"The ObamaCare Tax"

[bahia hombre]

To coin a phrase...Stephen Moore jumps out front in the WSJ:

http://online.wsj.com/article/SB1000...052048242.html

[Buck Godot]

For those of us who can't access the wall street journal can you give us a summary?

[bahia hombre]

Try it this way:

https://www.google.com/#hl=en&safe=o...w=1366&bih=610

It should be about the 2nd link as of right now and I think you will be able to view the entire article.

I guess the phrase has already been in existence, since there had been prior political discussion/debate about whether the mandate constitutes a tax; now that the impartial scotus has defined it as such, it's all we're gonna hear from the right..

[Jas09]

To me the Obamacare tax will always be the sales tax on tanning salons. I still think that might cost him Jersey.

[Simplicio]

Meh, it probably has some legs as campaign rhetoric. But I'm kinda sceptical that the GOP will sweep into the Whitehouse due to anger over a small penalty some fraction of one-percent of the US population will actually end up paying.

[Marley23]

They have to try to make lemons out of lemonade somehow, but the fact that the law was upheld puts a major dent in the "Obama is a failure" argument and I think it makes life harder for Romney because he'll either have to take a harder line on it or say how he'd replace it.

[GIGObuster]

Originally Posted by Marley23

They have to try to make lemons out of lemonade somehow, but the fact that the law was upheld puts a major dent in the "Obama is a failure" argument and I think it makes life harder for Romney because he'll either have to take a harder line on it or say how he'd replace it.

Yep, I do think that while many voters have the memory of a goldfish, there are still many that will not forget that just yesterday Romney was saying that if the courts did strike down Obamacare that Obama just wasted and was a useless president for all these last 3 years.

[Aside:] Now that gasoline prices are falling, I wonder why I do not see any Republicans congratulating Obama; after all, according to them, he was responsible for the gasoline prices.

[Simplicio]

Originally Posted by GIGObuster

Related to that, now that gasoline prices are falling, I wonder why I do not see any Republicans congratulating Obama; after all, according to them, he was responsible for the gasoline prices.

Granted, I haven't seen any of the Dopers that were saying it was a GOP and oil company conspiracy to unseat the Prez thanking our insidious plutocratic overlords for changing their minds.

[BobLibDem]

Originally Posted by Marley23

They have to try to make lemons out of lemonade somehow, but the fact that the law was upheld puts a major dent in the "Obama is a failure" argument and I think it makes life harder for Romney because he'll either have to take a harder line on it or say how he'd replace it.

I agree with this in principle but:
1) Romney will gain a few votes from those that can't stomach him but hate Obamacare even more.
2) Romney will likely fall back on the GOP party line "tort reform + interstate competition is all we need to do".
3) Obama has a little club to smack Romney with in the debates: have him explain why he loved it in Massachusetts but has since disowned it.
4) I'd have to say Tim "Obamneycare" Pawlenty's VP stock has gone down. If your own running mate used to beat you up on how similar your plan was to Obama's, you've got problems.

[Drunky Smurf]

Originally Posted by GIGObuster

[Aside:] Now that gasoline prices are falling, I wonder why I do not see any Republicans congratulating Obama; after all, according to them, he was responsible for the gasoline prices.

That's because Obama only lowered the prices because it's months out from the election and as soon as he frauds his way into the white house again he's going to raise them again.

[That Don Guy]

If the tax refers to the penalty for not having health insurance, I describe it here in another thread.

[John Mace]

The rigorous analysis in the OP has convinced me. Of what, I am not sure.

[Marley23]

Originally Posted by BobLibDem

1) Romney will gain a few votes from those that can't stomach him but hate Obamacare even more.

He already has their votes.

2) Romney will likely fall back on the GOP party line "tort reform + interstate competition is all we need to do".

Maybe. At this point that proposal seems even more insufficient than it did in the past. There are too many provisions of the health care law that people actually like.

4) I'd have to say Tim "Obamneycare" Pawlenty's VP stock has gone down.

Didn't Pawlentry pull out of the VP search a few days ago? (Meaning they told him he was out and let him say 'it's OK, I didn't want it anyhow.')

[bahia hombre]

Tax label is a small price to pay for survival of healthcare reform

http://www.latimes.com/news/politics...,3558600.story

[adaher]

I don't think that the mandate legally being changed into a tax will have an effect on the election, but it will have an effect on compliance. People obey the law, and now the mandate is no longer a mandate, it's just a tax. In addition, that means that Congress no longer has access to other measures to toughen the mandate, since the tax authority only includes the authority to tax, not to punish.

[Jas09]

Originally Posted by adaher

I don't think that the mandate legally being changed into a tax will have an effect on the election, but it will have an effect on compliance.

What is your prediction on compliance rates?

As a point of comparison, prior to the individual mandate in Mass it was estimated that 90% had insurance. In 2010, 44,000 or so paid the penalty. It's claimed something like 439,000 have adopted insurance since the law was enacted out of 6.6 million individuals. That would bump the insured rate up to around 97% (which is what I've seen in other studies). Cite for these numbers here: http://www.csmonitor.com/USA/Politic...-Massachusetts

Now other states are much worse off - Texas has something over 25% uninsured. And if they refuse the Medicaid expansion there will obviously be a big chunk of working poor that can't afford the mandated coverages. But beyond that (which is more of a self-inflicted wound than a flaw with the ACA), I'm not sure how many will choose to pay the penalty rather than take subsidies to buy coverage they previously couldn't afford.

I'm extremely dubious that a Supreme Court ruling changing the name of the action from "penalty" to "tax" would change that sort of personal calculation regarding insurance, but I guess it's not impossible.

[adaher]

For most people it won't change things, but it does mean something to me that it's not actually the law anymore than you have to have health insurance. Now it'll be more of a simple financial calculation rather than a moral imperative.

Let's look at another tax: cigarette taxes. If the government banned smoking, but didn't enforce the law except through the tax, how would that change smoking rates? Probably not much, but a little bit.

[Jas09]

Originally Posted by adaher

Let's look at another tax: cigarette taxes. If the government banned smoking, but didn't enforce the law except through the tax, how would that change smoking rates? Probably not much, but a little bit.

I'm not sure this is analogous. Here you have an activity that most people know is bad for them but that they enjoy doing. There's a pretty obvious payoff between paying money to do something you enjoy but that is bad for you.

Not buying health insurance is something that is bad for you and that you also don't enjoy doing (nobody likes being uninsured). Add in the penalty and there really isn't a good reason to go uninsured (assuming the subsidies make it affordable).

But I think we are in general agreement - if there is any change in compliance due to the ruling it will be minimal. Particularly compared to the effect of either (a) the mandate being struck down or (b) states rejecting the Medicaid expansion.

[Fear Itself]

Originally Posted by adaher

I don't think that the mandate legally being changed into a tax will have an effect on the election, but it will have an effect on compliance. People obey the law, and now the mandate is no longer a mandate, it's just a tax. In addition, that means that Congress no longer has access to other measures to toughen the mandate, since the tax authority only includes the authority to tax, not to punish.

That suits me fine. If the mandate isn't enforced, but the pre-existing condition law is enforced, it will drive private health insurers into bankruptcy. The sooner private health insurance companies leave the market, the sooner we will get single-payer, universal health care from the government.

[adaher]

Originally Posted by Jas09

But I think we are in general agreement - if there is any change in compliance due to the ruling it will be minimal. Particularly compared to the effect of either (a) the mandate being struck down or (b) states rejecting the Medicaid expansion.

The Medicaid expansion is a different story. For most states they might actually get more money if they don't take it, because those above the poverty line who won't be getting Medicaid will be getting subsidies for the exchanges. That's better health care for that group than they would otherwise receive, and more money for the states involved.

[adaher]

Originally Posted by Fear Itself

That suits me fine. If the mandate isn't enforced, but the pre-existing condition law is enforced, it will drive private health insurers into bankruptcy. The sooner private health insurance companies leave the market, the sooner we will get single-payer, universal health care from the government.

I think a more likely outcome is private insurance companies run a lot like public utilities. that's the model in most of the world. Single payer is obsolete.

[Fear Itself]

Originally Posted by adaher

I think a more likely outcome is private insurance companies run a lot like public utilities. that's the model in most of the world.

How's that going to work if the mandate can't be enforced?

[Jas09]

Originally Posted by adaher

The Medicaid expansion is a different story. For most states they might actually get more money if they don't take it, because those above the poverty line who won't be getting Medicaid will be getting subsidies for the exchanges. That's better health care for that group than they would otherwise receive, and more money for the states involved.

That won't happen unless the law is updated. Currently the subsidies only kick in at 133% of poverty (where the Medicaid expansion ends). If I'm mistaken please correct me.

[adaher]

Originally Posted by Fear Itself

How's that going to work if the mandate can't be enforced?

The insurance companies will be subsidized to prevent them from going under.

Sure, if the government just allowed everything to go to hell, a single payer system would have to emerge from the ashes. But that would be a painful and long process and any political party in charge would be booted out in a heartbeat for allowing it to happen without intervention.

[adaher]

Originally Posted by Jas09

That won't happen unless the law is updated. Currently the subsidies only kick in at 133% of poverty (where the Medicaid expansion ends). If I'm mistaken please correct me.

I can't cite the law itself, but Ezra Klein's site and TNR both stated that it's 100%. Up to 133% someone is automatically enrolled in Medicaid, but if Medicaid isn't an option then they'd get subsidies.

here's a couple of cites of that:

http://blogs.wsj.com/health/2012/06/...into-question/

http://www.healthcare.gov/news/facts...08122011a.html

In 2014, taxpayers with household incomes between 100 percent and 400 percent of the Federal Poverty Level will be eligible for premium tax credits for coverage purchased through the Exchanges for themselves and members of their family who are not eligible for other health care coverage.

[Fear Itself]

Originally Posted by adaher

The insurance companies will be subsidized to prevent them from going under.

Sure, if the government just allowed everything to go to hell, a single payer system would have to emerge from the ashes. But that would be a painful and long process and any political party in charge would be booted out in a heartbeat for allowing it to happen without intervention.

So, wouldn't it be easier to just enforce the mandate?

[adaher]

They can't enforce the mandate. The government may not command people to buy health insurance. They can impose a tax. It's a lot like a sin tax.

[Fear Itself]

Originally Posted by adaher

They can't enforce the mandate. The government may not command people to buy health insurance. They can impose a tax. It's a lot like a sin tax.

SCOTUS said they can impose a tax on those without insurance. And the IRS can compel people to pay the tax.

Does that not provide enough incentive to comply with the mandate?

[adaher]

The IRS can constitutionally compel people to pay the tax, but:

1) paying the tax places someone in full compliance with the law. A normal fine or penalty doesn't work that way. Payment means you still have to stop breaking the law, or else escalating penalties ensue.

2) The IRS is disallowed by statute from enforcing the mandate through any means other than docking someone's refund.

[Really Not All That Bright]

Originally Posted by Jas09

To me the Obamacare tax will always be the sales tax on tanning salons. I still think that might cost him Jersey.

Meh. Hard to get to the polls when you've got a full day of gym/tan/laundry already.

Originally Posted by adaher

Let's look at another tax: cigarette taxes. If the government banned smoking, but didn't enforce the law except through the tax, how would that change smoking rates? Probably not much, but a little bit.

Well, that depends on the tax. Proposed "bans" on smoking typically consist of prohibitions on point-of-sale advertising and 1000%+ tax increases.

Originally Posted by Fear Itself

SCOTUS said they can impose a tax on those without insurance. And the IRS can compel people to pay the tax.

Well, not really. One of the bugs/features of the mandate penalty is that the IRS can't use most of its normal channels to enforce it.

[Fear Itself]

Originally Posted by adaher

The IRS can constitutionally compel people to pay the tax, but:

1) paying the tax places someone in full compliance with the law. A normal fine or penalty doesn't work that way. Payment means you still have to stop breaking the law, or else escalating penalties ensue.

2) The IRS is disallowed by statute from enforcing the mandate through any means other than docking someone's refund.

In your opinion, would that provide incentive to comply with the mandate for the vast majority of people?

[adaher]

I think that was intended to be temporary. Enforcing an unpopular law is a great way to make it a lot less popular in a hurry. If the law became popular, then they probably would have created harsher penalties, not just financial ones.

[adaher]

Originally Posted by Fear Itself

In your opinion, would that provide incentive to comply with the mandate for the vast majority of people?

IMO, the vast majority will comply as it is. As candidate Obama said, "I don't think people need to be forced to buy health insurance." He was right the first time. The subsidies will cause most people to get insurance.

Those that don't will probably have very good reasons for not doing so. There are many things people HAVE to have, health care is one of them, but so is food, shelter, clothing, transportation to work. If a person has to skimp on something, I don't think the government or the public has a right to tell them where they are allowed to make their household budget cuts.

[Really Not All That Bright]

Well, I really need an iPad, so in that case I won't be paying my taxes.

[adaher]

Now you're making an argument similar to one right-wingers make about welfare recipients.

Personally, I think people do the best they can with their budgets, and if there's not enough money left over for health insurance given their individual situations, I'd say it's best left up to them whether they should get insurance or live in a more dangerous neighborhood or eat less food.

[Really Not All That Bright]

That's the problem with the health insurance market, specifically: it's not up to them. If they decide to skimp on insurance and have a heart attack, you and I foot the bill. If they decide to live in a shitty apartment, not our problem.

[adaher]

I think the idea that we pay for it is disputable, that depends on their individual situation. And a person raising kids in a crappy neighborhood also imposes costs on society, known as jail time. And poorer health outcomes. I dare say that living in a safe neighborhood and eating well are going to be more beneficial to a person's health than having health insurance. I can't prove it, but if we're going to take away people's right to manage their household budgets, the burden of proof that this isn't so really is on those wanting to take that right away.

By requiring the purchase of health insurance, the government is saying that this is THE most important thing a person must have, more important than food and shelter. Which to me sounds like a self-fulfilling prophecy. If you sacrifice those things to buy health insurance, you'll be needing that health insurance for sure.

[Gangster Octopus]

I've often wondered, if I could prove that the Health Care would absolutely save lives, provide for better health and health care, and reduce expenditures on Health Care, but to do so required this so-called tax, would conservatives be for or against that?

[adaher]

Originally Posted by Gangster Octopus

I've often wondered, if I could prove that the Health Care would absolutely save lives, provide for better health and health care, and reduce expenditures on Health Care, but to do so required this so-called tax, would conservatives be for or against that?

well, now that SCOTUS has ruled a mandate unconstitutional, I don't think you'll get conservatives to agree to one period, even through the legal backdoor that the tax power provides.

[Fear Itself]

Originally Posted by Gangster Octopus

I've often wondered, if I could prove that the Health Care would absolutely save lives, provide for better health and health care, and reduce expenditures on Health Care, but to do so required this so-called tax, would conservatives be for or against that?

Since it is a conservative article of faith that government can never do anything better than private enterprise, your proof would be rejected.

[adaher]

Among many conservatives, yes. Not me. I acknowledge that government does some things better. keeping health care costs down, for example, since the government has greater bargaining power.

[ElvisL1ves]

Originally Posted by Fear Itself

SCOTUS said they can impose a tax on those without insurance. And the IRS can compel people to pay the tax.

Does that not provide enough incentive to comply with the mandate?

Not if the tax is less than the premiums, which for many will be the case.

[gamerunknown]

Originally Posted by adaher

I think a more likely outcome is private insurance companies run a lot like public utilities. that's the model in most of the world. Single payer is obsolete.

According to wiki, the UK, Canada and Taiwan all run a form of single payer, each having a higher average lifespan than the US. By "private insurance company run like a public utility" (paraphrasing), do you mean something like Andorra, which has a mandate?

[adaher]

Like Switzerland and Germany and Japan. The Netherlands is also multi-payer. France, generally considered the #1 system in the world, is also multi-payer.

[Really Not All That Bright]

France does not have a multi-payor system. There are separate funds for farm employees and the self-employed, but everyone is covered by a government-administered policy.

[adaher]

It is a universal health care system, but is not a single-payer system. It features a mix of public and private services, relatively low expenditure, high patient success rates and low mortality rates,[12] and high consumer satisfaction.[13] Its aims are to combine low cost with flexibility of patient choice as well as doctors' autonomy.[14]

http://en.wikipedia.org/wiki/Health_...rance#Spending

Historian Paul Dutton claims that while many in the US deride the French system as "socialized medicine," the French do not consider their mixed public and private system "socialized" and the population tends to look down upon British- and Canadian-style socialized medicine.[14]

[Really Not All That Bright]

It's as close to a single payor system as actually exists; like every other country, there are private supplemental plans. You can read about it from an authoritative source here (financial stuff starts on page 43).

[adaher]

Canada and Britain are true single payer systems. There aren't "funds", the government pays the bills directly, in the same fashion as the US's Medicare system, and in the case of Canada, cash for basic care is against the law(although a Quebec court ruled that this law violates human rights).

Your source describes the French system as a mixed system. Now I notice that sometimes single payer supporters use single payer a synonym for "universal health care" primarily paid for by the government, even if indirectly and even if there's a role for private insurance. It's technically wrong, but in common enough usage that I won't quibble if that's what you're talking about.

[Really Not All That Bright]

It's not "technically wrong". It means funding comes from the government via taxation, which is how the French system works. If you exclude systems with any private funding, then even the NHS isn't a single payer system because you are free to purchase supplemental private coverage.

[adaher]

According to your source, the French system involves "numerous actors and sources of finance."