Congressional Democrats and the Obama administration bet that they could force the states to do their will. When they lost their bet, the administration ignored the Constitution and ordered the spending of monies that Congress never authorized.This was lawless behavior, and reckless as well. It promised to individuals acting in reliance on government regulations money that was subject to being clawed back if a court applied the statute as written.The alternative was, to be sure, politically unpalatable. The administration could have gone back to Congress and asked it to authorize subsidies in states with federal exchanges. House Republicans, now in the majority, would have demanded other changes in the law.So today the strongest argument for upholding the administration’s reckless regulation is that people might be hurt if the law is enforced as written. White House Press Secretary Josh Earnest says Congress meant to give money to lots of people — so who cares what the law actually says?
A three-judge panel of the U.S. Court of Appeals for the D.C. Circuit—a tribunal second only to the Supreme Court—ruled on Tuesday that the Obama administration broke the law. The panel found that President Obama spent billions of taxpayer dollars he had no authority to spend, and subjected millions of employers and individuals to taxes he had no authority to impose.
The CBO attributes the rising deficits to increases in mandatory spending on entitlement programs – specifically, Social Security, Medicare, Medicaid, and Obamacare. Economists and politicians on both sides acknowledge that these programs are the primary drivers of the national debt, which is quickly approaching $18 trillion. Total mandatory spending is well over $2.5 trillion a year, representing two-thirds of all federal spending. The major entitlement programs are about 45 percent of federal spending.These programs were already financially unsustainable before Barack Obama took office, but the addition of Obamacare, the expansion of Medicaid, and the unwillingness to reform Medicare and Social Security have made them even worse.
We find that in recent years, when fiscal conditions have been tight, health insurance premiums for state workers have grown materially less rapidly than premiums for comparable private- sector employers; this slower premium growth for state workers reflects, for example, changes from traditional comprehensive plans to networked plans, increases in deductibles, and/or non-transparent reductions in access due to reductions in payments to providers. Interestingly, the share of the premium paid by state workers has tended to rise in states with high rates of public-sector unionization, where the employee share started at a low base, while the share has fallen elsewhere.
In this analysis of nationally representative survey data from January 2012 through June 2014, we found a significant decline in the uninsured rate among nonelderly adults that coincided with the initial open-enrollment period under the ACA. These changes remained highly significant after adjustment for potential confounders such as employment, demographic characteristics, and income. As compared with the baseline trend, the uninsured rate declined by 5.2 percentage points by the second quarter of 2014, a 26% relative decline from the 2012–2013 period. Combined with 2014 Census estimates of 198 million adults 18 to 64 years of age,19 this corresponds to 10.3 million adults gaining coverage, although depending on the model and confidence intervals, our sensitivity analyses imply a wide range from 7.3 to 17.2 million adults.
Rationing by waiting is having its greatest effect on those at the bottom of the income ladder. As I wrote at the Health Affairs blog:“Think metaphorically of waiting in line for care. The lowest-income families are at the end of that line. The longer the line, the longer they will have to wait. If you do something to shorten the line, you will be mainly benefiting higher-income people who are at the front.”There is another study gated with abstract that suggests that even low-income patients are more deterred by non-price barriers than by money prices.
The D.C. court made the right call, based on a strict reading of the law. But the probability that this ruling leads to the collapse of Obamacare is somewhere between zero and zero. That is to say, zero.