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Thread: Health Insurance

  1. #91
    Coachella Junkie PlayaDelWes's Avatar
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    Default Re: Health Insurance

    Quote Originally Posted by malcolmjamalawesome View Post
    Wes, how much do you feel implementation of ACA costs?
    It doesn't matter. I've accepted it and have moved on. My early fears that this was all about redistribution and class warfare have subsided as specific details of the law emerged. While some of the sources of tax revenue are questionable, most are reasonable.
    .
    • Surtax on Investment Income - We really don't have a lot of unearned (investment / capital gains) income, so that 3.8% surcharge won't really matter. I completely agree with it though and think unearned income should be taxed more than earned income (certainly more than 15-20%) since it's passive and if that's your primary source of income, you're probably filthy rich.
    • Hike in Medicare Payroll Tax - (Yes, but as long as I get a wallet size photo of subsidized american each year, I'll be good)
    • Flexible Spending Account Cap – aka“Special Needs Kids Tax - May hurt us a little, but will certainly hurt many of the providers we use.
    • Employer Reporting of Insurance on W-2 - At some point insurance benefits are taxed maybe?


    I don't think I'm affected by any of the other revenue sources:
    • Excise Tax on Comprehensive Health Insurance Plans (This is what I don't understand about the mandate. If the penalty is so small, why not apply this tax to EVERYONE and then offset it with a tax credit for those who have qualifying” health insurance???)
    • Individual Mandate Excise Tax
    • Employer Mandate Tax
    • Medicine Cabinet Tax
    • HSA Withdrawal Tax Hike
    • Tax on Medical Device Manufacturers
    • Raise "Haircut" for Medical Itemized Deduction from 7.5% to 10% of AGI
    • Tax on Indoor Tanning Services
    • Elimination of tax deduction for employer-provided retirement Rx drug coverage in coordination with Medicare Part D
    • Blue Cross/Blue Shield Tax Hike
    • Excise Tax on Charitable Hospitals
    • Tax on Innovator Drug Companies
    • Tax on Health Insurers
    • $500,000 Annual Executive Compensation Limit for Health Insurance Executives
    • Corporate 1099-MISC Information Reporting
    • “Black liquor” tax hike
    • Codification of the “economic substance doctrine"

    Quote Originally Posted by summerkid View Post
    Well, if the states have to increase funding for medicaid one could easily see a state raise taxes or cut spending usually the first on the first thing on the chopping block is education.
    Exactly. Eductation and Pensions. Any idea on how this will affect CA?
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  2. #92
    Peaceful Oasis TomAz's Avatar
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    Default Re: Health Insurance

    The tanning booth tax is the real killer.
    Quote Originally Posted by captncrzy View Post
    HAY CAN SOMEONE DRIVE DOWN TO THE FESTIVAL GROUNDS AND SEE IF THE BEER BARN IS REALLY A BARN?

  3. #93

    Default Re: Health Insurance

    Love how Anthem Blue Cross just mails you arbitrary premium increase letters every so often. Got one yesterday.

  4. #94
    Peaceful Oasis TomAz's Avatar
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    Default Re: Health Insurance

    Jesus christ. I just now heard about Scalia's comments on the 'Cornhusker Kickback'. My wife mentioned it to me tonight and the first words out of my mouth were "but it's not in the final law". I didn't have to look it up, I just knew it off the top of my head. Now granted I have to know this law inside and out for my work, but at the same time, I'm not deciding its fate as a Supreme Court Justice. I had actually permitted myself the delusion that at least the conservative justices were intellectually competent, that they weren't a Palin or a Santorum.. god damn I fear for our country now.
    Quote Originally Posted by captncrzy View Post
    HAY CAN SOMEONE DRIVE DOWN TO THE FESTIVAL GROUNDS AND SEE IF THE BEER BARN IS REALLY A BARN?

  5. #95
    Coachella Junkie Miroir Noir's Avatar
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    Default Re: Health Insurance

    Yesterday's argument was the most absurd Supreme Court argument of my lifetime. They are up there going on and on about crazy hypotheticals and are seriously giving deference to arguments that were laughable to everyone but a group of libertarian law professors just six months ago. No discussion of precedent. No real discussion of the constitution. They were acting like the type of judicial super legislature that the right has so often accused the left of being. Scalia was the worst: he sounded like Glenn Beck. The scariest thought is that the craziest Justice of them all was silent.
    Quote Originally Posted by sk8r408 View Post
    The word "lulzy" is offensive.

  6. #96
    Peaceful Oasis TomAz's Avatar
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    Default Re: Health Insurance

    Yeah but he's always silent.
    Quote Originally Posted by captncrzy View Post
    HAY CAN SOMEONE DRIVE DOWN TO THE FESTIVAL GROUNDS AND SEE IF THE BEER BARN IS REALLY A BARN?

  7. #97
    Coachella Junkie Miroir Noir's Avatar
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    Default Re: Health Insurance

    Yep. But his opinions are always the loudest; he genuinely does not believe precedent applies, ever. That's why it's scary -- the most radical guy wasn't even the one saying this stuff.

    I wish there were a way to more easily explain to the general public what is at stake with this challenge, particularly with the Medicaid expansion issue. This is so much more significant than Trayvon Martin or the latest horse race stories in the campaign, but it occurs at a level of obscurity and complexity that prevents even high information voters from seeing how genuinely scary and radical it is that the Supreme Court is talking these challenges so seriously.

    Edit: Jonathan Chait explains the same sense of unease that I have. This is essential reading, too.
    Last edited by Miroir Noir; 03-29-2012 at 09:04 PM.
    Quote Originally Posted by sk8r408 View Post
    The word "lulzy" is offensive.

  8. #98
    Peaceful Oasis TomAz's Avatar
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    Default Re: Health Insurance

    Eh, I'm not particularly impressed by those articles. They tend to fall into that trap where they ridicule people they disagree with. That sometimes can rally the troops on your side but rarely succeeds in convincing neutral observers as to the merits of your case.
    Quote Originally Posted by captncrzy View Post
    HAY CAN SOMEONE DRIVE DOWN TO THE FESTIVAL GROUNDS AND SEE IF THE BEER BARN IS REALLY A BARN?

  9. #99
    Coachella Junkie Miroir Noir's Avatar
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    Default Re: Health Insurance

    Yeah, Chait can be that way because he uses sarcasm and ridicule as a rhetorical tool; at the same time, I think he is one of the best bloggers on the left for cutting through issues analytically. Koppelman is essentially where a lot of people on the legal left are right now: apoplectic that the Court is even considering arguments that are this unmoored from the constitutional framework that we all assumed that we were operating under. I have tried for years to give conservatives on the Supreme Court the benefit of the doubt. In some ways, I actually admire both John Roberts and Clarence Thomas (for very different reasons). But the types of questions they were asking this week -- the intimations that they were making and the hypotheticals that they were suggesting -- are so far out of the legal mainstream (even for the right) that you have the begin questioning either their sanity or their intellectual honesty.
    Quote Originally Posted by sk8r408 View Post
    The word "lulzy" is offensive.

  10. #100
    Peaceful Oasis TomAz's Avatar
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    Default Re: Health Insurance

    Unfortunately, much of the commentary on the left is better at apoplexy than persuasion. Not because they are without merit, but because they just don't know how to talk to non-intellectuals.
    Quote Originally Posted by captncrzy View Post
    HAY CAN SOMEONE DRIVE DOWN TO THE FESTIVAL GROUNDS AND SEE IF THE BEER BARN IS REALLY A BARN?

  11. #101
    Peaceful Oasis TomAz's Avatar
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    Default Re: Health Insurance

    The best thing about the article on Clement (link from the Chait article) though is the picture in the ad next to it.



    This is seriously healthy stuff right there.
    Quote Originally Posted by captncrzy View Post
    HAY CAN SOMEONE DRIVE DOWN TO THE FESTIVAL GROUNDS AND SEE IF THE BEER BARN IS REALLY A BARN?

  12. #102
    malcolmjamalaweful malcolmjama1awesome's Avatar
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    Default Re: Health Insurance

    Quote Originally Posted by malcolmjamalawesome View Post
    1) Yes. Plus the definition of the "poverty level" for Medicaid coverage gets expanded to include more people.
    2) Yes, to the extent that statewide "exchanges" get set up which are (in theory) more transparent "marketplaces" for health insurance for those buying personal insurance to comparison shop.
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  13. #103
    Coachella Junkie Miroir Noir's Avatar
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    Default Re: Health Insurance

    Okay, I'm predicting a 6-3 ruling upholding everything, including the mandate. Roberts will write the majority opinion either way. For the sake of the country, I really hope I am correct about this.
    Quote Originally Posted by sk8r408 View Post
    The word "lulzy" is offensive.

  14. #104

    Default Re: Health Insurance

    My gut feeling is the mandate will be overturned. I saw a headline that Democrats are preparing to push single-payer if this happens. Not sure how that works but ok.

    Either way my Facebook will be blowing up with Supreme Court love/hate all day long

  15. #105
    Coachella Junkie Miroir Noir's Avatar
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    Default Re: Health Insurance

    5-4, law upheld. Roberts saved the day, but threw out some significant crumbs to conservatives. I'll write more tonight.
    Quote Originally Posted by sk8r408 View Post
    The word "lulzy" is offensive.

  16. #106
    Peaceful Oasis TomAz's Avatar
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    Default Re: Health Insurance

    Medicaid expansion not upheld, however. This is important, and much more than a crumb.
    Quote Originally Posted by captncrzy View Post
    HAY CAN SOMEONE DRIVE DOWN TO THE FESTIVAL GROUNDS AND SEE IF THE BEER BARN IS REALLY A BARN?

  17. #107
    old school sonnyboy11's Avatar
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    Default Re: Health Insurance

    Very good news. Still need to read the entire ruling but it's definitely a small step in the right direction. Roberts' vote is a stunner.
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  18. #108
    ankle biter guedita's Avatar
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    Default Re: Health Insurance

    Quote Originally Posted by TomAz View Post
    Medicaid expansion not upheld, however. This is important, and much more than a crumb.
    More on that here: http://www.slate.com/blogs/moneybox/...the_deal_.html

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  19. #109
    Coachella Junkie PlayaDelWes's Avatar
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    Default Re: Health Insurance

    I was afraid there'd be no ruling because of the Anti-Injunction Act. I'm confused now that the basis for the ruling seems along the lines that the mandate is a tax. If it is a tax, then why doesn't it qualify under the Anti-Injunction Act and how were they able to rule on it in the first place?

  20. #110
    Coachella Junkie chairmenmeow47's Avatar
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    Default Re: Health Insurance

    god i wish i could watch fox news right now
    Quote Originally Posted by malcolmjamalawesome View Post
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  21. #111
    Coachella Junkie paulb's Avatar
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    Default Re: Health Insurance

    Obamacare explained in simple terms, just in case you missed something.


    What people call "Obamacare" is actually the Patient Protection and Affordable Care Act. However, people were calling it "Obamacare" before everyone even hammered out what it would be. It's a term mostly used by people who don't like the PPACA, and it's become popularized in part because PPACA is a really long and awkward name, even when you turn it into an acronym like that.

    Anyway, the PPACA made a bunch of new rules regarding health care, with the purpose of making health care more affordable for everyone. Opponents of the PPACA, on the other hand, feel that the rules it makes take away too many freedoms and force people (both individuals and businesses) to do things they shouldn't have to.

    So what does it do? Well, here is everything, in the order of when it goes into effect (because some of it happens later than other parts of it):

    Already in effect:

    It allows the Food and Drug Administration to approve more generic drugs (making for more competition in the market to drive down prices)

    It increases the rebates on drugs people get through Medicare (so drugs cost less)

    It establishes a non-profit group, that the government doesn't directly control, PCORI, to study different kinds of treatments to see what works better and is the best use of money. ( Citation: Page 665, sec. 1181 )

    It makes chain restaurants like McDonalds display how many calories are in all of their foods, so people can have an easier time making choices to eat healthy. ( Citation: Page 499, sec. 4205 )

    It makes a "high-risk pool" for people with pre-existing conditions. Basically, this is a way to slowly ease into getting rid of "pre-existing conditions" altogether. For now, people who already have health issues that would be considered "pre-existing conditions" can still get insurance, but at different rates than people without them.

    It renews some old policies, and calls for the appointment of various positions.

    It creates a new 10% tax on indoor tanning booths. ( Citation: Page 923, sec. 5000B )

    It says that health insurance companies can no longer tell customers that they won't get any more coverage because they have hit a "lifetime limit". Basically, if someone has paid for health insurance, that company can't tell that person that he's used that insurance too much throughout his life so they won't cover him any more. They can't do this for lifetime spending, and they're limited in how much they can do this for yearly spending. ( Citation: Page 14, sec. 2711 )

    Kids can continue to be covered by their parents' health insurance until they're 26.

    No more "pre-existing conditions" for kids under the age of 19.

    Insurers have less ability to change the amount customers have to pay for their plans.

    People in a "Medicare Gap" get a rebate to make up for the extra money they would otherwise have to spend.

    Insurers can't just drop customers once they get sick. ( Citation: Page 14, sec. 2712 )

    Insurers have to tell customers what they're spending money on. (Instead of just "administrative fee", they have to be more specific).

    Insurers need to have an appeals process for when they turn down a claim, so customers have some manner of recourse other than a lawsuit when they're turned down.

    New ways to stop fraud are created.

    Medicare extends to smaller hospitals.

    Medicare patients with chronic illnesses must be monitored more thoroughly.

    Reduces the costs for some companies that handle benefits for the elderly.

    A new website is made to give people insurance and health information. (I think this is it: http://www.healthcare.gov/ ).

    A credit program is made that will make it easier for business to invest in new ways to treat illness.

    A limit is placed on just how much of a percentage of the money an insurer makes can be profit, to make sure they're not price-gouging customers.

    A limit is placed on what type of insurance accounts can be used to pay for over-the-counter drugs without a prescription. Basically, your insurer isn't paying for the Aspirin you bought for that hangover.

    Employers need to list the benefits they provided to employees on their tax forms.

    8/1/2012

    Any health plans sold after this date must provide preventative care (mammograms, colonoscopies, etc.) without requiring any sort of co-pay or charge.

    1/1/2013

    If you make over $200,000 a year, your taxes go up a tiny bit (0.9%). Edit: To address those who take issue with the word "tiny", a change of 0.9% is relatively tiny. Any look at how taxes have fluctuated over the years will reveal that a change of less than one percent is miniscule, especially when we're talking about people in the top 5% of earners.

    1/1/2014

    This is when a lot of the really big changes happen.

    No more "pre-existing conditions". At all. People will be charged the same regardless of their medical history.

    If you can afford insurance but do not get it, you will be charged a fee. This is the "mandate" that people are talking about. Basically, it's a trade-off for the "pre-existing conditions" bit, saying that since insurers now have to cover you regardless of what you have, you can't just wait to buy insurance until you get sick. Otherwise no one would buy insurance until they needed it. You can opt not to get insurance, but you'll have to pay the fee instead, unless of course you're not buying insurance because you just can't afford it.

    Insurers now can't do annual spending caps. Their customers can get as much health care in a given year as they need. ( Citation: Page 14, sec. 2711 )

    Make it so more poor people can get Medicaid by making the low-income cut-off higher.

    Small businesses get some tax credits for two years.

    Businesses with over 50 employees must offer health insurance to full-time employees, or pay a penalty.

    Limits how high of an annual deductible insurers can charge customers.

    Cut some Medicare spending

    Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them.

    Establish health insurance exchanges and rebates for the lower and middle-class, basically making it so they have an easier time getting affordable medical coverage.

    Congress and Congressional staff will only be offered the same insurance offered to people in the insurance exchanges, rather than Federal Insurance. Basically, we won't be footing their health care bills any more than any other American citizen.

    A new tax on pharmaceutical companies.

    A new tax on the purchase of medical devices.

    A new tax on insurance companies based on their market share. Basically, the more of the market they control, the more they'll get taxed.

    The amount you can deduct from your taxes for medical expenses increases.

    1/1/2015

    Doctors' pay will be determined by the quality of their care, not how many people they treat. Edit: a_real_MD addresses questions regarding this one in far more detail and with far more expertise than I can offer in this post. If you're looking for a more in-depth explanation of this one (as many of you are), I highly recommend you give his post a read.

    1/1/2017


    If any state can come up with their own plan, one which gives citizens the same level of care at the same price as the PPACA, they can ask the Secretary of Health and Human Resources for permission to do their plan instead of the PPACA. So if they can get the same results without, say, the mandate, they can be allowed to do so. Vermont, for example, has expressed a desire to just go straight to single-payer (in simple terms, everyone is covered, and medical expenses are paid by taxpayers).

    2018

    All health care plans must now cover preventative care (not just the new ones).

    A new tax on "Cadillac" health care plans (more expensive plans for rich people who want fancier coverage).

    2020

    The elimination of the "Medicare gap"

    .

    Aaaaand that's it right there.

    The biggest thing opponents of the bill have against it is the mandate. They claim that it forces people to buy insurance, and forcing people to buy something is unconstitutional. Personally, I take the opposite view, as it's not telling people to buy a specific thing, just to have a specific type of thing, just like a part of the money we pay in taxes pays for the police and firemen who protect us, this would have us paying to ensure doctors can treat us for illness and injury.

    Plus, as previously mentioned, it's necessary if you're doing away with "pre-existing conditions" because otherwise no one would get insurance until they needed to use it, which defeats the purpose of insurance.
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  22. #112
    old school unit300021's Avatar
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    Default Re: Health Insurance

    I thought this was pretty funny and I guess it's the best place to put it.

    http://www.buzzfeed.com/daves4/peopl...e-of-obamacare
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  23. #113
    Banned marooko's Avatar
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    Default Re: Health Insurance

    In its argument to the court, the government left open the possibility that the mandate is a tax
    Where the fuck do you think the money was gonna come from, the fucking golden goose? Great time to tax, though, with unemployment down and all.
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  24. #114
    Coachella Junkie chairmenmeow47's Avatar
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    Default Re: Health Insurance

    Place a $2500 limit on tax-free spending on FSAs (accounts for medical spending). Basically, people using these accounts now have to pay taxes on any money over $2500 they put into them.
    i know this isn't the biggest deal or anything, but for my own curiosity, why is this a regulation? i put in about $2500 this year and will be out of money friday.
    Quote Originally Posted by malcolmjamalawesome View Post
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  25. #115
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    Default Re: Health Insurance

    Curse that down unemployment!

  26. #116
    old school sonnyboy11's Avatar
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    Default Re: Health Insurance

    Free Republic forums are a hoot, right now. A hoot!
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  27. #117
    The Encyclopedia bmack86's Avatar
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    Default Re: Health Insurance

    Quote Originally Posted by marooko View Post
    Where the fuck do you think the money was gonna come from, the fucking golden goose? Great time to tax, though, with unemployment down and all.
    The money for what?
    Quote Originally Posted by canexplain View Post
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  28. #118
    Coachella Junkie algunz's Avatar
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    Default Re: Health Insurance

    Quote Originally Posted by TomAz View Post


    This is seriously healthy stuff right there.
    I love these dresses. I'll bet they cost more than what I'll have to pay in taxes.

  29. #119
    Coachella Junkie Miroir Noir's Avatar
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    Default Re: Health Insurance

    Quote Originally Posted by TomAz View Post
    Medicaid expansion not upheld, however. This is important, and much more than a crumb.
    The most interesting part of the decision, and one that is deeply troubling to me outside of the immediate health care context (this could open up Spending Clause challenges to a host of cooperative federal and state projects). According to one of the NYT blogs on this,

    How much money will states have to spend to extend Medicaid coverage to all adults within 133 percent of the poverty line? How much federal funding they will turn down if they choose not to?
    The Kaiser Family Foundation has the estimates (see Table 1 on page 10 http://www.kff.org/healthreform/uplo...ow-133-fpl.pdf). Take, for instance, Texas. Kaiser estimates that in 2019, five years after the expansion would take effect, 1.38 million of the state’s residents who were previously uninsured would be enrolled in Medicaid. The state would spend about $2.6 billion between 2014 and 2019 to extend coverage, while the federal government would spend about $52.5 billion in the state.
    In aggregate, between 2014 and 2019, Kaiser estimates that states will spend $21.1 billion to extend Medicaid. The federal government will spend $443.5 billion.
    I still see all 50 states taking this deal. The Court ruled 7-2 that the ACA couldn't use the denial of all Medicaid funding to force state participation, but the first couple of years of 100% federal funding, followed by the very state-friendly ratios thereafter will probably mean that even the craziest of the crazy state legislatures won't be able to say no to Medicaid expansion to 133% of the poverty line.
    Last edited by Miroir Noir; 06-28-2012 at 10:08 AM.
    Quote Originally Posted by sk8r408 View Post
    The word "lulzy" is offensive.

  30. #120
    Coachella Junkie Miroir Noir's Avatar
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    Default Re: Health Insurance

    Quote Originally Posted by PlayaDelWes View Post
    I was afraid there'd be no ruling because of the Anti-Injunction Act. I'm confused now that the basis for the ruling seems along the lines that the mandate is a tax. If it is a tax, then why doesn't it qualify under the Anti-Injunction Act and how were they able to rule on it in the first place?
    This was a bit of a legal and rhetorical dance in the Roberts opinion. It was a "penalty" for purposes of the Anti-Injunction Act (the ACA never calls the mandate penalties a "tax") and a "tax" for the purposes of determining constitutionality under Congress' taxing power (because the penalties have the effect of operating like a tax, and not a more serious civil or criminal penalty).
    Quote Originally Posted by sk8r408 View Post
    The word "lulzy" is offensive.

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