CargoAdmin, Bureaucrats, Moderators (CommentStreams), fileuploaders, Interface administrators, newuser, Push subscription managers, Suppressors, Administrators
14,662
edits
Affordable Care Act: Difference between revisions
m
Text replacement - "fiscal year" to "fiscal year"
m (Text replacement - "Democratic" to "Democratic") |
m (Text replacement - "fiscal year" to "fiscal year") |
||
| (4 intermediate revisions by the same user not shown) | |||
| Line 57: | Line 57: | ||
[[File:View From the Speaker's Office Tonight (4452690853).jpg|thumb|right|[[Jim Clyburn]] and Nancy Pelosi celebrate after the House passes the amended bill on March 21.]] | [[File:View From the Speaker's Office Tonight (4452690853).jpg|thumb|right|[[Jim Clyburn]] and Nancy Pelosi celebrate after the House passes the amended bill on March 21.]] | ||
ACA amended the [[Public Health Service Act of 1944]] and inserted new provisions on affordable care into [[Title 42 of the United States Code]].<ref name="Oberlander2010">{{cite journal |last1=Oberlander |first1=Jonathan |title=Long Time Coming: Why Health Reform Finally Passed |journal=Health Affairs |publisher=Project HOPE |oclc=07760874 |date=June 1, 2010 |volume=29 |issue=6 |pages=1112–1116 |doi=10.1377/hlthaff.2010.0447 |pmid=20530339 |issn=0278-2715|doi-access=free }}</ref><ref name="Blumenthal2015">{{cite journal |last1=Blumenthal |first1=David |last2=Abrams |first2=Melinda |last3=Nuzum |first3=Rachel |title=The Affordable Care Act at 5 Years |journal=New England Journal of Medicine |date=June 18, 2015 |volume=372 |issue=25 |pages=2451–2458 |doi=10.1056/NEJMhpr1503614 |pmid=25946142 |s2cid=28486139 |issn=0028-4793 |doi-access=free }}</ref><ref name="CohenEtAl">{{cite book |last1=Cohen |first1=Alan B. |last2=Colby |first2=David C. |last3=Wailoo |first3=Keith A. |last4=Zelizer |first4=Julian E. |title=Medicare and Medicaid at 50: America's Entitlement Programs in the Age of Affordable Care |date=June 1, 2015 |publisher=Oxford University Press |isbn=978-0-19-023156-9 |url=https://books.google.com/books?id=H9DGBwAAQBAJ}}</ref><ref name="24health">{{cite news |last1=Stolberg |first1=Sheryl Gay |last2=Pear |first2=Robert |title=Obama Signs Health Care Overhaul Bill, With a Flourish |url=https://www.nytimes.com/2010/03/24/health/policy/24health.html |work=The New York Times |issn=0362-4331 |oclc=1645522 |access-date=June 22, 2022 |archive-date=March 25, 2010 |archive-url=https://web.archive.org/web/20100325200505/https://www.nytimes.com/2010/03/24/health/policy/24health.html |page=A19 |date=March 23, 2010}}</ref><ref name="ReutersSCOTUS">{{cite news |last1=Vicini |first1=James |last2=Stempel |first2=Jonathan |author-link3=Joan Biskupic |last3=Biskupic |first3=Joan |title=Top court upholds healthcare law in Obama triumph |url=https://www.reuters.com/article/us-usa-healthcare-court-idUSBRE85R06420120628 |work= | ACA amended the [[Public Health Service Act of 1944]] and inserted new provisions on affordable care into [[Title 42 of the United States Code]].<ref name="Oberlander2010">{{cite journal |last1=Oberlander |first1=Jonathan |title=Long Time Coming: Why Health Reform Finally Passed |journal=Health Affairs |publisher=Project HOPE |oclc=07760874 |date=June 1, 2010 |volume=29 |issue=6 |pages=1112–1116 |doi=10.1377/hlthaff.2010.0447 |pmid=20530339 |issn=0278-2715|doi-access=free }}</ref><ref name="Blumenthal2015">{{cite journal |last1=Blumenthal |first1=David |last2=Abrams |first2=Melinda |last3=Nuzum |first3=Rachel |title=The Affordable Care Act at 5 Years |journal=New England Journal of Medicine |date=June 18, 2015 |volume=372 |issue=25 |pages=2451–2458 |doi=10.1056/NEJMhpr1503614 |pmid=25946142 |s2cid=28486139 |issn=0028-4793 |doi-access=free }}</ref><ref name="CohenEtAl">{{cite book |last1=Cohen |first1=Alan B. |last2=Colby |first2=David C. |last3=Wailoo |first3=Keith A. |last4=Zelizer |first4=Julian E. |title=Medicare and Medicaid at 50: America's Entitlement Programs in the Age of Affordable Care |date=June 1, 2015 |publisher=Oxford University Press |isbn=978-0-19-023156-9 |url=https://books.google.com/books?id=H9DGBwAAQBAJ}}</ref><ref name="24health">{{cite news |last1=Stolberg |first1=Sheryl Gay |last2=Pear |first2=Robert |title=Obama Signs Health Care Overhaul Bill, With a Flourish |url=https://www.nytimes.com/2010/03/24/health/policy/24health.html |work=The New York Times |issn=0362-4331 |oclc=1645522 |access-date=June 22, 2022 |archive-date=March 25, 2010 |archive-url=https://web.archive.org/web/20100325200505/https://www.nytimes.com/2010/03/24/health/policy/24health.html |page=A19 |date=March 23, 2010}}</ref><ref name="ReutersSCOTUS">{{cite news |last1=Vicini |first1=James |last2=Stempel |first2=Jonathan |author-link3=Joan Biskupic |last3=Biskupic |first3=Joan |title=Top court upholds healthcare law in Obama triumph |url=https://www.reuters.com/article/us-usa-healthcare-court-idUSBRE85R06420120628 |work=Reuters |date=June 28, 2017 |access-date=July 1, 2017 |archive-date=March 8, 2021 |archive-url=https://web.archive.org/web/20210308202215/https://www.reuters.com/article/us-usa-healthcare-court-idUSBRE85R06420120628 |url-status=live }}</ref> The individual insurance market was radically overhauled, and many of the law's regulations applied specifically to this market,<ref name="Oberlander2010" /> while the structure of Medicare, Medicaid, and the [[Health insurance in the United States#Employer sponsored|employer market]] were largely retained.<ref name="Blumenthal2015" /> Some regulations applied to the employer market, and the law also made delivery system changes that affected most of the health care system.<ref name="Blumenthal2015" /> | ||
{{Further|Commission on Key National Indicators}} | {{Further|Commission on Key National Indicators}} | ||
| Line 179: | Line 179: | ||
The [[Risk corridor|risk-corridor]] program was a temporary risk management device.<ref>{{citation |url=http://www.rubio.senate.gov/public/_cache/files/1dc92ef8-c340-4cfd-95c0-67369a557f1e/2AA5EF8F125279800BFABC8B8BA37072.05.24.2016-crs-rubio-memo-risk-corridors-1-5-16-1-redacted.pdf |title=Lawsuits to Recover Payments under the Risk Corridors Program of the Affordable Care Act |date=January 5, 2016 |access-date=February 11, 2017 |author=Legislative Attorneys, American Law Division |publisher=[[Congressional Research Service]] |page=6 |archive-date=February 24, 2021 |archive-url=https://web.archive.org/web/20210224021300/https://www.rubio.senate.gov/public/_cache/files/1dc92ef8-c340-4cfd-95c0-67369a557f1e/2AA5EF8F125279800BFABC8B8BA37072.05.24.2016-crs-rubio-memo-risk-corridors-1-5-16-1-redacted.pdf |url-status=live }}</ref>{{rp|1}} It was intended to encourage reluctant insurers into ACA insurance market from 2014 to 2016. For those years the [[Department of Health and Human Services]] (DHHS) would cover some of the losses for insurers whose plans performed worse than they expected. Loss-making insurers would receive payments paid for in part by profit-making insurers.<ref>{{citation |title=Trouble on the Exchanges – Does the United States Owe Billions to Health Insurers? |author=Nicholas Bagley |journal=New England Journal of Medicine |date=November 24, 2016 |doi=10.1056/NEJMp1612486 |pmid=27959725 |volume=375 |issue=21 |pages=2017–2019}}</ref><ref>{{citation |url=https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/faq-risk-corridors-04-11-2014.pdf |date=April 11, 2014 |title=Risk Corridors and Budget Neutrality |publisher=[[Centers for Medicare & Medicaid Services]] (CMS) |location=Washington, DC |access-date=February 11, 2017 |archive-date=March 13, 2021 |archive-url=https://web.archive.org/web/20210313153006/https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/faq-risk-corridors-04-11-2014.pdf |url-status=live }} [[Department of Health and Human Services]]</ref>{{attribution needed |date=July 2017}} Similar risk corridors had been established for the [[Medicare Part D|Medicare prescription drug benefit]].<ref>{{citation |title=Yes, Marco Rubio Led The Effort To End Obamacare's Health |date=December 15, 2015 |url=https://www.forbes.com/sites/theapothecary/2015/12/15/yes-marco-rubio-led-the-effort-to-end-obamacares-health-insurance-slush-fund/?sh=18f0f95b4688 |work=[[Forbes]] |access-date=February 10, 2017}}{{cbignore|bot=medic}}</ref> | The [[Risk corridor|risk-corridor]] program was a temporary risk management device.<ref>{{citation |url=http://www.rubio.senate.gov/public/_cache/files/1dc92ef8-c340-4cfd-95c0-67369a557f1e/2AA5EF8F125279800BFABC8B8BA37072.05.24.2016-crs-rubio-memo-risk-corridors-1-5-16-1-redacted.pdf |title=Lawsuits to Recover Payments under the Risk Corridors Program of the Affordable Care Act |date=January 5, 2016 |access-date=February 11, 2017 |author=Legislative Attorneys, American Law Division |publisher=[[Congressional Research Service]] |page=6 |archive-date=February 24, 2021 |archive-url=https://web.archive.org/web/20210224021300/https://www.rubio.senate.gov/public/_cache/files/1dc92ef8-c340-4cfd-95c0-67369a557f1e/2AA5EF8F125279800BFABC8B8BA37072.05.24.2016-crs-rubio-memo-risk-corridors-1-5-16-1-redacted.pdf |url-status=live }}</ref>{{rp|1}} It was intended to encourage reluctant insurers into ACA insurance market from 2014 to 2016. For those years the [[Department of Health and Human Services]] (DHHS) would cover some of the losses for insurers whose plans performed worse than they expected. Loss-making insurers would receive payments paid for in part by profit-making insurers.<ref>{{citation |title=Trouble on the Exchanges – Does the United States Owe Billions to Health Insurers? |author=Nicholas Bagley |journal=New England Journal of Medicine |date=November 24, 2016 |doi=10.1056/NEJMp1612486 |pmid=27959725 |volume=375 |issue=21 |pages=2017–2019}}</ref><ref>{{citation |url=https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/faq-risk-corridors-04-11-2014.pdf |date=April 11, 2014 |title=Risk Corridors and Budget Neutrality |publisher=[[Centers for Medicare & Medicaid Services]] (CMS) |location=Washington, DC |access-date=February 11, 2017 |archive-date=March 13, 2021 |archive-url=https://web.archive.org/web/20210313153006/https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/faq-risk-corridors-04-11-2014.pdf |url-status=live }} [[Department of Health and Human Services]]</ref>{{attribution needed |date=July 2017}} Similar risk corridors had been established for the [[Medicare Part D|Medicare prescription drug benefit]].<ref>{{citation |title=Yes, Marco Rubio Led The Effort To End Obamacare's Health |date=December 15, 2015 |url=https://www.forbes.com/sites/theapothecary/2015/12/15/yes-marco-rubio-led-the-effort-to-end-obamacares-health-insurance-slush-fund/?sh=18f0f95b4688 |work=[[Forbes]] |access-date=February 10, 2017}}{{cbignore|bot=medic}}</ref> | ||
While many insurers initially offered exchange plans, the program did not pay for itself as planned, losing up to $8.3 billion for 2014 and 2015. Authorization had to be given so DHHS could pay insurers from "general government revenues".{{attribution needed |date=July 2017}} However, the [[Consolidated Appropriations Act, 2014]] (H.R. 3547) stated that no funds "could be used for risk-corridor payments".<ref>{{cite news |issn=0190-8286 |oclc=2269358 |url=https://www.washingtonpost.com/news/fact-checker/wp/2015/12/23/rubios-inaccurate-claim-that-he-inserted-a-provision-restricting-obamacare-bailout-funds/ |title=Rubio's inaccurate claim that he 'inserted' a provision restricting Obamacare 'bailout' funds |newspaper=[[The Washington Post]] |date=December 23, 2015 |first=Glenn |last=Kessler |access-date=July 27, 2017 |archive-date=March 6, 2021 |archive-url=https://web.archive.org/web/20210306054848/https://www.washingtonpost.com/news/fact-checker/wp/2015/12/23/rubios-inaccurate-claim-that-he-inserted-a-provision-restricting-obamacare-bailout-funds/ |url-status=live }}</ref>{{attribution needed |date=July 2017}} leaving the government in a potential breach of contract with insurers who offered qualified health plans.<ref name="latimes_GOP_ACA_corridor">{{cite news |author=Hiltzik, Michael |url=http://www.latimes.com/business/hiltzik/la-fi-hiltzik-risk-corridor-moda-20170210-story.html |title=With billions at stake, a federal judge just nullified the GOP's most cynical attack on Obamacare |work= | While many insurers initially offered exchange plans, the program did not pay for itself as planned, losing up to $8.3 billion for 2014 and 2015. Authorization had to be given so DHHS could pay insurers from "general government revenues".{{attribution needed |date=July 2017}} However, the [[Consolidated Appropriations Act, 2014]] (H.R. 3547) stated that no funds "could be used for risk-corridor payments".<ref>{{cite news |issn=0190-8286 |oclc=2269358 |url=https://www.washingtonpost.com/news/fact-checker/wp/2015/12/23/rubios-inaccurate-claim-that-he-inserted-a-provision-restricting-obamacare-bailout-funds/ |title=Rubio's inaccurate claim that he 'inserted' a provision restricting Obamacare 'bailout' funds |newspaper=[[The Washington Post]] |date=December 23, 2015 |first=Glenn |last=Kessler |access-date=July 27, 2017 |archive-date=March 6, 2021 |archive-url=https://web.archive.org/web/20210306054848/https://www.washingtonpost.com/news/fact-checker/wp/2015/12/23/rubios-inaccurate-claim-that-he-inserted-a-provision-restricting-obamacare-bailout-funds/ |url-status=live }}</ref>{{attribution needed |date=July 2017}} leaving the government in a potential breach of contract with insurers who offered qualified health plans.<ref name="latimes_GOP_ACA_corridor">{{cite news |author=Hiltzik, Michael |url=http://www.latimes.com/business/hiltzik/la-fi-hiltzik-risk-corridor-moda-20170210-story.html |title=With billions at stake, a federal judge just nullified the GOP's most cynical attack on Obamacare |work=Los Angeles Times |date=February 10, 2017 |access-date=February 10, 2017 |archive-date=February 11, 2017 |archive-url=https://web.archive.org/web/20170211224404/http://www.latimes.com/business/hiltzik/la-fi-hiltzik-risk-corridor-moda-20170210-story.html}}</ref> | ||
Several insurers sued the government at the [[United States Court of Federal Claims]] to recover the funds believed owed to them under the Risk Corridors program. While several were summarily closed, in the case of ''[[Moda Health]] v the United States'', Moda Health won a $214-million judgment in February 2017. Federal Claims judge [[Thomas C. Wheeler]] stated, "the Government made a promise in the risk corridors program that it has yet to fulfill. Today, the court directs the Government to fulfill that promise. After all, to say to [Moda], 'The joke is on you. You shouldn't have trusted us,' is hardly worthy of our great government."<ref>{{citation |url=https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2016cv0649-23-0 |title=Moda Health Plan, Inc. v. The United States |publisher=US Courts |date=February 10, 2017 |access-date=February 10, 2017 |pages=40 |archive-date=March 8, 2021 |archive-url=https://web.archive.org/web/20210308105404/https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2016cv0649-23-0 |url-status=live }}</ref> Moda Health's case was appealed by the government to the [[United States Court of Appeals for the Federal Circuit]] along with the appeals of the other insurers; here, the Federal Circuit reversed the Moda Health ruling and ruled across all the cases in favor of the government, that the appropriations riders ceded the government from paying out remain money due to the insurers. The Supreme Court reversed this ruling in the consolidated case, ''[[Maine Community Health Options v. United States]]'', reaffirming as with Judge Wheeler that the government had a responsibility to pay those funds under the ACA and the use of riders to de-obligate its from those payments was illegal.<ref name=":1">{{Cite web |title=Maine Community Health Options v. United States |url=https://www.scotusblog.com/case-files/cases/maine-community-health-options-v-united-states/ |website=SCOTUSblog |access-date=2020-05-02 |archive-date=March 8, 2021 |archive-url=https://web.archive.org/web/20210308145808/https://www.scotusblog.com/case-files/cases/maine-community-health-options-v-united-states/ |url-status=live }}</ref> | Several insurers sued the government at the [[United States Court of Federal Claims]] to recover the funds believed owed to them under the Risk Corridors program. While several were summarily closed, in the case of ''[[Moda Health]] v the United States'', Moda Health won a $214-million judgment in February 2017. Federal Claims judge [[Thomas C. Wheeler]] stated, "the Government made a promise in the risk corridors program that it has yet to fulfill. Today, the court directs the Government to fulfill that promise. After all, to say to [Moda], 'The joke is on you. You shouldn't have trusted us,' is hardly worthy of our great government."<ref>{{citation |url=https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2016cv0649-23-0 |title=Moda Health Plan, Inc. v. The United States |publisher=US Courts |date=February 10, 2017 |access-date=February 10, 2017 |pages=40 |archive-date=March 8, 2021 |archive-url=https://web.archive.org/web/20210308105404/https://ecf.cofc.uscourts.gov/cgi-bin/show_public_doc?2016cv0649-23-0 |url-status=live }}</ref> Moda Health's case was appealed by the government to the [[United States Court of Appeals for the Federal Circuit]] along with the appeals of the other insurers; here, the Federal Circuit reversed the Moda Health ruling and ruled across all the cases in favor of the government, that the appropriations riders ceded the government from paying out remain money due to the insurers. The Supreme Court reversed this ruling in the consolidated case, ''[[Maine Community Health Options v. United States]]'', reaffirming as with Judge Wheeler that the government had a responsibility to pay those funds under the ACA and the use of riders to de-obligate its from those payments was illegal.<ref name=":1">{{Cite web |title=Maine Community Health Options v. United States |url=https://www.scotusblog.com/case-files/cases/maine-community-health-options-v-united-states/ |website=SCOTUSblog |access-date=2020-05-02 |archive-date=March 8, 2021 |archive-url=https://web.archive.org/web/20210308145808/https://www.scotusblog.com/case-files/cases/maine-community-health-options-v-united-states/ |url-status=live }}</ref> | ||
| Line 332: | Line 332: | ||
On December 23, the Senate voted 60–39 to end debate on the bill: a [[Cloture#United States|cloture vote]] to end the [[Filibuster in the United States Senate|filibuster]].<ref>{{cite web |url=https://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00395 |title=Roll Call vote No. 395 – On the Cloture Motion (Motion to Invoke Cloture on H.R. 3590) |publisher=[[United States Senate|U.S. Senate]] |access-date=July 20, 2017 |archive-date=September 3, 2009 |archive-url=https://web.archive.org/web/20090903095012/https://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00395 |url-status=live }}</ref> The bill then passed, also 60–39, on December 24, 2009, with all Democrats and two independents voting for it, and all Republicans against (except [[Jim Bunning]], who did not vote).<ref name="USS RC 2009-396" /> The bill was endorsed by the [[American Medical Association]] and [[AARP]].<ref>[http://www.huffingtonpost.com/2010/03/19/aarp-ama-announce-support_n_506060.html "AARP, AMA Announce Support For Health Care Bill: Largest Doctors And Retiree Groups Backing Legislation"] {{Webarchive|url=https://web.archive.org/web/20160303203029/http://www.huffingtonpost.com/2010/03/19/aarp-ama-announce-support_n_506060.html |date=March 3, 2016 }}. ''The Huffington Post'', March 19, 2010.</ref> | On December 23, the Senate voted 60–39 to end debate on the bill: a [[Cloture#United States|cloture vote]] to end the [[Filibuster in the United States Senate|filibuster]].<ref>{{cite web |url=https://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00395 |title=Roll Call vote No. 395 – On the Cloture Motion (Motion to Invoke Cloture on H.R. 3590) |publisher=[[United States Senate|U.S. Senate]] |access-date=July 20, 2017 |archive-date=September 3, 2009 |archive-url=https://web.archive.org/web/20090903095012/https://www.senate.gov/legislative/LIS/roll_call_lists/roll_call_vote_cfm.cfm?congress=111&session=1&vote=00395 |url-status=live }}</ref> The bill then passed, also 60–39, on December 24, 2009, with all Democrats and two independents voting for it, and all Republicans against (except [[Jim Bunning]], who did not vote).<ref name="USS RC 2009-396" /> The bill was endorsed by the [[American Medical Association]] and [[AARP]].<ref>[http://www.huffingtonpost.com/2010/03/19/aarp-ama-announce-support_n_506060.html "AARP, AMA Announce Support For Health Care Bill: Largest Doctors And Retiree Groups Backing Legislation"] {{Webarchive|url=https://web.archive.org/web/20160303203029/http://www.huffingtonpost.com/2010/03/19/aarp-ama-announce-support_n_506060.html |date=March 3, 2016 }}. ''The Huffington Post'', March 19, 2010.</ref> | ||
On January 19, 2010, [[Massachusetts]] Republican [[Scott Brown (politician)|Scott Brown]] was [[United States Senate special election in Massachusetts, 2010|elected to the Senate in a special election]] to replace the recently deceased [[Ted Kennedy]], having campaigned on giving the Republican minority the 41st vote needed to sustain Republican filibusters.<ref name="reuterstimeline" /><ref>{{cite news |first=J. Scott |last=Applewhite |agency= | On January 19, 2010, [[Massachusetts]] Republican [[Scott Brown (politician)|Scott Brown]] was [[United States Senate special election in Massachusetts, 2010|elected to the Senate in a special election]] to replace the recently deceased [[Ted Kennedy]], having campaigned on giving the Republican minority the 41st vote needed to sustain Republican filibusters.<ref name="reuterstimeline" /><ref>{{cite news |first=J. Scott |last=Applewhite |agency=Associated Press |url=http://www.cleveland.com/nation/index.ssf/2010/01/senator-elect_scott_brown_welc.html |title=Senator-elect Scott Brown welcomed as Republican hero after upset victory in Massachusetts |publisher=McClatchy-Tribune News Service |access-date=April 19, 2012 |archive-date=September 16, 2018 |archive-url=https://web.archive.org/web/20180916052413/https://www.cleveland.com/nation/index.ssf/2010/01/senator-elect_scott_brown_welc.html |url-status=live }}</ref><ref>{{cite press release |url=http://www.votesmart.org/public-statement/477580/scott-brown-responds-to-martha-coakleys-misleading-health-care-distortions |title=Public Statements – Project Vote Smart |publisher=Votesmart.org |date=January 13, 2010 |access-date=April 9, 2012 |archive-date=September 16, 2018 |archive-url=https://web.archive.org/web/20180916052308/https://votesmart.org/public-statement/477580/scott-brown-responds-to-martha-coakleys-misleading-health-care-distortions |url-status=live }}</ref> Additionally, the symbolic importance of losing Kennedy's [[Massachusetts#Politics|traditionally Democratic Massachusetts seat]] made many Congressional Democrats concerned about the political cost of the bill.<ref>{{cite news |first=Nate |last=Silver |url=http://www.fivethirtyeight.com/2010/01/will-base-abandon-hope.html |title=Will the Base Abandon Hope? |work=[[FiveThirtyEight]] |date=January 21, 2010 |access-date=July 28, 2013 |archive-date=September 21, 2013 |archive-url=https://web.archive.org/web/20130921061425/http://www.fivethirtyeight.com/2010/01/will-base-abandon-hope.html |url-status=dead }}</ref><ref name="BillPassageOptions" /> | ||
====House==== | ====House==== | ||
| Line 377: | Line 377: | ||
A 2017 study found that the ACA reduced socioeconomic disparities in health care access.<ref>{{Cite journal |last1=Griffith |first1=Kevin |last2=Evans |first2=Leigh |last3=Bor |first3=Jacob |date=August 1, 2017 |title=The Affordable Care Act Reduced Socioeconomic Disparities In Health Care Access |journal=Health Affairs |volume=36 |issue=8 |pages=1503–1510 |doi=10.1377/hlthaff.2017.0083 |pmid=28747321 |pmc=8087201 |publisher=Project HOPE |oclc=07760874 |issn=0278-2715}}</ref> | A 2017 study found that the ACA reduced socioeconomic disparities in health care access.<ref>{{Cite journal |last1=Griffith |first1=Kevin |last2=Evans |first2=Leigh |last3=Bor |first3=Jacob |date=August 1, 2017 |title=The Affordable Care Act Reduced Socioeconomic Disparities In Health Care Access |journal=Health Affairs |volume=36 |issue=8 |pages=1503–1510 |doi=10.1377/hlthaff.2017.0083 |pmid=28747321 |pmc=8087201 |publisher=Project HOPE |oclc=07760874 |issn=0278-2715}}</ref> | ||
The Affordable Care Act reduced the percent of Americans between 18 and 64 who were uninsured from 22.3 percent in 2010 to 12.4 percent in 2016. About 21 million more people have coverage ten years after the enactment of the ACA.<ref>{{cite news |last1=Slavitt |first1=Andy |title=Affordable Care Act at 10: Amid coronavirus, never more popular, threatened or necessary |url=https://eu.usatoday.com/story/opinion/2020/03/23/obamacare-10th-anniversary-amid-coronavirus-column/2888511001/ |access-date=March 31, 2020 |work= | The Affordable Care Act reduced the percent of Americans between 18 and 64 who were uninsured from 22.3 percent in 2010 to 12.4 percent in 2016. About 21 million more people have coverage ten years after the enactment of the ACA.<ref>{{cite news |last1=Slavitt |first1=Andy |title=Affordable Care Act at 10: Amid coronavirus, never more popular, threatened or necessary |url=https://eu.usatoday.com/story/opinion/2020/03/23/obamacare-10th-anniversary-amid-coronavirus-column/2888511001/ |access-date=March 31, 2020 |work=USA Today|date=March 23, 2020 |archive-url=https://web.archive.org/web/20200331233236/https://www.usatoday.com/story/opinion/2020/03/23/obamacare-10th-anniversary-amid-coronavirus-column/2888511001/ |archive-date=March 31, 2020}}</ref><ref name=NYT20200323GoodnoughAbelsonetAl>{{cite news |author=Goodnough, Abby |author2=Abelson, Reed |author3=Sanger-Katz, Margot |author4=Kliff, Sarah |title=Obamacare Turns 10. Here's a Look at What Works and Doesn't. |url=https://www.nytimes.com/2020/03/23/health/obamacare-aca-coverage-cost-history.html |access-date=March 31, 2020 |date=March 23, 2020 |archive-url=https://web.archive.org/web/20200330105840/https://www.nytimes.com/2020/03/23/health/obamacare-aca-coverage-cost-history.html |archive-date=March 30, 2020 |issn=0362-4331 |oclc=1645522 |newspaper=The New York Times}}</ref> Ten years after its enactment studies showed that the ACA also had a positive effect on health and caused a reduction in mortality.<ref name=NYT20200323GoodnoughAbelsonetAl /> | ||
===Taxes=== | ===Taxes=== | ||
[[File:Excise taxes.jpg|thumb|right|upright=1.35|Excise taxes percentage 2015]] | [[File:Excise taxes.jpg|thumb|right|upright=1.35|Excise taxes percentage 2015]] | ||
[[Excise tax in the United States|Excise taxes]] from the Affordable Care Act raised $16.3 billion in | [[Excise tax in the United States|Excise taxes]] from the Affordable Care Act raised $16.3 billion in fiscal year 2015. $11.3 billion came from an excise tax placed directly on health insurers based on their market share. Annual excise taxes totaling $3 billion were levied on importers and manufacturers of prescription drugs. | ||
The [[Individual mandate]] tax was $695 per individual or $2,085 per family at a minimum, reaching as high as 2.5% of household income (whichever was higher). The tax was set to $0 beginning in 2019.<ref>{{Cite web |url=https://www.fool.com/taxes/2018/01/07/what-the-individual-mandate-repeal-means-for-the-a.aspx |title=What the Individual Mandate Repeal Means for the Average American - |last=Caplinger |first=Dan |date=January 7, 2018 |website=The Motley Fool |access-date=July 20, 2018 |archive-date=March 8, 2021 |archive-url=https://web.archive.org/web/20210308005204/https://www.fool.com/taxes/2018/01/07/what-the-individual-mandate-repeal-means-for-the-a.aspx |url-status=live }}</ref> | The [[Individual mandate]] tax was $695 per individual or $2,085 per family at a minimum, reaching as high as 2.5% of household income (whichever was higher). The tax was set to $0 beginning in 2019.<ref>{{Cite web |url=https://www.fool.com/taxes/2018/01/07/what-the-individual-mandate-repeal-means-for-the-a.aspx |title=What the Individual Mandate Repeal Means for the Average American - |last=Caplinger |first=Dan |date=January 7, 2018 |website=The Motley Fool |access-date=July 20, 2018 |archive-date=March 8, 2021 |archive-url=https://web.archive.org/web/20210308005204/https://www.fool.com/taxes/2018/01/07/what-the-individual-mandate-repeal-means-for-the-a.aspx |url-status=live }}</ref> | ||
| Line 832: | Line 832: | ||
===Hospitals=== | ===Hospitals=== | ||
From the start of 2010 to November 2014, 43 hospitals in [[Rural area#United States|rural areas]] closed. Critics claimed the new law had caused these closures. Many rural hospitals were built using funds from the 1946 [[Hill–Burton Act]]. Some of these hospitals reopened as other medical facilities, but only a small number operated [[Emergency department|emergency rooms]] (ER) or [[urgent care]] centers.<ref>{{cite news |last1=O'Donnell |first1=Jayne |last2=Ungar |first2=Laura |last3=Hoyer |first3=Meghan |date=November 12, 2014 |title=Rural hospitals in critical condition |url=https://www.usatoday.com/longform/news/nation/2014/11/12/rural-hospital-closings-federal-reimbursement-medicaid-aca/18532471/ |newspaper= | From the start of 2010 to November 2014, 43 hospitals in [[Rural area#United States|rural areas]] closed. Critics claimed the new law had caused these closures. Many rural hospitals were built using funds from the 1946 [[Hill–Burton Act]]. Some of these hospitals reopened as other medical facilities, but only a small number operated [[Emergency department|emergency rooms]] (ER) or [[urgent care]] centers.<ref>{{cite news |last1=O'Donnell |first1=Jayne |last2=Ungar |first2=Laura |last3=Hoyer |first3=Meghan |date=November 12, 2014 |title=Rural hospitals in critical condition |url=https://www.usatoday.com/longform/news/nation/2014/11/12/rural-hospital-closings-federal-reimbursement-medicaid-aca/18532471/ |newspaper=USA Today |access-date=January 28, 2015 |archive-date=September 16, 2015 |archive-url=https://web.archive.org/web/20150916011235/http://www.usatoday.com/longform/news/nation/2014/11/12/rural-hospital-closings-federal-reimbursement-medicaid-aca/18532471/ |url-status=live }}<br />{{cite news |last=Hamada |first=Omar L. |date=November 18, 2014 |title=Obamacare has detrimental effect on rural hospitals |url=http://www.tennessean.com/story/opinion/contributors/2014/11/19/obamacare-detrimental-effect-rural-hospitals/19087985/ |newspaper=The Tennessean |access-date=January 28, 2015 |archive-date=July 1, 2024 |archive-url=https://web.archive.org/web/20240701042654/https://www.tennessean.com/story/opinion/contributors/2014/11/19/obamacare-detrimental-effect-rural-hospitals/19087985/ |url-status=live }}</ref> | ||
Between January 2010 and 2015, a quarter of ER doctors said they had seen a major surge in patients, while nearly half had seen a smaller increase. Seven in ten ER doctors claimed they lacked the resources to deal with large increases in the number of patients. The biggest factor in the increased number of ER patients was insufficient primary care providers to handle the larger number of insured.<ref>{{cite news |url=http://www.washingtontimes.com/news/2015/may/4/er-visits-under-obamacare-doctors-say/#ixzz3ZH4xpm5H |title=ER visits up under Obamacare despite promises, doctors' poll finds |first=Tom Jr. |last=Howell |work=The Washington Times |date=May 4, 2015 |access-date=May 6, 2015 |archive-date=March 3, 2021 |archive-url=https://web.archive.org/web/20210303221345/https://www.washingtontimes.com/news/2015/may/4/er-visits-under-obamacare-doctors-say/#ixzz3ZH4xpm5H |url-status=live }}</ref> Michael Lee Jr. and [[Michael Monuteaux|Michael C. Monuteaux]] at Boston Children's Hospital analyzed national emergency department visits among children aged 0 to 17 from 2009 to 2016 using the American Community Survey (ACS) and Nationwide Emergency Department Sample (NEDS). They found no immediate change in pediatric emergency department visit rates the year after the ACA took full effect in 2014, but the rate of change from 2014 to 2016 was significantly higher than previous rate trends, almost 10%.<ref>{{cite journal |last1=Lee |first1=Michael |last2=Monuteaux |first2=Michael C. |title=Trends in pediatric emergency department use after the Affordable Care Act |journal=Pediatrics |date=2019 |volume=143 |issue=6 |doi=10.1542/peds.2018-3542 |pmid=31118219 |publisher=American Academy of Pediatrics |location=Itasca, IL |s2cid=162182158 |issn=1098-4275 |quote=ED visit rates increased by 1.1% per year pre-2014 and 9.8% from 2014 to 2016 (incidence rate ratio 1.09, 95% confidence interval 1.03-1.15, P = .005)|doi-access=free }}</ref> | Between January 2010 and 2015, a quarter of ER doctors said they had seen a major surge in patients, while nearly half had seen a smaller increase. Seven in ten ER doctors claimed they lacked the resources to deal with large increases in the number of patients. The biggest factor in the increased number of ER patients was insufficient primary care providers to handle the larger number of insured.<ref>{{cite news |url=http://www.washingtontimes.com/news/2015/may/4/er-visits-under-obamacare-doctors-say/#ixzz3ZH4xpm5H |title=ER visits up under Obamacare despite promises, doctors' poll finds |first=Tom Jr. |last=Howell |work=The Washington Times |date=May 4, 2015 |access-date=May 6, 2015 |archive-date=March 3, 2021 |archive-url=https://web.archive.org/web/20210303221345/https://www.washingtontimes.com/news/2015/may/4/er-visits-under-obamacare-doctors-say/#ixzz3ZH4xpm5H |url-status=live }}</ref> Michael Lee Jr. and [[Michael Monuteaux|Michael C. Monuteaux]] at Boston Children's Hospital analyzed national emergency department visits among children aged 0 to 17 from 2009 to 2016 using the American Community Survey (ACS) and Nationwide Emergency Department Sample (NEDS). They found no immediate change in pediatric emergency department visit rates the year after the ACA took full effect in 2014, but the rate of change from 2014 to 2016 was significantly higher than previous rate trends, almost 10%.<ref>{{cite journal |last1=Lee |first1=Michael |last2=Monuteaux |first2=Michael C. |title=Trends in pediatric emergency department use after the Affordable Care Act |journal=Pediatrics |date=2019 |volume=143 |issue=6 |doi=10.1542/peds.2018-3542 |pmid=31118219 |publisher=American Academy of Pediatrics |location=Itasca, IL |s2cid=162182158 |issn=1098-4275 |quote=ED visit rates increased by 1.1% per year pre-2014 and 9.8% from 2014 to 2016 (incidence rate ratio 1.09, 95% confidence interval 1.03-1.15, P = .005)|doi-access=free }}</ref> | ||
| Line 867: | Line 867: | ||
In February 2014, American [[Pulitzer Prize]]-winning syndicated columnist, political commentator and physician [[Charles Krauthammer]] described the buyer's remorse Americans are having over the ACA, saying it is having a "wide, broad effect". Because so many people are being negatively impacted by the law, he said, "the bleeding is happening among Independents and also among Democrats".<ref>{{cite news |url=http://www.foxnews.com/on-air/on-the-record/2014/02/28/krauthammer-buyers-remorse-obama-comes-obamacare-having-wide-broad-effect-bleeding-happen |title=Krauthammer: Buyer's remorse on Obama comes from ObamaCare having 'this wide, broad effect ... the bleeding is happening among Independents and Democrats' |publisher=[[Fox News]] |date=February 27, 2014}}</ref> --> | In February 2014, American [[Pulitzer Prize]]-winning syndicated columnist, political commentator and physician [[Charles Krauthammer]] described the buyer's remorse Americans are having over the ACA, saying it is having a "wide, broad effect". Because so many people are being negatively impacted by the law, he said, "the bleeding is happening among Independents and also among Democrats".<ref>{{cite news |url=http://www.foxnews.com/on-air/on-the-record/2014/02/28/krauthammer-buyers-remorse-obama-comes-obamacare-having-wide-broad-effect-bleeding-happen |title=Krauthammer: Buyer's remorse on Obama comes from ObamaCare having 'this wide, broad effect ... the bleeding is happening among Independents and Democrats' |publisher=[[Fox News]] |date=February 27, 2014}}</ref> --> | ||
As of October 2013, approximately 40% were in favor while 51% were against.<ref>{{cite web |url=http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html#polls |title=Obama and Democrats' Health Care Plan |website=RealClearPolitics |date=October 13, 2013 |access-date=March 26, 2014 |archive-date=March 16, 2021 |archive-url=https://web.archive.org/web/20210316053944/http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html#polls |url-status=live }}</ref><ref>{{cite news |last=Swanson |first=Emily |date=July 30, 2009 |url=http://www.huffingtonpost.com/2009/07/30/healthplan_n_725503.html |title=Health Care Plan: Favor/Oppose |work=Pollster.com |access-date=July 14, 2011 |archive-date=October 1, 2018 |archive-url=https://web.archive.org/web/20181001170205/http://www.huffingtonpost.com/2009/07/30/healthplan_n_725503.html |url-status=live }}</ref> About 29% of [[Non-Hispanic whites|whites]] approved of the law, compared with 61% of [[Hispanic and Latino Americans|Hispanics]] and 91% of [[African American]]s.<ref>{{cite web |url=http://www.people-press.org/files/legacy-pdf/9-16-13%20Health%20Care%20Release.pdf |title=As Health Care Law Proceeds, Opposition and Uncertainty Persist |date=September 16, 2013 |publisher=Pew Research Center |access-date=December 18, 2013 |archive-date=April 24, 2018 |archive-url=https://web.archive.org/web/20180424151816/http://www.people-press.org/files/legacy-pdf/9-16-13%20Health%20Care%20Release.pdf |url-status=live }}</ref> A solid majority of seniors opposed the idea and a solid majority of those under forty were in favor.<ref>{{cite news |url=https://www.usatoday.com/news/washington/2010-03-23-health-poll-favorable_N.htm |title=Poll: Health care plan gains favor |last=Page |first=Susan |date=March 24, 2010 |work= | As of October 2013, approximately 40% were in favor while 51% were against.<ref>{{cite web |url=http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html#polls |title=Obama and Democrats' Health Care Plan |website=RealClearPolitics |date=October 13, 2013 |access-date=March 26, 2014 |archive-date=March 16, 2021 |archive-url=https://web.archive.org/web/20210316053944/http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html#polls |url-status=live }}</ref><ref>{{cite news |last=Swanson |first=Emily |date=July 30, 2009 |url=http://www.huffingtonpost.com/2009/07/30/healthplan_n_725503.html |title=Health Care Plan: Favor/Oppose |work=Pollster.com |access-date=July 14, 2011 |archive-date=October 1, 2018 |archive-url=https://web.archive.org/web/20181001170205/http://www.huffingtonpost.com/2009/07/30/healthplan_n_725503.html |url-status=live }}</ref> About 29% of [[Non-Hispanic whites|whites]] approved of the law, compared with 61% of [[Hispanic and Latino Americans|Hispanics]] and 91% of [[African American]]s.<ref>{{cite web |url=http://www.people-press.org/files/legacy-pdf/9-16-13%20Health%20Care%20Release.pdf |title=As Health Care Law Proceeds, Opposition and Uncertainty Persist |date=September 16, 2013 |publisher=Pew Research Center |access-date=December 18, 2013 |archive-date=April 24, 2018 |archive-url=https://web.archive.org/web/20180424151816/http://www.people-press.org/files/legacy-pdf/9-16-13%20Health%20Care%20Release.pdf |url-status=live }}</ref> A solid majority of seniors opposed the idea and a solid majority of those under forty were in favor.<ref>{{cite news |url=https://www.usatoday.com/news/washington/2010-03-23-health-poll-favorable_N.htm |title=Poll: Health care plan gains favor |last=Page |first=Susan |date=March 24, 2010 |work=USA Today |access-date=March 24, 2010 |archive-date=June 20, 2012 |archive-url=https://web.archive.org/web/20120620184320/http://www.usatoday.com/news/washington/2010-03-23-health-poll-favorable_N.htm |url-status=live }}</ref> | ||
A 2014 poll reported that 26% of Americans support ACA.<ref>{{cite news |url=http://bigstory.ap.org/article/poll-obama-health-law-fails-gain-support |title=AP-GfK Poll: Obama's health care fails to gain support |date=March 28, 2014 |access-date=March 30, 2014 |publisher= | A 2014 poll reported that 26% of Americans support ACA.<ref>{{cite news |url=http://bigstory.ap.org/article/poll-obama-health-law-fails-gain-support |title=AP-GfK Poll: Obama's health care fails to gain support |date=March 28, 2014 |access-date=March 30, 2014 |publisher=Associated Press |archive-date=April 1, 2014 |archive-url=https://web.archive.org/web/20140401024529/http://bigstory.ap.org/article/poll-obama-health-law-fails-gain-support |url-status=dead}}</ref> A later 2014 poll reported that 48.9% of respondents had an unfavorable view of ACA versus 38.3% who had a favorable view (of more than 5,500 individuals).<ref>{{cite web |url=https://www.rand.org/health/projects/health-reform-opinion.html |title=RAND Health Reform Opinion Study |date=May 1, 2014 |publisher=RAND Health |access-date=May 10, 2014 |archive-date=November 29, 2018 |archive-url=https://web.archive.org/web/20181129194516/https://www.rand.org/health/projects/health-reform-opinion.html |url-status=live }}</ref> Another held that 8% of respondents agreed the Affordable Care Act "is working well the way it is".<ref>{{cite web |archive-url=https://web.archive.org/web/20140503034720/https://online.wsj.com/news/articles/SB10001424052702303678404579533362696579096 |archive-date=May 3, 2014 |url=https://online.wsj.com/news/articles/SB10001424052702303678404579533362696579096 |title=The ObamaCare 8% |newspaper=The Wall Street Journal |publisher=News Corp |oclc=781541372 |issn= 1042-9840 |date=April 30, 2014 |access-date=May 1, 2014}}</ref> In late 2014, a [[Rasmussen Reports|Rasmussen]] poll reported Repeal: 30%, Leave as is: 13%, Improve: 52%.<ref>[[Alan Colmes]], "[http://www.alan.com/2014/12/01/poll-voters-no-longer-want-to-repeal-obamacare/ Poll: Voters No Longer Want To Repeal Obamacare] {{Webarchive |url=https://web.archive.org/web/20171023012206/http://www.alan.com/2014/12/01/poll-voters-no-longer-want-to-repeal-obamacare/ |date=October 23, 2017 }}", ''Liberaland'', December 1, 2014.</ref> | ||
In 2015, a poll reported that 47% of Americans approved the health care law. This was the first time a major poll indicated that more respondents approved than disapproved.<ref>{{cite web |url=http://www.cbsnews.com/news/poll-obamacare-and-the-supreme-court/ |title=Poll: Obamacare and the Supreme Court |work=[[CBS News]] |date=June 22, 2015 |access-date=June 23, 2015 |archive-date=December 1, 2020 |archive-url=https://web.archive.org/web/20201201040030/https://www.cbsnews.com/news/poll-obamacare-and-the-supreme-court/ |url-status=live }}</ref> A December 2016 poll reported that: a) 30% wanted to expand what the law does; b) 26% wanted to repeal the entire law; c) 19% wanted to move forward with implementing the law as it is; and d) 17% wanted to scale back what the law does, with the remainder undecided.<ref>{{cite web |url=http://kff.org/health-reform/press-release/after-the-election-the-public-remains-sharply-divided-on-future-of-the-affordable-care-act/ |title=After the Election, the Public Remains Sharply Divided on Future of the Affordable Care Act |publisher=[[Kaiser Family Foundation]] |date=December 3, 2016 |access-date=December 3, 2016 |archive-date=February 25, 2021 |archive-url=https://web.archive.org/web/20210225032025/https://www.kff.org/health-reform/press-release/after-the-election-the-public-remains-sharply-divided-on-future-of-the-affordable-care-act/ |url-status=live }}</ref> | In 2015, a poll reported that 47% of Americans approved the health care law. This was the first time a major poll indicated that more respondents approved than disapproved.<ref>{{cite web |url=http://www.cbsnews.com/news/poll-obamacare-and-the-supreme-court/ |title=Poll: Obamacare and the Supreme Court |work=[[CBS News]] |date=June 22, 2015 |access-date=June 23, 2015 |archive-date=December 1, 2020 |archive-url=https://web.archive.org/web/20201201040030/https://www.cbsnews.com/news/poll-obamacare-and-the-supreme-court/ |url-status=live }}</ref> A December 2016 poll reported that: a) 30% wanted to expand what the law does; b) 26% wanted to repeal the entire law; c) 19% wanted to move forward with implementing the law as it is; and d) 17% wanted to scale back what the law does, with the remainder undecided.<ref>{{cite web |url=http://kff.org/health-reform/press-release/after-the-election-the-public-remains-sharply-divided-on-future-of-the-affordable-care-act/ |title=After the Election, the Public Remains Sharply Divided on Future of the Affordable Care Act |publisher=[[Kaiser Family Foundation]] |date=December 3, 2016 |access-date=December 3, 2016 |archive-date=February 25, 2021 |archive-url=https://web.archive.org/web/20210225032025/https://www.kff.org/health-reform/press-release/after-the-election-the-public-remains-sharply-divided-on-future-of-the-affordable-care-act/ |url-status=live }}</ref> | ||
| Line 900: | Line 900: | ||
One was that under the law, seniors could be denied care due to their age<ref>{{cite web |url=http://snopes.com/politics/medical/over75.asp |title=Seniors Beware |website=Snopes |date=August 23, 2012 |access-date=July 17, 2013 |archive-date=July 1, 2024 |archive-url=https://web.archive.org/web/20240701043153/https://www.snopes.com/fact-check/seniors-beware/ |url-status=live }}</ref> and the other that the government would advise seniors to end their lives instead of receiving care. The ostensible basis of these claims was the provision for an [[Independent Payment Advisory Board]] (IPAB).<ref name="salon08132013" /> IPAB was given the authority to recommend cost-saving changes to Medicare by facilitating the adoption of cost-effective treatments and cost-recovering measures when statutory expenditure levels were exceeded within any given three-year period. In fact, the Board was prohibited from recommending changes that would reduce payments before 2020, and was prohibited from recommending changes in premiums, benefits, eligibility and taxes, or other changes that would result in rationing.<ref>{{cite web |first1=Jack |last1=Ebeler |first2=Tricia |last2=Neuman |first3=Juliette |last3=Cubanski |title=The Independent Payment Advisory Board: A New Approach to Controlling Medicare Spending |url=http://kff.org/health-reform/issue-brief/the-independent-payment-advisory-board-a-new/ |publisher=[[Kaiser Family Foundation]] |date=April 13, 2011 |page=3 |access-date=November 27, 2013 |archive-date=March 1, 2021 |archive-url=https://web.archive.org/web/20210301060545/https://www.kff.org/health-reform/issue-brief/the-independent-payment-advisory-board-a-new/ |url-status=live }}</ref><ref>{{cite news |first=Jonathan |last=Cohn |url=https://newrepublic.com/blog/jonathan-cohn/87102/ipab-medicare-commission-repeal-ryan-schwartz |title=Here We Go Again, With the Death Panels |magazine=[[The New Republic]] |date=April 20, 2011 |access-date=March 10, 2017 |archive-date=September 22, 2015 |archive-url=https://web.archive.org/web/20150922221033/http://www.newrepublic.com/blog/jonathan-cohn/87102/ipab-medicare-commission-repeal-ryan-schwartz |url-status=live }}</ref> | One was that under the law, seniors could be denied care due to their age<ref>{{cite web |url=http://snopes.com/politics/medical/over75.asp |title=Seniors Beware |website=Snopes |date=August 23, 2012 |access-date=July 17, 2013 |archive-date=July 1, 2024 |archive-url=https://web.archive.org/web/20240701043153/https://www.snopes.com/fact-check/seniors-beware/ |url-status=live }}</ref> and the other that the government would advise seniors to end their lives instead of receiving care. The ostensible basis of these claims was the provision for an [[Independent Payment Advisory Board]] (IPAB).<ref name="salon08132013" /> IPAB was given the authority to recommend cost-saving changes to Medicare by facilitating the adoption of cost-effective treatments and cost-recovering measures when statutory expenditure levels were exceeded within any given three-year period. In fact, the Board was prohibited from recommending changes that would reduce payments before 2020, and was prohibited from recommending changes in premiums, benefits, eligibility and taxes, or other changes that would result in rationing.<ref>{{cite web |first1=Jack |last1=Ebeler |first2=Tricia |last2=Neuman |first3=Juliette |last3=Cubanski |title=The Independent Payment Advisory Board: A New Approach to Controlling Medicare Spending |url=http://kff.org/health-reform/issue-brief/the-independent-payment-advisory-board-a-new/ |publisher=[[Kaiser Family Foundation]] |date=April 13, 2011 |page=3 |access-date=November 27, 2013 |archive-date=March 1, 2021 |archive-url=https://web.archive.org/web/20210301060545/https://www.kff.org/health-reform/issue-brief/the-independent-payment-advisory-board-a-new/ |url-status=live }}</ref><ref>{{cite news |first=Jonathan |last=Cohn |url=https://newrepublic.com/blog/jonathan-cohn/87102/ipab-medicare-commission-repeal-ryan-schwartz |title=Here We Go Again, With the Death Panels |magazine=[[The New Republic]] |date=April 20, 2011 |access-date=March 10, 2017 |archive-date=September 22, 2015 |archive-url=https://web.archive.org/web/20150922221033/http://www.newrepublic.com/blog/jonathan-cohn/87102/ipab-medicare-commission-repeal-ryan-schwartz |url-status=live }}</ref> | ||
The other related issue concerned [[Advance health care directive|advance-care planning]] consultation: [[HR 3200#Reimbursement for counseling about living wills|a section of the House reform proposal]] would have reimbursed physicians for providing patient-requested consultations for Medicare recipients on end-of-life health planning (which is covered by many private plans), enabling patients to specify, on request, the kind of care they wished to receive.<ref>{{cite news |first=Jonathan |last=Cohn |url=https://newrepublic.com/blog/the-treatment/mandatory-death-counseling-exposed |title=Mandatory Death Counseling – exposed! |magazine=[[The New Republic]] |date=August 13, 2009 |access-date=March 10, 2017 |archive-date=September 21, 2015 |archive-url=https://web.archive.org/web/20150921235058/http://www.newrepublic.com/blog/the-treatment/mandatory-death-counseling-exposed |url-status=live }}</ref> The provision was not included in ACA.<ref>{{cite news |title=Senate committee scraps healthcare provision that gave rise to 'death panel' claims; Though the claims are widely discredited, the Senate Finance Committee is withdrawing from its bill the inclusion of advance-care planning consultations, calling them too confusing |first1=Christi |last1=Parsons |first2=Andrew |last2=Zajac |newspaper= | The other related issue concerned [[Advance health care directive|advance-care planning]] consultation: [[HR 3200#Reimbursement for counseling about living wills|a section of the House reform proposal]] would have reimbursed physicians for providing patient-requested consultations for Medicare recipients on end-of-life health planning (which is covered by many private plans), enabling patients to specify, on request, the kind of care they wished to receive.<ref>{{cite news |first=Jonathan |last=Cohn |url=https://newrepublic.com/blog/the-treatment/mandatory-death-counseling-exposed |title=Mandatory Death Counseling – exposed! |magazine=[[The New Republic]] |date=August 13, 2009 |access-date=March 10, 2017 |archive-date=September 21, 2015 |archive-url=https://web.archive.org/web/20150921235058/http://www.newrepublic.com/blog/the-treatment/mandatory-death-counseling-exposed |url-status=live }}</ref> The provision was not included in ACA.<ref>{{cite news |title=Senate committee scraps healthcare provision that gave rise to 'death panel' claims; Though the claims are widely discredited, the Senate Finance Committee is withdrawing from its bill the inclusion of advance-care planning consultations, calling them too confusing |first1=Christi |last1=Parsons |first2=Andrew |last2=Zajac |newspaper=Los Angeles Times |date=August 14, 2009 |url=https://www.latimes.com/archives/la-xpm-2009-aug-14-na-health-end-of-life14-story.html |access-date=July 20, 2013 |archive-date=November 26, 2010 |archive-url=https://web.archive.org/web/20101126193741/http://articles.latimes.com/2009/aug/14/nation/na-health-end-of-life14 |url-status=live }}</ref> | ||
In 2010, the [[Pew Research Center]] reported that 85% of Americans were familiar with the claim, and 30% believed it was true, backed by three contemporaneous polls.<ref>{{Cite journal |first=Brendan |last=Nyhan |title=Why the "Death Panel" Myth Wouldn't Die: Misinformation in the Health Care Reform Debate |journal=The Forum |volume=8 |issue=1 |year=2010 |doi=10.2202/1540-8884.1354 |url=http://www.dartmouth.edu/~nyhan/health-care-misinformation.pdf |citeseerx=10.1.1.692.9614 |s2cid=144075499 |access-date=July 1, 2013 |archive-date=June 4, 2019 |archive-url=https://web.archive.org/web/20190604135225/http://www.dartmouth.edu/~nyhan/health-care-misinformation.pdf |url-status=dead }}</ref> The allegation was named [[PolitiFact]]'s 2009 "Lie of the Year",<ref name="Not so" /><ref>{{Cite news |title=PolitiFact's Lie of the Year: 'Death panels' |publisher=[[PolitiFact]] |date=December 19, 2009 |url=http://politifact.com/truth-o-meter/article/2009/dec/18/politifact-lie-year-death-panels |first=Angie |last=Drobnic Holan |access-date=November 19, 2010 |archive-date=January 13, 2020 |archive-url=https://web.archive.org/web/20200113082025/https://www.politifact.com/truth-o-meter/article/2009/dec/18/politifact-lie-year-death-panels/ |url-status=live }}</ref> one of [[FactCheck.org]]'s "whoppers"<ref>{{Cite news |title=False Euthanasia Claims |first1=Jess |last1=Henig |first2=Lori |last2=Robertson |publisher=[[FactCheck.org]] |date=July 29, 2010 |url=http://www.factcheck.org/2009/07/false-euthanasia-claims |access-date=July 20, 2013 |archive-date=February 24, 2021 |archive-url=https://web.archive.org/web/20210224220630/https://www.factcheck.org/2009/07/false-euthanasia-claims/ |url-status=live }}</ref><ref>{{cite web |title=Whoppers of 2009—We review the choicest falsehoods from a year that kept us busy |date=December 24, 2009 |author=Robertson, Lori |url=http://www.factcheck.org/2009/12/whoppers-of-2009 |publisher=[[FactCheck.org]] |access-date=April 28, 2011 |archive-date=March 10, 2021 |archive-url=https://web.archive.org/web/20210310232257/https://www.factcheck.org/2009/12/whoppers-of-2009/ |url-status=live }}</ref> and the most outrageous term by the [[American Dialect Society]].<ref>{{cite web |url=http://www.americandialect.org/2009-Word-of-the-Year-PRESS-RELEASE.pdf |title={{-'}}Tweet' 2009 Word of the Year, 'Google' Word of the Decade, as voted by American Dialect Society |date=January 8, 2010 |publisher=[[American Dialect Society]] |access-date=October 8, 2010 |archive-date=April 12, 2019 |archive-url=https://web.archive.org/web/20190412061753/http://www.americandialect.org/2009-Word-of-the-Year-PRESS-RELEASE.pdf |url-status=live }}</ref> [[AARP]] described such rumors as "rife with gross—and even cruel—distortions".<ref name="snopes1" /> | In 2010, the [[Pew Research Center]] reported that 85% of Americans were familiar with the claim, and 30% believed it was true, backed by three contemporaneous polls.<ref>{{Cite journal |first=Brendan |last=Nyhan |title=Why the "Death Panel" Myth Wouldn't Die: Misinformation in the Health Care Reform Debate |journal=The Forum |volume=8 |issue=1 |year=2010 |doi=10.2202/1540-8884.1354 |url=http://www.dartmouth.edu/~nyhan/health-care-misinformation.pdf |citeseerx=10.1.1.692.9614 |s2cid=144075499 |access-date=July 1, 2013 |archive-date=June 4, 2019 |archive-url=https://web.archive.org/web/20190604135225/http://www.dartmouth.edu/~nyhan/health-care-misinformation.pdf |url-status=dead }}</ref> The allegation was named [[PolitiFact]]'s 2009 "Lie of the Year",<ref name="Not so" /><ref>{{Cite news |title=PolitiFact's Lie of the Year: 'Death panels' |publisher=[[PolitiFact]] |date=December 19, 2009 |url=http://politifact.com/truth-o-meter/article/2009/dec/18/politifact-lie-year-death-panels |first=Angie |last=Drobnic Holan |access-date=November 19, 2010 |archive-date=January 13, 2020 |archive-url=https://web.archive.org/web/20200113082025/https://www.politifact.com/truth-o-meter/article/2009/dec/18/politifact-lie-year-death-panels/ |url-status=live }}</ref> one of [[FactCheck.org]]'s "whoppers"<ref>{{Cite news |title=False Euthanasia Claims |first1=Jess |last1=Henig |first2=Lori |last2=Robertson |publisher=[[FactCheck.org]] |date=July 29, 2010 |url=http://www.factcheck.org/2009/07/false-euthanasia-claims |access-date=July 20, 2013 |archive-date=February 24, 2021 |archive-url=https://web.archive.org/web/20210224220630/https://www.factcheck.org/2009/07/false-euthanasia-claims/ |url-status=live }}</ref><ref>{{cite web |title=Whoppers of 2009—We review the choicest falsehoods from a year that kept us busy |date=December 24, 2009 |author=Robertson, Lori |url=http://www.factcheck.org/2009/12/whoppers-of-2009 |publisher=[[FactCheck.org]] |access-date=April 28, 2011 |archive-date=March 10, 2021 |archive-url=https://web.archive.org/web/20210310232257/https://www.factcheck.org/2009/12/whoppers-of-2009/ |url-status=live }}</ref> and the most outrageous term by the [[American Dialect Society]].<ref>{{cite web |url=http://www.americandialect.org/2009-Word-of-the-Year-PRESS-RELEASE.pdf |title={{-'}}Tweet' 2009 Word of the Year, 'Google' Word of the Decade, as voted by American Dialect Society |date=January 8, 2010 |publisher=[[American Dialect Society]] |access-date=October 8, 2010 |archive-date=April 12, 2019 |archive-url=https://web.archive.org/web/20190412061753/http://www.americandialect.org/2009-Word-of-the-Year-PRESS-RELEASE.pdf |url-status=live }}</ref> [[AARP]] described such rumors as "rife with gross—and even cruel—distortions".<ref name="snopes1" /> | ||
| Line 953: | Line 953: | ||
In ''[[Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania]]'', the Supreme Court ruled 7–2 on July 8, 2020, that employers with religious or moral objections to contraceptives can exclude such coverage from an employee's insurance plan. Writing for the majority, Justice [[Clarence Thomas]] said, "No language in the statute itself even hints that Congress intended that contraception should or must be covered. It was Congress, not the [administration], that declined to expressly require contraceptive coverage in the ACA itself." Justices Roberts, Alito, Gorsuch, and Kavanaugh joined Thomas's opinion. Justice [[Elena Kagan]] filed a concurring opinion in the judgment, in which [[Stephen Breyer]] joined. Justices Ginsburg and Sotomayor dissented, saying the court's ruling "leaves women workers to fend for themselves."<ref>{{cite web |title=Supreme Court allows Trump to exempt employers from Obamacare birth control mandate |url=https://abcnews.go.com/Politics/supreme-court-trump-exempt-employers-obamacare-birth-control/story?id=71254754&cid=clicksource_4380645_2_heads_hero_live_headlines_hed |archive-date=July 25, 2020 |archive-url=https://web.archive.org/web/20200725005137/https://abcnews.go.com/Politics/supreme-court-trump-exempt-employers-obamacare-birth-control/story?id=71254754&cid=clicksource_4380645_2_heads_hero_live_headlines_hed |work=[[ABC News (United States)|ABC News]] |publisher=Walt Disney |access-date=June 18, 2022 |last1=Dwyer |first1=Devin}}</ref> | In ''[[Little Sisters of the Poor Saints Peter and Paul Home v. Pennsylvania]]'', the Supreme Court ruled 7–2 on July 8, 2020, that employers with religious or moral objections to contraceptives can exclude such coverage from an employee's insurance plan. Writing for the majority, Justice [[Clarence Thomas]] said, "No language in the statute itself even hints that Congress intended that contraception should or must be covered. It was Congress, not the [administration], that declined to expressly require contraceptive coverage in the ACA itself." Justices Roberts, Alito, Gorsuch, and Kavanaugh joined Thomas's opinion. Justice [[Elena Kagan]] filed a concurring opinion in the judgment, in which [[Stephen Breyer]] joined. Justices Ginsburg and Sotomayor dissented, saying the court's ruling "leaves women workers to fend for themselves."<ref>{{cite web |title=Supreme Court allows Trump to exempt employers from Obamacare birth control mandate |url=https://abcnews.go.com/Politics/supreme-court-trump-exempt-employers-obamacare-birth-control/story?id=71254754&cid=clicksource_4380645_2_heads_hero_live_headlines_hed |archive-date=July 25, 2020 |archive-url=https://web.archive.org/web/20200725005137/https://abcnews.go.com/Politics/supreme-court-trump-exempt-employers-obamacare-birth-control/story?id=71254754&cid=clicksource_4380645_2_heads_hero_live_headlines_hed |work=[[ABC News (United States)|ABC News]] |publisher=Walt Disney |access-date=June 18, 2022 |last1=Dwyer |first1=Devin}}</ref> | ||
In a later lawsuit brought by private health insurance buyers and businesses, Judge [[Reed O'Connor]] of the Federal District Court for the Northern District of Texas ruled in March 2023 that the ACA's provision of contraceptives, HIV testing, and screenings for cancer, diabetes, and mental health violated the plaintiffs' freedom of religious exercise, and placed an injunction on that portion of the ACA. The Biden administration planned to seek a hold on O'Connor's decision.<ref>{{cite web | url=https://apnews.com/article/obamacare-insurance-preventative-care-texas-aa57fa6fd782e2170bc80210fd00065b | title=Judge's ruling undercuts US health law's preventive care | website= | In a later lawsuit brought by private health insurance buyers and businesses, Judge [[Reed O'Connor]] of the Federal District Court for the Northern District of Texas ruled in March 2023 that the ACA's provision of contraceptives, HIV testing, and screenings for cancer, diabetes, and mental health violated the plaintiffs' freedom of religious exercise, and placed an injunction on that portion of the ACA. The Biden administration planned to seek a hold on O'Connor's decision.<ref>{{cite web | url=https://apnews.com/article/obamacare-insurance-preventative-care-texas-aa57fa6fd782e2170bc80210fd00065b | title=Judge's ruling undercuts US health law's preventive care | website=Associated Press | date=March 30, 2023 | access-date=March 30, 2023 | archive-date=March 30, 2023 | archive-url=https://web.archive.org/web/20230330194018/https://apnews.com/article/obamacare-insurance-preventative-care-texas-aa57fa6fd782e2170bc80210fd00065b | url-status=live }}</ref> | ||
====''King v Burwell''==== | ====''King v Burwell''==== | ||
| Line 987: | Line 987: | ||
Democrats pointed out that the effect of invalidating the entire law would be to remove popular provisions such as the protection for preexisting conditions, and that the Republicans had still not offered any replacement plan—important issues in the 2020 elections.<ref name="ollstein" /> | Democrats pointed out that the effect of invalidating the entire law would be to remove popular provisions such as the protection for preexisting conditions, and that the Republicans had still not offered any replacement plan—important issues in the 2020 elections.<ref name="ollstein" /> | ||
On June 17, 2021, the Court rejected the challenge in a 7–2 decision, ruling that Texas and the other plaintiff states did not have standing to challenge the provision, leaving the full ACA intact.<ref>{{Cite web |url=https://apnews.com/article/supreme-court-dismisses-obamacare-challenge-67cc2e9604a70b1b329c5f3b4177a688 |title=Supreme Court dismisses challenge to Obama health law |first=Mark |last=Sherman |date=June 17, 2021 |access-date=June 17, 2021 |publisher= | On June 17, 2021, the Court rejected the challenge in a 7–2 decision, ruling that Texas and the other plaintiff states did not have standing to challenge the provision, leaving the full ACA intact.<ref>{{Cite web |url=https://apnews.com/article/supreme-court-dismisses-obamacare-challenge-67cc2e9604a70b1b329c5f3b4177a688 |title=Supreme Court dismisses challenge to Obama health law |first=Mark |last=Sherman |date=June 17, 2021 |access-date=June 17, 2021 |publisher=Associated Press |archive-date=October 15, 2021 |archive-url=https://web.archive.org/web/20211015225822/https://apnews.com/article/supreme-court-dismisses-obamacare-challenge-67cc2e9604a70b1b329c5f3b4177a688 |url-status=live }}</ref><ref>{{cite web |url=https://www.msnbc.com/rachel-maddow-show/affordable-care-act-survives-supreme-court-challenge-again-n1271151 |title=Affordable Care Act survives Supreme Court challenge (again) |first=Steve |last=Benen |author-link=Steve Benen |date=June 17, 2021 |access-date=June 17, 2021 |publisher=[[MSNBC]] |archive-date=November 6, 2021 |archive-url=https://web.archive.org/web/20211106212447/https://www.msnbc.com/rachel-maddow-show/affordable-care-act-survives-supreme-court-challenge-again-n1271151 |url-status=live }}</ref><ref>{{Cite web |author=Ariane de Vogue and Chandelis Duster |title=Supreme Court dismisses challenge to Affordable Care Act, leaving it in place |date=June 17, 2021 |url=https://www.cnn.com/2021/06/17/politics/supreme-court-affordable-care-act-obamacare/index.html |access-date=2021-06-18 |publisher=CNN |archive-date=June 18, 2021 |archive-url=https://web.archive.org/web/20210618193127/https://www.cnn.com/2021/06/17/politics/supreme-court-affordable-care-act-obamacare/index.html |url-status=live }}</ref> | ||
====Risk corridors==== | ====Risk corridors==== | ||
| Line 1,002: | Line 1,002: | ||
[[File:2017 House budget.pdf|thumb|2017 House Budget]] | [[File:2017 House budget.pdf|thumb|2017 House Budget]] | ||
On February 3, 2015, the House of Representatives added its 67th repeal vote to the record (239 to 186). This attempt also failed.<ref>{{cite news |title=House votes -again-to repeal Obamacare |url=http://www.cnn.com/2015/02/03/politics/obamacare-repeal-vote-house/index.html |agency= | On February 3, 2015, the House of Representatives added its 67th repeal vote to the record (239 to 186). This attempt also failed.<ref>{{cite news |title=House votes -again-to repeal Obamacare |url=http://www.cnn.com/2015/02/03/politics/obamacare-repeal-vote-house/index.html |agency=Reuters |date=February 3, 2015 |author=Deirdre Walsh |access-date=February 4, 2015 |archive-date=January 25, 2021 |archive-url=https://web.archive.org/web/20210125112222/https://www.cnn.com/2015/02/03/politics/obamacare-repeal-vote-house/index.html |url-status=live }}</ref> | ||
====2013 federal government shutdown==== | ====2013 federal government shutdown==== | ||
| Line 1,050: | Line 1,050: | ||
In 2010 small business tax credits took effect.<ref name="hist">{{cite web |url=https://resources.ehealthinsurance.com/affordable-care-act/history-timeline-affordable-care-act-aca |title=History of the Affordable Care Act (ACA) |date=October 22, 2014}}</ref> Then [[Pre-existing Condition Insurance Plan|Pre-Existing Condition Insurance Plan]] (PCIP) took effect to offer insurance to those who had been denied coverage by private insurance companies because of a preexisting condition.<ref name="hist" /> By 2011, insurers had stopped marketing child-only policies in 17 states, as they sought to escape this requirement.<ref>{{Cite web |url=http://www.help.senate.gov/imo/media/doc/Child-Only%20Health%20Insurance%20Report%20Aug%202,%202011.pdf |title=Health Care Reforrm Law's Impact on Child-Only Health Insurance Policies |last=Enzi |first=Michael B. |date=August 2, 2011 |website=United States Senate |access-date=August 10, 2016}}</ref> In ''[[National Federation of Independent Business v. Sebelius]]'' the Supreme Court allowed states to opt out of the Medicaid expansion.<ref>{{cite web |last=Liptak |first=Adam |date=September 30, 2012 |location=Pittsburgh |url=http://www.post-gazette.com/stories/news/us/supreme-court-justices-face-important-rulings-in-upcoming-term-655566/ |title=Supreme Court justices face important rulings in upcoming term September |website=post-gazette.com |agency=The New York Times |access-date=September 30, 2012}}</ref><ref>{{Cite web |url=http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/ |title=Status of State Action on the Medicaid Expansion Decision |publisher=[[Kaiser Family Foundation]] |access-date=August 12, 2016}}</ref><ref>{{cite web |last1=Walton |first1=Alice G. |title=How To Explain The Obamacare Ruling To A Five-Year-Old |url=https://www.forbes.com/sites/alicegwalton/2012/07/02/how-to-explain-the-obamacare-ruling-to-a-five-year-old/#23e103e723e1 |website=[[Forbes]]|access-date=May 5, 2017}}</ref> | In 2010 small business tax credits took effect.<ref name="hist">{{cite web |url=https://resources.ehealthinsurance.com/affordable-care-act/history-timeline-affordable-care-act-aca |title=History of the Affordable Care Act (ACA) |date=October 22, 2014}}</ref> Then [[Pre-existing Condition Insurance Plan|Pre-Existing Condition Insurance Plan]] (PCIP) took effect to offer insurance to those who had been denied coverage by private insurance companies because of a preexisting condition.<ref name="hist" /> By 2011, insurers had stopped marketing child-only policies in 17 states, as they sought to escape this requirement.<ref>{{Cite web |url=http://www.help.senate.gov/imo/media/doc/Child-Only%20Health%20Insurance%20Report%20Aug%202,%202011.pdf |title=Health Care Reforrm Law's Impact on Child-Only Health Insurance Policies |last=Enzi |first=Michael B. |date=August 2, 2011 |website=United States Senate |access-date=August 10, 2016}}</ref> In ''[[National Federation of Independent Business v. Sebelius]]'' the Supreme Court allowed states to opt out of the Medicaid expansion.<ref>{{cite web |last=Liptak |first=Adam |date=September 30, 2012 |location=Pittsburgh |url=http://www.post-gazette.com/stories/news/us/supreme-court-justices-face-important-rulings-in-upcoming-term-655566/ |title=Supreme Court justices face important rulings in upcoming term September |website=post-gazette.com |agency=The New York Times |access-date=September 30, 2012}}</ref><ref>{{Cite web |url=http://kff.org/health-reform/state-indicator/state-activity-around-expanding-medicaid-under-the-affordable-care-act/ |title=Status of State Action on the Medicaid Expansion Decision |publisher=[[Kaiser Family Foundation]] |access-date=August 12, 2016}}</ref><ref>{{cite web |last1=Walton |first1=Alice G. |title=How To Explain The Obamacare Ruling To A Five-Year-Old |url=https://www.forbes.com/sites/alicegwalton/2012/07/02/how-to-explain-the-obamacare-ruling-to-a-five-year-old/#23e103e723e1 |website=[[Forbes]]|access-date=May 5, 2017}}</ref> | ||
In 2013, the [[Internal Revenue Service]] ruled that the cost of covering only the individual employee would be considered in determining whether the cost of coverage exceeded 9.5% of income. Family plans would not be considered even if the cost was above the 9.5% income threshold.<ref>{{cite news |author=The Editorial Board |date=February 2, 2013 |title=A Cruel Blow to American Families |url=https://www.nytimes.com/2013/02/03/opinion/sunday/a-cruel-blow-to-american-families.html |archive-url=https://web.archive.org/web/20130207214914/https://www.nytimes.com/2013/02/03/opinion/sunday/a-cruel-blow-to-american-families.html |archive-date=February 7, 2013 |issn=0362-4331 |oclc=1645522 |work=The New York Times}}</ref><ref>{{cite news |url=https://newrepublic.com/article/112327/obamacare-not-universal-you-thought |title=Not-So-Universal Health Care |last=Cohn |first=Jonathan |date=February 5, 2013 |magazine=[[The New Republic]]}}</ref> On July{{nbsp}}2 Obama delayed the employer mandate until 2015.<ref name="CohnDelay" /><ref name="treasurystatement" /><ref name="REG-138006-12" /> The launch for both the state and federal exchanges was beset by management and technical failings. [[HealthCare.gov]], the website that offers insurance through the exchanges operated by the federal government, crashed on opening and suffered many problems.<ref>{{cite news |last=Kennedy |first=Kelly |date=December 1, 2013 |newspaper= | In 2013, the [[Internal Revenue Service]] ruled that the cost of covering only the individual employee would be considered in determining whether the cost of coverage exceeded 9.5% of income. Family plans would not be considered even if the cost was above the 9.5% income threshold.<ref>{{cite news |author=The Editorial Board |date=February 2, 2013 |title=A Cruel Blow to American Families |url=https://www.nytimes.com/2013/02/03/opinion/sunday/a-cruel-blow-to-american-families.html |archive-url=https://web.archive.org/web/20130207214914/https://www.nytimes.com/2013/02/03/opinion/sunday/a-cruel-blow-to-american-families.html |archive-date=February 7, 2013 |issn=0362-4331 |oclc=1645522 |work=The New York Times}}</ref><ref>{{cite news |url=https://newrepublic.com/article/112327/obamacare-not-universal-you-thought |title=Not-So-Universal Health Care |last=Cohn |first=Jonathan |date=February 5, 2013 |magazine=[[The New Republic]]}}</ref> On July{{nbsp}}2 Obama delayed the employer mandate until 2015.<ref name="CohnDelay" /><ref name="treasurystatement" /><ref name="REG-138006-12" /> The launch for both the state and federal exchanges was beset by management and technical failings. [[HealthCare.gov]], the website that offers insurance through the exchanges operated by the federal government, crashed on opening and suffered many problems.<ref>{{cite news |last=Kennedy |first=Kelly |date=December 1, 2013 |newspaper=USA Today |url=https://www.usatoday.com/story/news/politics/2013/12/01/federalexchangmeetsgoal/3795523/ |title=White House claims success on HealthCare.gov repairs |access-date=December 1, 2013}}</ref> Operations stabilized in 2014, although not all planned features were complete.<ref>{{cite news |url=http://www.cnn.com/2013/10/22/politics/obamacare-website-four-reasons |title=Rough Obamacare rollout: 4 reasons why |last=Cohen |first=Tom |date=October 23, 2013 |publisher=CNN|access-date=November 5, 2013}}</ref><ref>{{cite news |url=http://www.csmonitor.com/USA/Latest-News-Wires/2013/1106/Senate-Democrats-frustrated-with-botched-rollout-of-Obamacare |title=Senate Democrats frustrated with botched rollout of Obamacare |last1=Holland |first1=Steve |date=November 6, 2013 |newspaper=The Christian Science Monitor |last2=Rampton |first2=Roberta |agency=Reuters |access-date=November 19, 2013}}</ref> | ||
The [[Government Accountability Office]] released a non-partisan study in 2014 that concluded the administration had not provided "effective planning or oversight practices" in developing the exchanges.<ref name="AP-20140731" /> In ''[[Burwell v. Hobby Lobby]]'' the Supreme Court exempted closely held corporations with religious convictions from the contraception rule.<ref name=":2" /> At the beginning of the 2015, 11.7 million had signed up (ex-Medicaid).<ref>{{Cite news |url=https://www.bloomberg.com/news/articles/2015-06-02/obamacare-dropouts-lead-to-enrollment-decline-of-1-5-million |title=Obamacare Sign-Ups Decline to 10.2 Million as Some Don't Pay |last=Tracer |first=Zachary |website=Bloomberg.com |date=June 2, 2015 |access-date=August 21, 2016}}</ref> By the end of the year about 8.8 million consumers had stayed in the program.<ref>{{Cite web |url=https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-11.html |title=December 31, 2015 Effectuated Enrollment Snapshot |date=March 11, 2016 |access-date=June 18, 2022 |archive-date=April 11, 2016 |archive-url=https://web.archive.org/web/20160411120015/https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-11.html |location=Baltimore, MD |publisher=Health and Human Services |website=cms.gov}}</ref> Congress repeatedly delayed the onset of the "[[Cadillac tax]]" on expensive insurance plans first until 2020<ref>{{Cite web |url=http://www.politico.com/story/2015/12/white-house-obamacare-cadillac-tax-216881 |title=How the White House lost on the Cadillac Tax |last=COOK |first=NANCY |date=December 16, 2015 |publisher=[[Politico]]|access-date=August 21, 2016}}</ref> and later until 2022 and repealed it in late 2019.<ref name="auto1"/> | The [[Government Accountability Office]] released a non-partisan study in 2014 that concluded the administration had not provided "effective planning or oversight practices" in developing the exchanges.<ref name="AP-20140731" /> In ''[[Burwell v. Hobby Lobby]]'' the Supreme Court exempted closely held corporations with religious convictions from the contraception rule.<ref name=":2" /> At the beginning of the 2015, 11.7 million had signed up (ex-Medicaid).<ref>{{Cite news |url=https://www.bloomberg.com/news/articles/2015-06-02/obamacare-dropouts-lead-to-enrollment-decline-of-1-5-million |title=Obamacare Sign-Ups Decline to 10.2 Million as Some Don't Pay |last=Tracer |first=Zachary |website=Bloomberg.com |date=June 2, 2015 |access-date=August 21, 2016}}</ref> By the end of the year about 8.8 million consumers had stayed in the program.<ref>{{Cite web |url=https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-11.html |title=December 31, 2015 Effectuated Enrollment Snapshot |date=March 11, 2016 |access-date=June 18, 2022 |archive-date=April 11, 2016 |archive-url=https://web.archive.org/web/20160411120015/https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2016-Fact-sheets-items/2016-03-11.html |location=Baltimore, MD |publisher=Health and Human Services |website=cms.gov}}</ref> Congress repeatedly delayed the onset of the "[[Cadillac tax]]" on expensive insurance plans first until 2020<ref>{{Cite web |url=http://www.politico.com/story/2015/12/white-house-obamacare-cadillac-tax-216881 |title=How the White House lost on the Cadillac Tax |last=COOK |first=NANCY |date=December 16, 2015 |publisher=[[Politico]]|access-date=August 21, 2016}}</ref> and later until 2022 and repealed it in late 2019.<ref name="auto1"/> | ||
| Line 1,251: | Line 1,251: | ||
<ref name="Medicaiddeal">{{cite web |url=https://www.usnews.com/debate-club/is-medicaid-expansion-good-for-the-states |title=Is Medicaid Expansion Good for the States? |website=[[U.S. News & World Report]] |date=2012 |archive-url=https://web.archive.org/web/20120727073428/http://www.usnews.com/debate-club/is-medicaid-expansion-good-for-the-states |issn=0041-5537 |oclc=7786209 |archive-date=July 27, 2012 |access-date=June 21, 2022}} Arguments from seven [[subject-matter experts]].</ref> | <ref name="Medicaiddeal">{{cite web |url=https://www.usnews.com/debate-club/is-medicaid-expansion-good-for-the-states |title=Is Medicaid Expansion Good for the States? |website=[[U.S. News & World Report]] |date=2012 |archive-url=https://web.archive.org/web/20120727073428/http://www.usnews.com/debate-club/is-medicaid-expansion-good-for-the-states |issn=0041-5537 |oclc=7786209 |archive-date=July 27, 2012 |access-date=June 21, 2022}} Arguments from seven [[subject-matter experts]].</ref> | ||
<ref name="most">{{cite news |last=Zengerle |first=Patricia |url=https://www.reuters.com/article/us-usa-campaign-healthcare-idUSBRE85N01M20120624 |title=Reuters-Most Americans Oppose Health Law But Like the Provisions |work= | <ref name="most">{{cite news |last=Zengerle |first=Patricia |url=https://www.reuters.com/article/us-usa-campaign-healthcare-idUSBRE85N01M20120624 |title=Reuters-Most Americans Oppose Health Law But Like the Provisions |work=Reuters|date=June 24, 2012 |access-date=June 28, 2012}}</ref> | ||
<ref name="multiple2">PriceWaterHouseCoopers. "The CLASS Act". HRS Insight: Human Resource Services. 2010: 1–6. Web.</ref> | <ref name="multiple2">PriceWaterHouseCoopers. "The CLASS Act". HRS Insight: Human Resource Services. 2010: 1–6. Web.</ref> | ||
| Line 1,309: | Line 1,309: | ||
<ref name="REG-138006-12">{{cite journal |last=Madara |first=Matthew R. |date=February 11, 2014 |title=ACA Employer Shared Responsibility Delay Included in Final Regs |journal=Tax Notes Today |volume=28 |issue=1}}</ref> | <ref name="REG-138006-12">{{cite journal |last=Madara |first=Matthew R. |date=February 11, 2014 |title=ACA Employer Shared Responsibility Delay Included in Final Regs |journal=Tax Notes Today |volume=28 |issue=1}}</ref> | ||
<ref name="reuterstimeline">{{cite news |url=https://www.reuters.com/article/idUSTRE62L0JA20100322 |work= | <ref name="reuterstimeline">{{cite news |url=https://www.reuters.com/article/idUSTRE62L0JA20100322 |work=Reuters|title=Timeline: Milestones in Obama's quest for healthcare reform |date=March 22, 2010 |access-date=March 22, 2010}}</ref> | ||
<ref name="RollCallCBO">{{Cite news |title=CBO: Health Care Overhaul Would Cost $940 Billion |first=Steven |last=Dennis |url=http://www.rollcall.com/news/44347-1.html |newspaper=[[Roll Call]] |date=March 18, 2010 |access-date=March 22, 2010}}</ref> | <ref name="RollCallCBO">{{Cite news |title=CBO: Health Care Overhaul Would Cost $940 Billion |first=Steven |last=Dennis |url=http://www.rollcall.com/news/44347-1.html |newspaper=[[Roll Call]] |date=March 18, 2010 |access-date=March 22, 2010}}</ref> | ||