Umm, just to make sure you guys know I stand for reason and not one party or the other: all these opponents of the decision decrying the loss of the status quo, and these alleged newfound "restrictions" on health insurance are either looking super-long term, or not looking at all. health insurance and HMO stocks were trending up after the ruling, and it's no surprise, as the health insurance lobby was a major proponent of this provision in particular. Yes, in the long run this is the final nail in the coffin of private health insurance, but health insurers have been allowed to keep their 50 respective fiefdoms for, arguably, over a century if you look at Hooper v. Caliornia (1895). This was a decision upholding a California law to make it a misdemeanor crime to broker insurance across state lines, with the decision setting the precedent that "every reasonable construction must be resorted to, in order to save a statute from unconstitutionality".
The linked decision represents, I would argue, the beginning of coercive control of health care in America... 117 years ago! And the above principle I quoted from that decision was quoted today in the decision by Justice Roberts reverses (and for some reason supercedes) the founding principle of a country with limited federal power. I may seem to be baying at some nebulous ghost but this legal precedent shifts the balance of the court from striking down laws to upholding them, when in serious national doubt. If a law is poor or poorly written, it should not stand, whether it limits federal power or expands it. The precedents set by this decision upholding the ACA do both, and in potentially very destructive ways! This law is poor and poorly written and will bankrupt several states with demographically poor an/or demographically old populations. But in the short and medium term, the federal government has put a gun to the head of every middle-income citizen, and forced them into their local health insurer's office, this will lead to windfall profits, increases in prices (due to increased demand), and eventually the full move over to full single-payer.
Another thing for those in favour of the ruling to consider is the provision of the law (which was upheld by the court) expanding states' obligations to provide Medicaid coverage to adults (both those with children and those without) within 133% of the federally-defined poverty lines. People on the left often decry the expanding gap between rich and poor (a gap that historically tends to widen under relatively left-wing governments and narrow under relatively right-wing governments) and it may or may not be a legitimate social trend for one to concern oneself with, I am not questioning that. What I am questioning in this case is the conclusion. Those who are opposed to the phenomenon of an expanding gap between rich and poor (which is by no means permanent or constant) should be opposed to the provision of this law in particular (as well as many other hallmarks of new left ideology, but that's a different matter), because it pushes an estimated 26 000 000 into Medicaid over the next 4 years. This represents a 40% increase and these numbers are based on estimates by the federal Office of the Actuary This means 40% more money has to go into Medicaid funding. That money will come partially for taxes but it mostly will be borrowed. So how does this fuck over the middle class? Well it also kinda puts the sting on wealthy people but they can afford both their tax bills and the costs associated with healthcare so it's not that big a deal for them (although it will drive them to take more profits out of their companies, thereby affecting wages and non-healthcare benefits of their workers). People whose income is outside the new 133% threshold, but is not high enough to afford private healthcare face higher borrowing costs, the "shared responsibility" fee, and get poorer quality care than both the poor and the rich. So you might argue that this actually brings the poor and the rich closer together (even though it squeezes the middle class, but all it does is put them on equal footing in terms of one aspect of their economic lives, and leaves the massive gulf between them in every other economic aspect as wide as ever. But it will also slow the social mobility of the poor. Unless a person can make a massive leap in earning power, they will have no incentive to leave a job that keeps them in the Medicaid threshold for one that offers them more income, but not enough more that they can afford private health insurance.
In the end, the key point is that the goal of making healthcare available as broadly as possible to as many people of many different social orders is not ignoble, the flaw is found in the method; which in this case comes in the form of coercion on a massive scale. If you haven't yet seen why in the realms of education, manufacturing, finance, construction, telecommunications, home insurance, and agriculture, you're not gonna see why in the case of healthcare either.
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