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Mon Nov 19, 2012, 12:31 PM

Rant: who was the moron who drafted the ACA such that states can opt out automatically?

http://www.nytimes.com/2012/07/08/us/critics-of-health-care-law-prepare-to-battle-over-insurance-exchange-subsidies.html?_r=0

The geniuses who drafted the statute never considered the possibility that states would actually refuse to set up an exchange. Or, rather, they never addressed the consequences of that in drafting the legislation.

Long story short, they only authorized/appropriated money for subsidies to low income people in state run exchanges. If the state doesn't set it up and run it, there can be a federal exchange, but there will be no federal subsidies. None. Zilch.

And, good luck enforcing the mandate with no subsidies.

Which means that any state that refuses to set up an exchange can pretty much opt out of the ACA. It's a de facto waiver for all 50 states.

This is criminal incompetence.

And yeah yeah, they can go to court and argue legisliative intent, but do you really think the Roberts SCOTUS is going to go out of its way to ignore the plain language of the statute?

Sorry, folks who live in places like Wisconsin and Texas, no Obamacare for you.

62 replies, 3654 views

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Reply Rant: who was the moron who drafted the ACA such that states can opt out automatically? (Original post)
geek tragedy Nov 2012 OP
Drale Nov 2012 #1
geek tragedy Nov 2012 #4
BlueMan Votes Nov 2012 #6
sammytko Nov 2012 #2
geek tragedy Nov 2012 #9
BlueMan Votes Nov 2012 #10
MANative Nov 2012 #3
geek tragedy Nov 2012 #7
Starry Messenger Nov 2012 #5
1StrongBlackMan Nov 2012 #8
geek tragedy Nov 2012 #11
1StrongBlackMan Nov 2012 #49
tkmorris Nov 2012 #61
1StrongBlackMan Nov 2012 #62
Schema Thing Nov 2012 #12
geek tragedy Nov 2012 #17
Schema Thing Nov 2012 #19
geek tragedy Nov 2012 #20
Schema Thing Nov 2012 #23
geek tragedy Nov 2012 #33
Warren Stupidity Nov 2012 #24
geek tragedy Nov 2012 #28
LiberalFighter Nov 2012 #29
geek tragedy Nov 2012 #32
sammytko Nov 2012 #13
geek tragedy Nov 2012 #15
sammytko Nov 2012 #18
geek tragedy Nov 2012 #22
Warren Stupidity Nov 2012 #25
geek tragedy Nov 2012 #30
Warren Stupidity Nov 2012 #56
brokechris Nov 2012 #14
geek tragedy Nov 2012 #16
Turbineguy Nov 2012 #21
Warren Stupidity Nov 2012 #26
geek tragedy Nov 2012 #37
sammytko Nov 2012 #44
unblock Nov 2012 #27
geek tragedy Nov 2012 #31
grantcart Nov 2012 #34
geek tragedy Nov 2012 #35
grantcart Nov 2012 #51
geek tragedy Nov 2012 #52
ProgressiveProfessor Nov 2012 #36
geek tragedy Nov 2012 #41
ProgressiveProfessor Nov 2012 #45
Warren Stupidity Nov 2012 #54
geek tragedy Nov 2012 #55
hughee99 Nov 2012 #59
phleshdef Nov 2012 #38
geek tragedy Nov 2012 #42
phleshdef Nov 2012 #46
geek tragedy Nov 2012 #50
Agnosticsherbet Nov 2012 #39
geek tragedy Nov 2012 #43
ProgressiveProfessor Nov 2012 #47
geek tragedy Nov 2012 #48
caraher Nov 2012 #40
nashville_brook Nov 2012 #53
Roselma Nov 2012 #57
mdohoney Nov 2012 #58
On the Road Nov 2012 #60

Response to geek tragedy (Original post)

Mon Nov 19, 2012, 12:41 PM

1. They can't just opt out

they still can't denied health insurance for pre existing condition or kick kids off their parents insurance. Theres alot in their other than the mandate that everyone wants to focus on.

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Response to Drale (Reply #1)

Mon Nov 19, 2012, 12:44 PM

4. No subsidies means that that people won't be able to afford the insurance offered through

the exchanges.

It essentially means that there will be no exchanges in that state--because no one will participate in them.

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Response to Drale (Reply #1)

Mon Nov 19, 2012, 12:44 PM

6. it doesn't matter if they can't be denied a product that they can't afford.

 

and without the subsidies- MANY of them won't be able to.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 12:43 PM

2. The feds will run it instead - which is probably better n/t

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Response to sammytko (Reply #2)

Mon Nov 19, 2012, 12:46 PM

9. There will be nothing to run---the lack of subsidies means that no one will

participate.

There's not even any funding set up to run the exchanges in the first place.

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Response to sammytko (Reply #2)

Mon Nov 19, 2012, 12:47 PM

10. it won't be better if there are no subsidies to allow the poor to buy in.

 

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 12:43 PM

3. I don't think that was in the legislation...

I could be wrong, and don't have time to look it up right now, but I think that was a fallout from the Supreme Court review - that states couldn't be forced to participate.

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Response to MANative (Reply #3)

Mon Nov 19, 2012, 12:45 PM

7. No, the problem is that they explicitly limited subsidies to state-run exchanges.

They did NOT authorize subsidies for federally run exchanges.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 12:44 PM

5. That was discussed here back when it was drafted.

Many posters simply tossed off that people can vote with their feet and move. When informed that poor people can't really do that, there was dead silence. But people knew this could happen, absolutely.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 12:45 PM

8. This narrative is being pushed by the CATO Institute ...

And is being litigated before a very skeptical Oklahoma court.

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Response to 1StrongBlackMan (Reply #8)

Mon Nov 19, 2012, 12:47 PM

11. Unfortunately, the language is pretty clear.

The drafters screwed the pooch on it.

And the Roberts court is notorious for reading statutes very, very literally.

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Response to geek tragedy (Reply #11)

Mon Nov 19, 2012, 01:47 PM

49. Well ...

maybe a word from the agency responsible for administering the subsidies might put to rest your worries:

Douglas H. Shulman, the I.R.S. commissioner, defended the rule as consistent with the intent of Congress. “The statute,” he said, “includes language that indicates that individuals are eligible for tax credits whether they are enrolled through a state-based exchange or a federally facilitated exchange.”


Maybe?

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Response to 1StrongBlackMan (Reply #49)

Mon Nov 19, 2012, 05:02 PM

61. I would have thought this post at least warranted a response

It seems to directly debunk what was claimed in the OP. I could see disagreeing with it in some fashion but outright ignoring it? I hope the OPer had to run an errand or something, which would explain the lack of response.

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Response to tkmorris (Reply #61)

Mon Nov 19, 2012, 06:42 PM

62. Maybe he/she is on a bathroom break? n/t

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 12:47 PM

12. oh chill. everyone will get the same subsidies, everywhere.


this is just Republicans being Republicans.


They bitch about the "thousands of pages" but then have combed through and found some missed verbage to hang their next round of purely political bitching on.

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Response to Schema Thing (Reply #12)

Mon Nov 19, 2012, 12:53 PM

17. This isn't political bitching--it's a legal argument that the SCOTUS is going to buy. nt

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Response to geek tragedy (Reply #17)

Mon Nov 19, 2012, 12:58 PM

19. No, it's not. It's a glitch. The intent of the law is not going to be overturned


by the Supreme Court, even this Supreme Court, over a simple error.


Republicans are going to do what they do, and the IRS and the Obama administration is going to do what it is going to do. And that is: give subsidies.

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Response to Schema Thing (Reply #19)

Mon Nov 19, 2012, 01:01 PM

20. Courts generally don't care if it's an error. Especially Republican judges.

The legislature passes legislation in the form of words--it doesn't enact intent. That's their judicial philosophy.

Remember that 4 SCOTUS justices were ready to kill the entire bill over bogus arguments. This claim has much more credibility than the anti-mandate arguments did.

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Response to geek tragedy (Reply #20)

Mon Nov 19, 2012, 01:03 PM

23. this claim has ZERO credibility.



And yeah, actually judges DO care about intent.

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Response to Schema Thing (Reply #23)

Mon Nov 19, 2012, 01:22 PM

33. Judges care about intent if the language is unclear.

Unfortunately, the language isn't ambiguous.

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Response to geek tragedy (Reply #17)

Mon Nov 19, 2012, 01:05 PM

24. So you are asserting as fact something that has only been theorized

as an opportunity to sabotage the ACA by the Cato institute. The facts as they exist today are that the tax credits apply to both state and federal exchanges. Until the USSC decides otherwise the current administration, the one that administers laws, will interpret the ACA as it was intended by congress, not as the Cato Fucking Institute sees it.

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Response to Warren Stupidity (Reply #24)

Mon Nov 19, 2012, 01:13 PM

28. You really think the Roberts court is going to give the admin a pass on this?

The problem is that the Cato institute is correct on the statutory language. It's more than a little optimistic to assume that the Roberts court is going to effectively change the statute as it is written.

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Response to geek tragedy (Reply #17)

Mon Nov 19, 2012, 01:13 PM

29. They didn't buy the legal argument by everyone that ACA was totally unconstitutional.

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Response to LiberalFighter (Reply #29)

Mon Nov 19, 2012, 01:21 PM

32. Roberts did at first, and he backed down only because the shitstorm would be too big.

He'll have no such trouble doing it in this case.

They can rule "the law says what the law says. If it's a mistake, Congress needs to fix it."

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 12:48 PM

13. That is an old article - here is one from two days ago

http://www.nytimes.com/2012/11/17/us/states-decline-to-set-up-exchanges-for-insurance.html

The administration has been urging states to set up exchanges, as Congress intended. The federal government will create and run exchanges in any state that is unable or unwilling to do so.

Friday was to be the deadline for states to declare their intentions. But Ms. Sebelius said Thursday night that she was extending the deadline to Dec. 14. In any event, she must decide by Jan. 1 whether states are able to run their own exchanges.

Americans are supposed to be able to start shopping for insurance through exchanges in October 2013. By January 2014, most Americans will be required to have health insurance under the law.

Obama administration officials said they would be ready to run the federal exchanges, but they have not provided any information about their plans or their progress.

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Response to sammytko (Reply #13)

Mon Nov 19, 2012, 12:51 PM

15. That doesn't deal with the subsidy issue. nt

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Response to geek tragedy (Reply #15)

Mon Nov 19, 2012, 12:57 PM

18. ugh - the feds will pay that.

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Response to sammytko (Reply #18)

Mon Nov 19, 2012, 01:02 PM

22. Ugh, no. The law doesn't authorize them to.

The law only permits subsidies for exchanges that the states set up themselves. It does NOT include federally established/run exchanges.

The language is crystal clear.

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Response to geek tragedy (Reply #22)

Mon Nov 19, 2012, 01:06 PM

25. No it isn't. And you know better.

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Response to Warren Stupidity (Reply #25)

Mon Nov 19, 2012, 01:19 PM

30. ACA, Section 1401 only allows subsidies for people enrolled in exchanges established

by states per Section 1311.

The federal exchanges are authorized/created per Section 1321, not 1311.

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Response to geek tragedy (Reply #30)

Mon Nov 19, 2012, 02:14 PM

56. According to you and the Cato Institute.


In a recent article, Michael Cannon of the libertarian Cato Institute and Professor Jonathan Adler of Case Western University claim that this language is not only unambiguous but also intentional, that Congress intended to punish states that refused to establish exchanges by refusing premium tax credits to their residents. Cannon and Adler further claim that final rules promulgated by the IRS making premium tax credits available through federal as well as state exchanges are unauthorized by law, and thus illegal.
These claims are simply false. The legislative history of the ACA establishes that Congress understood that premium tax credits would be available through both federal and state exchanges. The availability of tax credits through federally facilitated exchanges is further demonstrated through the language of the ACA, as amended by the Health Care and Education Reconciliation Act (HCERA), which, although it could have been clearer, supports the interpretation of the statute adopted by the IRS.
The IRS is explicitly authorized by Congress to interpret the statute and its interpretation of the law will be given deference by the courts. The existence of exchanges in every state was assumed both by the Congressional Budget Office and by both proponents and opponents of the ACA as it was being debated. Moreover, the structure and purpose of the ACA requires that state or federal exchanges offer premium tax credits in every state. Finally, as Cannon and Adler concede, employers, the only persons with standing to challenge the IRS’s interpretation of the ACA, would be barred from doing so by the Tax Anti-injunction Act, as recently interpreted by the Supreme Court, probably until 2015.

http://healthaffairs.org/blog/2012/07/18/tax-credits-in-federally-facilitated-exchanges-are-consistent-with-the-affordable-care-acts-language-and-history/

Given that neither you nor the Cato institute will be in charge of administration of this law, I suggest that your opinion is irrelevant and that the CATO Institute is not a good source for substantiating your opinion.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 12:49 PM

14. why would they opt out?

they are going to have to pay the taxes (federal) anyway so they aren't going to save any money?

Is there any benefit to opting out?

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Response to brokechris (Reply #14)

Mon Nov 19, 2012, 12:52 PM

16. Because they're Republicans and they want to screw poor people. nt

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 01:01 PM

21. The whole law

had to be fucked up enough to pass Congress.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 01:07 PM

26. a) morons is vile language. b) this is a bullshit post.

You are off propagating and defending as fact CATO talking points.

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Response to Warren Stupidity (Reply #26)

Mon Nov 19, 2012, 01:28 PM

37. Okay, tell us how this language is unclear:

Section 1311 of the ACA deals with exchanges set up by the states.

Section 1321 of the ACA deals with exchanges set up by the federal government if the state does not do so.

Section 1401 is the section that authorizes subsidies, and it is explicitly limits those subsidies to health plans "which were enrolled in through an Exchange established by the State under 1311."


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Response to Warren Stupidity (Reply #26)

Mon Nov 19, 2012, 01:38 PM

44. thank you

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 01:10 PM

27. quite the contrary, they specifically allowed the feds to set it up in case some states didn't do it

this was actually well thought out. incompetence would have been drafting it so that states could defy the law through inaction. instead they thought this might happen and drafted a remedy into the law itself so as to avoid needing to go to court or amend the law to fix it.

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Response to unblock (Reply #27)

Mon Nov 19, 2012, 01:20 PM

31. The problem is that they authorized subsidies ONLY for state-run exchanges.

The section authorizing the subsidies explicitly limits those subsidies to exchanges created by the states (section 1311) not exchanges created by the federal government (section 1321).

Seriously, it's that bad of a screw up. Heck of a job brownie bad.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 01:23 PM

34. who is the moron that still uses the word 'moron'.


You might want to check your facts before your rant


To answer your question it was the Supreme Court that said that states could opt out of the expansion of Medicaid, not the original ACA. Moreover it is my understanding that citizens in states that don't have state exchanges will be able to participate in national exchanges



It all comes out of the Court’s opinion that states have the ability to opt out of Obamacare’s expansion of Medicaid.


http://www.forbes.com/sites/aroy/2012/06/28/why-the-supreme-court-decision-on-obamacare-may-dramatically-increase-the-deficit/


and


http://www.palmbeachpost.com/news/news/state-regional-govt-politics/scotts-health-care-law-refusal-makes-federal-contr/nPnKF/

If the states don’t do those things, the federal government will, according to documents. States have three options for setting up exchanges — a state-based exchange, a state partnership exchange in which the federal government operates the exchange but the state retains some regulatory functions, or a federal facilitated exchange in which the feds control virtually all aspects. States can also join the federal exchanges later.



entire time spend finding the facts 3 minutes

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Response to grantcart (Reply #34)

Mon Nov 19, 2012, 01:27 PM

35. The problem is that there are no subsidies for people in the federal exchanges.

Section 1311 of the ACA deals with exchanges set up by the states.

Section 1321 of the ACA deals with exchanges set up by the federal government.

Section 1401 is the section that authorizes subsidies, and it is explicitly limits those subsidies to health plans "which were enrolled in through an Exchange established by the State under 1311."

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Response to geek tragedy (Reply #35)

Mon Nov 19, 2012, 01:53 PM

51. No the problem is that the Supreme Court said that you could not compel states to expand Medicaid

but you could let them opt out.


If the state opts out they will indeed lose their subsidies, and they will be held accountable by the electorates in those states.


Your OP is offensive in language and confusing, at best. The question of setting up or not setting up an exchange is not related to the question of expanding Medicaid.


The question of making states expand their Medicaid was settled by the Supreme Court, who said that you couldn't force a state to increase Medicaid if they didn't want to (the penalty was that they would lose all of their Medicaid subsidy if they didn't) and that states could opt out of the Medicaid expansion.

And yes if a state is stupid enough to not want the extra subsidy then the fault lies with the state officials and not with the ACA.


Given the level of confusion that your OP is shrouded in and the aggressive use of the word 'moron' and it's general tone you would be advised to self delete it.

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Response to grantcart (Reply #51)

Mon Nov 19, 2012, 01:56 PM

52. Medicaid expansion is a separate issue from the tax credits offered

as subsidies under the exchanges.

This was a rant--this was a drafting error so obvious that it would constitute legal malpractice in the private sector.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 01:28 PM

36. This post was alerted. Jury voted 4-2 to retain

Juror comments:

ALERTER'S COMMENTS:

"morons" - really? clean up the language. Then consider deleting the post too, as it is CATO institute bullshit.

You served on a randomly-selected Jury of DU members which reviewed this post. The review was completed at Mon Nov 19, 2012, 12:14 PM, and the Jury voted 2-4 to LEAVE IT.

Juror #1 voted to LEAVE IT ALONE and said: No explanation given
Juror #2 voted to HIDE IT and said: No explanation given
Juror #3 voted to LEAVE IT ALONE and said: No explanation given
Juror #4 voted to LEAVE IT ALONE and said: This poster is very concerned that people will not be able to get access to health care. I feel his pain. The legislation was a rush job, it has holes, oversights and errors. He seems to think that they cannot be corrected readily. While I disagree, I feel his pain. While it clearly is not criminal behavior, this post is not over the top.
Juror #5 voted to LEAVE IT ALONE and said: No explanation given
Juror #6 voted to HIDE IT and said: RW talking points. Take it elsewhere.

====================================

The alerter and juror #6 are clearly off base. The poster is seriously concerned about people in those few recalcitrant states being unable to get the same health care at a reasonable price. That is not right wing or CATO talking points. While I disagree with his wording, it was not worthy of a hide.

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Response to ProgressiveProfessor (Reply #36)

Mon Nov 19, 2012, 01:31 PM

41. This got alerted? Oy.

Thanks for the words of support.

There was plenty of debate about the constitutionality of the mandate around here. This is an argument on which the wingnuts are on much more solid ground--we effectively have to ask the courts to assume that the language was a drafting error.

Courts HATE to assume a drafting error in legislation.

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Response to geek tragedy (Reply #41)

Mon Nov 19, 2012, 01:42 PM

45. It is clear to me in context that you are well meaning but incorrect

that should not result in smears and alerts, but some participants at DU seem to enjoy that.

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Response to geek tragedy (Reply #41)

Mon Nov 19, 2012, 02:09 PM

54. I alerted on it. The use of the term "moron" is unacceptable.

It is right up there with "retard". Your post is bullshit on many levels.

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Response to Warren Stupidity (Reply #54)

Mon Nov 19, 2012, 04:31 PM

59. Is "moronic" an okay term, or is that also unacceptable?

I've never seen an alert for moron before.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 01:29 PM

38. Here is a thorough explanation of why you are more than likely dead wrong about this.

But we do not need to rely on the courts to correct this error. Congress corrected it itself.

Four days after Congress passed the Patient Protection and Affordable Care Act, it enacted the Health Care and Education Reconciliation Act of 2010. Section 1004 of HCERA amended section 36B(f) of the IRC to impose on exchanges established under section 1311(f)(3)—that is, state exchanges—and under section 1321(c)—that is federal exchanges, the obligation to report to the IRS and to the taxpayer information regarding tax credits provided to individuals through the exchange. In this later-adopted legislation amending the earlier-adopted ACA, Congress demonstrated its understanding that federal exchanges would administer premium tax credits.


More at link.

http://www.healthreformwatch.com/2011/09/11/yes-the-federal-exchange-can-offer-premium-tax-credits/

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Response to phleshdef (Reply #38)

Mon Nov 19, 2012, 01:37 PM

42. That's a really weak argument, sorry to say. Two reaons

First, they note:

But now we seem to be stuck with the textualists delight: a statute whose words clearly say what Congress clearly did not mean.


In 99.9% of cases, if the words clearly say something, that's the end of the inquiry for courts.

Second, Section 1004 of the HCERA added a whole slew of reporting requirements but only required reporting of which subsidies were granted in any kind of exchange. It did NOT fix the original problem of failing to authorize the subsidies in federal exchanges.



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Response to geek tragedy (Reply #42)

Mon Nov 19, 2012, 01:43 PM

46. It seems to be a much stronger argument than the one you are attempting to make.

I think you just WANT to believe this.

The fact is, the amending Congress did after the fact creates ambiguity with what you claim is a clearly worded limitation on subsidies to only apply to state exchanges. The law gives HHS the power to remedy ambiguities in the law. So if HHS says the subsidies apply to federally operated exchanges, then it does, period.

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Response to phleshdef (Reply #46)

Mon Nov 19, 2012, 01:48 PM

50. Agency interpretations are accorded some deference

in situations like this. But, the language is sufficiently clear to allow a court to rule against them, if it can overcome standings challenges (nobody has standing to challenge the subsidies).

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 01:30 PM

39. U.S. House of Representatives, the Senate, President Obama...

This was one of the compromises made to get a sufficient number of signatures in the House and Senate so the President could sign the bill into law.

So everybody involved in the process of compromise that brought the entire bill, both the good and bad parts, are "the moron who drafted the ACA such that states can opt out automatically."
I hope this cleared that up.

And I, for one, am glad they did. We are bettter off with the ACA than without.

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Response to Agnosticsherbet (Reply #39)

Mon Nov 19, 2012, 01:38 PM

43. No, this was a simple screw up. Nobody was demanding that the federal exchanges

be set up without subsidies for people who participate.

It's just incredible incompetence on the part of whoever drafted Section 1401.

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Response to geek tragedy (Reply #43)

Mon Nov 19, 2012, 01:43 PM

47. Given the rushed nature of the legislation, errors and oversights were

to be expected. I do not think it was incompetence, criminal or otherwise. I also believe that it will be remedied easily enough.

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Response to ProgressiveProfessor (Reply #47)

Mon Nov 19, 2012, 01:47 PM

48. The IRS is remedying it via interpretation.

The best defense is probably arguing for deference to the agency's interpretation.

Next best defense is the standing requirement.

After that, probably arguing that a federal exchange set up under 1321 is actually one authorized by 1311 and should be considered as such for purposes of 1401.

I don't think a legislative fix will be coming until Democrats control both houses of Congress again.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 01:30 PM

40. Maybe this is making lemonade out of lemons...

But suppose Republicans do block subsidies in states that failed to set up exchanges. If I'm a state-level Democratic politician this should be a godsend! (Politically, that is, and at a terrific cost to poor individuals... I'd rather the states just set up the exchanges, but given that they won't we can at least make it clear that Republicans are not sticking up for people in their own states).

As sticker shock sets in and the RW noise machine kicks into high gear blaming Obama, just pound the message that it was their Republican governors who decided they had to pay so much for coverage. Better still, spin it as a tax increase on the poor. That might finally get the attention of red-staters who habitually vote against their own economic interests!

Of course, avoiding this kind of political fallout might prevent the nightmare scenario from happening even if the law is badly written...

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 01:57 PM

53. i've been trying to get an answer on this for almost 2 weeks

for an op-ed I'm working on.

In Florida Rick Scott is likely to either not participate in exchanges, OR put forth a non-compliant exchange that only offers the "free market" option (no subsidies).

So I've been reaching out to writers, researchers and analysts in FL, DC and NY to find out if specifically if small businesses in Florida would have the tax credits and the subsidies available.

The best answer I've received is that the tax credit would be available through the IRS (administered federally). BUT, we are still unclear on what this would mean for subsidies. It does appear as if the subsidy side is tied to the state exchange.

So, your OP poses quite a good question.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 02:17 PM

57. It is not moronic to set up a situation where red states, turn over

management of their exchanges to the federal government. It is ironic that Republican-led states fell for it. Now people living in those red states get a hint of how the federal government can and should help citizens no matter what state they live in.

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 03:36 PM

58. The non profit government option

perhaps you missed this feature in reading about the ACA. There are several types of insurance plans available on the aca market one is a government negotiated non-profit plan that will be available even if the state does not set up the machinery for other aca options through the fed governmnet. I suggest you read the following discussion of this plan.

http://www.dailykos.com/story/2012/10/30/1152771/-A-shocking-Obamacare-fact-no-one-realizes

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Response to geek tragedy (Original post)

Mon Nov 19, 2012, 04:54 PM

60. It Was Probably Necessary to Overcome Some Resistance to the ACA

However, states are notoriously anxious to get federal money wherever it's offered.

The states who are opting out have a powerful incentive to develop their own exchanges and meet the other requirements to get federal subsidies. States who are reconsidering their decision to opt out are undoubtedly having this discussion right now.

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