You misunderstand our system of government completely. Obama and Congressional Democrats don’t have any power to pass laws. Congress has the power to pass laws and the President may sign them and the Courts may rule on whether they are constitutional. In this instance, Congress passed the laws in both chambers by majority votes. That the votes were along party lines doesn’t have even the slightest legal significance to any judge in the world except Justice Scalia, who pretty much makes up fake history of founding fathers to support what his personal preferences are.
This bill that duly passed both houses went on to be signed by the President. It then became the law, much like the prohibitions against murdering of federal officials and draft registration requirements. That certain scum do not like the law does not make it optional with respect to compliance. People who do not like it may speak out against it, and propagandize about it and distort what it’s import is. That is their right. But the rest of us have the right to think that a four year old is more mature in response.
This law was then challenged as to its constitutionality in the court system. The court system found that it was constitutional. It’s the law of all of us in the US. If you don’t like it, then seek to change it to the way you would like. That is what I am doing.
I think the ACA is the worst health care law in any developed nation in the country. It is better than what we had, but that is no reason not to strive to make it better and the equivalent of what Canada, the UK and all other nations have, which all have better health care outcomes than our nation.
If you have a cite saying that individuals and small groups can buy plans not on the exchanges that ignore the rules for gold, silver, etc…, I’d be happy to see it. I know that it’s legal to buy directly from the insurers without going through the exchange but every source that I’ve seen says that the ACA’s rules still apply to plans purchased directly from insurers. As the NBC News article I linked to says:
Several insurance industry officials and state insurance commissioners expressed frustration Friday, saying they were “baffled” by President Barack Obama’s assertion that the cancellation of millions of insurance policies occurred because a key provision of the Affordable Care Act didn’t work as expected. The administration was warned three years ago that regulations would have exactly that effect, they said.
Yeah, it’s not entirely clear to me. But I feel no need to research your claims for you, when you haven’t established your central premise (which, as a reminder, is that plans with actuarial values of 75 or 85 or 95 are illegal).
Every article that I’ve seen agrees with the RealClearPolitics article and disagrees with you. For instance:
Categories are defined by the average share of total health spending on essential benefits paid for by the plan. The ACA identifies specific actuarial value categories as “metal levels” specified as bronze, silver, gold and platinum. Bronze plans have the least generous cost coverage, and platinum plans have the most generous cost coverage.
Coverage levels are as follows:
Bronze = 60 percent of the actuarial value with respect to essential benefits
Silver = 70 percent of the actuarial value with respect to essential benefits
Gold = 80 percent of the actuarial value with respect to essential benefits
Platinum = 90 percent of the actuarial value with respect to essential benefits
…
HHS is charged with developing guidelines to provide for a de minimis variation in the actuarial valuations used in determining the level of coverage of a plan to account for differences in actuarial estimates. HHS proposed allowing for an actuarial value de minimis variation of 2%. For example, a gold plan [80% actuarial value] could have an actuarial value of 78% to 82%.
The Department of Health and Human Services (HHS) allows for small variations (plus or minus two percentage points) in the actuarial value used to determine levels of coverage. For example, under HHS’ guidance, a silver plan could have an actuarial value between 68 percent and 72 percent.
Each insurance company will design plans that approximate the metal standards (plus or minus two percent). Thus, for a silver plan (70%), the actuarial values can range from 68%-72%. Insurance companies will be able to adjust the size of copays, deductibles, coinsurance and out-of-pocket maximums to appeal to different market segments, as long as they meet the actuarial values of the tier (plus or minus 2%).
All these sources clearly say that a silver plan can only have an actuarial value of 68 to 72, not higher or lower. Likewise a gold plan can only have an actuarial value of 78 to 82, not higher or lower. Perhaps these sources are wrong, but I’m going to believe them until I see a better source which contradicts them.
It very clearly contradicts what you wrote. You wrote this:
The legal mistake is the conclusion that the band ranges prevent plans that exceed the range from being marketed on the Exchange in that range. The reasoning seems to be that since the range is +/-2, then a plan with an AV of 85 cannot be marketed as gold because it exceeds 82. But that’s a rather counter-intuitive result to hang entirely on the little +/- symbol, isn’t it? Is there any other evidence that actuarial values in the middle ranges are not allowed to be marketed at the lowest band for which they qualify?
The three sources that I’ve just quoted very clearly say that a gold plan can only have an actuarial value between 78 and 82, that a silver plan can only have a value between 68 and 72, and so forth. You apparently believe that what they’re saying is not true. Perhaps you’re right and they’re wrong, but you can’t seem to offer any cites for your belief that the exchanges can legally sell gold or silver plans with an AV outside those ranges.
You’re still not getting it. Yes, the metallic bands are by definition for actuarial value of, say, 68-72. The inference you are making–which none of your sources except your opinion piece are also making–is that a plan that *exceeds *(rather than fails to meet) that range is not permitted to be marketed at a lower band.
If all we had were a set of rules and no outside knowledge of the world, then your reading of +/- is perfectly plausible. But since we know that there would be no reason at all to prevent an 85 plan to be marketed at a silver plan (since it would only be disadvantaging itself), and since we know that many plans would have AVs in the middle ranges and there is absolutely no reference to what happens to these plans anywhere in the lengthy regulation addressing questions and possible problems, I think your inference is speculative at best.
So believing that what reliable sources actually say is “speculative at best”? And meanwhile, you refuse to provide any source that backs up your interpretation? I guess we’re at an impasse.
If it’s true that the exchanges can legally offer a gold plan with any actuarial value over 78%, then why does the federal government bother saying that gold plans must have an AV of 80% plus or minus 2%? Why doesn’t the government just say straightforwardly that gold plans can have any AV over 78%? I mean, I know that the federal government does lots of idiotic things, but this would seem particularly dumb by any standard.
Once again, none of your sources actually state the inference you’re making from them, except for your GOP opinion piece.
What a silly argument. The federal government can’t have done something stupid (using +/- when they just meant -), so they must have done something stupid (prevented 85 AV plans from competing in the silver tier).
Once again, they all do: “a gold plan could have an actuarial value of 78% to 82%.” From this, I make the inference that a gold plan could have an actuarial value of 78% to 82%. “A silver plan could have an actuarial value between 68 percent and 72 percent.” From this, I make the inference that a silver plan could have an actuarial value between 68 percent and 72 percent.
I asked “Why doesn’t the government just say straightforwardly that gold plans can have any AV over 78%?” I take it you have no answer.
I think we understand each other perfectly. You just have an overabundance of faith in the ability to take language literally even when the author of that language wasn’t addressing the point you’re trying to make.
Don’t you think it’s interesting that you cannot find anyone other than a non-attorney at the Mercatus Center complaining about this weird, apparently unintended result? That not one of the 11,000 comments in the regulations took issue with this? Why do you think that is?
Again, I’m not certain either way. But I think your certainty is entirely misplaced. This may be the first time you’ve ever delved into the depths of complex federal regulations. What you’d find if you did so on a regular basis is that this kind of thing happens quite frequently.
Reviewing the text of the ACA, it’s quite clear that upper limits on actuarial values only apply to plans offered subject to the subsidies for those making 100-400% of the poverty line.
Since none of the subsidy-specific plans existed prior to passage of the ACA, no plans will be eliminated by this requirement.
As for “Pat”, the metallic tier requirements don’t apply to her anyway because it’s clear that her plan was not offered via the exchanges.
That’s what I thought too, but I think the tiers may well apply off the Exchanges. I’m not sure what it means for them to apply off the Exchanges, except perhaps to help people compare off-Exchange plans with on-Exchange plans, but you could certainly read the law to have that effect.
BCBS giddily announced I could keep my junk plan another year, wtf would i want to? 11k deductible, 8 k a year for the “healthy fit” plan which my spouses pre existing glaucoma was not covered for 6 months, still off to the eye doc he goes every 3 months…thru the exchange now we get choice of 29 plans, our physicians participate in all, we save 5k a year it’s a godsend!