Health Care Decision A Victory For Everyone, Except Millions Of Poor People Maybe

  always whining about the poor

Your Comics Curmudgeon has a Classics degree and is completely qualified to discuss thisGood news, liberal-arts majors with Internet connections! Now even though you don’t have a “real job” but are making a livable amount of money by cobbling together three blogging gigs and so don’t have health insurance, starting in 2014 you will be able to (and also required) to stone-cold buy health insurance from whoever you want — even if you have a pre-existing condition (i.e., herpes, we are going to guess that herpes is what you have). But wait, do you only have one blogging job, or maybe no blogging job and you work in a Wal-Mart, or as one of Newt Gingrich’s janitors or something, and so you can’t even afford to buy insurance through the subsidized exchanges and you were kind of counting on the expansion of the Medicaid to cover you? Well, we’ve got good news! Oh, do you live in a state with a Republican governor and/or legislature? Then we mean “bad news.” UPDATED WITH MAYBE SLIGHTLY LESS BAD NEWS?

One of the parts of the law that was not talked about so much by the chattering Internet classes (most of whom are able to more or less afford health insurance, but are often freelancers who are denied it, because of their VD) is that Medicaid would be radically expanded. You probably think of Medicaid as “health insurance for poor people” but in actuality it’s “health insurance for people who are disabled, blind, old, or extremely poor and also have children.” This leads to awesomely depressing stories like this one, where a uninsured lady with cervical cancer considered getting pregnant specifically so she could get on Medicaid and not die.

Medicaid is also a state-federal joint program administered by the states, which now have a lot of leeway about setting the standards for who is eligible and what kind of care they get. Obamacare changes the Medicaid program so that it has to cover literally everybody who is a human and who earns up to 133 percent of the federal poverty level (still pretty low, but higher than the current threshold), in every state; it also mandate a minimum threshold for what diseases and whatnot Medicaid covers (cough Arizona cough). Yay for poors, right?

Well, sorry poors, because that’s the only part that John Roberts didn’t agree with! Medicaid is technically a voluntary program that states don’t have to participate in if they don’t want to — Arizona didn’t implement it until 1982 (seriously, Arizona, WTF). Up until this point, Medicaid has been an all-or-nothing proposition, which means that either you accept the Federal monies and run it the way King Nobama says, or you get nothing and you let all your old/blind/disabled/poor-with-kids people die. And that was supposed to be the way expanded Medicaid works, except now it won’t, because Congress was tricky.

See, even though the program is still called “Medicaid,” it’s essentially an entirely new program, and by forcing all the states to sign up for it, the Feds are essentially “coercing” the states, by giving them money. And the Feds will give them money! 100% of the Medicaid expansion is paid for by the Feds for several years and then 90% thereafter. But it’s the principle of the thing! So whatever states (Arizona) decide that expanding Medicaid (Arizona) is a savage affront (Arizona) to Freedom will just (Arizona) stick with the old system, the one that Congress repealed. This system will apparently still live on in some kind of zombie existence for states that want it (Arizona).

Now, the whole point of expanding Medicaid in the first place was so that people who couldn’t afford even the newly subsidized insurance exchanges could still get the insurance that they were legally mandated to have. So — and sorry so long but here’s the punchline — in Arizona and other Republican-run states that will opt out of expanded Medicaid because it’s the one way they can spit in Obamacare’s eye, poor people won’t be able to get on Medicaid, but they’ll still be required by the 100% Constitutional individual manda-tax to buy health insurance. That they probably can’t afford. Because they’re poor. And now they’re screwed! Sorry poor people! Maybe you can make some extra money by claiming that you won a Bronze Star and Navy Cross when you fought in the Invasion of the Moon? Because that’s totally legal now. [The actual decision, read this and tell us if we're wrong, we're not fucking lawyers or anything]

UPDATE: Slate sez “But ideological zeal may well lead some states to turn it down. In that case, substantially more people than the law’s authors expected might find themselves eligible for either hardship waivers from the mandate or subsidies to buy insurance on exchanges,” so maybe the poors will have other avenues to not get screwed by this! Meanwhile, Bloomberg cannot believe that any state would really turn down that sweet, sweet Federal cash just to make a point. Have you met our states, Bloomberg?

UPDATE 2: Aaaand Nebraska is first up in saying they won’t expand Medicaid! Take a bow, Nebraska!

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About the author

Josh was born and raised in Buffalo, New York, leaving him with a love of chicken wings and a tendency to say “pop”. He taught ancient Greek and Roman history to undergraduates before fleeing from academia in terror; worked for a failed San Francisco dot-com that neglected to supply him with stock options or an Aeron chair; lived in Berlin, where he mostly ate Indian and Ethiopian food; finished in third place on his sole Jeopardy! appearance (the correct answer was “Golda Meir”); and was named 2007 Blogger of the Year by The Week, for obvious reasons. Josh is the creator/editor of COMICS CURMUDGEON (which you should read) and does geeky editing and writing about geeky things such as "the Java programming industry for JavaWorld." He lives in Baltimore with his wife Amber and his cat Hoagie.

View all articles by Josh Fruhlinger

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207 comments

  1. DrunkIrishman

    Ah yes, Wonkette once again has to be the dark cloud over an epic Obama win. Liberals just can't let loose for a day and celebrate, can they? Nope. I'm pretty sure Eeyore voted Nader in 2000.

    1. Billmatic

      Yeah golly i mean we should all just cheer Democrats on like our favorite sports team, to hell with facts n shit.

      1. Nopantsmcgee

        Well, it would be nice to at least get one drink of champagne for the piss begins to flow.

    2. iburl

      Yes, true liberals ignore the plight of the poor and sit back and rest on their laurels when John Roberts decides their already severely watered down ideas can be allowed to exist in an even more watered down form.

      21 million uninsured poor who are now also criminals for not buying into the corrupt private health care insurance schemes, you're welcome.

          1. CZL

            So what's the alternative? Wait until we finally find and elect the Magic Liberal Fairy who waives her magic wand and makes everything perfect the first time, forever? Or would you prefer to elect conservatives and just spend all of your time smugly grousing about how much you hate things while never actually hoping they change, because then you might have to learn how to appreciate victory every now and then?

            I'll keep the slow but inexorable progress we make. We may lurch forward into the future, but this is a good building block. It's a foundation. A foundation that will become like Social Security and Medicare.

          2. DrunkIrishman

            Exactly right. Progress is slow. Was Social Security perfect when it was passed in the 30s? Of course not. Most women & minorities were excluded from unemployment benefits & old age pensions. Yet today, liberals hail it as one of our greatest accomplishments. However, had you all been around back then, you would've been moping about FDR's failures.

            What happened? Over time, Social Security was transformed and updated to include more people. But it was a start and without that start, it wouldn't exist today.

            Policy is rarely ever thrown down in perfect form. It evolves, is defined over the years, and updated to reflect the changes in society. This was true with Social Security, Medicare and will be true with Obamacare.

          3. iburl

            Meanwhile the rest of the industrialized world has universal health care. I guess their fairies are more magical.

          4. DrunkIrishman

            All right, since it's so easy to implement, please head on down to Washington and do so. You talk as if it's just a matter of wiggling your nose – so, go do it. Please. I'll wait and see how far you get.

          5. iburl

            It may not be easy, but ALL of the other countries of the industrialized world accomplished this between 1960 and 1980. Our problem is that our conservatives are Nazis and our Liberals are conservatives.

    3. Diabeetis

      Where exactly was Furhlinger putting most of the blame for this on Obama and the Democrats? If anything, he was pointing out that it was the Supreme Court who gave poor uninsured people the shaft.

    1. Jus_Wonderin

      The decision really has energized me. I might put out an Obama sign. Of course, most of the 'hood will tear it down.

      1. miss_grundy

        Why don't you put up a sign on your front lawn that says: "Fuck you, Republicans, you now have health care coverage and Jesus loves you too." Or, "Fuck, yeah, I'm a Democrat!"

    2. Chet Kincaid

      Yes! Reading, ranting and hauling my ass out to vote every couple years has worn me out! (But seriously, congrats and thanks to those who did make this possible.)

      1. Barb

        Morning Chet! By "exhausting" I was talking about my own personal experience with my mom not having health insurance and how she died like a rat. I am sure many people could explain how exhausting the whole process is and what a struggle it is.

    3. Angry_Marmot

      Once the camel gets its nose into the tent, the rest of the camel follows– or is it the camel toe? I know which one I voted for…

    4. DemmeFatale

      Yay!
      My 25 yr. old daughter is still covered on our health insurance!
      Take that, conserva-turds!
      This time it's personal!
      (I'm sad to say that I have a tea-tard cousin-in-law, who is a fund raiser for Allen West!)

    5. nonbeliever7

      Anyone that's ever accomplished anything substantive (e.g.-raised kids, married a German lady whose dad's name is "Guenther") understands the value of incremental victories on the way to the ultimate goal. Today, most of us are delighted.

    6. Bobbysox22

      It's a "start," all right. What's next? Everybody has to buy a new car (salad-shooter, iphone, etc.) every three years or be fined? This is a big leap forward for state-subsidized capitalism.

      If the mandate is really a "tax," then it ought to go to a government-program, e.g., single payer. But that wouldn't benefit NY Life, Aetna, etc., whose interests must always come first, here in Vespucciland.

  2. ChernobylSoup

    Josh: I want you to perform the nuptials at my next wedding. You know just what to say on happy occasions.

  3. SorosBot

    As a currently poor person, the fact that so many benefits are only available for idiots who don't know how to use a condom really pisses me off.

      1. scvirginia

        You'd better do it soon- looks like those free abortions are not gonna be on offer forever.

    1. OneDollarJuana

      Wait, how can you be poor? You have access to the Internets! Shoot, you probably have a refrigerator.

    2. vodkamuppet

      I just don't like it, dude. Sexy fun pal time SUCKS when I have to bare any responsibity at all. That's why as soon as I start dating a chick, I put D-Con in her food. Can't be too safe.

  4. ChernobylSoup

    Conservative members of the Arkansas Legislature have attempted to delay spending tax payer dollars on the implementation of the President's Affordable Healthcare Act. Based on a cursory reading of the majority opinion, it appears that there is no longer any compulsion upon the state to implement the Federal Act.

    What this means is that the battle has now shifted to the States. We as conservatives, will not support spending tax payer dollars to implement this overly burdensome Act in Arkansas.

    If enough states refuse to implement the exchanges, the scheme will collapse under its own weight. If Republicans take over a majority in the Arkansas Legislature, we commit that we will not subject the residents of Arkansas to this burdensome Act.

    That's (obv) from a Repub state senator. Shorter version: Let's kill some poor kids to prove a point.

    1. anniegetyerfun

      Killing poorz for Liberty and Freedumb is a time-honored tradition in this great nation.

    2. Ducksworthy

      That's what Jeebus said. "Kill the poor." Problem is that compared to the Kochsukers in power in the GOP, we're all poor.

    3. Terry

      Republicans don't consider a person poor unless the person can gaze wistfully at Dustbowl photos and wish they had it so good.

    4. sullivanst

      Repub. state senator is a drooling moron.

      There was never any compulsion to set up an exchange, but there was the provision that wherever states opt out of creating exchanges, the Federal government will step in and create one the state has no control over. In other words, you can have it how you want it, or how we want it, your choice, but you're fucking getting it.

  5. Limeylizzie

    All I know is that I can afford for someone, other than MrLimeylizzie, to look at my vagina.

      1. widestanceromance

        Have you hung your 'Inspect Her Gadget' sign out yet?*

        *I really saw this 'film' advertised on a Seattle marquis many years ago. I did not see the actual film.

          1. widestanceromance

            OMG, did you see it (and do I recall that you are a Seattl-ite/-er)? BTW, 'Hell is other people' is among my favorite quotes ever.

            I read that the heroine's acting was flat, but the supporting actor thickens at the end.

          2. emmelemm

            Ah'm a Seattleite, all right!

            I did not see that particular Lusty Lady marquee, but I had seen many over the years. I applaud their dedication to producing daily new material.

          3. Lionel[redacted]Esq

            The lost of the Lusty Lady was truly a sad day for down town. It used to make my commute worth driving.

        1. Guppy

          Listening them to them speak, I don't think the labor movement is strong in the adult entertainment industry. Mary Carey still claims to be a Republican.

  6. Lascauxcaveman

    Mitt Rmoney is not concerned about the poors; why should I be?

    Actually, I'm very pleased how this whole deal fucks over Mitt Romney. The one really good thing he did as gov of MA has been copy pasted over onto the national scale, and his only realistic chance of winning is to campaign hard against it.

    1. badseeds

      Well, Mitts does have at least one avenue open to him as we head into the fall: screaming "It's a tax! He raised our taxes!! It's the biggest tax increase in our Exceptional Nation's history!!!"

      Over and over again. Good luck with that, Mitts.

    2. SheriffRoscoe

      Exactly what I was thinking. The conventional wisdom seems to be that this court decision will rally conservatives to unify behind Mittens, but haha! He wrote the whole fucking thing first. Sorry Poors, and imma let you finish, but this court made the best decision of all time!

    3. Puffperney

      No problem for Mitt. "Lying for the Lord" is permitted, nay, even required in this instance.

  7. Callyson

    Oh, do you live in a state with a Republican governor and/or legislature? Then we mean “bad news.”

    The civil rights movement of the 10's = uprising of decent people who fall within the borders of a red state.

    What? I can dream, right?

  8. MumbletyRadio

    Thanks for the clarifcation Josh… I think.

    Screw Congress. Your tired and your poor, are not just the impoverished of cash, but the non-profits and houses of worship and food pantries whose facilitators I hear over and over, interviewed on NPR and such, that they are exhausted and their resources depleted from picking up slack where these tight-fisted state gov'ts dropped their poor off. Insert trickle-downhill-joke here, I'm out of jokes.

  9. Chow Yun Flat

    My friend in Arizona (the one who refers to Sheriff Joe as "that cocksucker Arpiao") works two part-time jobs and is without health insurance. She says it is either time to move or time to punch a Republican and get health care in jail. She really wants to punch a Republican, so…

    1. Callyson

      Didn't AZ get rid of the speed cameras on the freeways? Meaning, she can do both, so long as she is all packed up and ready to speed off after bitch slapping some Reeps?

      1. Chow Yun Flat

        Her problem is that she is likes doomed but noble public action like kicking the crap out of a Repub on the statehouse steps (she is one tough momma) and then telling everyone else to do the same while she is getting arrested.

        Lovely woman, smart as hell but a bit unhinged.

        1. tessiee

          "smart as hell but a bit unhinged"

          I suspect that she'd be a regular Prom Queen among the wonketz of the male persuasion.

  10. Boojum

    I actually love this part. It means that people who want to lower their federal taxes will have to vote in not insane legislators. That is, not Republican.

    1. scvirginia

      I'd like to think all the good voters in my state will sit down before November, and ask themselves if voting Republican has been a logical choice for them. Sadly, no, I think they can't wait to vote for anyone with an 'R' after his* name as a protest against that darned Obamacare that will take away their guns and freedum.

      *Most likely his, not her (SC has the only state senate in the country that is all-male).

        1. scvirginia

          She doesn't need to rent 'em, she likes the sleazy bloggerz who are more than willing to wear the Reagan mask during sexytimez.

    2. Naked_Bunny

      Unfortunately, those people will no doubt blame Democrats for their increased tax burden when the Republicans sabotage the healthcare law.

    3. Puffperney

      Unfortunately the "What's the matter with Kansas?" principle applies here.

      I guess you and I can still enjoy a little schadenfreude though!

  11. scvirginia

    Okay, so let's say I'm unemployed (true) & can't afford health insurance (true) & live in a red state (true)… the tax penalty for my not buying health insurance is what? Is it a flat fee that's high enough to be a deterrent? Or is it based on income & therefore likely to be low (or nonexistent) for people who are not earning much?

    1. Woodshedding

      Woot! I too, an unemployed senior scraping by with no income, just realized that. Tax away, suckas. My good fortune is never having bought into the medical lies, so I'm actually healthier than all the peeps who bought/took all the pharmaceuticals and are even less healthy as a result. For example, I was borderline insulin resistant (which means too MUCH insulin in the body), so I changed my diet, problem solved. In the medical system, I'd be giving myself MORE insulin, at great cost, and for the rest of my life. And this is how FUCKING STUPID doctors and the public are, that they can't see a problem with that.

    2. MittBorg

      I haven't looked at the details, but last time I did, the mandate did not provide any penalty for those who could not afford to buy health insurance.

    3. sullivanst

      Anyone for whom their contribution to the cheapest plan in the Exchange is over 8% of household income is exempt from the penalty.

      The amount of the penalty if you are not exempt is at least $95 per year per non-covered person* in 2014, ramping up to at least $695 per year per non-covered person by 2016 and inflation-linked thereafter. If your income is sufficient that 1% (in 2014) of income exceeds the fixed amount, ramping up to 2.5% of income by 2016, you will pay that fraction of income.

      However, if you would've been eligible for Medicaid, you should never pay the penalty (except maybe in 2014 or 2015, depending on exact income level). Your income would've been no more than 133% of Federal Poverty Level, so let's look at what that means in terms of Exchange subsidies. In the Exchange, you'd receive a subsidy of the difference between the second-cheapest silver level plan (plans are bronze, silver or gold) and 2% of your annual income – in other words, you'd have to pay no more than 2% of income to get a decent level of coverage, and that's less than the penalty will be in 2016. What's more, because the subsidy is based on the silver level, there's a good chance that you'd be able to get a bronze-level plan fully covered by the subsidy.

      Now, bronze-level coverage leaves you having to foot quite a lot of the bill if you ever actually use it, probably more than you can afford if your income is low enough you would've qualified for expanded Medicaid if your state wasn't run by jackasses, so it might not be a tremendous value to you, but at least it'll prevent you from being penalized.

      If you're in the window where the subsidy doesn't cover the full cost of bronze care and you can't afford to pay anything in premiums, you'll have to write the Secretary of HHS and beg a hardship exemption. Better hope there's a Democrat in office, or the response will be "you have a refrigerator, don't you?"

        1. sullivanst

          What really gets me is that current Medicaid eligibility rules are impenetrably complicated. If you have kids under 6 then this, if you're blind then that, if you're disabled but still working the other, if you're pregnant something else, if you have kids over 6 a different set of rules again; plus whatever the state you're in chooses to add. The ACA swept a big chunk of that away with the “if your family is under 133% of FPL, you're eligible” rule. Which makes the people whining about implementation costs really irritating – the streamlining of eligibility rules would substantially reduce the administrative burden going forward.SC actually does a vastly better job of explaining their rules than NY does, I looked at the NY rules to try to work out who would be affected by the GOP's (I think ultimately successful) attempt to count 100% of Social Security income instead of 50% when determining Medicaid eligibility, as a “pay-for” for something or other I can't remember exactly what. The “savings” the GOP sought of course actually translated mostly to two things: kicking grannies out of their nursing homes, and preventing the permanently disabled from accessing ongoing care. Anyway, NY didn't have any plain-English materials I could find, and I quickly gave up even trying to make head or tail of the legislation.Under the Exchange's subsidy calculation, the highest contribution anyone who was intended to be covered by the Medicaid expansion would be asked to make for the second least-expensive silver plan would be $16.67 to $24.77 per month. I can almost guarantee the difference between a bronze and a silver level plan will be more than that, the difference between roughly comparable levels of coverage through my large-group employer plan is about $100/mo, so it's very likely that anyone who got screwed out of Medicaid eligibility by having the misfortune to live in a state run by vindictive fuckheads would be able obtain coverage that's fully paid for by the subsidy. The out of pocket expenses would be much higher than Medicaid, but it might be easier to find a Doctor, and at least (A) you'd avoid the penalty, and (B) you'd have access to covered preventative services at no charge. So, still a meaningful improvement over the pre-ACA situation, even if it falls substantially short of what the ACA was intended to achieve.

          1. scvirginia

            I was somewhat surprised to read an article in the Fiscal Times that points out that SC has quietly been restructuring health services in ways that anticipate the ACA: http://bit.ly/MZKxJZ

            Of course, SC was one of the states involved in the late, great Obamacare lawsuit & Nikki Haley apparently took $1million in Stimulus funds to fund her foregone conclusion that exchanges won't work & she currently is rabbiting on about how health care costs are going to soar because soshalizm, but behind the scenes somebody has apparently been making our state pre-compliant with ACA.

            Nikki Haley makes Romney actually look somewhat steadfast- no easy feat!

  12. freakishlywrong

    Then peeps need to be edumacated to 86 their rwbj legislatures and Governors then. (For more than just the Medicaid reason, they're old and mean and need to go).

    1. fuflans

      actually i think he was a bit of a coward. he voted against his own (likely) opinion to ensure that his court wasn't remembered as the 21st dred scott.

      1. Terry

        John Roberts, the Roger B Taney* of the 21st century?

        * Sadly enough, Taney was from the lovely blue State of Maryland, born in Prince Frederick, iirc. There is a middle school in Temple Hills, MD, that used to be named for Taney. A few years back, it was renamed in honor of Thurgood Marshall. A totally appropriate change.

  13. mavenmaven

    In Arkansas almost everyone has a preexisting condition- the result of either meth or incest.

  14. FakaktaSouth

    Barack comes out a swinging with the states' rights in yo face tea-fucks right from the get-go. The man knows how to talk, I will give him that. What a smart man. What a hot ass, reasonable sounding, actual policy discussing, smart smart man. No wonder so many fucking morons I know can't understand a thing he says – even to their own detriment.

    1. Redgyal

      So, stop reading my diary and posting it on here! A smart, compasionate, good-looking man is their worst fear because, well they look bad.

      1. MittBorg

        I'm tellin' ya. All KINDS channeling going on here on the Wonketz. Why, many's the time people just stone-cold post my wittiest comments before I even get a chance to type 'em in.

    2. prommie

      Congenital peons, dumb as they are, can sense their superiors, and they do resent them so.

      In any event, the Mad Tea Partiers who will now commence to cutting of their noses to spite Obama are just committing political suicide. Elections will cure this situation. And as soon as you see a denmocratic majority in the house again, I think we will see a single-payor option, medicare for all.

        1. MittBorg

          Don't disturb his delicate equilibrium. Barely a week ago, he was all but jumping off the ledge. We *need* the guy alive and functioning on our side.

    3. tessiee

      "so many fucking morons I know can't understand a thing he says"

      One of the Former Mr. Tessie's more insightful comments was, "Poor people don't hate rich people; they hate *smart* people".

  15. edgydrifter

    Freedom to die is the most important freedom. Unless you want to die, because that shit's illegal. Allow me to restate: the freedom to endure a protracted and excruciating descent into a hellish condition where you pray for death's sweet release while watching millionaires on TV throw lavish parties at palatial resorts where they bicker over marginal tax rates while sipping Champagne that costs more per bottle than the medicine that would keep you alive is the most important freedom.

  16. bumfug

    Everybody: "Ding dong, the witch is dead!"
    Josh: "Not in Arizona! There's still a witch in Arizona and she wants to kill your dog!"

  17. Lionel[redacted]Esq

    Ah yes, the Republican Party: Better to stomp all over the poor then allow the Democrats to govern. Basically a win/win for them.

  18. Dashboard Buddha

    As hard as this will be for the poors in the short run, I see a positive with this. First, it will highlight in an even clearer light just who the unutterable shitheels are. Second, for those governors who trend towards unutterable shitheel, it will either force them to ignore their teabag base or go full Galt. Neither path will help in their respective re-elections.

    1. MittBorg

      (Hugs proudgrampa) There, there. Don't you listen to the nasty man. Just get out that ice-cream from the freezer, or pour yourself some champagne. This was a HUGE victory for all those people (like me, and more of my friends than I'd care to name) who would otherwise have lost access to healthcare in one swell foop — some 3-30 million of us.

  19. Lionel[redacted]Esq

    Still, while I assume the Court's decision means that Health Care is Constitutional under the Kenyan Constitution, any word on if there will be a challenge under the US Constitution?

    1. MittBorg

      Senator Jim Demented beat you to it. He's already urging states to refuse to implement the ACA on the grounds that HE has deemed it unconstitutional, and fuck the Supreme Court.

  20. Lionel[redacted]Esq

    even if you have a pre-existing condition (i.e., herpes, we are going to guess that herpes is what you have).

    Please, I'm posting here. It is syphilis.

  21. Ducksworthy

    So now Rawmoney gets to run on repealing granma's prescription drug coverage, junior's health insurance and in favor of letting uninsured babies with leukemia die. How's that gonna play do ya think?

    1. Isyaignert

      It's funny as h3ll to listen to Rmoney dissing his OWN insurance mandate plan. WTF goes on in that empty head of his?

      I can't wait for the debates – they'll be most entertaining.

      OBAMA 2012!!!!

    1. MittBorg

      You know (sniff!), that gets me right (pounds chest) HEAH.

      Srsly, though. He fought all his life for this. I'm sorry he died before it became a reality. The Lion of the Senate would have been very happy today.

  22. ChernobylSoup

    Could this become an Equal Protection issue, then? Citizen A lives in a state with a good exchange, buys insurance, doesn't have to pay mandate tax. Citizen B lives in a red state, no exchange, can't afford insurance, gets taxed.

    EDIT: And by "equal protection" I mean I don't really know what I'm talking about but it sounded good.

    1. emmelemm

      Constitutional scholars on the internet!

      But in all seriousness, hopefully there are ways (such as you've noted) to make this work (and stick).

  23. joshleefolsom

    "the emergency room put it in an air cast and sent her on her way. Because she had no insurance, doctors did not operate to fix it." I thought this is supposed to be taken care of by the hospital's property tax exemption for being a charitable institution. THESE PRETZELS ARE MAKING ME THIRSTY!

  24. Baconzgood

    AZ gonna fuck the poorz? AL, AB, AK, NC, SC, GA, FL, pretty much the whole south and south west and upper mid west.

  25. tessiee

    Really, you guys, you know what?
    Even if the court's decision says somewhere in the fine print that I have to get punched in the boob once a day, I'm OK with it; because for freaking ONCE, the Republican assholes don't get to shit all over the rest of us just because they feel like it; for ONCE, they don't get their way.

    I'm sure that tomorrow, or five minutes from now, they'll go back to dismantling what's left of the safety net, overturning what's left of the Constitution, and siphoning what's left of our money to the 1% — but just this once, they didn't get to take a big steaming triple-coiled dump on America, as the bullies in grade school use to say, "Because I FEEL like it!".

    1. ChernobylSoup

      Favorite thing I've seen today was just a headline:

      Opinion: America Can Still Do Big Things

    2. Isyaignert

      "…big steaming triple-coiled dump…." is how I will think of all of those evil Republican fuk heads from this point forward.

      Thanks for that tessiee!! Oh, happy day!!!

  26. anniegetyerfun

    Quit whining, y'all. It's important to recognize how Congress and the far right are going to keep working to dismantle this bill.

  27. barto

    ACA always allowed people who met certain conditions to avoid the tax penalty, after all, even at full implementation some 26 million Merkins will remain without any coverage.

    The rest of us will get to "be stuck with the insurance you have, even if you hate it". It's a beautiful world we live in, makes me want to say…

  28. SayItWithWookies

    Well our wonderful Prez and Congress have two years to fix this before it's implemented and/or refused — and there's some sort of big election thingy coming up later this year. Hmmm — maybe these things go together?

      1. gullywompr

        Yes. Yes I am. The GOP only has a few more years left. Right-wingers, unfortunately, will be around much longer.

  29. Doktor Zoom

    I'm waiting for Idaho politicians to start competing for who can stick it to the Poors the hardest. We are in for some ugliness in the Gem State.

    Oh, OK…. MORE ugliness in the Gem State.

    1. glasspusher

      Not to worry. The rich will always need their servants. If their current servants die off, they can find more.

  30. randcoolcatdaddy

    Well…this is good news for the Great Poors Migration Out of Bat-Shit Crazy States movement of 2012…

  31. Woodshedding

    God, Wonkette, the depressing thing is, you seem to be the ONLY FUCKING PERSON IN THE WORLD WHO HAS A BRAIN. Liberals are coming all over themselves about a bill that seems to be nothing more than a fight between Big Pharma and Big Insurance. I've never seen anything quite as ludicrous. Even Kucinich is out flag-waving this morning.

    Vermont has the right idea; they're pushing toward a single-payer system.

    AND THE BOTTOM LINE, FOLKS, IS THAT MEDICINE/PHARMA AS IT IS TODAY IS THE NUMBER ONE KILLER OF AMERICANS. And you're celebrating that maybe (or maybe not) there's to be greater access to that? If you pay for it, that is, so you'll now be FORCED to pay for it?

    Insane, insane, insane, insane, insane, insane, insane.

    1. swordfis

      Even if Barry were Lincoln and FDR combined, he could never have gotten anything better past these idiots. At least there's some kind of control over the insurance industry now. And if there's a Dem sweep of Congress, it can be improved.

      1. bibliotequetress

        Sadly, better big pharma than no pharma. I lived largely insurance free from age 20 until 33, and had surgery during that time. It was one of the most nerve-wracking experiences of my life. As much as I dislike that any corporations exploit the market of basic necessities for profit– housing, food, medical care, etc– it is better than not even having the necessities at all. Frankly, I can be happy that the manymanymany uninsured adults and barely covered kids in the US will have medical access unavailable to them previously, even if it is through a very screwed up system.

    2. bobbert

      AND THE BOTTOM LINE, FOLKS, IS THAT MEDICINE/PHARMA AS IT IS TODAY IS THE NUMBER ONE KILLER OF AMERICANS.

      I'm sorry, but that's nuts. The number one cause of death for Americans is still cardiovascular disease and stroke, unless I'm mistaken, and number two is lung cancer. "Medicine/pharma" does not cause cvd or lung cancer. Indeed, one of the reasons I'm 64 and still haven't had my first heart attack, despite my fondness for red meat, is atorvastatin.

      Now, if you're suggesting that there is a problem with universal access to MEDICINE/PHARMA, and people grow ill and die because of lack of access, I'd agree with that. But, then I applaud the greater access granted by the ACA, while you appear to think it's a bad (or meh) idea.

      Evidently, one of us is insane.

  32. hatefulevilscum

    Wal*Mart's not really a good example here. I've worked for them for five years come August and I have better health insurance than I have have had in decades. Evil soulless corporation? Well, they alla re but Wal*Mart takes care of me in a way Kroger's and just about everybody else refuses to…

  33. Extemporanus

    But CNN is still wrong about Kennedy moving to Canada, right?

    (Sorry — my uninsured ass just got back from the doctor, and I'm trying to get caught up.)

  34. Goonemeritus

    Now that’s the Wonkette that I count on to know the glass is neither half full nor half empty it’s bone dry and coated with maggots.

  35. Lionel[redacted]Esq

    So, now that we know that alleged Constitutional Scholar Barack Hussein Obama might know something about the US Constitution, does that mean that everyone else who was wrong will now shut up?

    And, if they do, does that mean that FOX News will be in silence for the next few weeks?

  36. Jus_Wonderin

    If the ACA is never overturned is it going to be referred to as Obamacare forevar??????????

    1. Isyaignert

      Dont'cha just luv it? The 'cons called it "Obamacare" as a perjorative and now he'll be remembered fondly for doing what NO OTHER president has been able to do – and under the most fukked-up circumstances with the most sociopathic rat bastard opponents in modern history.

      That is something to celebrate!

      OBAMA 2012

  37. GeneralLerong

    Good ol' Brad DeLong gives us a reason to hope that Scalia is gnashing his teeth and rolling in the shit and crackercrumbs of humiliation because he forgot to edit his statement – it still refers to the Majority as "Dissent."

    No Majority For You

    Even juicier than CNN's Dewey/Truman call, si?

    Heh – that'll teach him to not read shit.

    1. bobbert

      I assume you refer to his statement that he wouldn't bother to read the ACA because it was too goddam long.

  38. BaldarTCrabass

    Well, some might see this as a setback to Republican hopes for November, but they should at least still be able to attack the President over upward-spiralling gas prices.

  39. prommie

    So who is going to be the one to start shouting about a Second Amendment Solution to healthcare tyranny?

  40. glamourdammerung

    I think we should all thank Scalia for being so blatantly partisan that it forced Roberts to do the right thing, if only for appearance's sake.

  41. lowaltflier

    My conservative colleagues here at work are being very quiet. And that makes it all the better.

  42. widestanceromance

    Victories for the poor kill jobs by frightening job creators, those fragile–yet bold–risk-taking heroes of the American story.

    It will be a long time before Amercia sees that kind of legislation passed. Nonetheless, this is a good day for watching pissed-off Rs soil their slacks, which they pretty much do every day before they get out of bed, but wtf.

  43. smitallica

    You all know as well as I do that this decision and this entire case have NOTHING to do with the actual healthcare law. Nothing. This entire judicial review was an attempt to discredit Obama, and SCOTUS upholding it should rightly be viewed as a giant "Fuck you" to all his haters. All this decision proves is that ANOTHER of the right wing's attempts to undo Obama has failed, along with his birth certificate and the BP spill and Fast and Furious and his birth certificate AGAIN and Reverend Wright and Bill Ayers and Saul Whothefuckisthat Alinsky and the gun restrictions he's never even mentioned. End of story.

    1. GeorgiaBurning

      They're not totally undoing Obama, judging by the Yahoo comments he's responsible for every bit of crap since 2001.

  44. BerkeleyBear

    The Medicaid decision is a somewhat nonsensical thumb in the eye. To suddenly decide every pissant incremental change is fine but rolling them all together is unduly coercive is bullshit and reflects a fundamental lack of understanding of how Medicaid has worked for decades – you think Mississippi would do shit for its poor if the Feds didn't force them. It will no doubt lead some stupid state legislatures to spite their nose to cut off their faces.

    However, it should not be a complete stone cold screwing for the poor. The Feds have the ability to implement healthcare exchanges where states don't under ACA as written, and should be able to make sure there's a low cost alternative available for most of the poor people the extension would otherwise cover. Usually it is invasive alternatives like that which, in the end, make the states adopt federal money and administrative oversight because at least then they have some small measure of control.

  45. Guppy

    So red states, being "fiscally responsible," will continue to refuse to take care of their own, and continue to be a net drain on federal coffers as a result.

    Tide goes in, tide goes out…

  46. Antispandex

    I have a completely non-partisan question. If people HAVE to buy something, and an industry knows they have to buy it, won't they just charge more?

    1. bibliotequetress

      When the freemarketeers were bemoaning the threat of a single payer system, they argued that despite, as you smartly point out, having a captive market that they will still need to compete amongst themselves for portions of that market.

      We can expect this to get particularly ugly if(when) one or two insurance companies get bigger and bigger– just as they are now, squeezing out or swallowing up their competition. Then, abosididdly, they will be able to charge whever they want JUST LIKE FUCKING COMCAST DOES sorry, internet overlord, didn't mean to let that slip out.

      edited because i'm having a shit typo week

    2. bobbert

      Medical Loss Ratio (MLR). The insurance companies are (generally) required to maintain an MLR of at least 85%, which means that at least 85% of their premium income must be used as reimbursements to actual health care providers (or they have to return the shortfall to the subscribers).

      Arguably, they could negotiate less favorable rates with providers to increase the reimbursement and hence their 15% rake-off, but at least in such a case the providers would be getting most of the benefit. Also, unless they did it via illegal collusion, an insurer who bucked the trend and kept premiums down could grab market share.

      As always, the tricky bit id preventing (or at least detecting) the illegal collusion.

  47. bibliotequetress

    Serious question: Can I tweet the Ned Stark image w/ credit to Wonkette (or appropriate party, if I'm told what that is) and not violate copyright?
    Love it!

  48. Diabeetis

    I knew that the Supreme Court would strip away any part of the bill that would actually help the poors, but keep the parts that cater to the American booboisie (even though most of them still think it's socialism). Why should anyone be surprised that John Roberts gave his approval?

    It's a sobering antidote to all of the victory dancing going on.

  49. ttommyunger

    First: I am totally gobsmacked by this decision. Second: I am feeling ashamed for the terrible things I've written about John Roberts, could he, in fact, be a thinking feeling human being after all? Third, this is a great PR win for Barry and a good first step for America. Now if we can just start talking about providing Health Care instead of Insurance…..

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