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Could Republican opposition to the mandate be a cover for dismantling the health care law?
This isn’t intended to say there isn’t valid opposition to the mandate, but that Republican opponents of the law are using disdain for the mandate to hide the real reason they’re opposed to the health care law. It's a typical Republican tactic, ride a wave of discontent while deceiving Americans. They did that last year by characterizing the savings achieved by Medicare as cuts.
The mandate seems to be the provision that those opposed to the law focused on because it's unpopular. So what are they afraid of? Everything about the exchanges promotes competition and transparency, both anathema to insurance companies. Yesterday, a post (http://www.democraticunderground.com/1002492196) spotlighted a theory by Wendell Potter:
“They don’t want the bill - quite honestly - to be overturned or repealed. They want the bill to go forward with the individual mandate intact. But what they want to do is to get people to vote out the Democrats who voted for the bill so that they’ll have more friends in Congress to strip out the consumer protections.”
It makes sense. After all, the insurance companies love the mandate, right? It’s a Republican idea, right? OK, I agree. They love the mandate. What they don’t like are the provisions that come with the mandate in the health care law. Think about it, if Republicans can strip out the consumer protections, including the ban on dropping people with pre-existing conditions, the mandate will simply be to purchase coverage in a pre-health care law status-quo system. Also consider this: While Republicans are railing against the mandate, Paul Ryan’s plan to kill Medicare includes a mandate. They don't talk much about it anymore, but Ryan admitted as much last year.
Paul Ryan Agrees That His Budget Includes An Individual Mandate
By Igor Volsky
Simon Lazarus thinks that Rep. Paul Ryan’s (R-WI) proposal to require future retirees to purchase coverage from an exchange of private insurers is reminiscent of the dreaded individual mandate in the Affordable Care Act. “[T]he Republicans’ proposal to replace Medicare with partially subsidized private insurance also operates to ‘compel’ people to pay for private health insurance policies. Moreover, this mandate is not even a pay-or-play option; Medicare taxes are mandatory, whether workers want to buy eligibility for old-age vouchers or not.” As Ezra Klein explained it, “If you decide not to use the voucher, or the voucher is insufficient, all the taxes you paid into the system are forfeit. Either you buy insurance as a senior, or you face a tremendous lifetime tax penalty.”
-more
http://thinkprogress.org/health/2011/05/05/172066/paul-ryan-individual-mandate/
By Igor Volsky
Simon Lazarus thinks that Rep. Paul Ryan’s (R-WI) proposal to require future retirees to purchase coverage from an exchange of private insurers is reminiscent of the dreaded individual mandate in the Affordable Care Act. “[T]he Republicans’ proposal to replace Medicare with partially subsidized private insurance also operates to ‘compel’ people to pay for private health insurance policies. Moreover, this mandate is not even a pay-or-play option; Medicare taxes are mandatory, whether workers want to buy eligibility for old-age vouchers or not.” As Ezra Klein explained it, “If you decide not to use the voucher, or the voucher is insufficient, all the taxes you paid into the system are forfeit. Either you buy insurance as a senior, or you face a tremendous lifetime tax penalty.”
-more
http://thinkprogress.org/health/2011/05/05/172066/paul-ryan-individual-mandate/
In fact, Republicans tried to sell Ryan's plan as “Obamacare for seniors,” which is completely bogus because the health care law strengthens Medicare and expands Medicaid.
Gohmert: Obamacare Is Like Paul Ryan’s Medicare Plan, But It Would Still Lead To Govt Takeover
http://thinkprogress.org/health/2011/04/25/172048/gohmert-medicare-ryan-aca/
Why RyanCare Is Not Like ObamaCare
By Igor Volsky
Since the GOP has endorsed Rep. Paul Ryan’s (R-WI) plan to completely privatize Medicare by 2022, some Republicans have abandoned their claim that the Affordable Care Act would lead to single payer government health care and begun arguing that Ryan’s reforms are very similar to the exchange structure in the ACA. “It’s exactly like Obamacare,” said NRSC chairman Sen. John Cornyn (R-TX) in the Capitol several weeks ago. “It is. It’s exactly like it. Which strikes me as bizarre that you’re seeing so much pushback [from Democrats].” TPM’s Brian Beutler points out that House Speaker John Boehner (R-OH) is now making the same argument:
- more -
http://thinkprogress.org/health/2011/04/27/172052/ryancare-obamacare/
By Igor Volsky
Since the GOP has endorsed Rep. Paul Ryan’s (R-WI) plan to completely privatize Medicare by 2022, some Republicans have abandoned their claim that the Affordable Care Act would lead to single payer government health care and begun arguing that Ryan’s reforms are very similar to the exchange structure in the ACA. “It’s exactly like Obamacare,” said NRSC chairman Sen. John Cornyn (R-TX) in the Capitol several weeks ago. “It is. It’s exactly like it. Which strikes me as bizarre that you’re seeing so much pushback [from Democrats].” TPM’s Brian Beutler points out that House Speaker John Boehner (R-OH) is now making the same argument:
According to Speaker John Boehner, the House Republican budget, which passed on April 15, “transforms Medicare into a plan that’s very similar to the President’s own healthcare bill.”
That’s from an interview with ABC’s Jon Karl. Boehner joins Sen. John Cornyn (R-TX) as one of the few high-profile elected Republicans who will admit that the GOP’s Medicare privatization plan is similar in many key respects to the health care law they have spent the last two years demonizing.
That’s from an interview with ABC’s Jon Karl. Boehner joins Sen. John Cornyn (R-TX) as one of the few high-profile elected Republicans who will admit that the GOP’s Medicare privatization plan is similar in many key respects to the health care law they have spent the last two years demonizing.
- more -
http://thinkprogress.org/health/2011/04/27/172052/ryancare-obamacare/
Yesterday, Republicans voted for the Ryan plan, again.
House Republicans vote to end Medicare as we know it, again
by Joan McCarter
The House Republicans made their ultimate dystopian statement today, in passing Rep. Paul Ryan's budget in a 228-191 vote. Ten Republicans voted against it, no Democrats voted for it and 13 members did not vote.
House Speaker John Boehner called this plan "a real vision of what we were to do if we get more control here in this town. It's still a Democrat-run town."
Just a few reminders about the Ryan budget, and what the House Republicans put down as their political marker for 2012, their vision for a Republican-ruled America: It would give the wealthy a humongous tax break, the lowest tax rate since the Hoover administration; it would gut nutritional assistance, cutting it by 17 percent over the next decade; it would cut Medicare benefits and begin the process of killing the program; it would kill millions of jobs; it turns Medicaid into a block grant and deeply cuts federal spending for it, and for SCHIP, the children's health program; and it breaks the already agreed upon Budget Control Act of 2011, threatening, once again, a government shutdown.
This is also the budget endorsed by Mitt Romney. Today the Republicans made their most definitive statement for the America they envision. This is their platform for 2012, from the top down.
http://www.dailykos.com/story/2012/03/29/1078938/-House-Republicans-vote-to-end-Medicare-as-we-know-it-nbsp-again-
by Joan McCarter
The House Republicans made their ultimate dystopian statement today, in passing Rep. Paul Ryan's budget in a 228-191 vote. Ten Republicans voted against it, no Democrats voted for it and 13 members did not vote.
House Speaker John Boehner called this plan "a real vision of what we were to do if we get more control here in this town. It's still a Democrat-run town."
Just a few reminders about the Ryan budget, and what the House Republicans put down as their political marker for 2012, their vision for a Republican-ruled America: It would give the wealthy a humongous tax break, the lowest tax rate since the Hoover administration; it would gut nutritional assistance, cutting it by 17 percent over the next decade; it would cut Medicare benefits and begin the process of killing the program; it would kill millions of jobs; it turns Medicaid into a block grant and deeply cuts federal spending for it, and for SCHIP, the children's health program; and it breaks the already agreed upon Budget Control Act of 2011, threatening, once again, a government shutdown.
This is also the budget endorsed by Mitt Romney. Today the Republicans made their most definitive statement for the America they envision. This is their platform for 2012, from the top down.
http://www.dailykos.com/story/2012/03/29/1078938/-House-Republicans-vote-to-end-Medicare-as-we-know-it-nbsp-again-
Republicans took ownership of Ryan's plan, which kills Medicare by turning it into a voucher system and mandates that seniors buy private insurance.
Boehner: Paul Ryan’s agenda is the GOP agenda
http://www.washingtonpost.com/blogs/plum-line/post/boehner-paul-ryans-agenda-is-the-gop-agenda/2012/03/29/gIQAZcDNjS_blog.html
Romney On Passage Of Ryan Budget: 'We Are Making Progress'
http://livewire.talkingpointsmemo.com/entries/romney-on-passage-of-ryan-budget-we-are
If Potter’s theory that Republicans want the mandate to survive so that they can gut the law is accurate, it appears that what the health care law foes are really afraid of is the increased competition and transparency, the aspects that will better inform Americans in making their health care choices and promote more choice. The following analysis supports the theory that focus on the mandate has served as a distraction from other key provisions that improve care, choice and quality.
Health Insurance Transparency under the Affordable Care Act
In February, a final rule was issued implementing the Affordable Care Act (ACA) requirement that all health plans provide a uniform summary of coverage for all enrollees and applicants. The idea of providing easy-to-understand summaries of coverage is, in fact, the most popular provision in the ACA, according to a recent Kaiser tracking poll.
<...>
With so much attention devoted to the ACA’s controversial requirement that individuals be insured and debates at the state level of whether to set up health insurance exchanges, the variety of provisions that would promote health insurance transparency have perhaps been somewhat lost in the shuffle. Implementation of some of these provisions is underway, while others await action.
Uniform Summary of Coverage (Section 2715, Public Health Service Act) – Starting this fall as they are offered or renewed, health plans and health insurance policies will have to provide enrollees and applicants with a uniform summary of benefits and coverage (SBC). All individual health insurance policies and group health plans must provide this summary. It will give consumers consistent information about what health plans cover and what limits, exclusions, and cost-sharing apply. It must be written in plain language and contain no fine print. At the outset, the final rule requires two illustrations of typical patient out-of-pocket costs for common medical events (routine maternity care and management of diabetes). Other care scenarios illustrating how coverage works for a broader set of benefits (such as expensive outpatient medical therapies, surgery, and mental health care) will be required at some time in the future.
<...>
Transparency in Coverage Disclosures (Section 2715A Public Health Service Act, Section 1311(e) of ACA) – Non-grandfathered health plans, whether offered through exchanges or outside, must also disclose other information that would help consumers understand how reliably the plan reimburses claims for covered services, whether the provider network is adequate to assure access to covered services, and other practical information. The law requires plans to disclose information, and for exchanges and the federal Department of Health and Human Services (HHS) to then make publicly-available accurate and timely disclosure of the following information:
<...>
Quality reporting for private health insurance (Section 2717, Public Health Service Act) – The ACA also requires the Secretary of HHS to develop reporting requirements for group and individual health plans with respect to covered benefits and provider reimbursement structures that improve health outcomes, prevent hospital readmissions, improve patient safety and reduce medical errors, and implement wellness and health promotion activities. This provision takes effect two years after the date of enactment, though federal guidance indicates that a phased-in approach to implementation of these requirements may be adopted.
<...>
Healthcare.gov (Section 1103, Affordable Care Act) – Under the ACA, the Secretary of HHS must establish a website to help individuals, families, and small businesses in every state identify affordable health insurance coverage options. This website, www.Healthcare.gov, was first launched in July 2010. It provides information about major medical health insurance policies offered by private insurers in the individual and small group markets. It also provides coverage, cost and eligibility information about the new Pre-Existing Condition Insurance Program (PCIP) and state high-risk pools, Medicaid, and the Children’s Health Insurance Program (CHIP).
- more -
http://healthreform.kff.org/notes-on-health-insurance-and-reform/2012/march/health-insurance-transparency-under-the-affordable-care-act.aspx
In February, a final rule was issued implementing the Affordable Care Act (ACA) requirement that all health plans provide a uniform summary of coverage for all enrollees and applicants. The idea of providing easy-to-understand summaries of coverage is, in fact, the most popular provision in the ACA, according to a recent Kaiser tracking poll.
<...>
With so much attention devoted to the ACA’s controversial requirement that individuals be insured and debates at the state level of whether to set up health insurance exchanges, the variety of provisions that would promote health insurance transparency have perhaps been somewhat lost in the shuffle. Implementation of some of these provisions is underway, while others await action.
Uniform Summary of Coverage (Section 2715, Public Health Service Act) – Starting this fall as they are offered or renewed, health plans and health insurance policies will have to provide enrollees and applicants with a uniform summary of benefits and coverage (SBC). All individual health insurance policies and group health plans must provide this summary. It will give consumers consistent information about what health plans cover and what limits, exclusions, and cost-sharing apply. It must be written in plain language and contain no fine print. At the outset, the final rule requires two illustrations of typical patient out-of-pocket costs for common medical events (routine maternity care and management of diabetes). Other care scenarios illustrating how coverage works for a broader set of benefits (such as expensive outpatient medical therapies, surgery, and mental health care) will be required at some time in the future.
<...>
Transparency in Coverage Disclosures (Section 2715A Public Health Service Act, Section 1311(e) of ACA) – Non-grandfathered health plans, whether offered through exchanges or outside, must also disclose other information that would help consumers understand how reliably the plan reimburses claims for covered services, whether the provider network is adequate to assure access to covered services, and other practical information. The law requires plans to disclose information, and for exchanges and the federal Department of Health and Human Services (HHS) to then make publicly-available accurate and timely disclosure of the following information:
<...>
Quality reporting for private health insurance (Section 2717, Public Health Service Act) – The ACA also requires the Secretary of HHS to develop reporting requirements for group and individual health plans with respect to covered benefits and provider reimbursement structures that improve health outcomes, prevent hospital readmissions, improve patient safety and reduce medical errors, and implement wellness and health promotion activities. This provision takes effect two years after the date of enactment, though federal guidance indicates that a phased-in approach to implementation of these requirements may be adopted.
<...>
Healthcare.gov (Section 1103, Affordable Care Act) – Under the ACA, the Secretary of HHS must establish a website to help individuals, families, and small businesses in every state identify affordable health insurance coverage options. This website, www.Healthcare.gov, was first launched in July 2010. It provides information about major medical health insurance policies offered by private insurers in the individual and small group markets. It also provides coverage, cost and eligibility information about the new Pre-Existing Condition Insurance Program (PCIP) and state high-risk pools, Medicaid, and the Children’s Health Insurance Program (CHIP).
- more -
http://healthreform.kff.org/notes-on-health-insurance-and-reform/2012/march/health-insurance-transparency-under-the-affordable-care-act.aspx
There are other provisions that will promote choice and competition.
Ensuring Free Choice
Effective January 1, 2014
Workers meeting certain requirements who cannot afford the coverage provided by their employer may take whatever funds their employer might have contributed to their insurance and use these resources to help purchase a more affordable plan in the new Affordable Insurance Exchanges. These new competitive marketplaces will allow individuals and small businesses to buy qualified health benefit plans.
http://www.healthcare.gov/law/timeline/index.html
Effective January 1, 2014
Workers meeting certain requirements who cannot afford the coverage provided by their employer may take whatever funds their employer might have contributed to their insurance and use these resources to help purchase a more affordable plan in the new Affordable Insurance Exchanges. These new competitive marketplaces will allow individuals and small businesses to buy qualified health benefit plans.
http://www.healthcare.gov/law/timeline/index.html
Consumer Operated and Oriented Plans (CO-OPs)
The Affordable Care Act creates a new type of non-profit health insurer, called a Consumer Operated and Oriented Plan (CO-OP). These insurers are run by their customers. CO-OPs are meant to offer consumer-friendly, affordable health insurance options to individuals and small businesses.
The federal government is offering loans to non-profit organizations to help establish CO-OPs.
What This Means for You
By January 1, 2014, you may have the opportunity to buy health insurance coverage from a CO-OP for yourself or your family. If you’re a small business owner, you may be able to buy health coverage for your employees from a CO-OP.
In a CO-OP, your health insurance needs and concerns are a top priority because you and your fellow CO-OP customer/members elect the board of directors. A majority of these directors must themselves be CO-OP customers. CO-OPs must use profits to lower premiums, improve benefits, or improve the quality of members’ health care.
As an individual or small business owner, you may be able to join others in creating a CO-OP and apply for a federal loan to help get it started.
Some Important Details
The Affordable Care Act creates a new type of non-profit health insurer, called a Consumer Operated and Oriented Plan (CO-OP). These insurers are run by their customers. CO-OPs are meant to offer consumer-friendly, affordable health insurance options to individuals and small businesses.
The federal government is offering loans to non-profit organizations to help establish CO-OPs.
What This Means for You
By January 1, 2014, you may have the opportunity to buy health insurance coverage from a CO-OP for yourself or your family. If you’re a small business owner, you may be able to buy health coverage for your employees from a CO-OP.
In a CO-OP, your health insurance needs and concerns are a top priority because you and your fellow CO-OP customer/members elect the board of directors. A majority of these directors must themselves be CO-OP customers. CO-OPs must use profits to lower premiums, improve benefits, or improve the quality of members’ health care.
As an individual or small business owner, you may be able to join others in creating a CO-OP and apply for a federal loan to help get it started.
Some Important Details
- By January 1, 2014, you may be able to buy a CO-OP health plan through a new competitive health care marketplace in your state, called an Affordable Insurance Exchange. You may also be able to buy a CO-OP health plan outside of an Exchange.
- CO-OPs are required to meet the same state and federal quality and financial standards as other health insurance plans.
- The health care law encourages CO-OP plans to offer better coordination of consumers’ medical care.
- Read the regulation at Regulations.gov.
- Find detailed technical and regulatory information on CO-OPs.
- Read the Report of the Federal Advisory Board on the Consumer Operated and Oriented Plan Program (PDF – 1.8 MB).
- Read the Funding Opportunity Announcement that explains the loan program.
- Fact Sheet: CO-OP Health Plans: More Competition, New Choices for Consumers and Small Business
- Use our interactive FAQ tool to find answers to insurance coverage-related questions or ask your own at answers.healthcare.gov.
New Federal Loan Program Helps Nonprofits Create Customer-Driven Health Insurers
http://cciio.cms.gov/resources/factsheets/coop_final_rule.html
ESTABLISHING HEALTH INSURANCE EXCHANGES: A National Overview of State Efforts
http://www.kff.org/healthreform/upload/8213-FS.pdf
Bottom line, if the mandate is unconstitutional so is Ryan's Plan. Bonus: Mitt Romney ran away from his support of the mandate in RomneyCare only to endorse a mandate in RyanCare.
Edited title to better reflect the content.
43 replies
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= new reply since forum marked as read
2. Only drivers of automobiles are required to have it.
Yes a mandate has been in place in Massachusetts for years.
http://en.wikipedia.org/wiki/Massachusetts_health_care_reform
"In Massachusetts, a fund of approximately $700 million, known as the Uncompensated Care Pool (or "free care pool"
, was used to partially reimburse hospitals and health centers for these expenses and the expenses of non-residents.[12] The fund was created through an annual assessment on insurance providers and hospitals, plus state and federal contributions. It was predicted that implementation of the Massachusetts health reform law would result in a decrease in expenses incurred in providing services to the uninsured, as the number of covered Massachusetts residents increased. In 2006, an MIT economics professor Jonathan Gruber predicted that the amount of money in the "free care pool" would be sufficient to pay for reform legislation without requiring additional funding or taxes.[13] In fact, the increased cost of subsidized insurance offset the reduction in "free care", while insurance premiums increased faster than the national average and became the highest in the country.[14]"
Does Massachusetts Health Care Law set precedent?
