The report found that while dropping the mandate would modestly reduce overall federal spending on the ACA, it would significantly increase the federal spending per new enrollee.

And I’m afraid that fact alone would be deemed to justify the end of premium subsidies if general austerity measures don’t get us there first. I can’t see any way subsidies will survive in a meaningful form–the deficit nazis won’t tolerate it.

If Rand sez it, it MUST be true.

Oh furgetaboudit. It no longer matters who says what about anything.

What it would be the death spiral of is employer-funded health insurance. And that in itself would be a very good thing for moving to single payer.

And it ignores the exchanges, which are not likely to be operating in 2014 because of individual state legislatures’ opposition to the ACA.

Um, no. End of employer funded med ins has been goal of Oners for a long time. That way they can go directly to medical treatment for only those who can afford it and the rest can die. Like other inds with cartel power, med ind makes a lot more profits by charging more & providing fewer services. It’s a general principal you will see displayed more & more often, so is worthwhile becoming intimately familiar with it.

heh. can’t argue. too true.

I think we need a new word.

Forcing people to buy health insurance in general (mandate) is bad, but forcing people to buy contraception coverage (mandate) is good?

With or without the mandate, people just can not afford insurance and the subsidies are too low to matter much. There is no way the mandate will force 12 million more to get coverage. People will take the (cheaper) tax penalty instead.

If it ain’t single payer it’s bullshit.

How is offering contraception coverage forcing?

“. . .many people using the exchange will effectively have the amount they pay capped at a set percentage of their income, and not based on the actual sticker price of the insurance. . .”

——————

In that case why not simply do away with premiums altogether, and roll the cost of healthcare into a more progressive and comprehensive taxation system at large?

Maybe it’s too radical an idea. Yet if healthcare is a right, nobody should have to pay anything directly for basic coverage or its use, period. Of course they do pay, however indirectly, simply based on how they are taxed.

That could eliminate mandates, policies, and some of the worst controversies in recent memory.

Again, every other major industrialized country HAS national heaLth insurance. I’ve seen it “at work” in New Zealand and Canada. THIS AIN’T ROCKET SCIENCE.

If one refuses to purchase health “insurance” as well as pay the penalty, will they be incarcerated in debtor’s prison?

You are obviously WAAY too smart to be living in THIS country.
Canuck or Kiwi?????? :-)

C’mon Nomics. We’re talkin microsimulation here. That’s gotta be some expensive shit.

Only if corporations are people is anyone being forced. Apparently the Bill of Rights only applies to corporate legal entities now and not to human individual persons.

Am I correct that you are suggesting that at the lower income level of taxation, the tax liability would amount to a negative income tax? That kind of progressive tax scheme?

How much could a kid, a computer, and a creative report writer cost?

I’m confused: does it mean most doctors will drive Buicks again, or be driven in Rollses and Bentleys?

Those other countries and societies rely on gasoline taxes and other taxes to fund social programs including mass transit (and they have relatively small military budgets). The US has no margin for such taxation since no one has any money for it.

Ahhhhhhhh. so THEY buy healthcare for all and WE buy 20 nucleur aircraft carriers at $4 billion a pop and $25 million strike fighters.

Now I get it!!!!!

Ain;t this the old “guns n butter” debate????

I think I got this one…….doctors=Buicks. Healthcare CEOs=Bentleys

Primary care doctors at large healthcare systems….Ford Escorts.

Ain;t this the old “guns n butter” debate????

Even if US military budget were slashed (and that $$ went to infrastructure, environmental cleanup, funding for regulating agencies, etc.) no one can afford $5-$6 gal gas.

Well, not exactly. Are you referring to the EITC?

Rather, I think there would be more income brackets, steeper marginal tax rate increases in higher brackets. There might be excise taxes levied on the cost of, say, a vehicle priced above a certain amount. How about a VAT?

Lower incomes might see relatively small increases in taxes. The middle and higher brackets would have to pay a lot more. However, none of them, nor their employers, would pay healthcare premiums directly.

I’m not opposed to the socialized medicine bugaboo at all. I think ACA stinks — conscientious people went about this the wrong way.

So patients are left with the poor man’s Escort — a Yugo?

Vermont has no mandate and has great participation.

The actuaries reported the same results as the Rand study long ago, but “ins. co. spokespersons” never reflected what the actuarial staff was saying and the media never searches out folks beyond the spokesperson.

The Feds take over for the States if the States refuse to act on the exchanges – not that it matters as the exchanges are just a visit to your agent and not a cost saver or a system improver.

Their only useful function is move money as either subsidies to premiums, or as a payment to state to reduce the cost of single payer – assuming Vermont gets the waiver that permits this.

Why should there be corporate welfare for the insurance companies? Obama did everything he could not to actually bring down the actual costs – no Dorgan amendment, no drug price negotiations, no public option, etc. The corporate subsidies merely hide the amount of corporate welfare in ACA rather than actually addressing the underlying problem of healthcare costs being so expensive.

I recall on CarTalk one of the hosts explaining that the defrosting heating filaments in the Yugo’s rear window are for keeping the driver’s hands warm while he pushes the car.

I can see and understand both sides, and am not passionate about either.

Your question:

How is offering contraception coverage forcing?

Strawman. Offering isn’t forcing. An offer is voluntary. A mandate is not.

My statement :

forcing people to buy contraception coverage

The answer is, the mandate is required. True? Obama will say yes.

Therefore everyone is required (forced) to pay the insurance company to, as you say “offer coverage”. You don’t have to take it, therefore not be forced to use it, but Obama says, you still need to pay for it (forced).

BTW, it’s not free. Premiums will reflect the added costs, and everyone will pay whatever it costs (unless you think the insurance companies are just a bunch of nice guys).

The Feds are to set up an exchange in any state which does not do so on its own. As of Nov (I’d expect today as well) the large majority of states have not taken any action on setting up an exchange.

Due to an ACA glitch (among many glitches) it seems the Feds are allowed to provide subsidies through an exchange set up by a state. However, exchanges set up by the Feds are in a different ACA section, which prohibits Fed subsidies. Most likely it’s inadvertent, but clearly in the Act nonetheless.

There was a WSJ article about this last fall, and the complications were more than what I listed above. I don’t have the link now.

My 2nd para isn’t clear. . . It should begin,

“The Feds are allowed to provide subsidies through an exchange set up by a state. However, due to an ACA glitch (among many glitches), the exchanges set up by the Feds are in a different ACA section, and that section prohibits Fed subsidies to exchanges which are set up by the Feds. . .”

Nope. Our healthcare-related tax burden is higher than anywhere else except Norway (oil-rich and heavily taxed generally), Switzerland (where ~2/3 of insureds have their premiums subsidized), and Luxembourg (a tiny, ultra-rich international banking haven). In the rest of the First World, healthcare-related taxes go primarily to pay for cost-effective healthcare. In the US, a really big chunk goes to pay for provider “monopoly profits” — our medical prices are much higher than they would be if monopsonistically negotiated by a single bargaining agent, as is generally the case elsewhere — and for the administrative costs and profits of a fragmented, inefficient insurance system dealing with tens of thousands of separate, constantly changing pools of insureds. A single-payer system would eliminate those parasitic drains and allow much more of our already high healthcare-related taxes to go to actual, cost-effective care. See, e.g.:

The questions our healthcare debate ignores
http://www.salon.com/2009/03/09/healthcare_5/

* * *

Although the public share of health expenditure in the United States is much lower than any other OECD country except Mexico,[*] the public expenditure on healthcare is much higher per capita than in most OECD countries. So we pay a lot more in taxes devoted to medical care — not including insurance premiums, co-payments, fees, and other health costs -– than taxpayers in those 27 countries that have universal coverage. Our public expenditure provides coverage only for the elderly and some of the poor (through Medicaid and the SCHIP program for children)[**] while other countries provide universal coverage while spending less.

* * * *

[*] If I’m remembering correctly, I believe the public share of health expenditures might actually be lower in Greece as well (even before the current crisis). However, I don’t recall whether that survey included indirect tax subsidies in public spending.

[**] Actually, our healthcare-related taxes also pay for or subsidize Department of Defense medical care, the Veterans Health Administration, the Indian Health Service, the Federal Employee Health Benefits Program, Tricare, state and local health insurance, employer-paid premiums, and itemized deductions. The point is, we don’t get dependable, lifelong insurance and access to care at no or low out-of-pocket cost in exchange for our very high healthcare-related taxes — unlike the citizens of our peer countries.