My Doctor Is Now the IRS

The unfortunately named Patient Protection and Affordable Care Act (PPACA) of 2010, passed by 111th Congress, touted the following:

• increased access to health insurance coverage (not necessarily access to health care)
• expansion of federal private health insurance market requirements
• creation of health insurance exchanges to provide individuals and small employers with access to insurance
• expansion of Medicaid coverage

The federal government pledged to cover the cost of the most massive bureaucratic expansion of our health care system by an increase in tax revenues and reduction in spending on Medicare and other federal health programs. According to the Congressional Budget Office estimates, Obamacare will add at least $1 trillion dollars to spending over the next ten years. Since we are already broke, do we really need more spending we cannot afford? As soon as Obamacare became law, the legal challenges began. Individuals, states, and other groups sued on constitutional grounds - the forced mandate for individuals to purchase health insurance being beyond Congress’s enumerated powers. The states sued because the expansion of Medicaid infringed on states’ rights, forcing them to accept “onerous conditions in exchange for federal funds.” The Supreme Court issued on June 28, 2012 its decision on National Federation of Independent Business v. Sebelius. The findings were as follows:

• “the individual mandate is a constitutional exercise of Congress’s authority to levy taxes”
• “the individual mandate is not a valid exercise of Congress’s power under the Commerce Clause or the Necessary and Proper Clause”
• “In regards to the Medicaid expansion, the federal government cannot terminate current Medicaid program federal matching funds if a state refuses to expand its Medicaid program”
• “If a state accepts the new Obamacare Medicaid expansion funds, it must abide by the new expansion coverage rules”
• A state can refuse to participate in the expansion without losing any of its current federal Medicaid matching funds”
• “All other provisions of Obamacare remain intact” (ACA: Summary, July 3, 2012)

The Supreme Court, using semantics in its decision, changed the law written and passed by Congress, making the individual mandate a “tax.” Justice Roberts used the opportunity to make his mark in “judicial activism from the bench” history, by siding with the liberals. “While most of the major provisions of the law do not take effect until 2014, some provisions are already in place, with others to be phased in over the next few years,” more specifically, 2018. (CRS Report for Congress, July 3, 2012) Temporary programs were created for “targeted groups.” These programs were responsible for the premium escalation of everybody’s health insurance since 2010. The targeted groups were:

• High-risk uninsured individuals with preexisting conditions
• Reinsurance program to reimburse employers for a portion of the health insurance claims costs for 55-64 year old retirees (unions must be protected)
• Small business tax credits for businesses with less than 25 full-time “equivalents” (FTEs), average wages below $50,000 who choose to offer health insurance.(suddenly, employees have become “equivalents” in federal jargon)
• Prior to 2014, “states may choose voluntarily to expand their Medicaid programs”

Private health insurance changes have taken effect and are responsible for such increase in premiums that eventually everybody will be forced into the federal health exchanges, including “children” under the age of 26.

• Children under 19 cannot be denied insurance and benefits based on preexisting conditions
• Major medical plans cannot impose any lifetime dollar limits on essential health benefits and are prohibited from doing so beginning in 2014 (Does anyone believe that these companies will stay in business after 2014?)
• Preventive care with no cost sharing must be provided
• Coverage cannot be rescinded except in case of fraud
• Insurers must have an appeals process for coverage and claims (I thought that existed already, are they trying to reinvent the wheel?)
• Insurers have to limit the ratio of premiums spent on administrative costs v. medical costs – called the medical loss ratio, MLRs.

I predict that most private insurers will be pushed out of business. Americans will be forced into a government health insurance exchange, a privilege for which they will have to pay a tax determined by the omnipotent government. A 15-member bureaucratic death panel will deny as much medical care as possible based on age and utility of a “unit” (person) in order to save money. Obamacare is so great that the ruling elites and Congress have exempted themselves from it. We will have a two tier healthcare system, just like under communism, the elites will have their private hospitals and polyclinics while the proletariat will become part of the exchanges where shortages, rationing, and denial of care will dominate. Health care will be financed, organized, and delivered according to the rules of the IRS and HHS. Poor families will receive subsidies to purchase coverage through health exchanges. Excise taxes will be imposed on those who can afford Cadillac plans. The tax code, Medicare, Medicaid, CHIP, and other federal programs will be modified in order to reduce benefits for rationing purposes and to tax those able to pay more. As enacted, Obamacare “requires state Medicaid programs to expand coverage to all eligible non-pregnant legal residents with incomes up to 133% of the federal poverty level, or risk losing their federal Medicaid matching funds.” The Supreme Court, however, found that the Medicaid expansion violated the Constitution. (CRS, p. 6) Obamacare will make the doctor shortage worse. It has already caused the cancellation of many doctor-owned hospitals. Thousands of new bureaucrats will take over our health care system while the federal government will replace American trained physicians, who might leave the profession, with third world doctors. Plans to admit students to medical school based on racial and ethnic quotas and not merit, involving shorter training, will exacerbate the problem and deliver substandard care. Doctors will be paid the same regardless of specialty and the government will set all doctors’ fees. (ACA, p. 241, p. 253) Based on the Massachusetts model of Romneycare, the average wait to see a doctor will expand similarly from 33 days to over 55 days. Patients will have to pay for life-saving drugs but life-ending drugs will be free. If health care for everyone is important, shouldn’t life-saving drugs be free instead of life-ending drugs? The government will specify which doctors will write an end-of-life order. (p. 429) Patients on social security will be required to attend end-of-life planning seminars every five years, a sort of death counseling, and a mandated advanced-care planning consultation. (p. 425) Oncology hospitals will ration cancer care according to the patient’s age. (p. 272, section 1145) IRS will control the enforcing of Obamacare, have direct and mandated access to our bank accounts, will levy 20 new taxes, will control costs, promote efficiency, and, in the process, will reduce our life expectancy by denying needed care - that will kill many Americans before their time. IRS will have real-time access to an individual’s bank account and will have the authority to make electronic fund transfers from those accounts. (ACA, pp. 58-59) The Congressional Budget Office and the Joint Committee on Taxation cost projections for Obamcare do not include the Supreme Court’s decision, which precludes HHS Secretary Sebelius from penalizing states that choose not to participate in the Medicaid expansion. (CRS Report, July 3, 2012, p. 5) If a state decides not to implement the Medicaid expansion, “low-income adults below the poverty line who were not covered by, or eligible for, the state’s existing Medicaid program would in general be ineligible for the exchange subsidies.” (CRS Report, p. 8) Low-income Americans would have to pay for the health exchange out of their own pockets. The very people President Obama vowed to help with his mandate are now being taxed by his regime because they merely exist and the government knows what is best for them. If the medical profession is allowed to unionize and thus strike, a new Pandora’s Box will be opened. Recently in the UK, unionized doctors and nurses went on strike, leaving patients without care, while scheduled surgeries were postponed. David Martin, Executive President of the Media Research Center, said, “the media played a role in deceiving Americans about the impact of this horrific law, regurgitating verbatim every lie told by the Obama Administration. Every promise the media and the Obama Administration made about Obamacare – that it would make healthcare cheaper without increasing taxes or deficits, that you can keep your doctor, the businesses would not be hit with crippling regulations and taxes – has been broken.” (June 28, 2012) Political pundits, liberals and RINOs, have attempted miserably to spin the Supreme Court’s decision in perplexing ways such as, Justice Roberts tricked the liberals by siding and voting with them, but he is such a brilliant and clever conservative. Interestingly, Senator Obama voted in 2005 against the man who saved his health care law. “The bottom line is this: I will be voting against John Roberts’ nomination.” Senator Obama continued, “I hope that his jurisprudence is one that stands up to the bullies of all ideological types.” Justice Robert’s “jurisprudence and outstanding legal thinking” did not stand up to liberal bullying and he voted against the productive Americans in our society. Americans are not giving up. Orly Taitz filed a class action suit on behalf of Christian and Jewish U.S citizens.

“Healthcare Obama Tax is illegal as it violates Equal Protection Clause, Due Process Clause, Establishment Clause, and Free Exercise of Religion Clause of the U.S. Constitution by exempting Muslim citizens, and places a heavy tax burden on Christian and Jewish U.S. Citizens to pay a de facto Judeo-Christian Obama Tax not only for themselves, but also for Muslim citizens, who are exempt.” (July 5, 2012, 113-page complaint, filed in the U.S. District Court for the Central District of California)

The stark truth in Realityville is that Obamacare is the biggest victory for President Obama, the biggest loss of personal freedom in America, the downgrading of medical care quality to levels of third world nations, the highest tax hike in the history of our country, and the biggest usurpation of our Constitution. Columnist Note: Credit due to Honorable David Kithil of Marble Falls, Texas for providing specific page numbers from HB3200