it no wonder that congress is viewed so unfavorably by the public? In the meantime, recent polls suggest that Obama's ratings that he is doing a good job have risen to 50%* and even higher for his handling of the economy (52%).** I wondered when the public would wise up that the economy is doing pretty well.
* I consider this one of the all-time bad decisions by the Supreme Court (that companies are people) and presume that some year it will be fixed.
* http://www.cnn.com/2015/06/30/politics/obama-approval-rating-cnn-poll/
http://www.washingtonexaminer.com/obamas-approval-rating-grows-to-50-percent/article/2567295
Friday, September 26, 2014
OBAMACARE: THE YOUNG AND THE POOR
"The findings suggest that the Affordable Care Act is beginning to achieve its central goal—reducing the number of Americans who are uninsured, and improving access to health care," [Commonwealth Fund Vice President] Collins said. "Adults who are being helped the most are those who historically have had the greatest difficulty affording health insurance and getting the care they need."**
*Obamacare and the poor: http://www.cnbc.com/id/101823365; Medicaid expansion: http://www.cnbc.com/id/101715324
** http://www.commonwealthfund.org/publications/issue-briefs/2014/jul/Health-Coverage-Access-ACA
Tuesday, June 24, 2014
CHILD REFUGEE PROBLEM IN U.S.
The influx of child refugees into the U.S., some accompanied by adults but many not, is creating a number of problems in addition to processing them:
One side effect of the crisis: Easier drug smuggling by cartels. "The arrival of large groups of women and children on the U.S. side of the Rio Grande is pulling agents away from their patrol stations elsewhere along the border, creating gaps in coverage that the traffickers can exploit, according to Chris Cabrera, the Border Patrol union representative here. The smugglers wait on the southern banks of the Rio Grande as migrant groups as large as 250 wade across at dusk and turn themselves in to the Border Patrol, he said. Then groups of single men proceed to cross under cover of darkness....The most recent statistics...show that narcotics seizures have fallen across the entire border with Mexico this year, with the drop being larger in Texas than the average."Joshua Partlow and Nick Miroff" in The Washington Post. (http://webmailb.juno.com/webmail/new/5?userinfo=8b254f2f4f26b1dc56d8fe41da329a7b&count=1403622068&cf=SP2&randid=1822163293)
We should remember that there was a bill passed by the Senate and submitted to the House of Representatives but never acted upon that contained provision for 19,000 new border agents. The inability of the House to act on anything but try to repeal Obamacare is causing problems I'm sure that opponents of immigration reform don't like. Why can't they at least try to see if they can get through the 19,000 new agents? Among other things it is a good lower paid jobs program. (http://stopcontinentaldrift.blogspot.com/2013/07/complete-danged-fence.html)
One side effect of the crisis: Easier drug smuggling by cartels. "The arrival of large groups of women and children on the U.S. side of the Rio Grande is pulling agents away from their patrol stations elsewhere along the border, creating gaps in coverage that the traffickers can exploit, according to Chris Cabrera, the Border Patrol union representative here. The smugglers wait on the southern banks of the Rio Grande as migrant groups as large as 250 wade across at dusk and turn themselves in to the Border Patrol, he said. Then groups of single men proceed to cross under cover of darkness....The most recent statistics...show that narcotics seizures have fallen across the entire border with Mexico this year, with the drop being larger in Texas than the average."Joshua Partlow and Nick Miroff" in The Washington Post. (http://webmailb.juno.com/webmail/new/5?userinfo=8b254f2f4f26b1dc56d8fe41da329a7b&count=1403622068&cf=SP2&randid=1822163293)
We should remember that there was a bill passed by the Senate and submitted to the House of Representatives but never acted upon that contained provision for 19,000 new border agents. The inability of the House to act on anything but try to repeal Obamacare is causing problems I'm sure that opponents of immigration reform don't like. Why can't they at least try to see if they can get through the 19,000 new agents? Among other things it is a good lower paid jobs program. (http://stopcontinentaldrift.blogspot.com/2013/07/complete-danged-fence.html)
Saturday, December 14, 2013
SELECTIVE POLLING
Have you noticed that political parties only pay attention to polls that agree with their views? For example, Republicans accept the polls that show that 52% of the people don't like Obamacare (even though in this number are those who don't like it because it doesn't go far enough), but reject polls that show that about 83% of the people,* including a majority of the members of the NRA, are for background checks on gun purchases. Recent polling also shows 66% of those polled favor an increase in the minimum wage to an average of $10.25/hr.* It remains to be seen what the House of Representatives will do about that. President Obama has proposed $10.10/hr.
Note too that Republicans say that it would be better to adopt a piece of medical reform at a time.** I actually agree with this approach, but, when a piece at a time is proposed on gun control, they reject it. The polling numbers on mental health with regard to guns has similar acceptance numbers to background checks, i.e. 79% of the responders voted in favor of increasing government spending on mental health programs for young people as of late April 2013.*
* http://www.gallup.com/poll/1645/guns.aspx#2
http://abcnews.go.com/blogs/politics/2013/12/most-back-minimum-wage-hike-policies-to-address-the-wealth-gap/
** The first thing I would do is tort reform which Democrats refuse to do. I'm told that this would save "only" 3% of the Medicare expenses, though I suspect that defensive medicine costs much more.
Note too that Republicans say that it would be better to adopt a piece of medical reform at a time.** I actually agree with this approach, but, when a piece at a time is proposed on gun control, they reject it. The polling numbers on mental health with regard to guns has similar acceptance numbers to background checks, i.e. 79% of the responders voted in favor of increasing government spending on mental health programs for young people as of late April 2013.*
* http://www.gallup.com/poll/1645/guns.aspx#2
http://abcnews.go.com/blogs/politics/2013/12/most-back-minimum-wage-hike-policies-to-address-the-wealth-gap/
** The first thing I would do is tort reform which Democrats refuse to do. I'm told that this would save "only" 3% of the Medicare expenses, though I suspect that defensive medicine costs much more.
Wednesday, November 13, 2013
OUR BACKUP HEALTH PLAN INCREASE
We are on Medicare so we have a backup plan to cover costs that Medicare doesn't completely cover. We are with a non-profit and have had to choose the standard family plan though there are only two of us as the only other choice was for singles. We got a letter yesterday saying that our cost was going up a moderate 6%, which is less than many years.
In view of the news media emphasizing those who have had troubles with Obamacare, I thought that those of us with real life stories that aren't disasters need to say something.
Starting last Tuesday, I have tired using the healthcare.gov site just to see how it works. I got into the site right away and had no trouble registering and getting into our states plan. I stopped there because we really are happy with the plan we have. Then for the next 4 days, I tried to get into the site again and wasn't able to do so. So I checked forgot password (which may be true), and they said that an e-mail was sent to my e-mail address; however, when I looked at my e-mails, nothing was there. So I called the Call Center and got through right away. The lady said they were having problems with that and was quite willing to enroll me over the phone. I didn't need this so I signed out. I went back to healthcare.gov and checked "forgot my username." Again I got a message that said I was sent an e-mail and sure enough they did, so my username and e-mail addresses are all right. This time I checked Chat. In about 3 min. I got a message to ask my question so I wrote that the password wasn't working. After awhile, I got the message back that said that they were having trouble with this. They would send me a paper copy to enroll if I wished. Then today, 8 days after my initial application, I tried healthcare.com again with the same problem. It would accept my new password request and would send me an e-mail to get a new one, but again I got no e-mail. I wonder how many people are having this problem of trying to get back into the site?
So the the telephone application seems to work fine and the chat is acceptable, but there is still a serious problem with the www.healthcare.gov site in a fundamental way. My suggestion is that if you are having repeated problems, try the telephone route.
In view of the news media emphasizing those who have had troubles with Obamacare, I thought that those of us with real life stories that aren't disasters need to say something.
Starting last Tuesday, I have tired using the healthcare.gov site just to see how it works. I got into the site right away and had no trouble registering and getting into our states plan. I stopped there because we really are happy with the plan we have. Then for the next 4 days, I tried to get into the site again and wasn't able to do so. So I checked forgot password (which may be true), and they said that an e-mail was sent to my e-mail address; however, when I looked at my e-mails, nothing was there. So I called the Call Center and got through right away. The lady said they were having problems with that and was quite willing to enroll me over the phone. I didn't need this so I signed out. I went back to healthcare.gov and checked "forgot my username." Again I got a message that said I was sent an e-mail and sure enough they did, so my username and e-mail addresses are all right. This time I checked Chat. In about 3 min. I got a message to ask my question so I wrote that the password wasn't working. After awhile, I got the message back that said that they were having trouble with this. They would send me a paper copy to enroll if I wished. Then today, 8 days after my initial application, I tried healthcare.com again with the same problem. It would accept my new password request and would send me an e-mail to get a new one, but again I got no e-mail. I wonder how many people are having this problem of trying to get back into the site?
So the the telephone application seems to work fine and the chat is acceptable, but there is still a serious problem with the www.healthcare.gov site in a fundamental way. My suggestion is that if you are having repeated problems, try the telephone route.
Thursday, November 7, 2013
DID VOTES FOR LIBERTARIAN SINK REPUBLICAN FOR GOVERNOR IN VIRGINIA?
If you think that the Libertarian candidate for Governor in Virginia, Robert Sarvis, was responsible for the loss of Tea Party candidate Ken Cuccinelli to Democrat Terry McAullife in Virginia perhaps you should think again. Sarvis got 145,470 votes for governor which if added to Cuccinelli's total would have meant a clear victory for Cuccinelli. But not so fast.
In the contest for Lieutenant Governor, Democrat Ralph Northram won more handily than did McAullife and got 189,000 more votes than did McAullife. If you added all the Sarvis votes to McAullife, McAullife would still be 65,000 votes short of his Lieutenant Governor colleague. About 35,000 more people voted for Governor than did for Lieutenant Governor.
Why would Libertarians vote for a Democrat? Well, for one thing, Democrats are Social Libertarians. A real Libertarian does not want the government in our bedrooms, which Cuccinelli was (is) eager to do, any more than Democrats. Normally Libertarians side with the Republican Party because of economic issues, but when personal issues become the issue, perhaps they will go for a Democrat.
The popular view in the media is that Cuccinelli's stand against Obamacare almost gained him a victory, Perhaps, but please note that he still did not win, even though Democrats do not like McAullife and felt he was a weak candidate all along, so it is likely that a lot of Democrats just didn't turn out for the election and some who did, just did not vote for McAullife.
Time will tell just how good or bad a governor McAullife will be. I do not know enough about him to judge.
Wednesday, November 6, 2013
JONATHAN KARL HARASSES JAY CARNEY
ABC News man Johathan Karl kept on and on asking White House press secretary Jay Carney about some one having to wait 25 min. on the phone to apply for Obamacare (Afforable Care Act or ACA). Carney patiently explained the process again and again but Karl kept on and on. You can see and hear the whole thing on (http://abcnews.go.com/blogs/politics/2013/11/jay-carney-declares-jon-i-get-it-to-abcs-karl-on-health-law-bypass/), but here is the key part of the conversation:
"KARL: I wanted to go back to exactly what the president said. He said you can bypass the website and apply by phone or in-person, and that it can be done in 25 minutes. But these memos say that at the end of the day, we are all stuck in the same queue, because they all have to go through the same portal. "
"CARNEY: Jon, I get it, but the person who calls isn’t the one who continues to wait after the application is filled, right?"
Carney said this in a mocking style as he had explained it many times already and had shown the patience of Job. Much to my surprise, many in the media sympathized with Karl and criticized Carney for treating Karl as sort of a child. Frankly Karl deserved it and more. I think that Carney should have cut him off long before the telling comment. Incredibly even after this, Karl kept on refusing to understand. He seemed bound and determined to land some sort of criticism of the president on this 25 min. topic. Certainly to me and I think everyone there is a huge difference between me having to wait 25 min. on the phone and someone else having to do it for me. So for me it is all much ado about nothing. It seems as if the so-called liberal press is bending far over backward to find criticism with the president.
Monday, October 21, 2013
PRESIDENTIAL MANAGERIAL STYLES
It is pretty clear that politicians don't like Obama's managerial style. I'm amazed they don't seem to know what it is. His management style is what I imagine that of Warren Buffet's is. Buffet buys good companies and keeps the management in place and let's them continue to run their companies. So if Obama is the CEO of a conglomerate (sounds reasonable), he lets his CEOs run the ball. In this case it is Senator Harry Reid, leader of the Senate, and Representative Nancy Pelosi, now minority leader of the House. He let them run the ball on what is called Obamacare (actually the PPACA), it was the same with Dodd-Frank, and also with the recent government shutdown and near disaster of the debt limit. I haven't followed other victories as closely so I don't know how much they were involved in getting of other successes such as of "Don't Ask, Don't Tell."
Though the PPACA is much more conservative than I like, it is a beginning
The problem with this managerial style with politicians is that they all have egos that won't quit. They all think they are God's gift to humanity. They all want to talk to the Big Boss and are frustrated when they have to settle for talking to their CEOs. This is true of Democrats of the President's party as well as the opposition Republicans. And it is also true of the media. Somehow the media can't get enough access though it seems to me they have a lot. At least after the fact, they like the former President Bill Clinton style better (My memory is that when he was president, the Republicans did everything in their power to screw him.). The glad handing, good ol' boy, type of politician. The thoughtful, introspective type of politician is not as much fun.
The Republicans rolled him so often because he is by nature a compromiser, but finally he caught on and said, "No more!" He didn't realize for a long time that the current crew that controls the House, in particular, views compromise as a sign of weakness.
Though the PPACA is much more conservative than I like, it is a beginning
The problem with this managerial style with politicians is that they all have egos that won't quit. They all think they are God's gift to humanity. They all want to talk to the Big Boss and are frustrated when they have to settle for talking to their CEOs. This is true of Democrats of the President's party as well as the opposition Republicans. And it is also true of the media. Somehow the media can't get enough access though it seems to me they have a lot. At least after the fact, they like the former President Bill Clinton style better (My memory is that when he was president, the Republicans did everything in their power to screw him.). The glad handing, good ol' boy, type of politician. The thoughtful, introspective type of politician is not as much fun.
The Republicans rolled him so often because he is by nature a compromiser, but finally he caught on and said, "No more!" He didn't realize for a long time that the current crew that controls the House, in particular, views compromise as a sign of weakness.
Friday, October 4, 2013
WHY ARE DEMOCRATS SO KIND TO JOHN BOEHNER?
I don't understand why Democrats are so kind to John Boehner. I haven't heard any Democratic Senator or Representative bad mouth him; yet every time I hear him speak he lets out one or more whoppers. The Continuing Resolution supposedly being considered is the number wanted by Republicans. The Republicans not only won that battle but the number is lower than the Sequester value.
Boehner says "This is not some damn game." But I'm sorry Mr Boehner, it is some damn game you are playing. (http://www.cnbc.com/id/101065750) and a dangerous one at that. All that posturing by Republican Representatives in front of the WW-II Memorial when they voted to lower funding for the VA. If it isn't a political game, what is it? You and some other Republicans may feel this was the place to get rid of the Afforadable Care Act, but many other Republicans and conservatives warned against it. A threat is no good if the other side isn't worried.
But I understand that some strategy is needed and to wait for the Debt limit and then allow an up or down vote will be the time to fall on your sword. You don't want to do it too early. Maybe in the end you will actually have missed the sword and survive. I also have heard some Democrats trying to think of ways to bail you out. What weird politics we are in when it is the opposing party trying to find a way to bail you out.
Boehner says "This is not some damn game." But I'm sorry Mr Boehner, it is some damn game you are playing. (http://www.cnbc.com/id/101065750) and a dangerous one at that. All that posturing by Republican Representatives in front of the WW-II Memorial when they voted to lower funding for the VA. If it isn't a political game, what is it? You and some other Republicans may feel this was the place to get rid of the Afforadable Care Act, but many other Republicans and conservatives warned against it. A threat is no good if the other side isn't worried.
But I understand that some strategy is needed and to wait for the Debt limit and then allow an up or down vote will be the time to fall on your sword. You don't want to do it too early. Maybe in the end you will actually have missed the sword and survive. I also have heard some Democrats trying to think of ways to bail you out. What weird politics we are in when it is the opposing party trying to find a way to bail you out.
Thursday, October 3, 2013
JOHN BOEHNER - THE FATE OF THE COUNTRY IN HIS HANDS
The issue supposedly is the Continuing Resolution. There is no argument over the Continuing Resolution (CR). The Democrats have agreed with the Republican figure. So there is no argument. The Republicans won that battle, and the agreed upon figure is actually below the Sequester level. The argument has nothing to do with the CR and is actually over a law that survived a test in the Supreme Court, if narrowly, the so called Obamacare or Affordable Care Act law (ACA). So the Speaker of The House, has refused to let the CR be voted upon unless the ACA is destroyed. Oh yes, they have proposed delaying ithe ACA for a year, but then will demand another year, etc. In the meantime, the ACA is open for business and early returns seems very encouraging.
Most if not all Republicans would like to see this ACA law repealed; however, the president is not likely to let this law be destroyed, especially since everyone seems to agree that the House would approve the CR if allowed to vote on it. So to prevent the CR from being passed and allow the Federal government to remain open, the Speaker Of The House, John Boehner, has refused to let the CR be voted upon. Thus now, 40% of the government is shut down, except for essential positions. I fully expect the government to remain closed for the next two weeks until we face the debt limit. We are undergoing other cute maneuvers like trying to open the government piecemeal but, in the end, never funding the ACA. Paying our soldiers on time has been the one exception that has been passed on a bipartisan basis, an exception with which I agree.
So will the Speaker refuse to let the Debt Limit be raised and destroy the Full Faith And Credit Of The U.S. Government because we will not pay bills that are already incurred? Oh, perhaps if we let this go for a few days, it will not matter, but we don't know what our creditors will do. And if you do this the first time, doing it a second time is easier, etc. So Mr. Boehner holds the fate of America in his hands. Will he keep the government closed and, in addition, destroy the full faith and credit of America? It seems to be his choice. Will he be the man who destroyed America or the hero that saved it? Right now we do not know. Is holding the Speakership worth destroying a great country?
[Warren] Buffett did provide a glimmer of hope if the Oct. 17 debt limit deadline is breached. "If it goes one second beyond the debt limit, that will not do us in. If it goes a year beyond that would be unbelievable." http://www.cnbc.com/id/101083360
[Hank Paulsen] said he hates the whole concept of the debit limit—calling it a "flaw" in the system. "Congress has already approved the spending. And then say 'you have to then come back and agree to allow us to meet our obligations,' that's ridiculous." http://www.cnbc.com/id/101083367
Most if not all Republicans would like to see this ACA law repealed; however, the president is not likely to let this law be destroyed, especially since everyone seems to agree that the House would approve the CR if allowed to vote on it. So to prevent the CR from being passed and allow the Federal government to remain open, the Speaker Of The House, John Boehner, has refused to let the CR be voted upon. Thus now, 40% of the government is shut down, except for essential positions. I fully expect the government to remain closed for the next two weeks until we face the debt limit. We are undergoing other cute maneuvers like trying to open the government piecemeal but, in the end, never funding the ACA. Paying our soldiers on time has been the one exception that has been passed on a bipartisan basis, an exception with which I agree.
So will the Speaker refuse to let the Debt Limit be raised and destroy the Full Faith And Credit Of The U.S. Government because we will not pay bills that are already incurred? Oh, perhaps if we let this go for a few days, it will not matter, but we don't know what our creditors will do. And if you do this the first time, doing it a second time is easier, etc. So Mr. Boehner holds the fate of America in his hands. Will he keep the government closed and, in addition, destroy the full faith and credit of America? It seems to be his choice. Will he be the man who destroyed America or the hero that saved it? Right now we do not know. Is holding the Speakership worth destroying a great country?
[Warren] Buffett did provide a glimmer of hope if the Oct. 17 debt limit deadline is breached. "If it goes one second beyond the debt limit, that will not do us in. If it goes a year beyond that would be unbelievable." http://www.cnbc.com/id/101083360
[Hank Paulsen] said he hates the whole concept of the debit limit—calling it a "flaw" in the system. "Congress has already approved the spending. And then say 'you have to then come back and agree to allow us to meet our obligations,' that's ridiculous." http://www.cnbc.com/id/101083367
Thursday, August 15, 2013
CONGRESS TOO ACTIVE?
Congress is getting only a 12% approval rating and an 80% disapproval rating. The media assumes that this means that the electorate feels congress should do something. But I don't know, maybe it means that the electorate feels that congress is doing too much!*
Consider: The speaker of the House says that congress should not be judged by how many laws it makes but how many it repeals. The electorate keeps electing and reelecting the do nothings that would indicate they don't want congress to do anything. They say insanity is to do the same thing over and over expecting different results. Is the electorate insane?
A lot of the news media and some conservatives say that the Republicans should propose an alternative to Obamacare. But Obamacare is already a conservative medical law. Every liberal knows that we should have a single payer health system to control medical costs, for example. It was a conservative proposal to go to the individual mandate. The alternative to Obamamcare really is to do nothing and to just let the previous system ride with more and more people shut out of health insurance because it has become prohibitively expensive. This is not to say that Obamacare cannot be improved. After all it is a huge and cumbersome law. Some improvements have already been made, but I doubt that single payer is in the cards.
* Also see The Government You Voted For: http://stopcontinentaldrift.blogspot.com/2013/08/the-government-you-voted-for.html
Consider: The speaker of the House says that congress should not be judged by how many laws it makes but how many it repeals. The electorate keeps electing and reelecting the do nothings that would indicate they don't want congress to do anything. They say insanity is to do the same thing over and over expecting different results. Is the electorate insane?
A lot of the news media and some conservatives say that the Republicans should propose an alternative to Obamacare. But Obamacare is already a conservative medical law. Every liberal knows that we should have a single payer health system to control medical costs, for example. It was a conservative proposal to go to the individual mandate. The alternative to Obamamcare really is to do nothing and to just let the previous system ride with more and more people shut out of health insurance because it has become prohibitively expensive. This is not to say that Obamacare cannot be improved. After all it is a huge and cumbersome law. Some improvements have already been made, but I doubt that single payer is in the cards.
* Also see The Government You Voted For: http://stopcontinentaldrift.blogspot.com/2013/08/the-government-you-voted-for.html
Friday, December 14, 2012
DEATH PANELS & $716 BILLION FROM MEDICARE
I've never heard it discussed, but I think that Democrats are well concerned about making proposals to cut Medicare. After all the Democrats had proposed in Section 123 of bill HR 3200 that would have paid physicians for counseling patients about living will, advances directives, and end-of -life care options. Sarah Palin coined the phrase "death panels" to describe this and said that these panels would judge just how much health care you deserved. Of those that knew about the claim, 30% said they thought it was true (about 255 of Americans).* The provision about physicians counseling was removed from the final bill though end-of-life provisions, in particular, are a major expense in Medicare, but political hysteria had set in. You should read the entire Wikipedia report but just to quote one claim "Rep Virginia Foxx (R-NC) charged that the proposal would 'put seniors in a position of being put to death by their government.'"
There is an Independent Payment Advisory Board (IPAB) that will force cuts in Medicare if inflation in Medicare costs exceeds a certain number.** These cuts specifically cannot reduce benefits or ration health care (Section 3403 of the health care law), but deal with things like Medicare Advantage costs, physician's reimbursement, hospital reimbursements. Congress can rescind these cuts, but then must find the savings elsewhere. This Board has been demagogued too. Republican Presidential candidate Mitt Romney claimed that, "In order to bring health care costs down, we don't need to have `15 people telling us what kinds of treatments we should have." But Romney's falsehood is relatively mild compared to that by others
IPAB is a change from where a previous panel called MedPac advised the congress on cuts to medical costs, which congress duly ignored. The panel consists of 15 members appointed by the President subject to Senate confirmation. It is specified that the president must consult with the leaders of the Senate and House majorities and minorities for the appointment of 3 members each or 12 members total. The other three members are the Head of HHS, and two health Administrators as non-voting members. Though these members are not elected (thank heavens for that), they have more scrutiny than Department Secretaries, it seems to me.
Then there is the demogoging the $716 billion in cuts from Medicare, a sum identical to the cuts Rep. Paul Ryan (R-WI). These cuts are expected to extend the life of Medicare for 8 years. Now in Obamacare, these cuts are used elsewhere to do things like close the "donut hole" in Medicare D, and one might want to use the cuts for other purposes like reducing the Federal deficit, but that was not what was claimed. It was claimed by various Republicans that the cuts were to reduce benefits to Medicare beneficiaries. In fact, 30.2% of the cuts involve Medicare Advantage (Medicare-C) that cost 17% more than Medicare-B (and I feel Advantage should be eliminated entirely), 34.8% were to reduce hospital costs (and hospitals agreed to this because of an expected increase in patients under Obamacare), and 35 % for everything else (e.g. insurance cuts, home care provider cuts, uninsured patient cuts to hospitals, etc., about a dozen in all).*** Republicans implied or claimed that this sum would be taken from Medicare benefits, though such was not the case. Republican candidate for President even claimed he would restore the cuts.
The funny thing is that all these were cuts were made by people that actually want to destroy Medicare. Paul Ryan wanted to eliminate Medicare in favor of vouchers to people to seek medical insurance. Besides he still wants to eliminate $716 billion from Medicare.**** But is it any wonder that Democrats are wary of mentioning specific cuts to Medicare?
* http://en.wikipedia.org/wiki/Death_panel
** http://www.politifact.com/truth-o-meter/statements/2012/oct/04/mitt-romney/romney-says-ipab-board-can-tell-people-ultimately-/
*** http://www.washingtonpost.com/blogs/wonkblog/wp/2012/08/14/romneys-right-obamacare-cuts-medicare-by-716-billion-heres-how/
**** http://reason.com/blog/2012/12/03/republicans-likely-to-stick-with-medicar
There is an Independent Payment Advisory Board (IPAB) that will force cuts in Medicare if inflation in Medicare costs exceeds a certain number.** These cuts specifically cannot reduce benefits or ration health care (Section 3403 of the health care law), but deal with things like Medicare Advantage costs, physician's reimbursement, hospital reimbursements. Congress can rescind these cuts, but then must find the savings elsewhere. This Board has been demagogued too. Republican Presidential candidate Mitt Romney claimed that, "In order to bring health care costs down, we don't need to have `15 people telling us what kinds of treatments we should have." But Romney's falsehood is relatively mild compared to that by others
IPAB is a change from where a previous panel called MedPac advised the congress on cuts to medical costs, which congress duly ignored. The panel consists of 15 members appointed by the President subject to Senate confirmation. It is specified that the president must consult with the leaders of the Senate and House majorities and minorities for the appointment of 3 members each or 12 members total. The other three members are the Head of HHS, and two health Administrators as non-voting members. Though these members are not elected (thank heavens for that), they have more scrutiny than Department Secretaries, it seems to me.
Then there is the demogoging the $716 billion in cuts from Medicare, a sum identical to the cuts Rep. Paul Ryan (R-WI). These cuts are expected to extend the life of Medicare for 8 years. Now in Obamacare, these cuts are used elsewhere to do things like close the "donut hole" in Medicare D, and one might want to use the cuts for other purposes like reducing the Federal deficit, but that was not what was claimed. It was claimed by various Republicans that the cuts were to reduce benefits to Medicare beneficiaries. In fact, 30.2% of the cuts involve Medicare Advantage (Medicare-C) that cost 17% more than Medicare-B (and I feel Advantage should be eliminated entirely), 34.8% were to reduce hospital costs (and hospitals agreed to this because of an expected increase in patients under Obamacare), and 35 % for everything else (e.g. insurance cuts, home care provider cuts, uninsured patient cuts to hospitals, etc., about a dozen in all).*** Republicans implied or claimed that this sum would be taken from Medicare benefits, though such was not the case. Republican candidate for President even claimed he would restore the cuts.
The funny thing is that all these were cuts were made by people that actually want to destroy Medicare. Paul Ryan wanted to eliminate Medicare in favor of vouchers to people to seek medical insurance. Besides he still wants to eliminate $716 billion from Medicare.**** But is it any wonder that Democrats are wary of mentioning specific cuts to Medicare?
* http://en.wikipedia.org/wiki/Death_panel
** http://www.politifact.com/truth-o-meter/statements/2012/oct/04/mitt-romney/romney-says-ipab-board-can-tell-people-ultimately-/
*** http://www.washingtonpost.com/blogs/wonkblog/wp/2012/08/14/romneys-right-obamacare-cuts-medicare-by-716-billion-heres-how/
**** http://reason.com/blog/2012/12/03/republicans-likely-to-stick-with-medicar
Wednesday, November 7, 2012
COMEBACK KID COMES BACK -- AGAIN!
Well! So Obama came back to be reelected after all. He has fooled me several times (an example is getting Obamacare), and here I had suggested he might be the best one-term president ever (http://stopcontinentaldrift.blogspot.com/2010/08/best-one-term-president-ever.html). I did, however, protect myself a bit in writing " Therefore I feel that President Obama probably will be a one-term president no matter his other outstanding accomplishments; however, we have learned that it is dangerous to count out The Comeback Kid." And so he did. There is concern that Obama has not outlined a visionary agenda for his second term, but there is much to his first term that still need to be consummated. A good example is that the Dodd-Frank bill is still being assimilated with maybe two-thirds of the regulations still to be decided. Obamacare is not yet fully implemented. And then there is the Dream Act still to be consummated as well as the infrastructure legislation among others. Also the "fiscal cliff" seems to need to be dealt with.
Will Republicans be more flexible in doing the nations' business? Mitch McConnell's stated primary goal of defeating President Obama's reelection didn't work out so well. Will Republican's somehow grow to love Hispanic Americans? Oh sure, they do have a few Republican Hispanic governors, Senators and Representative, but, after all, Obama did get 71% of the Hispanic vote. Are Republican's happy that they kept Elizabeth Warren from being head of the Consumer Protection Agency only to have her take away a Senate seat from them?
So it has happened again. As I type this, the stock exchanges are down big time although in 80% of the Democratic Presidencies, the S&P500 has been up and the DJIA almost as much.
It will interesting to follow. But it sure appears that Obamamcare is protected.
Will Republicans be more flexible in doing the nations' business? Mitch McConnell's stated primary goal of defeating President Obama's reelection didn't work out so well. Will Republican's somehow grow to love Hispanic Americans? Oh sure, they do have a few Republican Hispanic governors, Senators and Representative, but, after all, Obama did get 71% of the Hispanic vote. Are Republican's happy that they kept Elizabeth Warren from being head of the Consumer Protection Agency only to have her take away a Senate seat from them?
So it has happened again. As I type this, the stock exchanges are down big time although in 80% of the Democratic Presidencies, the S&P500 has been up and the DJIA almost as much.
It will interesting to follow. But it sure appears that Obamamcare is protected.
Monday, October 8, 2012
THE OBAMACARE "COMMITTEE"
One frequently hears about a committee (panel or board) in Obamacare that is going to make judgements about what benefits you will get. Most recently Mitt Romney made the complaint in the first presidential election debate. The committee is actually called the Independent Payment Advisory Board (IPAB) or, originally the Independent Medicare Advisory Board. This IPAB is explicitly restricted to making savings without affecting rationing, beneficiary costs, coverage or quality of care , but is given the task of meeting certain goals as to the cost of Medicare.* Furthermore Congress can overrule the Board with a supermajority vote, but then must find the savings elsewhere.* Lastly the IPAB consists of 15 members appointed by the president but subject to congressional confirmation.* The President must consult with the Majority Leader of the Senate on the appointment of three members, the Speaker of the House of Representatives on appointment of three others, and then consult for three each with the Minority Leaders of these two bodies.* This leaves three to be appointed by the Administration as ex-officio non-voting members.* The members will serve six years in staggered terms.*
The obfuscation of the real IPAB purpose is, of course, done for political reasons. IPAB in fact replaces a previous Medicare Payment Advisory Committee (Med Pac) whose recommendation of cuts to Medicare have been ignored by Congress.* You are advised to read the entire article in Wikipedia.
(http://en.wikipedia.org/wiki/Independent_Payment_Advisory_Board)
The obfuscation of the real IPAB purpose is, of course, done for political reasons. IPAB in fact replaces a previous Medicare Payment Advisory Committee (Med Pac) whose recommendation of cuts to Medicare have been ignored by Congress.* You are advised to read the entire article in Wikipedia.
(http://en.wikipedia.org/wiki/Independent_Payment_Advisory_Board)
Friday, June 29, 2012
OBAMACARE LARGELY UPHELD
The Supreme Court largely upheld the Affordable Care Act, the most important legislation since the Civil Rights Act of 1964. The individual mandate is now ruled to be a tax and is constitutional.
Frankly, I would have preferred a single payer provision over the individual mandate, but compromises had to be made to pass the legislation.
It was a surprise to me that Chief Justice John Roberts cast the deciding vote for Obamacare rather than Associate Justice Anthony Kennedy; however, some pundits before the decision had suggested that Roberts might vote for the Act. I'm rather surprised that Kennedy didn't go along.
The part of Obamacare ruled unconstitutional by a 7 to 2 vote was a provision on the expansion of Medicaid where, if state voted to not participate in the expansion, they would lose all or part of the regular Federal contribution to Medicaid which was judged to be coercive. In the first few years, the Federal government will cover all the cost of the Medicaid expansion, but the Federal governments contribution will eventually drop to 90% leaving states to pick up the remaining 10%. This could cost a state like Texas to pick up $500 million/year by 2019. http://www.guardian.co.uk/world/2012/jun/29/supreme-court-medicaid-expansion-states?newsfeed=true. If states opt out of the expanded Medicaid, this will add thousands to millions of poor people to the uninsured role and make them use the emergency room for their primary care, as is the situation now, adding costs to the insurance bills of those who have health insurance thus defeating an important part of Obamacare.
Roberts' ruling makes up a bit, perhaps, for the worst ruling the Supreme Court has ever made that corporations are people, the Citizens United decision, which they not only ruled constitutionally initially but reaffirmed recently. Maintaining this ruling perhaps led Roberts to his vote on Obamacare to preserve the reputation of the Court.
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