Tag Archives: Patient Protection and Affordable Care Act

Proof That Obamacare ‘Rate Shock’ Is An Ugly Insurance Company Deception

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Source: Forbes

Author: Rick Ungar

“Over the past few months, the nation’s largest health insurance companies have been hard at work selling a narrative claiming that the Affordable Care Act is about to result in dramatically larger premium costs for a significant number of Americans. Indeed, the warnings have become so worrisome that the massive increases they are predicting have taken on a frightening descriptor all its own—rate shock.

At the heart of the health insurers’ retelling of the Chicken Little story is a regulation promulgated by the Department of Health and Human Services a few months back limiting what a health insurer can charge a 64 year old to three times what they charge a 21 year old. Currently, the average bump for older participants is typically five times that of the younger customers—although there are examples where the increase can reach ten times what is paid by the young immortals buying coverage.

As a result of the lower premium prices that will be paid by older participant, the expectation—one created by the large insurance companies—is that the youngest participants will have to pay significantly more to make up the difference.

Now, The Urban Institute—an organization so clearly bi-partisan that even the most suspicious partisan would encounter extreme difficulty making a case for bias—is out with a study that states that the ‘rate shock’ argument is “unfounded”, particularly when applied to the millions of Americans in the individual market.

As noted in the report summary:

“Overall, we find that loosening the rate bands from 3:1
to 5:1 would have very little impact on out-of-pocket
rates paid by the youngest nongroup purchasers, once subsidies are taken into account. This is not only the case for all likely purchasers, but also for two populations of particular concern: the 10 million 21-27 year olds who are currently uninsured and the 3 million who currently have nongroup coverage.”

By suggesting that the insurance company claims are merely ‘unfounded’, The Urban Institute is being quite kind as I would suggest a far harsher explanation for their scare tactics.

What the insurance industry is not telling you—as revealed by The Urban Institute study—is that the overwhelming majority of young people who would be charged a higher premium to make up for the lower premiums to be paid by their elders will either be covered by the premium subsidies offered via the insurance exchanges or eligible for Medicaid under the expansion of the program extending health coverage to those earning 133 percent above the federal poverty line.

Therefore, as clearly stated by the report, the lowered premium costs to the oldest participants in an insurance plan “would have very little impact on out-of-pocket rates paid by the youngest nongroup purchasers.” 

According to the study, here are the estimates:

  • 92 percent of people ages 21 to 27 projected to buy an individual plan in an exchange in 2017 are expected to have incomes less than 300 percent of the poverty line, so they would be eligible either for Medicaid (if their state expands it) or for substantial subsidies to help pay premiums in the exchange.
  • Similarly, 88 percent of 18- to 20-year-olds projected to buy a plan in the exchange are expected to be eligible for premium subsidies or Medicaid.

In addition to the above statistics, The Urban Institute study highlights the fact that of the 961,000 young adults between the age of 21 and 27 who currently buy their own health insurance as an individual and make too much money to qualify for premium subsidies or Medicaid, a full two-thirds are 26 years old or younger and are in families receiving employer coverage. Accordingly, these kids can receive health insurance coverage under their parent’s employment policy as Obamacare requires that insurers allow parents to add their kids who are under 26 to their employment based health care plan.

While any new law as significant as the Affordable Care Act creates questions and concerns, the false campaign being waged by the health insurance companies is a prime example of an industry using fear as a tool to get the government to change a regulation that they don’t like.

There remain questions as to the impact the rate band limitations will have on businesses that provide health insurance to employees—particularly those with a younger employee base. However, the expectation is that—given the reality that businesses tend to have a ‘spread’ in the age of employees—things should average out. Under the current structure, businesses are paying less in premium contributions for younger employees but considerably more for older employees. Under Obamacare, the prices will rise at the younger end of the scale but decrease significantly for older workers.

For this reason, the primary concern has been focused on what the changes will mean for younger health insurance customers who purchase individual policies.

As The Urban institute study makes crystal clear, the ‘rate shock’ controversy has far more to do with insurance company lobbying efforts and far less to do with the reality of what health insurance will cost for millions of young Americans.

Contact Rick at thepolicypage@gmail.com and follow me on Twitter andFacebook.

Emphasis Mine

see: http://www.forbes.com/sites/rickungar/2013/03/26/proof-that-obamacare-rate-shock-is-an-ugly-insurance-company-deception/

 

The Facts Behind Romney and Ryan’s Medicare Lies

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From: workingamerica blog

By: Seth D. Michaels

N.B.: A concise, lucid explanation of what they say, what they mean, and what we need.

“It took approximately five minutes after the announcement of Paul Ryan as the Republican running mate for the spin to begin. Anxious to pre-empt a conversation about Ryan’s plan to end the guarantee of Medicare, the Mitt Romney campaign ison the air with some (strikingly dishonest) Medicare ads of their own. They have plenty of money to advance this message, so it’s worth unpacking what’s really going on.

First and foremost, the Ryan plan, in any form, would mark the end of Medicare as we know it—as a guarantee of health coverage for senior citizens. Instead, it would give older people a voucher to go buy their own private insurance. The Ryan budget would also increase the eligibility age, delaying the time when retirees could get Medicare. That’s the proposal the U.S. House voted on and passed in March and it’s the model Ryan has continued to promote even as he’s suggested possible tweaks.

So let’s move on to the claims the Romney campaign is making. The Affordable Care Act is paid for partly through billions in future savings—about $700 billion over 10 years in reduced payments to health insurance companies and providers. A lot of that money stays in the Medicare system, by paying for free preventative care for seniors and closing the prescription drug “doughnut hole.” The attack leveled by Romney, Ryan and their allies—an attack that’s Jonathan Cohn rightly called “astoundingly cynical”—is that this constitutes a massive cut to Medicare.

But here’s the catch: in the Ryan budget that passed, these future savings are included, even as the rest of the ACA is repealed. So the same reductions that the Romney campaign is complaining about were voted on and approved by Ryan and virtually every House Republican.

In the ACA, the cost savings that come out of Medicare go back into the health care system. In the Ryan budget, they’ll be needed to pay for the massive tax cuts proposed in that plan. Cohn notes that not only does this money get pulled out of providing health care entirely, but the attack the Romney campaign is making is a “brazen misrepresentation of reality.” Or, to say it in fewer and shorter words, “a lie.”

The Ryan plan doesn’t replace the guarantee with the vouchers for 10 years, so that major change doesn’t immediately affect today’s retirees. But the repeal of the ACA’s provisions on prescription drugs and preventative care absolutely will. If those provisions are gone, seniors who are on Medicare now will be paying hundreds of dollars more out of pocket. Ryan’s cuts to Medicaid, which many seniors depend on for nursing home care, would also have a big impact—his proposed cuts to Medicaid and the repeal of the ACA Medicaid expansion are a big and under-covered change in his budget. Some 6 million of today’s retirees depend on Medicaid and could lose out under Ryan’s plan. This is what was in the Ryan budget the House passed, and he hasn’t backed off of this at all.

What’s more, if Ryan’s plan kicks in ten years from now, today’s Medicare beneficiaries will getan unpleasant wake-up call as the voucher plan starts to erode the program:

In 2022, when the limited-subsidy program would be introduced, seniors who qualified for traditional Medicare would be allowed to switch to the new program. If healthier or younger beneficiaries make the change to lower their out-of-pocket costs, those still participating in Medicare would be part of an insurance pool that is less healthy and more expensive. To cover those higher per-person costs, Medicare might well be forced to either raise premiums or limit reimbursements to health care providers—which could prompt many to stop taking Medicare patients.

Romney has suggested he may back off of the Medicare savings that Ryan included in his original budget. But in that case, the Ryan budget math gets even more implausible. And by the standards Romney has laid out for how he wants his budget to work, Medicare would have to be slashed either way. That these cuts to programs for vulnerable people would be required in order to pass his huge tax cuts for the rich adds insult to injury. As Derek Thompson notes, Romney’s proposals “have clear and inevitable conclusions: Tax cuts for the richest and spending cuts for the poorest.”

It’s hard to overstate how hypocritical and dishonest the new Romney-Ryan attacks over Medicare are, coming from two people who have pledged changes so radical that they’d leave it unrecognizable.

Emphasis Mine

see::http://blog.workingamerica.org/2012/08/15/the-facts-behind-romney-and-ryan%E2%80%99s-medicare-lies/

Kathleen Sebelius: The Affordable Care Act has made the U.S. health-care system stronger

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From:Washington  Post

By:Kathleen Sebelius

“The Supreme Court decision upholding the Affordable Care Act was a turning point in the health-care debate, a chance to stop refighting old political battles and move forward with implementing and improving a law that is already lowering health-care costs and providing more security for millions of American families. Instead, congressional Republicans will spend Wednesday staging yet another repeal vote.

Fortunately for those Americans whose health and finances depend on protections in the law, the vote is only symbolic. But it’s worth setting the record straight about some false claims that have recently resurfaced.

One claim is that the Affordable Care Act is driving up Americans’ health-care costs. The facts tell a different story.

In the decade before the law was passed, national health expenditures increased about 7 percent a year. But in the past two years, those increases have dropped to less than 4 percent per year, saving Americans more than $220 billion. And that trend is expected to continue, with health-care costs projected to stay level as a share of gross domestic product from 2009 all the way through 2013.

You can see the same trend with premiums. Between 2000 and 2009, the average family premium more than doubled, from $6,438 to $13,375, an annual increase of 8.1 percent. From 2009 to 2011, family premiums still rose — but at a rate 25 percent lower. That generated savings of more than $1,200 per family, a trend of lower premium increases that independent experts such as Mercer, the human resources consultant, and the nonprofit National Business Group on Health project will continue. And the law will provide even more relief in the years to come, including a tax cut averaging $4,000 for 18 million middle-class Americans — a tax break that repeal would eliminate.

Another falsehood repeated by opponents of the law is that it is putting a greater burden on small businesses. Again, the facts show that the opposite is true.

Small-business owners were struggling in the health insurance market long before the law passed, spending an average of 18 percent more than their large competitors annually for health coverage and often seeing their insurance bills skyrocket if a single employee got sick. The result was that the number of small businesses in the United States offering coverage to employees was falling rapidly — from nearly 70 percent in 2000 to less than 60 percent of employers by 2009 — leaving millions of working families without coverage.

Since the law passed, the share of small businesses offering employee coverage has held steady at 59 percent, the Kaiser Family Foundation has found, in part because new tax credits in the law are saving hundreds of thousands of small companies thousands of dollars each on their insurance costs. And independent experts such as Rand Corp. predict the number of employers offering coverage will rise in 2014 — just as it did in Massachusetts after health reform was passed — when small-business owners have the choice of shopping for health coverage in new competitive marketplaces.

A third false attack recycled in recent weeks is that the Affordable Care Act cuts Medicare benefits. In truth, Medicare is stronger than ever.

Thanks to the law, seniors have new benefits such as free preventive care as well as discounts on brand-name medications in the “doughnut hole” coverage gap that have already saved more than 5 million people with Medicare about $600 each. Medicare Advantage premiums have fallen two years running. New crackdowns on fraud and abuse returned a record $5.4 billion to Medicare in 2010 and 2011. And the health-care law has strengthened Medicare’s long-term outlook, adding eight additional years to the projected solvency of the Medicare trust fund.

Those calling for repeal have yet to propose credible ideas for lowering health-care costs. In fact, the same House Republicans who are voting Wednesday to repeal these Medicare savings voted to keep them in their budget in March.

People are entitled to their opinions, but not to their own facts. And the facts in this case are clear: Since the Affordable Care Act was passed, national health spending is rising at a slower rate, health insurance premiums are rising at a slower rate, small-business coverage is holding steady and Medicare is on a stronger financial footing.

Now that the Supreme Court has issued a decision, the American people would be better served if Congress joined the president in working to build on that progress, not undo it.

Emphasis Mine

see:http://www.washingtonpost.com/opinions/kathleen-sebelius-the-affordable-care-act-has-made-the-us-health-care-system-stronger/2012/07/09/gJQA1BOOZW_story.html?wpisrc=nl_opinions

10 Reasons Most People Like Obamacare Once They Know What’s Really In It

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From AlterNet

By: Josh Holland

“There are two Affordable Care Acts. There’s the legislation passed by Congress in 2009, and then there’s the mythical Affordable Care Act – the perfidious “government takeover” decried and demagogued by so many conservatives (and quite a few liberals). The former is quite popular, the latter gets decidedly mixed reviews.

Don’t take my word for it. A recent poll by the Kaiser Family Foundation found Americans split down the middle, with 41 percent approving of the law, and 40 percent saying they didn’t like it (PDF). But then Kaiser asked about 12 specific provisions in the legislation, and found that, on average, 63 percent of respondents approved of the nuts and bolts of Obamacare. Of the 12 measures they tested, only one – the controversial mandate to carry health insurance or pay a penalty – received the approval of less than half of Americans (35 percent).

Or consider this divide: while only 12 percent of Republicans had a positive view of the law overall, 47 percent, on average, viewed its specifics favorably.

And here’s the kicker: Kaiser found that the most popular parts of the law were also the ones most Americans weren’t aware of, and vice-versa. Almost everyone knows about the mandate, which most people don’t like, but fewer than half of those polled knew about the law’s tax credits for small businesses that offer their employees coverage, a provision that eight out of 10 people liked when they heard about it.

None of this should come as a surprise, given the level of mendacity of the law’s opponents. If the Affordable Care Act did in fact feature “death panels,” resulted in deep cuts to Medicare, represented a “massive” tax increase and “Sovietized” our healthcare system, nobody would support it. Fortunately, none of that bears any resemblance to reality.

Obviously, the law should be judged on what it actually contains, but according to Kaiser, six in 10 say they don’t have enough information about the details to understand how it will impact them personally. So here, in no particular order, are 10 things you may not know about the Affordable Care Act.

1. People Will Be Getting Checks

Call it a crazy hunch, but my guess is that the law will look a lot less tyrannical when people start getting checks in the mail to help pay for their insurance.

Folks making up to four times the federal poverty line will be eligible for subsidies. In 2012, that would mean a family of four making up to $92,200 (it’s a bit higher in Alaska) would see some cash.

Those subsidies will come in the form of “advanceable” tax credits, meaning that people won’t have to wait until they pay their taxes to get the cash, and they’ll be fully refundable, so those who don’t pay enough in federal income taxes will get a check in the mail from the IRS.

2. The Richest Americans Are Going to Pay More Taxes

Wealthy investors are outraged, but most people probably don’t know that a 3.8% surcharge on investment income – dividends and capital gains — kicks in this January for everyone with an adjusted gross income of over $200,000 ($250,000 for joint filers). So those currently enjoying the lowest rate on investments in our nation’s history will pay for a decent chunk of the bill.

3. Insurers’ Overhead – and Profit Margins — Are Limited

For the past 18 months or so, insurers have been required to spend 85 percent of the premiums they collect on healthcare (80 percent for individual and small-group plans). If they spend less than that, they have to send their customers a rebate to cover the difference.

Forbes‘ Rick Ungar called it, “the true ‘bomb’ contained in Obamacare and the one item that will have more impact on the future of how medical care is paid for in this country than anything we’ve seen in quite some time.”

4. Much Ado About the Mandate

With the Supreme Court’s ruling last week, the mandate is gone, but the penalty for not carrying insurance remains. If there’s one thing Democrats, Republicans and independents agree on, it’s that they don’t like it.

And they shouldn’t. But most people probably don’t know just how modest the impact of the mandate really is. According to the Congressional Budget Office, just 1 percent of the population will pay the penalty, which maxes out at 1 percent of one’s income.

A lot of conservatives are convinced that jack-booted gummint thugs will round them up and stick them in FEMA camps if they don’t pay up. But as Timothy Noah points out, “the health reform law explicitly states (on Page 336): ‘In the case of any failure by a taxpayer to timely pay any penalty imposed by this section, such taxpayer shall not be subject to any criminal prosecution or penalty with respect to such failure.’” They can only dock future tax refunds.

5. And Nobody Ever Talks About the Employer Mandate

Starting in 2014, companies with 50 or more full-time workers (two part-timers count as one full-timer for this purpose) will have to pay penalties if they don’t cover their employees’ health insurance. (This provision is a bit complicated — all the details are here.)

6. Shaves the Deficit

Mitt Romnney says that “Obamacare adds trillions to our deficits and to our national debt, and pushes those obligations onto coming generations.”

That message appears to be sinking in. According to Kaiser, a majority of Americans – and a third of Democrats – think the healthcare law will increase the deficit. But according to the Congressional Budget Office, the law will reduce the projected deficit by $210 billion over the next decade.

7. Chicks Will Dig This

Many people are aware of the regulation requiring insurers to cover people with pre-existing conditions. It’s one of the most popular parts of the whole. But fewer know that, beginning in 2014, insurers won’t be able to charge women higher premiums than men.

Also coming in 2014: a ban on insurers placing annual limits on healthcare (lifetime coverage limits were already banned in 2010).

The Kaiser poll found that few people were aware of another popular new insurance regulation: since 2010, insurance companies can no longer charge co-pays or hold you to a deductible for preventive health services.

8. New Dollars for Community Health Centers

Kaiser didn’t ask for people’s opinions on this one, but it may be one of those under-the-radar provisions that actually ends up helping a lot of people.

Community health centers (CHCs) now serve the primary care needs of about 20 million Americans, and they have a proven track record. But the system is strained and underfunded.

The expansion of Medicaid will help alleviate some of the pressure, and the healthcare law also allocates $11 billion over a five-year period to build new CHCs and upgrade existing infrastructure. Most of the dollars will end up in poorer communities.

A lot of underserved people live in rural America, and the law also provides money to train and place 16,000 primary caregivers in rural communities over a five-year period.

9. Essential Benefits

Starting in 2014, in order for insurers to sell coverage through state-based exchanges – a place where a lot of the newly insured will likely end up – they will be required to cover a package of “essential benefits,” including maternity care, mental healthcare and substance abuse treatment, pediatric care, ambulance rides and hospitalization.

They don’t have to if they don’t want to participate in the exchanges, yet this measure is, according to many, at the heart of the supposed “government takeover” of our healthcare system.

10. It’s Not So Easy to Repeal

There is no doubt that we’ll hear lots of Republicans blustering about how they’ll repeal Obamacare on day one if they win the White House and the Senate, but it’s a lot less clear that they’d actually follow through.

As Igor Volsky notes, unless the Republicans were to win both the White House and a huge number of senate seats, they “can do little more than weaken Obamacare’s regulations and defund some of its provisions.” They also have nothing to replace it with, and would own our screwed up healthcare system for a generation. And they’d lose an issue that fires up the conservative base. They will, however, do their best to gum up the works as the law is implemented.

The takeaway to all of this is that the healthcare law is only going to get more popular as it’s provisions kick in. People will see some tangible benefits, and the fearmongering will prove unfounded.

Like the idea of government itself, people are suspicious of the Affordable Care Act as an abstraction, but when it gets to the specifics they tend to like it a lot better.

Joshua Holland is an editor and senior writer at AlterNet. He is the author of The 15 Biggest Lies About the Economy: And Everything else the Right Doesn’t Want You to Know About Taxes, Jobs and Corporate America. Drop him an email or follow him on Twitter.


Emphasis Mine

see:http://www.alternet.org/story/156149/10_reasons_most_people_like_obamacare_once_they_know_what%27s_really_in_it

The One-Sided War Against Obamacare

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From: Mother Jones

By: Kevin Drum

“Abby Goodnough of the New York Times explains why misinformation and fear of Obamacare is increasingly widespread. It’s the money, stupid:

In all, about $235 million has been spent on ads attacking the law since its passage in March 2010, according to a recent survey by Kantar Media’s Campaign Media Analysis Group….Here in the suburbs of Philadelphia, which, according to the Campaign Media Analysis Group, is one of the top five media markets for ad spending against the health care law, it is apparent how such messaging is playing out. (The other top markets are Orlando, Fla.; Tampa, Fla.; Pittsburgh; and Denver, all in swing states.) In interviews with about two dozen residents who were mostly opposed to the law, certain worries, resentments and dark predictions about it came up time and again.

By contrast, only $69 million has been spent on pro-Obamacare ads, most of it bland public-service spots from HHS. Add to that the fact that most Democrats seem petrified of actually defending the law, and it’s no surprise that the Fox News portrayal of Obamacare has been steadily gaining ground. That’s what happens when you slink into a corner when the other guys declare war.”

Emphasis Mine

see:http://www.motherjones.com/kevin-drum/2012/06/one-sided-war-against-obamacare?utm_medium=twitter&utm_source=twitterfeed

The ACA meets the SCUS on a sunny Thursday afternoon in Cleveland

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The ACA meets the SCUS on a sunny Thursday afternoon in Cleveland

The Cleveland Chapter of the American Constitution Society for Law and Policy hosted

” A Review of the Supreme Court’s ‘Health Care’ Oral Arguments”

Thursday 12 April 2012 at the Squire Sanders office in downtown Cleveland.  The presentation featured Elizabeth Wydra http://www.huffingtonpost.com/elizabeth-b-wydra)

The presenter ( who has a face made for television – on which she often appears) is General Counsel, Constitutional Accountability Center.  Ms. Wydra heard the arguments all three days, and presented a very lucid summary.  In general, she did not agree with some of the negative summaries one heard on various news sources.

She told us that when the ACA was signed into law, even conservative constitutional scholars agreed that it was clearly constitutional, and  when the first suits were filed challenging it, there were suggestions that those attorneys should be sanctioned!

She also observed that Justice Scalia read from Tea Party Talking points…

At the end of the event, I feel more confident than ever that we will win this one.

Having said that, I am still displeased to be living in a country where helping grandma on the other side of town pay for her prescription drugs is more controversial than unilaterally invading a sovereign nation and  killing, maiming, injuring, and dislocating at least a million of its citizens…

Overturning Obamacare Would Make Roberts Court Most Activist, Partisan in Modern History

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From:HuffPost

By: Robert Creamer

“Time was, not long ago, when the right wing railed against the overreach of unelected judges with lifetime appointments who tried to usurp the power of Congress and impose their own vision of society.

That was before the Roberts Court. In fact, it turns out, many extreme conservatives didn’t give a rat’s left foot about the overreach of unelected judges. They simply wanted judges who would impose their vision of society on the rest of us.

Justices Roberts and Kennedy will likely be the deciding votes on the question of whether the individual responsibility provision of the Affordable Care Act passes constitutional muster. But they will also decide whether the Roberts Court goes down as the most activist, partisan court in modern history.

Up to now the Court’s decision in the Citizens United case allowing corporations and billionaires to make virtually unlimited contributions to political candidates and “Super Pacs” stood out as its most glaring beacon of judicial activism. Citizens United reversed a century of legal precedent to reach a result that gives corporations the political rights of people, and distributes the right of free political expression in proportion to one’s control of wealth. Not exactly what Thomas Jefferson had in mind.

It was, of course, exactly what the far Right had in mind. Extreme conservative voices found themselves strangely silent in the face of the Supreme Court’s willingness to substitute its judgment for that of elected Members of Congress and to upend the bi-partisan McCain-Feingold law that had been passed to regulate federal elections.

But if the Court rejects the individual responsibility provisions in the Affordable Care Act, that will take the cake.

In fact, when Congress passed Obamacare there were very few serious constitutional scholars who questioned the constitutionality of this provision.

There is no question whatsoever, that government in America has the right to require our citizens to pay for public goods or for services that we decide can best be provided through government.

Clearly, government can tax homeowners to provide the community with fire protection, for example. You might not need fire protection for years — or decades — or ever — but government can decide that you have to pay into the fire protection district because if your house catches fire, it could affect the entire community.

But, says the right wing, government can’t require an individual to purchase a product from a privatecompany they may not want or “need.”

Now I personally believe that it would make much more sense to expand Medicare to all Americans, and maintain one, efficient government-run insurance system that covers everyone — and cuts out the need to pay huge profits to Wall Street and the big bonuses to insurance company CEO’s.

But some years ago, conservative Republicans like Mitt Romney proposed providing universal health care coverage by requiring everyone to buy insurance from private insurance companies that are regulated through state-based exchanges.

When Romney was Governor of Massachusetts he got the state legislature to pass this kind of system — Romneycare — which has been functioning in the state for many years and whose constitutionality has never been questioned by the Supreme Court.

There is no question that the government can require parents to pay private pharmaceutical companies for their kids’ vaccinations before they enter school – and it can also require them to attend school — because both issues affect the welfare of the entire community.

And there is no question as to the the constitutionality of the many state laws that require anyone who drives a car to purchase private car insurance.

But, you say, the difference is that you don’t have to drive a car — you can simply decide not to get a drivers license if you want to avoid buying private car insurance.

True. But the need for health care is not elective. Last time I looked, everyone ultimately dies. I don’t care how healthy you are, everyone inevitably has some health problem in their lives. The question is not whether you will need health care, the question is how you will pay for it when you do.

And in this respect, health care is entirely different than virtually any other commodity.

First, it is not entirely subject to the normal laws of economic activity. People can’t determine how sick they can afford to be, or which diseases fit into the family budget. You don’t come home one day and say: “Gee honey I just got a raise, now I can have cancer!” Health care needs are not elective purchases like cars or TV’s.

And when it comes to health care, there is often little relationship between cost and value. A ten-dollar vaccine can add decades to your life, and hundreds of thousands of dollars of intensive care can add weeks or days.

But most important, while we might not agree that every American is entitled to a Cadillac (or in the case of Mitt Romney, two Cadillac’s), we do agree — as a society — that everyone is entitled to the best health care that is available no matter their wealth or station in life. We don’t believe that anyone should be left as roadkill after a traffic accident because he or she can’t pay for health care.

That being the case, someone can be young and healthy and vibrant one minute, and in need of massive, costly health care services the next.

The individual responsibility provisions of the Affordable Care Act simply says that everyone be required to pay — at a level they can afford -- for the fact that society won’t leave them by the side of the road to die after an accident — or when they are struck by cancer or a heart attack. It recognizes that in America everyone actually does participate in a form of health insurance system, whether they pay for it or not. It says that young, healthy people should not be allowed to be “free riders” in the system, until the moment they become sick or injured.

The fact is that in the current system, 40 million Americans are not formally part of health insurance plan — most because they can’t afford it without the kind of subsidies provided in the Affordable Care Act. Of course some are also uninsured because they think they are “immortal.” But being uninsured often means that you don’t go to the doctor because you can’t afford checkups or preventive care. It often means that you only go to the emergency room of a hospital or a neighborhood clinic when you already need costly health care interventions that would have been unnecessary had you had the security of a formal health insurance plan.

That costs all of us money, and because they often wait too long, it costs many of our fellow citizens their health and often their lives. What’s more, it places many American families one illness away from financial ruin.

And it could lead us all to financial ruin. The crazy-quilt way we pay for our health care in America has resulted in skyrocketing health care costs that include expenditures for administration and overhead that are far greater than in any other country on earth. These costs put our products and companies at a huge competitive disadvantage with our competitors abroad. That’s because we were the only industrial country in the world that did not provide universal health care to its citizens — until we passed Obamacare.

Well, you say, the states may have the legal right to require Americans to buy private insurance, but not the Federal Government.

Does anyone doubt that the massive health care industry is engaged in interstate commerce?

Congress’ power to regulate interstate commerce is explicitly granted by the Constitution. That power has been interpreted expansively and has a long established history, fortified by scores of rulings by previous Supreme Courts.

If the current Supreme Court holds that the federal government has no right to structure the national health care market place, it will be reversing years of precedent. It will brand itself as a band of judicial activists who substitute the will of unelected judges for that of the representative body of Congress.

If the Supreme Court strikes down the Affordable Care Act, it will not be protecting a minority’s right to refrain from buying health care. That is not possible, since everyone ultimately needs health care. If it takes that extraordinary step, it will simply be substituting its own political philosophy for that of Congress. Just as it did with Bush v. Gore, it will once again be turning the Supreme Court into an instrument of brazen partisanship.”

Robert Creamer is a long-time political organizer and strategist, and author of the book: Stand Up Straight: How Progressives Can Win, available on Amazon.com. He is a partner in Democracy Partnersand a Senior Strategist for Americans United for Change. Follow him on Twitter @rbcreamer

Emphasis Mine

see:http://www.huffingtonpost.com/robert-creamer/overturning-obamacare-wou_b_1385448.html?utm_source=Alert-blogger&utm_medium=email&utm_campaign=Email%2BNotifications