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Affordable Care Act: Difference between revisions
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{{See also|Health care reforms proposed during the Obama administration}} | {{See also|Health care reforms proposed during the Obama administration}} | ||
Healthcare reform was a major topic during the [[2008 Democratic presidential primaries]]. As the race narrowed, attention focused on the plans presented by the two leading candidates, [[Hillary Clinton]] and the eventual nominee, [[Barack Obama]]. Each candidate proposed a plan to cover the approximately 45 million Americans estimated to not have health insurance at some point each year. Clinton's proposal would have required all Americans to obtain coverage (in effect, an individual mandate), while Obama's proposal provided a [[subsidy]] without a mandate.<ref name="promise" /><ref>{{cite news |title=CNN Democratic presidential debate |url=http://www.cnn.com/2008/POLITICS/01/21/debate.transcript2/ |publisher= | Healthcare reform was a major topic during the [[2008 Democratic presidential primaries]]. As the race narrowed, attention focused on the plans presented by the two leading candidates, [[Hillary Clinton]] and the eventual nominee, [[Barack Obama]]. Each candidate proposed a plan to cover the approximately 45 million Americans estimated to not have health insurance at some point each year. Clinton's proposal would have required all Americans to obtain coverage (in effect, an individual mandate), while Obama's proposal provided a [[subsidy]] without a mandate.<ref name="promise" /><ref>{{cite news |title=CNN Democratic presidential debate |url=http://www.cnn.com/2008/POLITICS/01/21/debate.transcript2/ |publisher=CNN |date=January 21, 2008 |access-date=September 26, 2013 |archive-date=October 29, 2013 |archive-url=https://web.archive.org/web/20131029221240/http://www.cnn.com/2008/POLITICS/01/21/debate.transcript2/ |url-status=live }}</ref> | ||
During the [[2008 United States presidential election|general election]], Obama said fixing healthcare would be one of his top four priorities as president.<ref name="Sep2008FirstPresidentialDebate" /> Obama and his opponent, Senator [[John McCain]], both proposed health insurance reforms, though their plans differed. McCain proposed tax credits for health insurance purchased in the individual market, which was estimated to reduce the number of uninsured people by about 2{{nbsp}}million by 2018. Obama proposed private and public group insurance, income-based subsidies, consumer protections, and expansions of Medicaid and SCHIP, which was estimated at the time to reduce the number of uninsured people by 33.9 million by 2018 at a higher cost.<ref>{{Cite web |last1=Rustgi |first1=Sheila |last2=Collins |first2=Sara R. |last3=Davis |first3=Karen |last4=Nicholson |first4=Jennifer L. |title=The 2008 Presidential Candidates' Health Reform Proposals: Choices for America |website=The Commonwealth Fund |date=October 2008 |url=http://www.commonwealthfund.org/publications/fund-reports/2008/oct/the-2008-presidential-candidates-health-reform-proposals--choices-for-america |access-date=January 24, 2017 |archive-date=April 19, 2018 |archive-url=https://web.archive.org/web/20180419053058/http://www.commonwealthfund.org/publications/fund-reports/2008/oct/the-2008-presidential-candidates-health-reform-proposals--choices-for-america |url-status=live }}</ref> | During the [[2008 United States presidential election|general election]], Obama said fixing healthcare would be one of his top four priorities as president.<ref name="Sep2008FirstPresidentialDebate" /> Obama and his opponent, Senator [[John McCain]], both proposed health insurance reforms, though their plans differed. McCain proposed tax credits for health insurance purchased in the individual market, which was estimated to reduce the number of uninsured people by about 2{{nbsp}}million by 2018. Obama proposed private and public group insurance, income-based subsidies, consumer protections, and expansions of Medicaid and SCHIP, which was estimated at the time to reduce the number of uninsured people by 33.9 million by 2018 at a higher cost.<ref>{{Cite web |last1=Rustgi |first1=Sheila |last2=Collins |first2=Sara R. |last3=Davis |first3=Karen |last4=Nicholson |first4=Jennifer L. |title=The 2008 Presidential Candidates' Health Reform Proposals: Choices for America |website=The Commonwealth Fund |date=October 2008 |url=http://www.commonwealthfund.org/publications/fund-reports/2008/oct/the-2008-presidential-candidates-health-reform-proposals--choices-for-america |access-date=January 24, 2017 |archive-date=April 19, 2018 |archive-url=https://web.archive.org/web/20180419053058/http://www.commonwealthfund.org/publications/fund-reports/2008/oct/the-2008-presidential-candidates-health-reform-proposals--choices-for-america |url-status=live }}</ref> | ||
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The CBO reported in multiple studies that ACA would reduce the deficit, and repealing it would increase the deficit, primarily because of the elimination of Medicare reimbursement cuts.<ref name="CBO50252" /><ref name="CBO22077" /> The 2011 comprehensive CBO estimate projected a net deficit reduction of more than $200 billion during the 2012–2021 period:<ref name="CBO22077" /><ref name="CBO43104" /> it calculated the law would result in $604 billion in [[Government spending|total outlays]] offset by $813 billion in [[Government revenue|total receipts]], resulting in a $210 billion net deficit reduction.<ref name="CBO22077" /> The CBO separately predicted that while most of the spending provisions do not begin until 2014,<ref name="CBO-Pelosi" /><ref name="RollCallCBO" /> revenue would exceed spending in those subsequent years.<ref name="CBO-Pelosi2" />{{Dead link|date=February 2023}} The CBO claimed the bill would "substantially reduce the growth of Medicare's payment rates for most services; impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the federal tax code, Medicare, Medicaid, and other programs"<ref name="CBO-Reid-Dec2009" />—ultimately extending the solvency of the [[Medicare (United States)#The solvency of the Medicare HI trust fund|Medicare trust fund]] by eight years.<ref>{{cite news |author1=Judith Solomon |author2=Paul N. Van de Water |url=http://www.cbpp.org/cms/?fa=view&id=3746 |title=Letter: Improving the Strength and Solvency of Medicare |publisher=The Center on Budget and Policy Priorities |date=April 18, 2012 |access-date=September 3, 2013 |archive-date=September 21, 2013 |archive-url=https://web.archive.org/web/20130921054048/http://www.cbpp.org/cms/?fa=view&id=3746 |url-status=live }}</ref> | The CBO reported in multiple studies that ACA would reduce the deficit, and repealing it would increase the deficit, primarily because of the elimination of Medicare reimbursement cuts.<ref name="CBO50252" /><ref name="CBO22077" /> The 2011 comprehensive CBO estimate projected a net deficit reduction of more than $200 billion during the 2012–2021 period:<ref name="CBO22077" /><ref name="CBO43104" /> it calculated the law would result in $604 billion in [[Government spending|total outlays]] offset by $813 billion in [[Government revenue|total receipts]], resulting in a $210 billion net deficit reduction.<ref name="CBO22077" /> The CBO separately predicted that while most of the spending provisions do not begin until 2014,<ref name="CBO-Pelosi" /><ref name="RollCallCBO" /> revenue would exceed spending in those subsequent years.<ref name="CBO-Pelosi2" />{{Dead link|date=February 2023}} The CBO claimed the bill would "substantially reduce the growth of Medicare's payment rates for most services; impose an excise tax on insurance plans with relatively high premiums; and make various other changes to the federal tax code, Medicare, Medicaid, and other programs"<ref name="CBO-Reid-Dec2009" />—ultimately extending the solvency of the [[Medicare (United States)#The solvency of the Medicare HI trust fund|Medicare trust fund]] by eight years.<ref>{{cite news |author1=Judith Solomon |author2=Paul N. Van de Water |url=http://www.cbpp.org/cms/?fa=view&id=3746 |title=Letter: Improving the Strength and Solvency of Medicare |publisher=The Center on Budget and Policy Priorities |date=April 18, 2012 |access-date=September 3, 2013 |archive-date=September 21, 2013 |archive-url=https://web.archive.org/web/20130921054048/http://www.cbpp.org/cms/?fa=view&id=3746 |url-status=live }}</ref> | ||
This estimate was made prior to the [[#Legal challenges|Supreme Court's ruling]] that enabled states to [[#Medicaid expansion|opt out of the Medicaid expansion]], thereby forgoing the related federal funding. The [[Congressional Budget Office|CBO]] and [[United States Congress Joint Committee on Taxation|JCT]] subsequently updated the budget projection, estimating the impact of the ruling would reduce the cost estimate of the insurance coverage provisions by $84 billion.<ref name="fewer" /><ref name="CBO43472" /><ref>{{cite news |last=Sahadi |first=Jeanne |url=https://money.cnn.com/2012/03/13/news/economy/health-reform-costs |title=Health reform coverage cost falls slightly |publisher= | This estimate was made prior to the [[#Legal challenges|Supreme Court's ruling]] that enabled states to [[#Medicaid expansion|opt out of the Medicaid expansion]], thereby forgoing the related federal funding. The [[Congressional Budget Office|CBO]] and [[United States Congress Joint Committee on Taxation|JCT]] subsequently updated the budget projection, estimating the impact of the ruling would reduce the cost estimate of the insurance coverage provisions by $84 billion.<ref name="fewer" /><ref name="CBO43472" /><ref>{{cite news |last=Sahadi |first=Jeanne |url=https://money.cnn.com/2012/03/13/news/economy/health-reform-costs |title=Health reform coverage cost falls slightly |publisher=CNN |date=March 13, 2012 |access-date=June 29, 2012 |archive-date=May 15, 2012 |archive-url=https://web.archive.org/web/20120515143358/http://money.cnn.com/2012/03/13/news/economy/health-reform-costs/ |url-status=live }}</ref> | ||
The CBO in June 2015 forecast that repeal of ACA would increase the deficit between $137 billion and $353 billion over the 2016–2025 period, depending on the impact of macroeconomic [[dynamic scoring|feedback]] effects. The CBO also forecast that repeal of ACA would likely cause an increase in GDP by an average of 0.7% in the period from 2021 to 2025, mainly by boosting the supply of labor.<ref name="CBO50252" /> | The CBO in June 2015 forecast that repeal of ACA would increase the deficit between $137 billion and $353 billion over the 2016–2025 period, depending on the impact of macroeconomic [[dynamic scoring|feedback]] effects. The CBO also forecast that repeal of ACA would likely cause an increase in GDP by an average of 0.7% in the period from 2021 to 2025, mainly by boosting the supply of labor.<ref name="CBO50252" /> | ||
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Public views became increasingly negative in reaction to specific plans discussed during the legislative debate over 2009 and 2010. Approval varied by party, race and age. Some elements were more widely favored (preexisting conditions) or opposed (individual mandate). | Public views became increasingly negative in reaction to specific plans discussed during the legislative debate over 2009 and 2010. Approval varied by party, race and age. Some elements were more widely favored (preexisting conditions) or opposed (individual mandate). | ||
In a 2010 [[Opinion poll|poll]], 62% of respondents said they thought ACA would "increase the amount of money they personally spend on health care", 56% said the bill "gives the government too much involvement in health care", and 19% said they thought they and their families would be better off with the legislation.<ref>{{cite news |url=http://i2.cdn.turner.com/cnn/2010/images/03/22/rel5a.pdf |title=CNN Opinion Research Poll |date=March 22, 2010 |publisher= | In a 2010 [[Opinion poll|poll]], 62% of respondents said they thought ACA would "increase the amount of money they personally spend on health care", 56% said the bill "gives the government too much involvement in health care", and 19% said they thought they and their families would be better off with the legislation.<ref>{{cite news |url=http://i2.cdn.turner.com/cnn/2010/images/03/22/rel5a.pdf |title=CNN Opinion Research Poll |date=March 22, 2010 |publisher=CNN |access-date=December 28, 2010 |archive-date=February 16, 2021 |archive-url=https://web.archive.org/web/20210216230530/http://i2.cdn.turner.com/cnn/2010/images/03/22/rel5a.pdf |url-status=live }}</ref> Other polls found that people were concerned the law would cost more than projected and would not do enough to control costs.<ref>{{cite news |title=Why Obama Can't Move the Health-Care Numbers |last1=Rasmussen |first1=Scott |date=March 9, 2010 |work=[[The Wall Street Journal]] |last2=Schoen |first2=Doug |publisher=News Corp |oclc=781541372 |issn=0099-9660 |archive-url=https://web.archive.org/web/20150402002455/https://www.wsj.com/articles/SB10001424052748704784904575111993559174212 |archive-date=April 2, 2015 |url=https://www.wsj.com/articles/SB10001424052748704784904575111993559174212}}</ref> | ||
In a 2012 poll 44% supported the law, with 56% against. By 75% of Democrats, 27% of Independents and 14% of Republicans favored the law. 82% favored banning insurance companies from denying coverage to people with preexisting conditions, 61% favored allowing children to stay on their parents' insurance until age 26, 72% supported requiring companies with more than 50 employees to provide insurance for their employees, and 39% supported the individual mandate to own insurance or pay a penalty. By party affiliation, 19% of Republicans, 27% of Independents, and 59% of Democrats favored the mandate.<ref name="most" /> Other polls showed additional provisions receiving majority support, including the exchanges, pooling small businesses and the uninsured with other consumers and providing subsidies.<ref>{{cite news |issn=0190-8286 |oclc=2269358 |url=https://www.washingtonpost.com/blogs/ezra-klein/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does |title=Republicans hate 'Obamacare', but like most of what it does |website=Wonkblog |publisher=[[The Washington Post]] |author=Klein, Ezra |date=June 26, 2012 |access-date=June 28, 2012 |archive-url=https://web.archive.org/web/20120629112038/http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does/ |archive-date=June 29, 2012 |url-status=dead}}</ref><ref>{{cite web |author=Sargent, Greg |issn=0190-8286 |oclc=2269358 |url=https://www.washingtonpost.com/blogs/plum-line/post/republicans-support-obamas-health-reforms--as-long-as-his-name-isnt-on-them/2012/06/25/gJQAq7E51V_blog.html |title=Republicans Support Obama's Health Reforms – As Long As His Name Isn't On Them |work=The Plum Line |publisher=[[The Washington Post]]|date=June 25, 2012 |archive-url=https://web.archive.org/web/20120707184007/https://www.washingtonpost.com/blogs/plum-line/post/republicans-support-obamas-health-reforms--as-long-as-his-name-isnt-on-them/2012/06/25/gJQAq7E51V_blog.html |archive-date=July 7, 2012 |access-date=June 28, 2012}}</ref> | In a 2012 poll 44% supported the law, with 56% against. By 75% of Democrats, 27% of Independents and 14% of Republicans favored the law. 82% favored banning insurance companies from denying coverage to people with preexisting conditions, 61% favored allowing children to stay on their parents' insurance until age 26, 72% supported requiring companies with more than 50 employees to provide insurance for their employees, and 39% supported the individual mandate to own insurance or pay a penalty. By party affiliation, 19% of Republicans, 27% of Independents, and 59% of Democrats favored the mandate.<ref name="most" /> Other polls showed additional provisions receiving majority support, including the exchanges, pooling small businesses and the uninsured with other consumers and providing subsidies.<ref>{{cite news |issn=0190-8286 |oclc=2269358 |url=https://www.washingtonpost.com/blogs/ezra-klein/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does |title=Republicans hate 'Obamacare', but like most of what it does |website=Wonkblog |publisher=[[The Washington Post]] |author=Klein, Ezra |date=June 26, 2012 |access-date=June 28, 2012 |archive-url=https://web.archive.org/web/20120629112038/http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does/ |archive-date=June 29, 2012 |url-status=dead}}</ref><ref>{{cite web |author=Sargent, Greg |issn=0190-8286 |oclc=2269358 |url=https://www.washingtonpost.com/blogs/plum-line/post/republicans-support-obamas-health-reforms--as-long-as-his-name-isnt-on-them/2012/06/25/gJQAq7E51V_blog.html |title=Republicans Support Obama's Health Reforms – As Long As His Name Isn't On Them |work=The Plum Line |publisher=[[The Washington Post]]|date=June 25, 2012 |archive-url=https://web.archive.org/web/20120707184007/https://www.washingtonpost.com/blogs/plum-line/post/republicans-support-obamas-health-reforms--as-long-as-his-name-isnt-on-them/2012/06/25/gJQAq7E51V_blog.html |archive-date=July 7, 2012 |access-date=June 28, 2012}}</ref> | ||
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===="If you like your plan"==== | ===="If you like your plan"==== | ||
At various times during and after ACA debate Obama said, "If you like your health care plan, you'll be able to keep your health care plan."<ref>{{cite web |url=https://obamawhitehouse.archives.gov/blog/A-Town-Hall-and-a-Health-Care-Model-in-Green-Bay |work=[[whitehouse.gov]] |title=A Town Hall, and a Health Care Model, in Green Bay |date=June 11, 2009 |via=[[NARA|National Archives]] |access-date=November 9, 2013 |archive-date=May 4, 2021 |archive-url=https://web.archive.org/web/20210504003513/https://obamawhitehouse.archives.gov/blog/A-Town-Hall-and-a-Health-Care-Model-in-Green-Bay |url-status=live }}</ref><ref name="ObamaPromise" /> However, in fall 2013 millions of Americans with individual policies received notices that their insurance plans were terminated,<ref>{{cite news |url=http://www.cnn.com/2013/11/08/politics/obama-obamacare-apology |title=After the big Obamacare apology: where things stand |date=November 8, 2013 |access-date=November 9, 2013 |publisher= | At various times during and after ACA debate Obama said, "If you like your health care plan, you'll be able to keep your health care plan."<ref>{{cite web |url=https://obamawhitehouse.archives.gov/blog/A-Town-Hall-and-a-Health-Care-Model-in-Green-Bay |work=[[whitehouse.gov]] |title=A Town Hall, and a Health Care Model, in Green Bay |date=June 11, 2009 |via=[[NARA|National Archives]] |access-date=November 9, 2013 |archive-date=May 4, 2021 |archive-url=https://web.archive.org/web/20210504003513/https://obamawhitehouse.archives.gov/blog/A-Town-Hall-and-a-Health-Care-Model-in-Green-Bay |url-status=live }}</ref><ref name="ObamaPromise" /> However, in fall 2013 millions of Americans with individual policies received notices that their insurance plans were terminated,<ref>{{cite news |url=http://www.cnn.com/2013/11/08/politics/obama-obamacare-apology |title=After the big Obamacare apology: where things stand |date=November 8, 2013 |access-date=November 9, 2013 |publisher=CNN |archive-date=November 9, 2013 |archive-url=https://web.archive.org/web/20131109074558/http://www.cnn.com/2013/11/08/politics/obama-obamacare-apology/ |url-status=live }}</ref> and several million more risked seeing their current plans canceled.<ref>{{cite web |url=http://www.cnn.com/2013/11/07/politics/obama-obamacare-apology |title=Obama apologizes for insurance cancellations due to Obamacare |date=November 7, 2013 |publisher=CNN |access-date=July 29, 2014 |archive-date=November 8, 2013 |archive-url=https://web.archive.org/web/20131108072839/http://www.cnn.com/2013/11/07/politics/obama-obamacare-apology |url-status=live }}</ref><ref>{{cite news |url=http://www.bizjournals.com/denver/news/2013/11/08/health-insurers-canceling-plans-say.html |title=Health insurers say they're canceling plans because of federal law |last=Sealover |first=Ed |date=November 8, 2013 |work=Denver Business Journal |access-date=November 9, 2013 |archive-date=November 9, 2013 |archive-url=https://web.archive.org/web/20131109210039/http://www.bizjournals.com/denver/news/2013/11/08/health-insurers-canceling-plans-say.html |url-status=live }}</ref> | ||
Obama's previous unambiguous assurance that consumers could keep their own plans became a focal point for critics, who challenged his truthfulness.<ref>{{cite magazine |last=Weigel |first=David |date=November 8, 2013 |title=The White House's Website Still Says If You Like Your Plan You Can Keep It |url=http://www.slate.com/blogs/weigel/2013/11/08/the_white_house_s_web_site_still_says_if_you_like_your_plan_you_can_keep.html |magazine=Slate |access-date=November 9, 2013 |archive-date=November 8, 2013 |archive-url=https://web.archive.org/web/20131108232659/http://www.slate.com/blogs/weigel/2013/11/08/the_white_house_s_web_site_still_says_if_you_like_your_plan_you_can_keep.html |url-status=live }}</ref><ref>{{cite news |url=https://www.economist.com/news/united-states/21588951-congress-hears-tales-baffling-ineptitude-debacle |title=Obamacare: The debacle |date=November 2, 2013 |newspaper=[[The Economist]] |access-date=November 8, 2013 |archive-date=November 7, 2013 |archive-url=https://web.archive.org/web/20131107185749/http://www.economist.com/news/united-states/21588951-congress-hears-tales-baffling-ineptitude-debacle |url-status=live }}</ref> Various bills were introduced in Congress to allow people to keep their plans.<ref>{{cite news |url=http://www.mcclatchydc.com/2013/11/08/207999/congress-weighing-laws-to-let.html |title=Congress weighing laws to let people keep health insurance |last=Schoof |first=Renee |date=November 8, 2013 |access-date=November 14, 2013 |publisher=McClatchyDC |archive-date=November 13, 2013 |archive-url=https://web.archive.org/web/20131113010850/http://www.mcclatchydc.com/2013/11/08/207999/congress-weighing-laws-to-let.html |url-status=live }}</ref> | Obama's previous unambiguous assurance that consumers could keep their own plans became a focal point for critics, who challenged his truthfulness.<ref>{{cite magazine |last=Weigel |first=David |date=November 8, 2013 |title=The White House's Website Still Says If You Like Your Plan You Can Keep It |url=http://www.slate.com/blogs/weigel/2013/11/08/the_white_house_s_web_site_still_says_if_you_like_your_plan_you_can_keep.html |magazine=Slate |access-date=November 9, 2013 |archive-date=November 8, 2013 |archive-url=https://web.archive.org/web/20131108232659/http://www.slate.com/blogs/weigel/2013/11/08/the_white_house_s_web_site_still_says_if_you_like_your_plan_you_can_keep.html |url-status=live }}</ref><ref>{{cite news |url=https://www.economist.com/news/united-states/21588951-congress-hears-tales-baffling-ineptitude-debacle |title=Obamacare: The debacle |date=November 2, 2013 |newspaper=[[The Economist]] |access-date=November 8, 2013 |archive-date=November 7, 2013 |archive-url=https://web.archive.org/web/20131107185749/http://www.economist.com/news/united-states/21588951-congress-hears-tales-baffling-ineptitude-debacle |url-status=live }}</ref> Various bills were introduced in Congress to allow people to keep their plans.<ref>{{cite news |url=http://www.mcclatchydc.com/2013/11/08/207999/congress-weighing-laws-to-let.html |title=Congress weighing laws to let people keep health insurance |last=Schoof |first=Renee |date=November 8, 2013 |access-date=November 14, 2013 |publisher=McClatchyDC |archive-date=November 13, 2013 |archive-url=https://web.archive.org/web/20131113010850/http://www.mcclatchydc.com/2013/11/08/207999/congress-weighing-laws-to-let.html |url-status=live }}</ref> | ||
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Texas and 19 other states filed a civil suit in the [[United States District Court for the Northern District of Texas]] in February 2018, arguing that with the passage of the [[Tax Cuts and Jobs Act of 2017]], which eliminated the tax for not having health insurance, the individual mandate no longer had a constitutional basis and thus the entire ACA was no longer constitutional.<ref>{{cite web |title=Complaint for Declaratory and Injunctive Relief |id=Case 4:18-cv-00167-O |date=2018-02-26 |url=https://www.courtlistener.com/recap/gov.uscourts.txnd.299449/gov.uscourts.txnd.299449.1.0.pdf |access-date=December 15, 2018 |archive-date=July 26, 2020 |archive-url=https://web.archive.org/web/20200726051600/https://www.courtlistener.com/recap/gov.uscourts.txnd.299449/gov.uscourts.txnd.299449.1.0.pdf |url-status=live }}</ref> The [[United States Department of Justice|Department of Justice]] said it would no longer defend the ACA in court, but 17 states led by California stepped in to do so.<ref name="cnn 20181214" /> | Texas and 19 other states filed a civil suit in the [[United States District Court for the Northern District of Texas]] in February 2018, arguing that with the passage of the [[Tax Cuts and Jobs Act of 2017]], which eliminated the tax for not having health insurance, the individual mandate no longer had a constitutional basis and thus the entire ACA was no longer constitutional.<ref>{{cite web |title=Complaint for Declaratory and Injunctive Relief |id=Case 4:18-cv-00167-O |date=2018-02-26 |url=https://www.courtlistener.com/recap/gov.uscourts.txnd.299449/gov.uscourts.txnd.299449.1.0.pdf |access-date=December 15, 2018 |archive-date=July 26, 2020 |archive-url=https://web.archive.org/web/20200726051600/https://www.courtlistener.com/recap/gov.uscourts.txnd.299449/gov.uscourts.txnd.299449.1.0.pdf |url-status=live }}</ref> The [[United States Department of Justice|Department of Justice]] said it would no longer defend the ACA in court, but 17 states led by California stepped in to do so.<ref name="cnn 20181214" /> | ||
District Judge [[Reed O'Connor]] of Texas ruled for the plaintiffs on December 14, 2018, writing that the "Individual Mandate can no longer be fairly read as an exercise of Congress's Tax Power and is still impermissible under the Interstate Commerce Clause—meaning the Individual Mandate is unconstitutional." He then further reasoned that the individual mandate is an essential part of the entire law, and thus was not severable, making the entire law unconstitutional.<ref>{{Cite web |last=Sullivan |first=Peter |date=December 14, 2018 |url=https://thehill.com/policy/healthcare/421511-federal-judge-in-texas-strikes-down-obamacare/ |title=Federal judge in Texas strikes down ObamaCare |website=[[The Hill (newspaper)|The Hill]] |issn=1521-1568 |oclc=31153202 |access-date=December 15, 2018 |archive-date=December 15, 2018 |archive-url=https://web.archive.org/web/20181215013835/https://thehill.com/policy/healthcare/421511-federal-judge-in-texas-strikes-down-obamacare |url-status=live }}</ref><ref>{{Cite web |url=https://www.wsj.com/articles/federal-judge-rules-affordable-care-act-is-unconstitutional-11544838743 |title=Federal Judge Rules Affordable Care Act Is Unconstitutional Without Insurance-Coverage Penalty |last=Armour |first=Stephanie |date=December 14, 2018 |publisher=News Corp |oclc=781541372 |issn=0099-9660 |website=[[The Wall Street Journal]] |access-date=December 15, 2018 |archive-date=December 15, 2018 |archive-url=https://web.archive.org/web/20181215043107/https://www.wsj.com/articles/federal-judge-rules-affordable-care-act-is-unconstitutional-11544838743 |url-status=live }}</ref> O'Connor's decision regarding severability turned on several passages from the Congressional debate that focused on the importance of the mandate.<ref>{{Cite web |url=https://lawshelf.com/blog/post/federal-judge-in-texas-strikes-down-obamacare |title=Federal Judge in Texas Strikes Down "Obamacare" |website=lawshelf.com |access-date=May 14, 2019 |archive-date=May 14, 2019 |archive-url=https://web.archive.org/web/20190514121812/https://lawshelf.com/blog/post/federal-judge-in-texas-strikes-down-obamacare |url-status=live }}</ref> While he ruled the law unconstitutional, he did not overturn the law.<ref name="cnn 20181214">{{cite web |url=https://www.cnn.com/2018/12/14/politics/texas-aca-lawsuit/index.html |title=Federal judge in Texas strikes down Affordable Care Act |first1=Ariane |last1=de Vogue |first2=Tami |last2=Luhby |date=December 14, 2018 |access-date=December 14, 2018 |publisher= | District Judge [[Reed O'Connor]] of Texas ruled for the plaintiffs on December 14, 2018, writing that the "Individual Mandate can no longer be fairly read as an exercise of Congress's Tax Power and is still impermissible under the Interstate Commerce Clause—meaning the Individual Mandate is unconstitutional." He then further reasoned that the individual mandate is an essential part of the entire law, and thus was not severable, making the entire law unconstitutional.<ref>{{Cite web |last=Sullivan |first=Peter |date=December 14, 2018 |url=https://thehill.com/policy/healthcare/421511-federal-judge-in-texas-strikes-down-obamacare/ |title=Federal judge in Texas strikes down ObamaCare |website=[[The Hill (newspaper)|The Hill]] |issn=1521-1568 |oclc=31153202 |access-date=December 15, 2018 |archive-date=December 15, 2018 |archive-url=https://web.archive.org/web/20181215013835/https://thehill.com/policy/healthcare/421511-federal-judge-in-texas-strikes-down-obamacare |url-status=live }}</ref><ref>{{Cite web |url=https://www.wsj.com/articles/federal-judge-rules-affordable-care-act-is-unconstitutional-11544838743 |title=Federal Judge Rules Affordable Care Act Is Unconstitutional Without Insurance-Coverage Penalty |last=Armour |first=Stephanie |date=December 14, 2018 |publisher=News Corp |oclc=781541372 |issn=0099-9660 |website=[[The Wall Street Journal]] |access-date=December 15, 2018 |archive-date=December 15, 2018 |archive-url=https://web.archive.org/web/20181215043107/https://www.wsj.com/articles/federal-judge-rules-affordable-care-act-is-unconstitutional-11544838743 |url-status=live }}</ref> O'Connor's decision regarding severability turned on several passages from the Congressional debate that focused on the importance of the mandate.<ref>{{Cite web |url=https://lawshelf.com/blog/post/federal-judge-in-texas-strikes-down-obamacare |title=Federal Judge in Texas Strikes Down "Obamacare" |website=lawshelf.com |access-date=May 14, 2019 |archive-date=May 14, 2019 |archive-url=https://web.archive.org/web/20190514121812/https://lawshelf.com/blog/post/federal-judge-in-texas-strikes-down-obamacare |url-status=live }}</ref> While he ruled the law unconstitutional, he did not overturn the law.<ref name="cnn 20181214">{{cite web |url=https://www.cnn.com/2018/12/14/politics/texas-aca-lawsuit/index.html |title=Federal judge in Texas strikes down Affordable Care Act |first1=Ariane |last1=de Vogue |first2=Tami |last2=Luhby |date=December 14, 2018 |access-date=December 14, 2018 |publisher=CNN |archive-date=December 15, 2018 |archive-url=https://web.archive.org/web/20181215021340/https://www.cnn.com/2018/12/14/politics/texas-aca-lawsuit/index.html |url-status=live }}</ref> | ||
The intervening states appealed the decision to the [[United States Court of Appeals for the Fifth Circuit|Fifth Circuit]]. These states argued that Congress's change in the tax was only reducing the amount of the tax, and that Congress had the power to write a stronger law to this end.<ref>{{cite web |url=https://www.cnn.com/2019/07/08/politics/affordable-care-act-court/index.html |title=Affordable Care Act gears up for momentous test in court |last=Biskupic |first=Joan |author-link=Joan Biskupic |date=July 8, 2019 |publisher= | The intervening states appealed the decision to the [[United States Court of Appeals for the Fifth Circuit|Fifth Circuit]]. These states argued that Congress's change in the tax was only reducing the amount of the tax, and that Congress had the power to write a stronger law to this end.<ref>{{cite web |url=https://www.cnn.com/2019/07/08/politics/affordable-care-act-court/index.html |title=Affordable Care Act gears up for momentous test in court |last=Biskupic |first=Joan |author-link=Joan Biskupic |date=July 8, 2019 |publisher=CNN |access-date=July 8, 2019 |archive-date=July 8, 2019 |archive-url=https://web.archive.org/web/20190708130932/https://www.cnn.com/2019/07/08/politics/affordable-care-act-court/index.html |url-status=live }}</ref><ref name="wapost 20181214">{{cite news |url=https://www.washingtonpost.com/national/health-science/federal-judge-in-texas-rules-obama-health-care-law-unconstitutional/2018/12/14/9e8bb5a2-fd63-11e8-862a-b6a6f3ce8199_story.html |title=Federal judge in Texas rules entire Obama health-care law is unconstitutional |first=Amy |last=Goldstein |date=December 14, 2018 |access-date=December 14, 2018 |issn=0190-8286 |oclc=2269358 |newspaper=[[The Washington Post]] |archive-date=December 15, 2018 |archive-url=https://web.archive.org/web/20181215021631/https://www.washingtonpost.com/national/health-science/federal-judge-in-texas-rules-obama-health-care-law-unconstitutional/2018/12/14/9e8bb5a2-fd63-11e8-862a-b6a6f3ce8199_story.html |url-status=live }}</ref> O'Connor stayed his decision pending the appeal.<ref>{{cite web |url=https://www.cnn.com/2018/12/30/politics/judge-affordable-care-act-remain-in-effect-appeal/index.html |title=Judge says Affordable Care Act will remain in effect during appeal |first1=Kate |last1=Sullivan |first2=Tami |last2=Luhby |date=December 30, 2018 |access-date=December 31, 2018 |publisher=CNN |archive-date=December 31, 2018 |archive-url=https://web.archive.org/web/20181231012052/https://www.cnn.com/2018/12/30/politics/judge-affordable-care-act-remain-in-effect-appeal/index.html |url-status=live }}</ref> The Fifth Circuit heard the appeal on July 9, 2019; in the interim, the U.S. Department of Justice joined with Republican states to argue that the ACA was unconstitutional, while the Democratic states were joined by the Democrat-controlled U.S. House of Representatives. An additional question was addressed, as the Republican plaintiffs challenged the Democratic states' [[Standing (law)|standing]] to defend the ACA.<ref>{{cite web |url=https://www.nytimes.com/2019/07/09/health/obamacare-appeals-court.html |title=Appeals Court Seems Skeptical About Constitutionality of Obamacare Mandate |first=Abby |last=Goodnough |date=July 9, 2019 |access-date=July 9, 2019 |archive-date=July 10, 2019 |archive-url=https://web.archive.org/web/20190710222740/https://www.nytimes.com/2019/07/09/health/obamacare-appeals-court.html |issn=0362-4331 |oclc=1645522 |work=The New York Times}}</ref> | ||
In December 2019, the Fifth Circuit agreed the individual mandate was unconstitutional, but did not agree that the entire law should be voided. Instead, it remanded the case to the District Court for reconsideration of that question.<ref>{{cite news |last=Demko |first=Paul |title=Court voids Obamacare mandate—but not the whole law |newspaper=[[Politico]] |date=December 18, 2019 |url=https://www.politico.com/news/2019/12/18/court-finds-obamacare-mandate-unconstitutional-sends-case-back-to-lower-court-087389 |access-date=February 6, 2020 |archive-date=January 9, 2021 |archive-url=https://web.archive.org/web/20210109011307/https://www.politico.com/news/2019/12/18/court-finds-obamacare-mandate-unconstitutional-sends-case-back-to-lower-court-087389 |url-status=live }}</ref> The Supreme Court accepted the case in March 2020, to be heard in the 2020–2021 term,<ref>{{cite web |url=https://www.nytimes.com/2020/03/02/us/supreme-court-obamacare-appeal.html |title=Supreme Court to Hear Obamacare Appeal |first=Adam |last=Liptak |date=March 2, 2020 |access-date=March 2, 2020 |issn=0362-4331 |oclc=1645522 |work=The New York Times |archive-date=March 2, 2020 |archive-url=https://web.archive.org/web/20200302151009/https://www.nytimes.com/2020/03/02/us/supreme-court-obamacare-appeal.html |url-status=live }}</ref> with the ruling likely falling after the 2020 elections.<ref name="ollstein">{{Citation |last1=Ollstein |first1=Alice Miranda |last2=Arkin |first2=James |title=Democrats seize on anti-Obamacare ruling to steamroll GOP in 2020 |newspaper=[[Politico]] |date=December 26, 2019 |url=https://www.politico.com/news/2019/12/26/democrats-anti-obamacare-2020-elections-089765 |access-date=February 6, 2020 |archive-date=February 15, 2021 |archive-url=https://web.archive.org/web/20210215013002/https://www.politico.com/news/2019/12/26/democrats-anti-obamacare-2020-elections-089765 |url-status=live }}</ref> | In December 2019, the Fifth Circuit agreed the individual mandate was unconstitutional, but did not agree that the entire law should be voided. Instead, it remanded the case to the District Court for reconsideration of that question.<ref>{{cite news |last=Demko |first=Paul |title=Court voids Obamacare mandate—but not the whole law |newspaper=[[Politico]] |date=December 18, 2019 |url=https://www.politico.com/news/2019/12/18/court-finds-obamacare-mandate-unconstitutional-sends-case-back-to-lower-court-087389 |access-date=February 6, 2020 |archive-date=January 9, 2021 |archive-url=https://web.archive.org/web/20210109011307/https://www.politico.com/news/2019/12/18/court-finds-obamacare-mandate-unconstitutional-sends-case-back-to-lower-court-087389 |url-status=live }}</ref> The Supreme Court accepted the case in March 2020, to be heard in the 2020–2021 term,<ref>{{cite web |url=https://www.nytimes.com/2020/03/02/us/supreme-court-obamacare-appeal.html |title=Supreme Court to Hear Obamacare Appeal |first=Adam |last=Liptak |date=March 2, 2020 |access-date=March 2, 2020 |issn=0362-4331 |oclc=1645522 |work=The New York Times |archive-date=March 2, 2020 |archive-url=https://web.archive.org/web/20200302151009/https://www.nytimes.com/2020/03/02/us/supreme-court-obamacare-appeal.html |url-status=live }}</ref> with the ruling likely falling after the 2020 elections.<ref name="ollstein">{{Citation |last1=Ollstein |first1=Alice Miranda |last2=Arkin |first2=James |title=Democrats seize on anti-Obamacare ruling to steamroll GOP in 2020 |newspaper=[[Politico]] |date=December 26, 2019 |url=https://www.politico.com/news/2019/12/26/democrats-anti-obamacare-2020-elections-089765 |access-date=February 6, 2020 |archive-date=February 15, 2021 |archive-url=https://web.archive.org/web/20210215013002/https://www.politico.com/news/2019/12/26/democrats-anti-obamacare-2020-elections-089765 |url-status=live }}</ref> | ||
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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=[[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= | 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==== | ||
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{{Main|2017 Patient Protection and Affordable Care Act replacement proposals}} | {{Main|2017 Patient Protection and Affordable Care Act replacement proposals}} | ||
[[File:John McCain Votes No on Obamacare Repeal.jpg|left|thumb|McCain votes no on repealing the Affordable Care Act by giving a thumbs down.]] | [[File:John McCain Votes No on Obamacare Repeal.jpg|left|thumb|McCain votes no on repealing the Affordable Care Act by giving a thumbs down.]] | ||
During a midnight congressional session starting January 11, the Senate of the [[115th United States Congress|115th Congress of the United States]] voted to approve a "budget blueprint" that would allow [[Republican Party (United States)|Republicans]] to repeal parts of the law "without threat of a [[Democratic Party (United States)|Democratic]] [[filibuster]]".<ref>{{Cite news |url=https://www.nytimes.com/2017/01/12/us/politics/health-care-congress-vote-a-rama.html |title=Senate Takes Major Step Toward Repealing Health Care Law |last1=Kaplan |first1=Thomas |date=January 12, 2017 |work=The New York Times |issn=0362-4331 |oclc=1645522 |last2=Pear |first2=Robert |access-date=January 12, 2017 |archive-date=January 12, 2017 |archive-url=https://web.archive.org/web/20170112113923/https://www.nytimes.com/2017/01/12/us/politics/health-care-congress-vote-a-rama.html |url-status=live }}</ref><ref>{{Cite news |url=https://www.foxnews.com/politics/gop-senate-to-move-forward-on-obamacare-repeal |title=GOP Senate to Move Forward on ObamaCare Repeal |date=January 11, 2017 |publisher=[[Fox News]] Politics |access-date=January 12, 2017}}</ref> The plan, which passed 51–48, was named by Senate Republicans the "Obamacare 'repeal resolution.{{' "}}<ref>{{Cite news |url=http://www.cnn.com/2017/01/11/politics/senate-obamacare-repeal/ |title=Senate Opens Obamacare Repeal Drive with Overnight Marathon |last1=Lee |first1=MJ |date=January 12, 2017 |publisher= | During a midnight congressional session starting January 11, the Senate of the [[115th United States Congress|115th Congress of the United States]] voted to approve a "budget blueprint" that would allow [[Republican Party (United States)|Republicans]] to repeal parts of the law "without threat of a [[Democratic Party (United States)|Democratic]] [[filibuster]]".<ref>{{Cite news |url=https://www.nytimes.com/2017/01/12/us/politics/health-care-congress-vote-a-rama.html |title=Senate Takes Major Step Toward Repealing Health Care Law |last1=Kaplan |first1=Thomas |date=January 12, 2017 |work=The New York Times |issn=0362-4331 |oclc=1645522 |last2=Pear |first2=Robert |access-date=January 12, 2017 |archive-date=January 12, 2017 |archive-url=https://web.archive.org/web/20170112113923/https://www.nytimes.com/2017/01/12/us/politics/health-care-congress-vote-a-rama.html |url-status=live }}</ref><ref>{{Cite news |url=https://www.foxnews.com/politics/gop-senate-to-move-forward-on-obamacare-repeal |title=GOP Senate to Move Forward on ObamaCare Repeal |date=January 11, 2017 |publisher=[[Fox News]] Politics |access-date=January 12, 2017}}</ref> The plan, which passed 51–48, was named by Senate Republicans the "Obamacare 'repeal resolution.{{' "}}<ref>{{Cite news |url=http://www.cnn.com/2017/01/11/politics/senate-obamacare-repeal/ |title=Senate Opens Obamacare Repeal Drive with Overnight Marathon |last1=Lee |first1=MJ |date=January 12, 2017 |publisher=CNN|last2=Barrett |first2=Ted |last3=LoBianco |first3=Tom |access-date=January 12, 2017}}</ref> Democrats opposing the resolution staged a protest during the vote.<ref>{{Cite news |url=http://www.nbcnews.com/politics/congress/senate-vote-obamacare-repeal-measure-late-night-session-n705816 |title=Senate Approves First Step Toward Repealing Obamacare in Late-Night Session |last=Caldwell |first=Leigh Ann |date=January 12, 2017 |publisher=[[NBC News]] |access-date=January 12, 2017}}</ref> | ||
[[Republican Conference of the United States House of Representatives|House Republicans]] announced their replacement, the [[American Health Care Act]], on March 6.<ref>{{cite news |last1=Golstein |first1=Amy |last2=DeBonis |first2=Mike |last3=Snell |first3=Kelsey |title=House Republicans release long-awaited plan to repeal and replace Obamacare |url=https://www.washingtonpost.com/powerpost/new-details-emerge-on-gop-plans-to-repeal-and-replace-obamacare/2017/03/06/04751e3e-028f-11e7-ad5b-d22680e18d10_story.html |access-date=March 7, 2017 |issn=0190-8286 |oclc=2269358 |newspaper=[[The Washington Post]]}}</ref> On March 24, the AHCA failed amid a revolt among Republican representatives.<ref>{{cite news |last1=Pear |first1=Robert |title=Push to Repeal Health Law Fails |url=https://www.nytimes.com/2017/03/24/us/politics/health-care-affordable-care-act.html |access-date=March 24, 2017 |issn=0362-4331 |oclc=1645522 |newspaper=The New York Times |date=March 24, 2017}}</ref> | [[Republican Conference of the United States House of Representatives|House Republicans]] announced their replacement, the [[American Health Care Act]], on March 6.<ref>{{cite news |last1=Golstein |first1=Amy |last2=DeBonis |first2=Mike |last3=Snell |first3=Kelsey |title=House Republicans release long-awaited plan to repeal and replace Obamacare |url=https://www.washingtonpost.com/powerpost/new-details-emerge-on-gop-plans-to-repeal-and-replace-obamacare/2017/03/06/04751e3e-028f-11e7-ad5b-d22680e18d10_story.html |access-date=March 7, 2017 |issn=0190-8286 |oclc=2269358 |newspaper=[[The Washington Post]]}}</ref> On March 24, the AHCA failed amid a revolt among Republican representatives.<ref>{{cite news |last1=Pear |first1=Robert |title=Push to Repeal Health Law Fails |url=https://www.nytimes.com/2017/03/24/us/politics/health-care-affordable-care-act.html |access-date=March 24, 2017 |issn=0362-4331 |oclc=1645522 |newspaper=The New York Times |date=March 24, 2017}}</ref> | ||
On May 4 the House voted to pass the AHCA by a margin of 217 to 213.<ref>{{cite news |url=http://edition.cnn.com/2017/05/04/politics/health-care-vote/ |title=House Republicans pass bill to repeal and replace Obamacare |publisher= | On May 4 the House voted to pass the AHCA by a margin of 217 to 213.<ref>{{cite news |url=http://edition.cnn.com/2017/05/04/politics/health-care-vote/ |title=House Republicans pass bill to repeal and replace Obamacare |publisher=CNN |date=May 4, 2017 |access-date=May 4, 2017}}</ref> The Senate Republican leadership announced that Senate Republicans would write their own version of the bill instead of voting on the House version.<ref>{{Cite web |url=https://www.businessinsider.com/senate-plan-for-healthcare-bill-ahca-2017-5 |title=Senate Republicans signal they plan to scrap bill the House just passed and write their own |first=Bob |last=Bryan |website=[[Business Insider]] |date=May 4, 2017}}</ref> | ||
[[Party leaders of the United States Senate|Leader]] McConnell named a group of 13 Republicans to draft the substitute version in private, raising bipartisan concerns about lack of transparency.<ref>{{cite news |work=The New York Times |title=Secrecy Surrounding Senate Health Bill Raises Alarms in Both Parties |url=https://www.nytimes.com/2017/06/15/us/politics/secrecy-surrounding-senate-health-bill-raises-alarms-in-both-parties.html |issn=0362-4331 |oclc=1645522 |first1=Thomas |last1=Kaplan |first2=Robert |last2=Pear |date=June 15, 2017 |url-status=live |archive-url=https://web.archive.org/web/20170618182849/https://www.nytimes.com/2017/06/15/us/politics/secrecy-surrounding-senate-health-bill-raises-alarms-in-both-parties.html |archive-date=June 18, 2017}}</ref><ref>{{cite news |newspaper=[[The Washington Post]] |title=The remarkable steps Republicans are taking to obscure what's in their health-care bill |first=Philip |last=Bump |issn=0190-8286 |oclc=2269358 |url=https://www.washingtonpost.com/news/politics/wp/2017/06/13/the-remarkable-steps-republicans-are-taking-to-obscure-whats-in-their-health-care-bill/ |date=June 13, 2017 |url-status=live |archive-url=https://web.archive.org/web/20170620082523/https://www.washingtonpost.com/news/politics/wp/2017/06/13/the-remarkable-steps-republicans-are-taking-to-obscure-whats-in-their-health-care-bill/ |archive-date=June 20, 2017}}</ref><ref>{{cite news |publisher=[[NBC News]] |title=The Senate's Health Care Bill Remains Shrouded in Secrecy |first1=Benjy |last1=Sarlin |first2=Leigh Ann |last2=Caldwell |url=http://www.nbcnews.com/politics/congress/senate-s-health-care-bill-remains-shrouded-secrecy-n772456 |date=June 15, 2017 |url-status=live |archive-url=https://web.archive.org/web/20170619162148/http://www.nbcnews.com/politics/congress/senate-s-health-care-bill-remains-shrouded-secrecy-n772456 |archive-date=June 19, 2017}}</ref> On June 22, Republicans released the first discussion draft, which renamed it the "Better Care Reconciliation Act of 2017" (BCRA).<ref>{{cite web |url=https://www.budget.senate.gov/imo/media/doc/SENATEHEALTHCARE.pdf |title=H.R. 1628, Better Care Reconciliation Act of 2017, discussion draft ERN17282 |publisher=Senate Budget Committee |date=June 22, 2017}}</ref> On July 25, although no amendment proposal had garnered majority support, Republicans voted to advance the bill to the floor and begin formal consideration of amendments. Senators [[Susan Collins]] and [[Lisa Murkowski]] were the only two dissenting Republicans, making the vote a 50–50 tie. Vice President [[Mike Pence]] then cast the tie-breaking vote in the affirmative.<ref>{{cite web |url=http://www.cnn.com/2017/07/25/politics/senate-health-care-vote/index.html |title=McCain returns as Senate advances health bill |author1=Lauren Fox |author2=MJ Lee |author3=Phil Mattingly |author4=Ted Barrett |publisher= | [[Party leaders of the United States Senate|Leader]] McConnell named a group of 13 Republicans to draft the substitute version in private, raising bipartisan concerns about lack of transparency.<ref>{{cite news |work=The New York Times |title=Secrecy Surrounding Senate Health Bill Raises Alarms in Both Parties |url=https://www.nytimes.com/2017/06/15/us/politics/secrecy-surrounding-senate-health-bill-raises-alarms-in-both-parties.html |issn=0362-4331 |oclc=1645522 |first1=Thomas |last1=Kaplan |first2=Robert |last2=Pear |date=June 15, 2017 |url-status=live |archive-url=https://web.archive.org/web/20170618182849/https://www.nytimes.com/2017/06/15/us/politics/secrecy-surrounding-senate-health-bill-raises-alarms-in-both-parties.html |archive-date=June 18, 2017}}</ref><ref>{{cite news |newspaper=[[The Washington Post]] |title=The remarkable steps Republicans are taking to obscure what's in their health-care bill |first=Philip |last=Bump |issn=0190-8286 |oclc=2269358 |url=https://www.washingtonpost.com/news/politics/wp/2017/06/13/the-remarkable-steps-republicans-are-taking-to-obscure-whats-in-their-health-care-bill/ |date=June 13, 2017 |url-status=live |archive-url=https://web.archive.org/web/20170620082523/https://www.washingtonpost.com/news/politics/wp/2017/06/13/the-remarkable-steps-republicans-are-taking-to-obscure-whats-in-their-health-care-bill/ |archive-date=June 20, 2017}}</ref><ref>{{cite news |publisher=[[NBC News]] |title=The Senate's Health Care Bill Remains Shrouded in Secrecy |first1=Benjy |last1=Sarlin |first2=Leigh Ann |last2=Caldwell |url=http://www.nbcnews.com/politics/congress/senate-s-health-care-bill-remains-shrouded-secrecy-n772456 |date=June 15, 2017 |url-status=live |archive-url=https://web.archive.org/web/20170619162148/http://www.nbcnews.com/politics/congress/senate-s-health-care-bill-remains-shrouded-secrecy-n772456 |archive-date=June 19, 2017}}</ref> On June 22, Republicans released the first discussion draft, which renamed it the "Better Care Reconciliation Act of 2017" (BCRA).<ref>{{cite web |url=https://www.budget.senate.gov/imo/media/doc/SENATEHEALTHCARE.pdf |title=H.R. 1628, Better Care Reconciliation Act of 2017, discussion draft ERN17282 |publisher=Senate Budget Committee |date=June 22, 2017}}</ref> On July 25, although no amendment proposal had garnered majority support, Republicans voted to advance the bill to the floor and begin formal consideration of amendments. Senators [[Susan Collins]] and [[Lisa Murkowski]] were the only two dissenting Republicans, making the vote a 50–50 tie. Vice President [[Mike Pence]] then cast the tie-breaking vote in the affirmative.<ref>{{cite web |url=http://www.cnn.com/2017/07/25/politics/senate-health-care-vote/index.html |title=McCain returns as Senate advances health bill |author1=Lauren Fox |author2=MJ Lee |author3=Phil Mattingly |author4=Ted Barrett |publisher=CNN|date=July 25, 2017 |url-status=live |archive-url=https://web.archive.org/web/20170725204952/http://www.cnn.com/2017/07/25/politics/senate-health-care-vote/index.html |archive-date=July 25, 2017}}</ref> | ||
The revised BCRA failed, 43–57. A subsequent "Obamacare Repeal and Reconciliation Act" abandoned the "repeal and replace" approach in favor of a straight repeal, but that too failed, 45–55. Finally, the "Health Care Freedom Act", nicknamed "skinny repeal" because it would have made the least change to ACA, failed by 49–51, with Collins, Murkowski, and McCain joining all Democrats and independents in voting against it.<ref>{{Citation |last=Klein |first=Ezra |author-link=Ezra Klein |title=The GOP's massive health care failures, explained |publisher=[[Vox (website)|Vox]] |date=July 28, 2017 |url=https://www.vox.com/health-care/2017/7/28/16055284/gop-massive-health-care-failures-explained |archive-url=https://web.archive.org/web/20170728212507/https://www.vox.com/health-care/2017/7/28/16055284/gop-massive-health-care-failures-explained |archive-date=July 28, 2017 |access-date=August 3, 2017}}</ref> | The revised BCRA failed, 43–57. A subsequent "Obamacare Repeal and Reconciliation Act" abandoned the "repeal and replace" approach in favor of a straight repeal, but that too failed, 45–55. Finally, the "Health Care Freedom Act", nicknamed "skinny repeal" because it would have made the least change to ACA, failed by 49–51, with Collins, Murkowski, and McCain joining all Democrats and independents in voting against it.<ref>{{Citation |last=Klein |first=Ezra |author-link=Ezra Klein |title=The GOP's massive health care failures, explained |publisher=[[Vox (website)|Vox]] |date=July 28, 2017 |url=https://www.vox.com/health-care/2017/7/28/16055284/gop-massive-health-care-failures-explained |archive-url=https://web.archive.org/web/20170728212507/https://www.vox.com/health-care/2017/7/28/16055284/gop-massive-health-care-failures-explained |archive-date=July 28, 2017 |access-date=August 3, 2017}}</ref> | ||
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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=[[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= | 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"/> | ||
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<ref name="CMSMedicarePPACA">{{cite web |title=Affordable Care Act Update: Implementing Medicare Cost Savings |url=http://www.cms.gov/apps/docs/aca-update-implementing-medicare-costs-savings.pdf |publisher=Centers for Medicare and Medicaid Services |date=August 2, 2010 |access-date=October 7, 2013 |url-status=dead |archive-url=https://web.archive.org/web/20130418015959/http://www.cms.gov/apps/docs/aca-update-implementing-medicare-costs-savings.pdf |archive-date=April 18, 2013 }}</ref> | <ref name="CMSMedicarePPACA">{{cite web |title=Affordable Care Act Update: Implementing Medicare Cost Savings |url=http://www.cms.gov/apps/docs/aca-update-implementing-medicare-costs-savings.pdf |publisher=Centers for Medicare and Medicaid Services |date=August 2, 2010 |access-date=October 7, 2013 |url-status=dead |archive-url=https://web.archive.org/web/20130418015959/http://www.cms.gov/apps/docs/aca-update-implementing-medicare-costs-savings.pdf |archive-date=April 18, 2013 }}</ref> | ||
<ref name="CNN-Mar18">{{Cite news |url=http://www.cnn.com/2010/POLITICS/03/18/health.care.latest/index.html |publisher= | <ref name="CNN-Mar18">{{Cite news |url=http://www.cnn.com/2010/POLITICS/03/18/health.care.latest/index.html |publisher=CNN|title=Where does health care reform stand? |date=March 18, 2010 |access-date=May 12, 2010}}</ref> | ||
<ref name="CNNMedicaid">{{cite news |url=https://money.cnn.com/2013/07/01/news/economy/medicaid-expansion-states/index.html |title=States forgo billions by opting out of Medicaid expansion |author=Luhby, Tami |publisher=Time Warner |website=CNNMoney |access-date=June 21, 2022 |archive-date=July 4, 2013 |archive-url=https://web.archive.org/web/20130704110006/https://money.cnn.com/2013/07/01/news/economy/medicaid-expansion-states/index.html |date=July 1, 2013}}</ref> | <ref name="CNNMedicaid">{{cite news |url=https://money.cnn.com/2013/07/01/news/economy/medicaid-expansion-states/index.html |title=States forgo billions by opting out of Medicaid expansion |author=Luhby, Tami |publisher=Time Warner |website=CNNMoney |access-date=June 21, 2022 |archive-date=July 4, 2013 |archive-url=https://web.archive.org/web/20130704110006/https://money.cnn.com/2013/07/01/news/economy/medicaid-expansion-states/index.html |date=July 1, 2013}}</ref> | ||
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<ref name="Const-Revenue">[[United States Constitution|U.S. Const.]] art. I, § 7, cl. 1.</ref> | <ref name="Const-Revenue">[[United States Constitution|U.S. Const.]] art. I, § 7, cl. 1.</ref> | ||
<ref name="CNN20120625Obamacare">{{cite news |url=http://www.cnn.com/2012/06/25/politics/obamacare-word-debate/ |title='Obamacare': The word that defined the health care debate |last=Wallace |first=Gregory |date=June 25, 2012 |publisher= | <ref name="CNN20120625Obamacare">{{cite news |url=http://www.cnn.com/2012/06/25/politics/obamacare-word-debate/ |title='Obamacare': The word that defined the health care debate |last=Wallace |first=Gregory |date=June 25, 2012 |publisher=CNN|access-date=September 4, 2012}}</ref> | ||
<ref name="cnncontra">{{cite news |url=http://www.cnn.com/2011/HEALTH/07/19/birth.control.iom/index.html |title=Birth control should be fully covered under health plans, report says |last=Park |first=Madison |date=July 19, 2011 |publisher= | <ref name="cnncontra">{{cite news |url=http://www.cnn.com/2011/HEALTH/07/19/birth.control.iom/index.html |title=Birth control should be fully covered under health plans, report says |last=Park |first=Madison |date=July 19, 2011 |publisher=CNN|access-date=August 27, 2012}}</ref> | ||
<ref name="CohnDelay">{{cite news |url=https://newrepublic.com/article/113745/obamacare-employer-mandate-delayed-not-what-doctor-ordered |title=Some Bad News About Obamacare That Isn't Bogus |last=Cohn |first=Jonathan |date=July 2, 2013 |magazine=[[The New Republic]]}}</ref> | <ref name="CohnDelay">{{cite news |url=https://newrepublic.com/article/113745/obamacare-employer-mandate-delayed-not-what-doctor-ordered |title=Some Bad News About Obamacare That Isn't Bogus |last=Cohn |first=Jonathan |date=July 2, 2013 |magazine=[[The New Republic]]}}</ref> | ||