Okay, so if the ACA Mandate is struck down...

[cthulu2016]

Last edited Tue Mar 27, 2012, 05:50 PM - Edit history (3)

If Obamacare (The WH used the term yesterday, so it's okay to say) is struck down. what will Republicans run on?

Their platform kind of begins and ends with repeal Obamacare.

The political impact is hard to predict, but I am not feeling it as a big deal. A program that for the most part hasn't been implemented and that few can even describe doesn't get implemented.

What's the big deal?

Also, the SCOTUS will surely not strike down the ACA in its entirety. That requires a total constitutional interaction, where the entire thing is incoherrent if rendered constitutional.

In this case, since there is not even any penalty for ignoring the mandate there's no way the whole ACA is sufficiently dependent on the mandate to be struck down entirely.

The mandate is desirable for the practical function of the overall plan but losing the mandate does not render all elements of the plan incoherrant as law. It is, in my opinion, severable. (Particularly since esimates of participation are estimates. Maybe everyone will sign on voluntarily. That's unlikely, but it is not barred by the remaining law.) So the court will, IMO, not strike down the whole thing. If the court mandates a change in a program that makes it more expensive then the legislature gets to decide whether to pony up money from somewhere else or repeal the now-expensive bill.

And, as law, I expect that all current implemented benefits will continue. Obviously, none of them are wholly dependent on the mandate.

[Inuca]

1. A LOT is dependent on the mandate

if it is struck down, another revenue source will be needed.

[cthulu2016]

3. You are talking about in practice

I am talking about the standards under which the court strikes down a portion or all of a bill.

I do not believe the court would strike down the whole thing because the mandate was nessecary to paying for it. That is not their job. That is a job for Congress.

Example: A bill authorizes the construction of a new school house. One section specifies that part of the construction cost will be met by a 5% property tax surcharge on African Americans.

The surcharge is struck down as facially unconstitutional, but that doesn't mean construction of the school is no longer authorized. That dollars and cents problem is a mess for the legislature to clean up.

There is nothing unconstitutional about constructing a school.

[regnaD kciN]

4. Haven't you learned...

...that the Republican majority on the SCOTUS isn't bound by legal logic?

They proved it in 2000, and they have a more ideological right-wing tilt now than they did then (Roberts and Alito versus O'Connor and Rehnquist).

[BlueDemKev]

2. Without a mandate....

....it will be virtually impossible for insurance companies to absorb the cost of people with pre-existing conditions which will result in insurance premiums skyrocketing. In fact, it's possible the Supreme Court may rule that the entire law must be struck down because the mandate is so intertwined with the rest of the law.

[fencesitter]

5. If the ind. mandate is struck down..

How would that effect Romneycare in Mass? Would a state program be effected?

[BlueDemKev]

6. No. This is a federal issue, not a state issue

[stevenleser]

7. But in terms of the campaign, its a relevant question. If it is wrong for a government to force a

mandate on a populace, does it really matter whether it is state or federal government doing the forcing? I know the arguments the Romney people will try to make, but I dont think that it is going to impress a lot of people.

[fencesitter]

8. That's what I was thinking

I don't think it would be an issue in the campaign though. That is unless Romney attacks Obama on the court decision, which would be dumb on his part since it's his plan also.

[TheKentuckian]

9. It matters because there is division of powers built into the system.

It isn't a good/bad thing. We don't need Arizona making up immigration policy or Texas running diplomacy.

That said, I'm also in disagreement with such power for the states either and have always opposed Rmoney's bullshit before it was even in the works and it is what it is, from acorn to tree.

[cthulu2016]

10. depends on the basis

the federal constitution limits only the federal government.

Through the 14th amendment the limitations on federal power in the bill of rights were gradually applied to the states also.

But the two are still different. For instance, Congress cannot regulate commerce in Ohio. It can regulate interstate commerce, which is so broad a category that it sometimes means everything.

But the fact remains that Ohio can do lots of things within Ohio that the federal Congress cannot do within Ohio.

[Motown_Johnny]

11. The vast majority of the law does not depend on the mandate

and only the expanded coverage directly depends on it. Beyond that it is simply cheaper to have more people contributing to the pool. If the mandate is removed it really changes nothing other than the cost. Even then there are ways to reduce the impact such as automatic enrollment or
penalties for late enrollment.

Neither are anymore than a partial fix but they are something. Both those options are discussed at this link: http://www.americanprogress.org/issues/2011/02/gruber_mandate.html



I tried to make a list of portions of the ACA that do not depend on the mandate at all, if you see an error please point it out I would love to be able to refine this list.


Small business tax credits which are then increased in 2014
Increased Federal funds to states for Medicare
"doughnut hole" closed
Anti-fraud measures
Expanded coverage for early retirees
Healthcare.gov site to help compare insurance options and choices
Children able to stay on parent's plan until age 26
Requiring plans to cover preventive care
Prohibiting Insurance Companies from Rescinding Coverage
People can now appeal insurance company coverage determinations
Lifetime limits on coverage are gone
Annual limits are regulated until 2014, then eliminated
Rate hikes need to be justified
Funding for scholarships and loan repayments for primary care doctors and nurses
Establishing Consumer Assistance Programs in the States
A new $15 billion Prevention and Public Health Fund
Funding for community health centers
Increased payments to rural health care providers
Prescription drug discounts
Free preventive care for Seniors
At least 85% of premiums spent on health care services (some exceptions)
Reforming the Medicare Advantage program
A new Center for Medicare & Medicaid Innovation that will begin testing new ways of delivering care to patients
Improved care for seniors after they leave the hospital
The Independent Payment Advisory Board
Increased access to at home services
Incentives for integrated health systems
Fighting racial and ethnic health disparities
Reduced paperwork and administrative costs
Payments linked to quality outcomes
Improved Preventive Health Coverage
Increased Medicaid Payments for Primary Care Doctors
A national pilot program to encourage hospitals, doctors, and other providers to work together to improve the coordination and quality of patient care
More funding for CHIP
Establishing Affordable Insurance Exchanges
Increased Access to Medicaid
Tax credits to help the middle class
Insurers will be prohibited from dropping or limiting coverage because an individual chooses to participate in a clinical trial
Paying Physicians Based on Value Not Volume



http://www.healthcare.gov/law/timeline/

[cthulu2016]

12. This is awesome. Thanks for your work.

[cthulu2016]

13. kicking for your post