jetson

Well, we have another one. Today, Obama, has extended it for a year. The only ones coming to the Obama care are the poor. The ones that get it free. Where will the funds come from, to support it. No one buying into the exchanges. Now, they can keep their insurance, or buy some other. By the time another year goes by, we will have a nation full of insured poor, with empty funds in the exchanges, to pay for it. Probably, biggest entitlement ever.

Boo_Boo Loc: Jellystone

I keep saying, Obamacare was designed to fail so a single payer program or another entitlement program can burden our country. What will the next entitlement be?? Not cell phones, that has been done. Not housing, that has been done. Not food, that has been done. Utilities, nope that has been done. Day care, nope that too has been done. Perhaps vacations to Hawaii to see where Obama claims to be born??

lpnmajor Loc: Arkansas

It will be free wall street profit sharing. I think there might just be enough for $2 per person.

NAVSOG

Read if you want the simple break down
This article below is the most comprehensive analysis available of “Obamacare” – the Patient Protection and Affordable Care Act. The author, a knowledgeable person who wishes to remain anonymous, explains how Obamacare works for the insurance companies but not for you.
Obamacare was formulated on the concept of health care as a commercial commodity and was cloaked in ideological slogans such as “shared responsibility,” “no free riders” and “ownership society.” These slogans dress the insurance industry’s raid on public resources in the cloak of a “free market” health care system.
You will learn how to purchase a subsidized plan at the Exchange, what will happen when income and family circumstances change during the year or from one year to the next, and other perils brought to you by Obamacare. It is one of the most important articles that will be posted on my website this year. Americans will be shocked to learn the extent to which they have been deceived. The legislation neither protects the patient nor are the plans affordable.
The author shows that for those Americans whose income places them between 138% and 400% of the Federal Poverty Level, the out-of-pocket cost for one of the least expensive (lower coverage) subsidized policies ranges from 2% to 9.5% of Modified Adjusted Gross Income (MAGI), a tax base larger than the adjusted Gross Income used for calculating federal income tax.
What this means is that those Americans with the least or no disposable income are faced in effect with a substantial pay cut. The author provides an example of a 35 year-old with a MAGI of $27,925. The out-of- pocket cost to this person of a Silver level plan (second least expensive) is $187.33 per month. This cost is based on pre-tax income, that is, before income is reduced by payroll and income taxes. There goes the car payment or utility bill. The lives of millions of Americans will change drastically as they struggle with a new, large expense – particularly in an era of no jobs, low-paying jobs and rising cost of living.
The author also points out that the cost of using the mandated policies will be prohibitive because of the large deductibles and co-pays. Many Americans will find themselves not only with a policy they can’t afford, but also with one they cannot afford to use. Those who cannot afford the insurance, even with a subsidy, will be faced with a costly penalty, and in many cases, this, too, will be difficult, if not impossible, to pay. As each year’s subsidy is based on last year’s income, there will be a substantial year-end tax liability for those who must repay the subsidy in whole or part because their income increased during the year. The stress alone from such a regressive scheme is, without a doubt, not conducive to good health and well-being.
• A d v e r t i s e m e n t
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Diets will worsen for millions of Americans as they struggle with a new large expense. Thus, the effect of Obamacare will be to worsen the health of millions. Indeed, a “glitch” in the legislation allows millions to be priced out of coverage. http://www.huffingtonpost.com/2013/01/30/obamacare-glitch-priced-out-of-health-care_n_2585695.html?view=print&comm_ref=false

Alternatively, Americans might be able to acquire health insurance coverage but have no doctors willing to treat them. http://www.californiahealthline.org/road-to-reform/2013/access-denied-implications-of-medi-cal-pay-cut.aspx#
The demand that Obamacare places on household budgets in which there is no slack makes me wonder where the president’s economists were while the insurance lobby crafted the product that serves the profits of insurance companies. Two well-known economic facts are that real family income has been stagnant or declining for a number of years and Americans are over their heads in debt.
How does Obama preside over a recovery when consumer purchasing power is redirected to insurance company profits?
Obamacare not only rations health care by what a person or family can afford, but also has implications for Medicare patients. Hundreds of billions of dollars are siphoned from Medicare to help pay the cost of Obamacare. The health care provided to Medicare patients will decline with the reduced payments to care providers. Health care seems destined to be rationed according to the age and illnesses of Medicare patients. Those judged too old and too ill could be denied expensive treatments or procedures that would prolong their lives.
Obama will rue the day that his name was put on this special interest legislation, and most Americans, once they realize what has been done to them, will be angry that special interests again prevailed over the health of the nation.
OBAMACARE: DEVILS IN THE DETAILS
The Patient Protection and Affordable Care Act of 2010, commonly referred to as the ACA or Obamacare, will go into full effect in 2014. This decree mandates that all Americans must purchase and maintain government-approved health insurance or pay a penalty to the IRS. Touted as a plan to provide all Americans with access to medical care, in reality, this compulsory shakedown commands everyone to purchase insurance that for many will be too expensive, even with government subsidies – or unaffordable to use – or both.
The ACA was not selflessly designed with the intent of providing affordable and equitable medical services to those in need, but rather to acquire taxpayer money for the private insurance companies under the seemingly helpful guise of health care and the ideological excuse of personal responsibility. It takes money from ordinary people and gives it to a medical insurance industry that profits handsomely from this legally-enforced corporate welfare – all while keeping Americans locked in the same broken system that puts profit before patients. The law was essentially written by business executives from the industry so that special interests would not be upset and profits assured.
There’s a lot to digest about how the ACA works and much is buried in a complex, convoluted maze of regulations and procedures. A few websites contain explanations, but very important details have either been left out or glossed over. These details are well worth understanding so you will know what’s at stake for you and your family. This lesson is not meant to convey a political opinion. This is how the ACA works and under this law, there are no sacred cows.
In today’s lesson, you will learn why 2013 is an important year for many of you with regard to your income and the ACA. We will discuss 1) use of Modified Adjusted Gross Income, 2) tax credits (help paying for insurance), 3) your share of the premium, 4) paying back the tax credits to the IRS, 5) expansion of Medicaid and estate recovery which could affect you if you are put into that plan, 6) inadequate coverage in most subsidized plans, 7) penalties, 8) exemptions and 9) a few tidbits. We’ll also take a look at the agenda of Enroll America and the Health Insurance Exchanges, and what you can expect to hear in the very near future.
Here we go. Fasten your seat belts.
1. HEALTH INSURANCE EXCHANGE BASICS
In 2014, each state will have an Affordable Insurance Exchange where qualified individuals and families with incomes between 138 and 400 percent of the Federal Poverty Level (FPL) can shop for commercial insurance policies. Most individuals and families with incomes at or below 138 percent FPL will be put into Medicaid. You may be eligible for help paying for your insurance in the form of a tax credit. In most states, the Children’s Health Insurance Program (CHIP) will continue to cover children in families with incomes up to at least 200 percent FPL. Some states may offer a Basic Health Plan for those who earn up to 200 percent FPL and are not eligible for Medicaid. Under limited circumstances, you may also be eligible for a cost-sharing credit.
Eligibility to receive a tax credit, the amount of your tax credit and your out-of-pocket share for the insurance will be determined by your income and where you fall in the Federal Poverty Level Guidelines (FPL). This is easy to understand.
Your annual gross income determines which FPL you’re in. For example, based on 2012 FPL Guidelines, an individual with an annual income of $33,510 is at 300 percent FPL; a family of 4 with an annual income of $69,150 is at 300 percent FPL. To see where you’re at, try the handy calculator at this link. FPL Guidelines are revised every January, so the 2013 edition should be up soon.http://www.safetyweb.org/fpl.php
The ACA requires use of MODIFIED ADJUSTED GROSS INCOME (MAGI) instead of Adjusted Gross Income for all determinations made by an Exchange including eligibility for Medicaid except in certain cases. So, in this lesson, we’ll refer to annual income as MAGI.
Modified Adjusted Gross Income (MAGI) is defined as Adjusted Gross Income PLUS
a) all tax exempt interest accrued or received in the taxable year;
b) the non-taxable portion of Social Security benefits provided under Title II of the Social Security Act which includes old-age benefits, disability benefits, spousal benefits, child benefits, survivor benefits and parental benefits;
c) tier 1 Railroad Retirement benefits that are not includible in gross income; and
d) the exclusion from gross income for citizens or residents living abroad.
The adoption of MAGI, created by the ACA, is defined in a new section of the IRS code.
2. DETERMINING ELIGIBILITY FOR A TAX CREDIT
The tax credit is to help you pay for insurance. The ACA says it must be based on annual income for the tax year it’s received, but since you will need help paying for your plan during that year, the ACA allows for advance payment of the tax credit.
Here’s an example of what that means: Let’s say you apply for insurance at an Exchange in 2014. Therefore, 2014 is the tax year you will receive your tax credit, and per the ACA, the amount you receive must be based on that year’s MAGI. But, that year’s MAGI won’t be available until 2015 when you file your 2014 tax return and you need help paying for your insurance plan when you buy it in 2014. So, the amount of your tax credit has to be determined on information that is available such as your prior-year (2013) tax return. Thus, the tax credit morphs into an ‘advance payment of the tax credit’ (also referred to as an advance premium assistance credit). Now you see why 2013 is an important year for many of you.
The ACA allows for limited disclosure of tax return info in order for an Exchange employee to verify your citizenship status and MAGI, and, not only to let you know how much your advance tax credit will be, but also to see if you are eligible to receive this in the first place. An Exchange can also consider using your real-time income by looking at your state’s most current quarterly wage database, or it may agree to accept paper verification (pay stubs, etc.) as a last resort or an attestation of your income with no verification. Creation of a federal ‘data services hub’ is in the works so your income information will be more readily accessible. But, no matter how this plays out, you’ll still receive an advance payment of the tax credit because your actual MAGI for 2014 will not be known by you nor can it be verified by an Exchange until you file your 2014 tax return in 2015.
Ultimately, no matter which method is used – prior year or partial current year – this advance payment of the tax credit carries with it some heavy-duty consequences which are discussed in topic 4 of this lesson.
3. TAX CREDITS AND YOUR SHARE OF THE PREMIUM
The amount of your tax credit will be based on the second lowest-cost Silver plan in the area where you live and your MAGI. Here’s how this works – it’s quite simple:
a) First, the amount you will pay out of your pocket for that Silver plan – copays and deductibles not included – will be a specific percentage of your MAGI, and you will pay this to the insurer on a monthly basis. The way this percentage will be calculated is described a few lines down.
b) Next, your share will be deducted from the cost of that Silver plan and the difference will be your tax credit which the government will pay directly to the insurer on a monthly basis when you purchase a plan.
The specific percentage you will have to pay for the second lowest-cost Silver plan will be based on your FPL using a well-greased sliding scale. As your FPL increases little by little, the percentage you will pay increases. The same percentage applies to an individual or a family. Here’s how much of your MAGI you will pay for that Silver plan:
— up to 138 % FPL: 2% for people legally present less than 5 full years and residents of states that do not expand Medicaid
— 138-150% FPL: 3 to 4%
— 150-200% FPL: 4 to 6.3%
— 200-250% FPL: 6.3 to 8.05%
— 250-300% FPL: 8.05 to 9.5%
— 300-400% FPL: 9.5% – there’s no range, but the dollar amount of your share will change because 9.5% of a lower MAGI is less than 9.5% of a higher MAGI.
Here are two examples in dollars using 2012 FPL Guidelines and an estimate for a second lowest-cost Silver plan which will vary depending where you live – actual costs are not yet available:
a) You are 35 years old and the price of the second lowest-cost Silver plan for an individual in the area where you live is $4,750 with no tax credit. If your MAGI is $33,510 ($2,792.50 per month) putting you at 300 percent FPL, your share for that Silver plan, per the chart above, would be 9.5 percent of your MAGI which comes to $3,183 ($265.25 per month). Your tax credit would be $1,567 which is the difference between the unsubsidized cost of that Silver plan and your share.
b) You are 35 years old and your MAGI is $27,925 ($2,327 per month) putting you at 250 percent FPL, so, your share of that Silver plan would be 8.05 percent of your MAGI which comes to $2,247.96 ($187.33 per month) and your tax credit would be $2,502.
If the second lowest-cost Silver plan is too expensive, you can apply your tax credit to a Bronze plan which will be cheaper but less comprehensive. If you want a better plan than the Silver, you will have to pay the full difference in the premium.
Don’t forget that your share of the monthly premium will be figured on your MAGI which is pre-tax income. So, after you deduct your income taxes and your share of an insurance plan, will you be able to cover your monthly basic living costs including paying off debt you may owe and still have some cash left to pay for medical care if you have to use your insurance? Check out topic 6 in this lesson for a rundown of plans and coverage you can expect to find at an Exchange. Hope you don’t faint.
Once you purchase a plan, your share and your tax credit won’t change until the next enrollment period unless, before that time, your income goes up or down enough to bump you into a different FPL or you get a job with insurance. You can let your Exchange know by phone or via your online account, or, your Exchange might notice while cruising the data services hub you learned about in topic 2 and notify you that you must ‘up’ your coverage or that you’ve been tossed into Medicaid if your MAGI has decreased enough to make you eligible for that plan. Exchanges will be encouraged to use as many different avenues as possible including private databases to keep tabs on your income.
Thus, you could end up bouncing from Medicaid to a subsidized plan or vice versa. By the same token, you could take some extra work to help pay the bills or to save for a vacation, and, oops, you went over 400 percent FPL and are no longer eligible for a tax credit. The Exchange may not find out about this unless you spill the beans, but, no matter how it all plays out, income changes will catch up with you when you file your tax return.
To be eligible for a tax credit you must file your tax return no later than April 15. Married taxpayers must file a joint return. Individuals who are listed as dependents on a return are ineligible for a tax credit.
If you are eligible for Medicaid, you will not be allowed to receive a tax credit or a cost-sharing credit although some states impose premium and cost-sharing charges on certain Medicaid enrollees per the Deficit Reduction Act of 2005 (DRA) and clarified in the Tax Relief and Health Care Act of 2006.
On January 22, 2013, the Centers for Medicare & Medicaid Services (CMS) proposed allowing states to further increase Medicaid premiums and out-of-pocket costs by 5 percent. The most egregious part of this proposed rule says that states may allow providers to deny services for failure to pay the required cost-sharing in certain circumstances. The Obama administration is behind this proposed rule hoping to persuade states to expand Medicaid since many have refused and others are still undecided – the expansion of Medicaid is an integral part of the ACA. Allowing states to further increase premiums and cost-sharing for the poorest segment of the population under- scores the existing political bias toward low-income Americans despite rhetoric which claims otherwise.https://www.federalregister.gov/articles/2013/01/22/2013-00659/medicaid-childrens-health-insurance-programs-and-exchanges-essen- tial-health-benefits-in-alternative#h-186
http://www.nytimes.com/2013/01/23/health/medicaid-patients-could-face-higher-fees-under-a-proposed-federal-policy.html

Affordability rates (the percentage of your MAGI the government has decided you can afford to pay for insurance) are based on boardroom formulas which don’t take particular individual needs into account such as housing costs, property taxes, debt, education, t***sportation, retirement savings, etc. Also, FPL Guidelines are standard across the country and do not take into consideration those who reside in a more expensive region or vice versa. They are one-size-fits-all with the exception of Alaska and Hawaii. See topic 8 in this lesson to learn about exemptions.
Check out what self-proclaimed health care expert Jonathan Gruber says about affordability and get a load of all the “formulas.” According to Mr. Gruber, you may be having too much fun in life and need to get serious, buy health insurance and live under a rock in order to pay for it. He was involved with Romneycare in Massachusetts and was also Mr. Obama’s go to man under a no-bid contract. Per a bar graph on page 6 of a report prepared by Stan Dom for the Urban Institute, subsidized plans under the ACA are estimated to cost 2 to 3 times more (give or take) than the subsidized plans under Romneycare. Per several surveys during the years that Romneycare has been in effect, many low and modest income MA residents have had difficulty paying for those plans and the out-of-pocket costs to use the insurance, particularly chronically-ill residents.
http://ebookbrowse.com/1493-gruber-will-affordable-care-act-make-hlt-ins-affordable-reform-brief-v2-pdf-d124754327
http://www.statecoverage.org/files/TheBasicHealthProgramOptionUnderHealthReform.pdf
4. PAYBACK OF TAX CREDITS TO THE IRS
Perhaps you recall hearing politicians including Mr. Obama say if you can’t afford to pay for health insurance, the government will help you. That was one of the key talking points repeated non stop. We just went over the help part – the tax credits. Now we’ll look at what Mr. Obama et al didn’t tell you which is important to understand because it could cause you some serious financial distress.
Remember the “advance payment of the tax credit” in topic 2 of this lesson? Well, essentially, that was a loan from the government which was paid in advance to the insurer on your behalf when you purchased your plan, and, as you know, loans have to be paid back. So, when you file your tax return for the year you received your “advance tax credit” (your loan), if your income has changed, you have to settle this with the IRS. Here’s the deal:
a) If your MAGI is higher and the increase puts you into a higher FPL, you may have to pay back a portion or all of the tax credit because it was based on a lower MAGI. In other words, you could have an additional tax liability on top of the income taxes you already paid (or still owe) because you received a higher tax credit than you were entitled to.
b) If your MAGI is lower and the decrease puts you into a lower FPL, a refund could be coming to you because you were eligible for a larger tax credit than the government paid to the insurer. In other words, you overpaid for your portion of the insurance premium.
c) If you earned a bit more or less, but your extra earnings or loss didn’t bump you into another FPL, you’re home free.
To figure out your payback, you will have to enter the relevant figures on the reconciliation page of the tax return. Changes in filing status such as the number of people in your household will also have an impact. For those of you who marry or divorce, the rules for the payback amount as well as the amount of the tax credit you are eligible to receive will make your head spin – the computation includes pre- and post-marriage FPL and uses the highest FPL of the two people involved. Ditto for divorce.
Here is one of the reconciliation explanations in IRS-speak: Your liability for an excess tax credit you received must be reflected on your current year income tax return subject to a limitation on the amount of such liability.
Oh! Limitation on the amount of such liability. That sounds good.
Let’s take a peek at the payback limitations on record at the time of this writing. “At the time of this writing” are the operative words because the cap has been increased twice since the ACA was signed into law. The original payback was capped at $400 for families under 400 percent FPL and $200 for individuals. We’ll skip over the first increase. The story behind the second one is that a particular revenue stream was removed from the original law, so something had to be done to compensate for this lost money. Thus, an amendment was passed that increased the cap using a sliding scale, thereby putting a huge financial burden on the backs of the very people the ACA claims to help. In other words, tag, you’re it. You are the cash cow.
Here are the current sliding-scale caps:
If the household income (expressed as a percent of poverty line) is:
less than 200 percent, the applicable dollar amount is $600
at least 200 percent but less than 300 percent, the applicable dollar amount is $1,500
at least 300 percent but less than 400 percent, the applicable dollar amount is $2,500
Effective date: the amendment made by this topic shall apply to taxable years ending after December 31, 2013. Very truly yours, House Ways and Means Committee
The name of this bloodsucker is The Comprehensive 1099 Taxpayer Protection and Repayment of Exchange Subsidy Overpayments Act of 2011.
http://www.gpo.gov/fdsys/pkg/PLAW-112publ9/html/PLAW-112publ9.htm
But wait, there’s more!
a) Update: Today (Feb. 17) (2011) the House Ways and Means Committee approved the 1099 repeal bill which requires consumers earning more than 400 percent of the poverty line to pay back the [entire] subsidy. http://thehill.com/blogs/healthwatch/health-reform-implementation/144847-1099-repeal-gets-trickier-with-house-bill

b) Also, per IRS final regulations: for taxable years beginning after December 31, 2014, the payback caps may be adjusted to reflect changes in the consumer price index.
Payback amounts are reduced to one-half for unmarried individuals who are not surviving spouses or filing as heads of households. There is no help if you get hit with a payback and many of you will have difficulty paying this liability.
Chances that you may have received an incorrect tax credit are not exactly slim because this poorly thought-out scheme does not take into account the unpredictable and complex financial situations that confront the low and modest income population.
Keep in mind that by ending up in a higher FPL, you may also have to pay more out of your pocket for an insurance premium. You learned how that works in topic 3. If you can’t afford a higher premium and drop your insurance, you may still owe a payback plus a penalty for being uninsured which is also MAGI-based. Penalties are discussed in topic 7. If your MAGI puts you over 400 percent FPL, you just knocked yourself into left field and are on your own paying for an insurance plan on the open market. And, you may also be required to payback the entire tax credit.
If you get a job during the current year that offers health insurance which is not more than 9.5 percent of your total salary and the coverage is not less than 60 percent, you must take that insurance or pay a penalty for being uninsured. But, you may owe a payback for the months you received a tax credit before you landed the job. How large that payback is will depend on your MAGI for the entire tax year, not just on your income during the months you received the tax credit. Or, you may lose a job during the year and have a significantly reduced income even though the amount reported on your tax return is high because you had a job for part of the year. In this case as well, your payback will be based on your MAGI for the entire tax year.
More interest income from taxable and tax-exempt savings or a year-end bonus could also contribute to an increased MAGI and the possibility of a payback as well as taking extra work to help pay the monthly bills, house and car repairs, educational aspirations or a vacation. So, whether or not you end up in payback land will depend on how close you are teetering on the edge of an FPL. Ditto for your share of the premium and the amount of your tax credit.
The payback may stop many of you from purchasing insurance at the Exchange because you know in advance you will not have the money to pay it. If this is the case, you may be allowed to negotiate a lesser tax credit by paying more out of your pocket for your monthly insurance premium in order to avoid or decrease the payback. It’s a crap shoot. Considering what you’ve learned so far in today’s lesson, many of you will find yourselves between a rock and a hard place under the ACA, and you will be forced to make unten- able choices. Given the skyrocketing costs of food, heat and other basics, how will you even tread water under this set-up, nevermind get ahead?
Being told you will receive help from the government if you can’t afford to purchase insurance and finding out at tax time this was really a loan and you owe the IRS a substantial debt on top of your income taxes is outright shameful. But most politicians have no shame – which brings us to the next topic.
5. MEDICAID EXPANSION AND ESTATE RECOVERY
In order to expand Medicaid, several Medicaid regulations were changed:
a) the income limit for eligibility was increased to 133 percent FPL, but since states must apply a 5 percent disregard, this effectively raises the eligibility to 138 percent FPL
b) Modified Adjusted Gross Income will be used in most cases to determine eligibility (also applies to certain CHIP applicants)
c) the age limit was increased to 64, childless adults will be eligible; and
d) the asset test was dropped except for certain groups such as the elderly and people on Social Security Disability – BINGO!
The fact that the asset test was dropped is very important, but before we look at why, you must first understand that if an Exchange determines you are eligible for Medicaid, you have no other choice. Code for Exchanges specifies, “an applicant is not eligible for advance payment of the premium tax credit (a subsidized plan) or cost-sharing reductions to the extent that he or she is eligible for other minimum essential coverage, including coverage under Medicaid and CHIP.” Therefore, you will be tossed into Medicaid unless there are specific rules as to why you would not be eligible. If you are enrolled in a private plan through an Exchange and have been receiving a tax credit, and your income decreases making you eligible for Medicaid, in you go. If you are allowed to opt out because you don’t want Medicaid, you will have to pay a penalty for being uninsured unless you can afford to purchase insurance in the open market.
Just so you’re clear on this: the ACA stipulates that the system will ensure that if any individual applying to an Exchange is found to be eligible for Medicaid or a state children’s health insurance program (CHIP), the individual will be enrolled in such a plan.
Furthermore, to increase enrollment in health coverage without requiring people to complete an application on their own, states are advised to automate enrollment whenever possible by using existing databases for social services programs such as SNAP (food stamps) to enroll people who appear eligible for Medicaid but are not currently enrolled. Therefore, you could find yourself auto-enrolled in Medicaid against your will if your state acts on this advice.
Many times over Mr. Obama et al told you that all Americans would have choice. Choice was another big talking point. Are poor and low-income Americans undeserving of choice? Is the ACA a class-based system? Maybe they meant that for this segment of the population, the choice would be between Medicaid or a penalty for remaining uninsured. This is blatant discrimination.
Here’s why dropping the asset test got the BINGO – Estate Recovery! You won’t find the following info in the ACA. It’s in the Omnibus Reconciliation Act of 1993 (OBRA 1993) – a federal statute which applies to Medicaid, and, if you are enrolled in Medicaid, it will apply to you depending on your age.
a) OBRA 1993 requires all states that receive Medicaid funding to seek recovery from the estates of deceased individuals who used Medicaid benefits at age 55 or older. It allows recovery for any items or services under the state Medicaid plan going beyond nursing homes and other long-term care institutions. In fact, The Centers for Medicare & Medicaid Services (CMS) site says that states have the option of recovering payments for all Medicaid services provided. The Department of Health and Human Services (HHS) site says at state option, recovery can be pursued for any items covered by the Medicaid state plan.
b) The HHS site has an overview of the Medicaid estate recovery mandate which also says that at a minimum, states must pursue recoveries from the “probate estate,” which includes property that passes to the heirs under state probate law, but states can expand the definition of estate to allow recovery from property that bypasses probate. This means states can use procedures for direct recovery from bank accounts and other funds.
c) Some states use recovery for RX and hospital only as required by OBRA 1993; some recover for a few additional benefits and some recover for all benefits under the state plan. Recovery provides revenue for cash-strapped states and it’s a big business.
Your estate is what you own when you die – your home and what’s in it, other real estate you may own, your bank account, annuities and so on. And even if you have a will, your heirs are chopped liver. Low-income people often have only one major asset – the home in which they live and, in some cases, this has been the family home through several generations.
So what this boils down to is: if you are put into Medicaid – congratulations – you just got a collateral loan if you use Medicaid benefits at age 55 or older! States keep a running tally.
Estate recovery can be exempted or deferred in certain situations after your death, but the regulations for this are limited and complicated with multitudes of conditions. You may not have an attorney on speed dial, but with regard to this hundred pound gorilla, it sure would be handy.
Should you decide to ask your congresscritter about estate recovery, be prepared for responses such as:
— “Estate recovery doesn’t apply to you.” (Great news. Please overnight a copy of the amendment to OBRA 1993 that stipulates estate recovery is no longer required and no longer allowed. Here’s my address.)
— “Oh, estate recovery is state, I’m federal.” (Wrong – estate recovery is federally mandated although the estate recovery program itself is administered by each state.)
— “I don’t know anything about this.” (Highly unlikely because the expansion of Medicaid is an integral part of the ACA and estate recovery is not a secret.)
— “The ACA wasn’t about revamping Medicaid.” (As explained above, Medicaid regs were revised in order to expand Medicaid.)
— “I’ll look into that and get back to you.” (Don’t hold your breath – they don’t want to go there.)
If you ask about estate recovery when you contact an Exchange or speak with an outreach agency, you’ll probably run into a brick wall or be told it doesn’t apply to you – wh**ever. But, it doesn’t matter because what you are told is not legally binding. What is legally binding is your signature on the Medicaid application which indicates that you agree to the terms of the contract – which brings us to another item in OBRA 1993. Read on.
OBRA 1993 also contains procedural rules intended to ensure that individuals are informed about Medicaid program requirements including disclosure of estate recovery before they complete the application process and also during the annual re-determination process. Notification of estate recovery should be on the signature page of your state’s Medicaid application and is usually a one-liner: I understand that if I am aged 55 or older, (name of your state’s Medicaid plan) may be able to get back money from my estate after I die. (Use of the word ‘may’ doesn’t mean if the state feels like it – it means recovery will take place unless there are specific circumstances for exemption or deferment as mentioned above.) There are also strict recovery/repayment clauses for injury-related settlements disclosed on the signature page and a few other ditties that apply to you or a family member who is enrolled in Medicaid. All of these items must also be disclosed in your state’s Medicaid handbook.
Under the ACA and proposed federal rules for implementation, states will be required to provide a single, simple application to apply for and enroll in Exchange plans, Medicaid and CHIP, and consumers must be able to apply by phone, in person or online. The Secretary (HHS) is charged with this task and it’s in the works. This begs an answer to the following questions:
— Will Medicaid applicants be diligently informed about estate recovery and other rules that apply to Medicaid enrollees on this single application? Failure to do so would be in non compliance with OBRA 1993 and would also be deceptive.
— Will applicants be provided with a signature page that contains appropriate disclosure of these rules so they can be reviewed before signing on the dotted line?
— How will appropriate disclosure and obtaining a signature work for those who are bumped into Medicaid due to a decrease in income or who might be auto-enrolled because they were presumed eligible through a database.
If an applicant or someone who has been bumped or auto-enrolled in Medicaid is not satisfied with the terms of the Medicaid contract, lack of another health insurance option that is in the best interest of low-income earners represents undue and unconscionable advantage being taken of this segment of the population under a law that mandates health insurance or a penalty.
Do the health insurance policies enjoyed by lawmakers on Capitol Hill and paid for by taxpayers include an estate recovery program?
Medicaid is poor, underfunded, overstretched and constantly bombarded by state budget cuts – even before an ACA expansion. It offers a low quality of care in many states, and, in general, represents inequities in care. Office-based doctors typically refuse to accept Medicaid patients, thus, millions thrust into this plan will have difficulty finding a primary-care doctor or a specialist.
A perfect example is the December 2012 federal appeals court decision that allowed California to cut reimbursements by 10 percent to doctors, pharmacies and others who serve low-income residents under the state’s Medi-Cal plan (a version of Medicaid) due to state budget issues. California was already at the bottom of the rate-reimbursement heap which made finding doctors difficult for residents in Medi-Cal. This decision will further reduce the number of health care providers willing to take new Medi-Cal patients, thus jeopardizing their access to primary and specialized care. Under the ACA’s expansion of Medicaid, state budget crises across the nation will exacerbate the ongoing problems regarding access to care for Medicaid patients, particularly in states that have a high low-income population. http://www.sfgate.com/health/article/Medi-Cal-cuts-upheld-by-appellate-court-4116971.php
6. INSURANCE PLANS AT THE EXCHANGES
Below are the 4 plan levels that will be offered at Exchanges for people between 138 and 400 percent FPL. Each one has government- approved benefits including prescription coverage. You will be entitled to one free preventive visit each year. Per the most recent study commissioned by the Kaiser Family Foundation, several cost-sharing options were estimated for non-group (individual and family) Bronze and Silver plans. Cost-sharing is the amount you must pay to use your insurance. Your share of the premium is not part of cost-sharing. http://www.kff.org/healthreform/upload/8303.pdf
The way this works is you will pay for all your medical care until you reach the annual deductible. Then you’ll pay the applicable percent- age of coinsurance until you reach the annual out-of-pocket spending cap which will be set on a sliding scale. Annual means these amounts start again the following year, and if they change, you will find out when you re-apply for insurance. There will also be copays – an amount you will pay to the doctor for an office visit.
Here are the current estimates:
Bronze: cheapest and dry as dust with 60/40 coverage – a win-win for insurers
a) annual deductible of $4,375 for an individual (double for a family) with 20 percent coinsurance, b)annual deductible of $3.475 for an individual (double for a family) with 40 percent coinsurance
Silver: next cheapest – offers an illusion of coverage at 70/30
a) annual deductible of $2,050 for an individual (double for a family) with 20 percent coinsurance, b)annual deductible of $650 for an individual (double for a family) with 40 percent coinsurance
Gold: expensive – 80/20 – better coverage
Platinum: most expensive – 90/10 – most comprehensive coverage
A fifth plan will be available for the under-30 crowd and people who have been granted a hardship exemption. See topic 8 in this lesson. Coverage in this plan will be less comprehensive than the Bronze – it is primarily for major-medical expenses except that it has a free preventive visit. Cost-sharing for people at 138 to 200 percent FPL is estimated to be a bit less than the Bronze and Silver estimates mentioned above.

The high deductibles in all but the two most expensive plans could saddle you with mounting bills for routine care and may stop you from seeking necessary treatment for illness or injuries. Many of you will find that the promise of access to affordable health care really means access to inadequate coverage at a price the government has decided you can afford to pay.
The number of drugs in each plan at an Exchange will vary from state to state. In some states, plans will offer up to 99 percent of available drugs and others only 45 percent which means you may not have access to the specific drugs you need. Perhaps Big Pharma will change its stance on this before 2014.
The cost of plans at an Exchange will vary from state to state based on where you live and your age. The ACA allows insurers to charge older customers up to three times more for a plan, even if they are in good health, as long as the state in which an Exchange is located doesn’t have a law that caps age-rating. Some Exchanges will tuck an administrative fee of 2 to 4 percent into premiums to help cover operating expenses.
Cost-sharing tax credits will be available if you are below 250 percent FPL to protect you from high deductibles and copays – but only if you purchase a Silver plan. If you buy the cheaper Bronze plan, you won’t be eligible for these credits, which are, by the way, direct federal payouts to private health insurance companies.
Obamacare has no cost controls. There is nothing stopping the insurance companies from increasing their rates, and Washington has already estimated higher premium costs at the Exchange for 2016 which doesn’t mean that 2015 won’t have an increase. Sounds like 2014 prices will be an Introductory Offer. Get ‘em while their hot!
7. PENALTY FOR BEING UNINSURED
The ACA requires that people who have been deemed able to purchase health insurance but decide not to buy it starting in 2014 will owe a penalty (a tax) to the IRS. Here’s what this looks like:
a) In 2014, the annual penalty will be $95 per adult and $47.50 per child, up to a family maximum of $285 or 1 percent of family income, whichever is greater.
b) In 2015, the penalty will be $325 per adult and $162.50 per child, up to a family maximum of $975 or 2 percent of family income, whichever is greater.
c) In 2016, the penalty will be $695 per adult and $347.50 per child, up to a family maximum of $2,085 or 2.5 percent of family income, whichever is greater.
The IRS collects the penalty, but the ACA stipulates that taxpayers shall not be subject to any criminal prosecution or penalty, tax liens, seizure of bank accounts or garnishment of wages for failure to pay it and no accumulation of interest on the unpaid balance. So, it appears that all the IRS can do is deduct the penalty from a refund it owes you, and if you’re not due a refund, then you’ll have an out- standing tax obligation.
Keep in mind that the penalty is described in annual amounts but is really monthly. So, if you are uninsured for only part of the year, you will accrue only 1/12 of the total for each month you are uninsured unless you qualify for an exemption.
8. EXEMPTIONS FROM THE PENALTY
You may be eligible for official permission that excuses you from having to pay the penalty for being uninsured. The requirements are:
a) If the cheapest health care plan available costs more than 8 percent of your MAGI after subtracting the tax credit or employer contribution, whichever is applicable.
b) Your income is so low that you aren’t required to file federal income taxes.
c) You are between jobs and without insurance for up to three months.
d) You have a sincerely-held religious belief that prevents you from seeking and obtaining medical care.
e) You are in jail.
f) You are an undocumented immigrant.
g) You are a member of an Indian tribe or a religious group currently exempt from paying Social Security tax.
If item d) is the case, you must file a sworn statement as part of your tax return, and should you obtain care during the tax year, the exemption will no longer apply and you will have to pay a penalty for being uninsured. Per H.R. 6597, medical care is defined as acute care at a hospital emergency room, walk-in clinic or similar facilities. Medical care excludes treatment not administered or supervised by a medical doctor such as chiropractic, dental, midwifery, personal care assistance, optometry, physical exams or treatment where required by law or third parties such as an employer, and v******tions.

If you think you can’t afford the amount the government has decided you can afford to pay for your insurance plan, and you don’t fit into any of the categories described above, you can apply for a Hardship Waiver. Details have not yet been provided regarding hardship eligibility requirements under the ACA, but, for an idea of what they might look like, let’s check out what the deal is in Massachusetts which already has a mandated health insurance law – Romneycare! In fact, Romneycare was the model for Obamacare. That’s why some people call Obamacare, Obamneycare.
To qualify for a Certificate of Exemption under Romneycare, a Massachusetts resident must demonstrate that health insurance is not affordable due to one of the following: 1) homelessness; 2)eviction or foreclosure notice; 3) domestic violence-related medical trauma; 4) major long-term illness of a child; 5) death of your spouse; 6) your house burned down; or 7) “you can establish that the expense of purchasing health insurance would cause you to experience serious deprivation of food, shelter, clothing or other necessities.”
Ya gotta luv number 7. And in Massachusetts, exemptions come with an expiration date, so you have to clean up your act in short order. Under the ACA, the Secretary of Health and Human Services will determine if, indeed, you have suffered a hardship that keeps you from being able to pay for coverage.
9. OTHER TIDBITS
There is much more in the ACA including all kinds of rules and penalties for employers, employees and the self employed as well as the Accountable Care Organization (ACO) model which will be mandated starting in 2014. The latter works as follows: under the simplest option available, a small group of doctors and hospitals – an ACO – will manage your care and be graded and paid based on the outcome of all patients who seek treatment with that ACO. The ACO will also be rewarded with a share of the savings in health costs it achieves by following best treatment practices and reaching specific benchmarks set by CMS. The second option, “shared savings plus risk,” is for larger ACOs. Providers will receive a lump-sum payment to treat their patients and assume a portion of the risk for above target spending but are eligible to keep a greater portion of the savings.
Either of these options reduce patient care to numbers and paperwork because doctors are essentially controlled and incentivized by an administrator in some far-flung office. The ACO model is the insurance industry’s version of “budgeting” the cost of health care which ultimately benefits insurers at the expense of doctors and their patients.
Doctors say that basing their pay on treatment outcomes creates an incentive for them to avoid tough cases whose outcomes could “k**l my numbers.” “Paradoxically,” writes Dr. G. Keith Smith, “doctors who are doing sham surgery will be the ones with the best outcomes, as their patients, many of whom don’t need surgery in the first place, will exhibit great, basically perfect outcomes. Physicians who don’t do unnecessary surgery will be pushed to do so to improve their ‘scores.’ ‘Pay for performance’ trends in medicine are not a good idea in my opinion. Paying based on patient outcomes will have perverse effects, not the least of which will be the complete denial of care to the very sick.” http://www.medibid.com/blog/2012/10/your-disease-can-k**l-you-in-more-than-one-way/?utm_source=Registered+Physicians&utm_campaign=8f9028ddaf-October_Physician_Newsletter11_17_2012&utm_medium=email
The ACA also requires Health Insurance Exchanges to establish a navigator program to inform the uninsured about the availability of government-approved subsidized plans at an Exchange and to facilitate enrollment in these plans, but it leaves the design of the program up to each Exchange.
Depending how an Exchange sets up its program, some Navigators will sell plans offered by an Exchange while others will be responsible for maintaining the existing market but may also be allowed to sell Exchange plans. All seller Navigators will be compensated either by Exchanges or insurance carriers for the plans they sell. Many options are being considered by Exchanges including using insurance agents. Hopefully, Navigators and insurance agents will not be knocking on your door or contacting you by phone. That would be over the top. Here’s a link to read what the California Exchange is pondering with regard to its Navigation program.http://www.healthexchange.ca.gov/StakeHolders/Documents/CHBE,DHCS,MRMIB_StatewideAssistersProgramDesignOptionsRecommendationsandWorkPlan_6-26-12.pdf
10. ENROLL AMERICA, HERNDON ALLIANCE & THE EXCHANGES – MASTERS OF SPIN
Since many Americans don’t know about the ACA, somehow the word has to get out and people must be encouraged to purchase health insurance either in the open market or at an Exchange. And who better to do this?
Enter “Enroll America” – a nonprofit 501(c)3, financially backed by Aetna, Blue Cross Blue Shield, UnitedHealth, America’s Health Insurance Plans, hospitals, associations that represent drug manufacturers and nonprofits with vested interests. For insurers and pharma, the ACA is manna from heaven – scratch that – manna from Capitol Hill – and the dollar signs in their eyes are on fire! These profit seekers and connected nonprofits will be using every avenue possible to maximize their bottom lines.
The mission of Enroll America per its website is to “ensure that all Americans are enrolled in and retain health coverage.” It’s Board of Directors and Avisory Council reads like a Who’s Who in the Medical Industry Cartel – CEOs, presidents, vice presidents and directors of such entities as the American Hospital Association, Express Scripts, Medicaid Health Plans of America, Kaiser Permanente and many others – the list is long. If you would like to donate to these mega-profit vultures, you can do so on the Enroll America home- page. The goal is $100 million by 2014.
http://www.enrollamerica.org
In its publication, “Ten Ways to Make Health Coverage Enrollment and Renewal Easy,” Enroll America has recommended availability of web-based applications to increase the places where people can enroll in coverage: at home, at grocery stores, community health centers, state fairs, sporting events, places of worship, and more. Gee, you can apply for insurance while you pray. How thoughtful.http://www.enrollamerica.org/best-practices-institute

The strategy for insurers and state Exchanges to persuade you to purchase insurance and warn you about the penalties includes using ads, social media, blogs, YouTube, Flickr, Twitter, hospitals, health centers, McDonald’s, in-store radio announcements, ballparks, county fairs, libraries, laundromats, community events, libraries, county fairs and drugstores – you name it. Blue Cross Blue Shield has partnered with H & R Block. Health insurers are already setting up shop inside some supermarkets so they can answer your questions and sign you up for coverage while you do your grocery shopping. They will likely be showing up in shopping malls – maybe even in parking lots, on street corners and at church fairs. And, their aim is to recreate themselves from the bloodsucking l***hes that they are to your new, cool-dude friends.
We’ll be living in Occupied Territory.
Let’s connect some dots. The executive director of Enroll America is Ron Pollack, also president of Families USA – a nonprofit and friend of the industry. On its website, Families USA bills itself as “a national non-partisan organization dedicated to the achievement of high quality, affordable health care for all Americans.” Philippe Villers and Robert Crittenden, M.D. are on Families USA Board of Directors. Mr. Villers is also on the BOD of Herndon Alliance, Bob Crittenden is a Herndon staff member and Ron Pollack is a Herndon founder. http://www.familiesusa.org
Herndon Alliance is an influential health care spinmeister creating messaging to change public opinion and tweaking each message to reach particular groups.
Herndon has close ties to Capitol Hill and helped market the ACA providing words politicians and supporters should use to promote the bill. For example, during the national health care debacle a few years ago, you heard Mr. Obama et al continually talk about ‘choice,’ ‘we need a uniquely American solution,’ ‘fair rules,’ ‘investing in America’s future’ and ‘high-quality, affordable healthcare.’ That last one is used in Families USA mission statement. The Council for Affordable Health Insurance, a frontgroup for the industry, gets right to the point – its name. Ron Pollack worked with the Obama administration to help reshape public opinion of Mr. Obama’s unpopular health care bill. Leading up to 2014 when the Exchanges are scheduled to open, there will most likely be a blitz of TV ads in which you will hear many of these same nebulous, feel-good words. And, you’ll undoubtedly read or hear plenty of Herndon spin from your Exchange and throughout your state in the immediate future.
In the interest of coming up with messaging, Enroll America held a few focus groups and commissioned a nationwide survey in fall 2012. Research was provided by Celinda Lake from Lake Research Partners, a national public opinion and political strategy research firm. One takeaway was when a monthly premium cost was given, the majority of people polled thought that it was too expensive and the ACA would not provide affordable and comprehensive coverage even with the government tax credits (subsidies). So, Lake Research Partners advised Enroll America not to mention specific costs but to use the phrase ‘free or low-cost plans.’http://www.nytimes.com/2012/12/20/us/officials-confront-skepticism-over-health-law.html?ref=us&_r=0&pagewanted=all
Herndon has been working on messaging various parts of the ACA that will be used by outreach partners, insurers and state Exchanges. Its messaging is not based on t***h or evidence – Herndon actually stays away from any mention of facts as you read above regarding the cost of plans. Instead, its messaging is designed to mislead an uninformed public.
A few of Herndon’s target populations include v**ers, people of color, red states, skeptical audiences, and you’ll love this one – Elevator Language with a list of succinct scripts to use based on the person you’re speaking to during the ride. You must check out Herndon’s website and read the many instructions of what to say and what not to say. You’ll either get very annoyed or laugh yourself silly.http://herndonalliance.org/resources/research/communications-tips-exchange-talking-with-v**ers.html
http://herndonalliance.org/resources/implementation-basics/communications-tips-to-use-with-skeptical-audiences.html
Here are some examples of Herndon spin regarding the ACA:
— Use “family values” when talking to the public about the expansion of Medicaid. Is estate recovery a family value? http://herndonalliance.org/resources/what-s-new/talking-about-medicaid-connecting-with-the-public.html
— When talking about the ACA’s required Accountable Care Organization (ACO) model that will pay doctors according to patient outcomes and reward them for savings they achieve, Herndon says to call this “Coordinated Patient Care” and “do not connect pricing with rewards or incentives for doctors” or “with lump-sum payments for medical care” and do not mention “payment based on positive patient outcomes.” Why not? The three do-nots are how ACOs work. (ACOs are described in topic 9.) http://herndonalliance.org/resources/system-change/payment-reform-quality-care-pricing.html http://herndonalliance.org/resources/system-change/coordinated-patient-care.html
— Here’s an award winner: “Members of Congress will purchase their insurance at the Exchange. If members of Congress are part of the marketplace then it’s got to offer quality plans and protections.”http://herndonalliance.org/resources/research/communications-tips-exchange-talking-with-v**ers.html

— Stressing that under the ACA insurers won’t be able to deny coverage for pre-existing diseases is a Herndon biggie. In fact, you heard this many times over from Mr. Obama and other politicians. But a loophole in the law allows insurers to rescind (cancel) your policy if you intentionally put false or incomplete information on your application. The ACA says you must be given at least 30 days’ notice before your coverage can be rescinded, giving you time to appeal the decision or find new coverage. So, if your care becomes costly for the insurer and you didn’t mention you had a rash on your arm when you were 15, that’ll work. How can you prove if leaving this out was intentional or not? It’s them against you.
Enroll America’s Best Practices Institute is publishing a series of briefs on the best way to write and design websites and marketing materials, no doubt, using Herndon messaging. PR and marketing firms are helping various state Exchanges come up with appealing branding such as using a name everyone will like and spiffy logos with cool type styles in colors that will appeal to all audiences. Branding lessons include advising Exchanges which words to ‘embrace’ such as emphasizing choice, control, t***sparency and competition. Other messaging includes, “the Exchange should be viewed as an educator, not an enforcer” and using the word ‘marketplace’ instead of Exchange is a must. Tennessee Health Care Campaign will be telling potential customers “. . . the exchange offers us more choices, greater control over our health care, and more competition to control costs.” It’s all Herndon’s handywork in one form or another.http://www.thcc2.org/PDFs/rtm_exchange_talking_point.pdf" rel="nofollow" target="_blank">http://dhmh.maryland.gov/exchange/pdf/Brand_Recommd_may182012_final.pdfhttp://www.thcc2.org/PDFs/rtm_exchange_talking_point.pdf
More choice means choice of insurance companies, not choice of doctors and hospitals. In rural areas, there may be only one insurer offer- ing plans which means one network and doctors may not be taking new patients. This happened in MA under Romneycare, and on top of that, many doctors would not accept people in the subsidized plans because of time-consuming red tape and low reimbursement rates. Under the ACA, insurers are planning to limit networks in the cheaper plans at the Exchanges. Having too few doctors in a network is a means of suppressing the use of health care which increases an insurer’s profits. Further on in this lesson, you’ll learn that the Maryland Exchange has been advised to ignore negative problems such as not enough doctors to serve the newly insured. http://www.kaiserhealthnews.org/Stories/2013/January/23/HMO-limited-networks-comeback-in-exchanges.aspx
Choice is definitely a non starter for people found eligible for Medicaid – the ACA allows no other choice for this segment of the popula- tion and many doctors do not accept Medicaid. As for giving you greater control, considering all the rules about income and FPL, not to mention the data-mining to monitor your income during the year and those nasty tax credit paybacks, it’s you who is being controlled. And competition? Read this stunning op-ed by Nomi Prins: “Real Danger of “Obamacare” Insurance Company Takeover of Health Care.” http://www.nationofchange.org/real-danger-obamacare-insurance-company-takeover-health-care-1352648027
In Enroll America’s January 15, 2013 press release, Executive Director Rachel Klein says the ACA offers the promise of “access to comprehensive, affordable health coverage.” That is a false promise. As you learned in this lesson, coverage in the plans that will be offered at the Exchanges, with the exception of the two most expensive, is anything but comprehensive – the cheaper plans are unafford- able to use. Furthermore, how can she claim that the cost of the plans are affordable? Ms. Klein should be well aware of the nationwide survey Enroll America commissioned in which the majority of people polled said that the plans are too expensive.www.enrollamerica.org/news-room/press-releases/Enroll_America_Plans_Major_Affordable_Care_Act_Enrollment_Campaign_1-15-13.pdf" rel="nofollow" target="_blank">http://files.www.enrollamerica.org/news-room/press-releases/Enroll_America_Plans_Major_Affordable_Care_Act_Enrollment_Campaign_1-15-13.pdf
http://www.nytimes.com/2012/12/20/us/officials-confront-skepticism-over-health-law.html?ref=us&_r=0&pagewanted=all
Currently PR firms are working with some state Exchanges to develop effective communications plans and advertising campaigns. Names include Mintz & Hoke, Hill & Company Communications and Weber Shandwick just to name a few. Ask the Massachusetts Health Insurance Connector – the prototype of an Exchange in the land of Romneycare – how much it spent on PR contracts over the years. In 2007, board members signed off on a two-year contract with Weber Shandwick for $1.85 million the first year with nearly $3 million for advertising – commission on media buys not included. And, by the way, the MA Connector upper management boasts six-figure salaries. Former MA Connector Executive Director Jon Kingsdale’s salary in 2007 was $225,000 and increased in 2008 to $231,750. In 2007, Deputy Director Rosemary Day alternated between a four-day and five-day work week to the tune of $175,000. These are only two examples of the many high-flying salaries at the MA Connector, an operation run by politicians and unelected political appointees and influenced by executives from the private insurance industry,http://www.boston.com/yourlife/health/other/articles/2007/01/27/6_figure_pay_for_care_plan_overseers/?page=full" rel="nofollow" target="_blank">http://www.wickedlocal.com/cambridge/news/x497793387/Connector-re-ups-contract-with-Cambridge-based-Weber-Shandwickhttp://www.boston.com/yourlife/health/other/articles/2007/01/27/6_figure_pay_for_care_plan_overseers/?page=full http://www.highbeam.com/doc/1G1-166773095.html
Add up pay scales like that for every Exchange in the country, throw in some bennies, a PR contract for each Exchange, campaign costs and compensation paid by Exchanges to Navigators for plans they sell – a grand and costly effort to push more people into America’s for-profit health care system. Your tax dollars at work and mega bucks that could be used for actual hands-on medical care.
The Maryland Exchange has three campaign funding levels – Basic, Plus and Full-Scale – with a total for year one, two and three. Basic funding for year one is $2,450,000, Plus is $4,000,000 and Full-Scale is $6,300,000. See p.137 at this link for years two and three.http://www.dhmh.maryland.gov/exchange/pdf/FinalAdvertisingReportWeber.pdf

The following, from the maryland link above, gives you an idea of some of the strategies that will be in play, most likely in all states. The Maryland Exchange has been advised by Weber Shandwick to “establish a system to monitor newspaper, radio, TV and online conversations about the Exchange and the program and to establish procedures and priorities for responding to negative media stories, op-eds, blogs and reports.” You can find this in the Risk Management and Responses section of Maryland’s strategic marketing plan.
In the Earned Media/Public Relations section, advice includes “ . . . putting out stories on the first effective enrollees, enrollment number milestones, and enrollee testimonials. Each of these becomes the focus for positive, brand-reinforcing stories. There will also be the risk of negative stories, including potential topics such as enrollment snafus, delays in issuing insurance cards, the cost of Qualified Health Plans [government-approved plans], claims of ‘shoddy’ Bronze coverage, incidents of physicians refusing to accept enough new patients to serve the uninsured and other negative topics.” “While coverage is bound to include some level of criticism it can be success- fully countered by putting a human face on heatlh reform.”
The Social and Digital Media section advises an invasion of the Internet including social media to market health insurance by “delivering the right messages to the right audience at the right time,” (probably using Herndon spin) to “help drive enrollment in the Exchange,” and also flooding newspapers with op-eds to contradict reported adverse effects of the ACA.
More details can be found at the Maryland pdf link below. It’s worth looking at this presentation to grasp the big business approach of Exchanges which is clearly profit-driven. The Maryland Exchange strategy is just one example. The goal of Exchanges is sell, sell, sell.http://www.dhmh.maryland.gov/exchange/pdf/FinalAdvertisingReportWeber.pdf
Exchanges certainly have a lofty goal – promote success stories only and be ready to contradict and cover up the bad stuff as quickly as possible. Massachusetts residents have been there. The Connector and state politicians including the governor made sure that anyone being harmed by Romneycare would not be heard in spite of statewide survey reports put together by outreach agencies advising state legislators and powerplayers that low-income people were not faring well under this law. Various issues were spelled out and testimonials were included, but residents’ concerns about the adverse effects of Romneycare were ignored. MA national legislators also went along with this agenda as did the mainstream media.
When $130 million was needed in 2009 to balance the Massachusetts state budget, the Connector – with the blessing of MA Gov. Deval Patrick and the MA legislature – removed about 28,000 legal immigrants – working people paying taxes – from their insurance plans. Another 8,000 or so were barred from enrolling in insurance plans because the MA legislature v**ed to cap enrollment in the subsidized plans. This took place at the same time Mr. Obama was trying to sell the ACA to the nation, so, under pressure from Washington, the MA legislature restored some of the money, and the Connector dumped these people, without their consent, into an out-of-state plan with higher copays, less comprehensive coverage and next to no doctors or safety net hospitals in its network.http://www.huffingtonpost.com/iyah-romm/lessons-from-massachusett_b_380718.html
This has huge implications for the ACA. If legal immigrants can be removed from their plans and others denied enrollment when a state budget is squeezed, which vulnerable segment of the population is next in line? The good news is these legal immigrants in MA sued the Connector and its then-Executive Director, Jon Kingsdale, and the Massachusetts Supreme Judicial Court ruled unanimously that the state could not violate their right to equal protection under the state and federal constitutions and fiscal considerations alone can not justify a state’s invidious discrimination against them. As a result of this decision, the state had to come up with some bucks, and the Connector was forced to put the plaintiffs back into their original plans.
http://www.healthlawadvocates.org/priority-areas?id=0015
Getting back to Enroll America, Herndon Alliance and some of the less-than-honorable Exchange strategies – it’s one thing to inform Americans about the ACA and Exchanges that offer the possibility of either purchasing high-deductible or catastrophic coverage with a loan from the government to help pay for it or being tossed into expanded Medicaid – but, mounting a costly, massive campaign to purposely deceive and manipulate the public with the unstated goal of more profit for the already extremely lucrative health insurance industry is disgraceful.
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Is the ACA a fair law if it helps only one small segment of the population but hurts and exploits a larger number to do so? The way this law works is fundamentally unfair and will not bring medical care to the many, but, instead will progress to greater personal debt for individuals and families who can’t afford the “affordable” insurance as well as those who must keep an eye on their income to avoid the many traps and false ends this law creates. At their expense, the forced purchase of health insurance will bring increased revenue to the industry, not to mention more kickbacks to Congress, and in the very near future, the health insurance industry will be “too big to fail.”
The ACA is most definitely a “uniquely American solution” which has little to do with reforming this country’s barbaric health care system. It merely controls peoples’ finances and choices while leaving insurance companies in charge and does virtually nothing to end their abuses. It will leave many millions of Americans uninsured and millions more underinsured at a staggering cost to taxpayers.

Politicians, health care policy wonks and vested interests will brush aside the ACA’s adverse effects. You’ll hear that some have fallen through the cracks of health care reform but the problems can be easily tweaked. You will also witness the usual dog-and-pony show on Capitol Hill in which the two parties play the blame game. The bought-and-paid-for mainstream media will regurgitate wh**ever Washington feeds it, and TV talking heads will chime in, inviting their “experts” to analyze the situation while real people in the real world struggle to get by under this law or fall by the wayside.
Good luck everyone and watch out for the folding chairs.
addendum:
Obamacare architect leaves White House for pharmaceutical industry job
http://www.guardian.co.uk/commentisfree/2012/dec/05/obamacare-fowler-lobbyist-industry1
Physician payments based on outcomes
http://www.medibid.com/blog/2012/10/your-disease-can-k**l-you-in-more-than-one-way/?utm_source=Registered+Physicians&utm_campaign=8f9028ddaf-October_Physician_Newsletter11_17_2012&utm_medium=email
Dr. Paul Craig Roberts is the father of Reaganomics and the former head of policy at the Department of Treasury. He is a columnist and was previously the editor of the Wall Street Journal. His latest book, “How the Economy Was Lost: The War of the Worlds,” details why America is disintegrating.

NAVSOG

now read the North American Law Center brief.

Shut Down of Federal Government Set to Uphold
Federal Health Care Extortion Scheme
ObamaCare declared “unconstitutional” by US Supreme Court
The Basis for this Brief
The current budget battle between the US House of Representatives and the US Senate is over the funding
or defunding of ObamaCare, which was in fact declared “unconstitutional” by the US Supreme Court in
its ruling dated June 28, 2012 – has resulted in an impasse and a partial “shut down” of the Federal
Government starting on October 1, 2013.
Despite numerous efforts by the House of Representatives to pass a budget funding everything except
ObamaCare, the Senate under the command and control of Democrat Senator Harry Reid (Nevada) has
rejected every effort to reopen all federal agencies on grounds that they intend to “extort” money illegally
and unconstitutionally from the American people under their Affordable Health Care Act in which the
Federal Government is attempting to seize control of the health care industry, namely ALL related
revenue.
This document is prepared for the American people and the several States because Republicans currently
in control of the House of Representatives are almost certain to cave to the extortion underway, led by
Senate Leader Harry Reid of Nevada, unless the States and the people directly engage. The people must
prepare to take appropriate measures in that event.
Before discussing the criminal nature of events surround the forced acceptance of ObamaCare, we must
first state that ObamaCare originated in the US Senate. As the Constitution rests all congressional power
to “lay and collect taxes” in the House of Representatives, from which all “tax” revenue related bills must
originate, the Senate bill known as ObamaCare denied that it was a “tax,” therefore allowing the bill to
originate from the Senate.
As you will see here, the courts then attempt to re-write ObamaCare, making it a “tax” in order to make it
appear “constitutional.” However, the bill in its current form is NOT a “tax” and if it is a “tax,” it could
only exist if originated in the House.
ObamaCare is in fact “unconstitutional” in its current form. But it is much worse that “unconstitutional,”
it is the greatest theft of private property, freedom and liberty in the history of the United States.
Extortion
The legal term “extortion” is defined in Common Law as – “a misdemeanor consisting of an unlawful
taking of money by a government officer. It is an oppressive misuse of the power with which the law
clothes a public officer.”
Extortion is further defined as follows;
“The essence of extortion by a public officer is the oppressive use of official position to obtain a
fee. The officer falsely claims authority to take that to which he or she is not lawfully entitled.
This is known as acting under color of office. The victim, although consenting to payment, is not
doing so voluntarily, but is yielding to official authority.”
“Extortion is generally punished by a fine or imprisonment, or both. When the offense is
committed by a public officer, the penalty may include Forfeiture of office. Under some statutes,
the victim of an extortion may bring a civil action and recover pecuniary damages.”
Not a Victimless Crime
In the case of the ObamaCare extortion, the victims are both the individual States, which are threatened
with the loss of federal funding if they refuse to accept the unconstitutional expansion of Medicare and
Medicaid within their State, private businesses forced to comply with unconstitutional ObamaCare
employer mandates or face extreme financial penalty, and the people of the United States, who are forced
to “opt-in” to ObamaCare or face extreme “fines” and “penalties” for “opting-out.” As every State,
business owner and citizen is a direct victim of this crime, each in and of themselves, has “legal standing”
to bring an action against the people involved in committing the crime.
The Supreme Court Ruling of June 28, 2012
Key parts of the decision rendered on 28 June, 2012 regarding the constitutionality of the ObamaCare
racket are vital to the defeat and defunding of the effort to extort revenue from the States, private
businesses and American citizens.
Specifically, the following parts of the 193 page decision written by Chief Justice John Roberts are as
follows.
1) Congress did NOT pass ObamaCare by constitutional legislative process, but rather by a heavyhanded
strictly partisan process which completely eliminated half of the US Representatives from
the process in the dark of night. Further, it did NOT pass as a “tax” bill under the Direct Tax
authority of congress, which must initiate in the House.
Preamble to the Ruling;
In 2010, Congress enacted the Patient Protection and Affordable Care Act in order to increase the
number of Americans covered by health insurance and decrease the cost of health care. One key
provision is the individual mandate, which requires most Americans to maintain “minimum
essential” health insurance coverage. 26 U. S. C. §5000A. For individuals who are not exempt,
and who do not receive health insurance through an employer or government program, the means
of satisfying the requirement is to purchase insurance from a private company. Beginning in
2014, those who do not comply with the mandate must make a “[s]hared responsibility payment”
to the Federal Government. §5000A(b)(1). The Act provides that this “penalty” will be paid to the
Internal Revenue Service with an individual’s taxes, and “shall be assessed and collected in the
same manner” as tax penalties. §§5000A(c), (g)(1). Another key provision of the Act is the
Medicaid expansion. The current Medicaid program offers federal funding to States to assist
pregnant women, children, needy families, the blind, the elderly, and the disabled in obtaining
medical care. 42 U. S. C. §1396d(a). The Affordable Care Act expands the scope of the Medicaid
program and increases the number of individuals the States must cover.
The Act increases federal funding to cover the States’ costs in expanding Medicaid coverage.
§1396d(y)(1). But if a State does not comply with the Act’s new coverage requirements, it may
lose not only the federal funding for those requirements, but all of its federal Medicaid funds.
§1396c. Twenty-six States, several individuals, and the National Federation of Independent
Business brought suit in Federal District Court, challenging the constitutionality of the individual
mandate and the Medicaid expansion. The Court of Appeals for the Eleventh Circuit upheld the
Medicaid expansion as a valid exercise of Congress’s spending power, but concluded that
Congress lacked authority to enact the individual mandate. Finding the mandate severable from
the Act’s other provisions, the Eleventh Circuit left the rest of the Act intact.
In short, as Democrats passed the Act through congress on pure partisan lines as a “fine” and/or
“penalty,” it was “unconstitutional” as written and passed, as any such Act falls beyond the scope and
power of congress and falls under the definition of “extortion.”
Part 1 of the Ruling
“CHIEF JUSTICE ROBERTS delivered the opinion of the Court with respect to Part II,
concluding that the Anti-Injunction Act does not bar this suit.
The Anti-Injunction Act provides that “no suit for the purpose of restraining the assessment or
collection of any tax shall be maintained in any court by any person,” 26 U. S. C. §7421(a), so
that those subject to a tax must first pay it and then sue for a refund. The present challenge seeks
to restrain the collection of the shared responsibility payment from those who do not comply with
the individual mandate. But Congress did not intend the payment to be treated as a “tax” for
purposes of the Anti-Injunction Act. The Affordable Care Act describes the payment as a
“penalty,” not a “tax.” That label cannot control whether the payment is a tax for purposes of the
Constitution, but it does determine the application of the Anti-Injunction Act. The Anti-Injunction
Act therefore does not bar this suit.”
This is of critical importance because today, the House of Representatives, States or the people could
petition the court for an injunction blocking the implementation and funding of ObamaCare on
constitutional grounds, as declared in Part 1 of the Supreme Court decision. In short, the text of
ObamaCare as passed by Democrats in congress is hereby deemed “unconstitutional” as is.
Part 2 of the Ruling
“CHIEF JUSTICE ROBERTS concluded in Part III–A that the individual mandate is not a valid
exercise of Congress’s power under the Commerce Clause and the Necessary and Proper Clause.
Pp. 16–30.”
This part of the ruling establishes that the Act as passed in original form by congressional Democrats is
beyond the scope and authority of congress under both the Commerce Clause (used by Democrats to pass
the Act) and the Necessary and Proper Clause, (used by Democrats to defend the Act). Once again, as
written and passed, the Act is ruled “unconstitutional” as-is under the constitutional authority granted in
these two clauses.
Part 3 of the Ruling
“CHIEF JUSTICE ROBERTS concluded in Part III–B that the individual mandate must be
construed as imposing a tax on those who do not have health insurance, if such a construction is
reasonable. The most straightforward reading of the individual mandate is that it commands
individuals to purchase insurance. But, for the reasons explained, the Commerce Clause does not
give Congress that power. It is therefore necessary to turn to the Government’s alternative
argument: that the mandate may be upheld as within Congress’s power to “lay and collect Taxes.”
Art. I, §8, cl. 1.”
The basis for passing the Act under the Commerce Clause failed the constitutional challenge on its
original foundations. Therefore, Democrats used an “alternate” argument in the lower Federal Courts that
even though they denied the Act was a form of “taxation” during the passage of the Act, they now claim
that it is a “tax” because what they had passed was unconstitutional on its face in its original form.
The alternate argument declaring the Act a form of “taxation” under Congress’s constitutional authority to
“lay and collect taxes” also fails the constitutional test however, as it violates numerous constitutional
protections for the States and the people, to include the General Welfare Clause which requires congress
to only pass laws that serve the best interest of the general population without singling out any individual
for special treatment, taxation, fines, penalties or directives in which all citizens are not treated equally.
The lower Federal Courts had already issued and upheld rulings separating the individual mandate out
from the balance of the Act, deeming that particular clause “unconstitutional.” By the time the case
reached the Appellate Review of the US Supreme Court, the court was forced to review and rule on the
basis of the lower court rulings.
Original Jurisdiction
A purposeful judicial error was made when 26 states joined a suit in lower Federal Court challenging the
constitutionality of ObamaCare. Stated in Article III – Section II – Clause II of the US Constitution is the
“original jurisdiction clause,” which reads as follows;
“In all cases affecting ambassadors, other public ministers and consuls, and those in which a state
shall be party, the Supreme Court shall have original jurisdiction. In all the other cases before
mentioned, the Supreme Court shall have appellate jurisdiction, both as to law and fact, with such
exceptions, and under such regulations as the Congress shall make.”
The US Supreme Court has two types of jurisdiction, a) appellate review over lower court decisions; b)
original jurisdiction; intended to bring cases directly before the US Supreme Court for adjudication in
case where a State (in this case 26 states) and the Federal Government are in dispute over the
“constitutional authority” between the Federal Government and the State.
Original Jurisdiction is defined as – “A court's power to hear and decide a case before any appellate
review.” – “The original jurisdiction of the Court is laid out by statute in 28 U.S.C. § 1251. Section
1251(a) provides that with one type of dispute (disputes between states), the Court's jurisdiction is not
only "original," it is exclusive.”
This means that the lower Florida Federal Court in which the 26 States originally filed their joint claim
had NO legal jurisdiction over the matter of “constitutionality” concerning ObamaCare. The case should
have never been filed anywhere but in the US Supreme Court, which holds “original jurisdiction” on all
cases involving a dispute between a State and the Federal Government, especially when the case is based
on the “constitutionality” of a Federal act.
The Florida Federal Court should have dismissed the case filed by the 26 States on the grounds of
“improper jurisdiction” – the US Supreme Court holding “original jurisdiction” on the matter at hand.
Instead, the Florida court acted beyond its constitutional jurisdiction by hearing and ruling on a case in
which only the US Supreme Court has jurisdiction under Article III.
The Appeals Review also acted beyond its constitutional authority in its review and upholding of the
lower court’s opinion in Florida.
As a result, by the time the case reached the US Supreme Court, precious time and taxpayer resources had
been wasted in courts with no jurisdiction, and the judicial activism in both lower court rulings,
essentially re-writing the “unconstitutional Act” from the bench in an effort to make it constitutional
under Congress’s power to “lay and collect taxes,” the US Supreme Court was now playing an “appellate
review” role as opposed to their constitutional role under original jurisdiction.
Part 4 of the Ruling
“CHIEF JUSTICE ROBERTS delivered the opinion of the Court with respect to Part III–C,
concluding that the individual mandate may be upheld as within Congress’s power under the
Taxing Clause. Pp. 33–44.
The Affordable Care Act describes the “[s]hared responsibility payment” as a “penalty,” not a
“tax.” That label is fatal to the application of the Anti-Injunction Act. It does not, however,
control whether an exaction is within Congress’s power to tax. In answering that constitutional
question, this Court follows a functional approach, “[d]isregarding the designation of the
exaction, and viewing its substance and application.” United States v. Constantine, 296 U. S. 287,
294. Pp. 33–35.
(b) Such an analysis suggests that the shared responsibility payment may for constitutional
purposes be considered a tax.”
The problem with what the courts are doing here is that they are re-writing the Act from the bench to suit
the Democrats who illegally passed an unconstitutional Act. The court has no such constitutional
authority, to write or re-write legislation from the bench, making an Act which is “unconstitutional” on its
face “constitutional” by perverted judicial fiat.
Had Democrats tried to pass the Act as a “tax” – it would have had to meet conditions of the General
Welfare Clause for starters, and it would NOT have passed even by a strict party line v**e. By altering the
Act at the court, the American people are misled into believing the Act in its true form is “constitutional”
when in fact all three courts ruled it “unconstitutional” in its legislative form.
The courts then exceed their constitutional authority by issuing rulings they have no constitutional
authority to issue, and re-writing the legislation from the bench to keep the effort to extort assets from the
States, businesses and the people intact.
Part 5 of the Ruling
“CHIEF JUSTICE ROBERTS, joined by JUSTICE BREYER and JUSTICE KAGAN, concluded
in Part IV that the Medicaid expansion violates the Constitution by threatening States with the
loss of their existing Medicaid funding if they decline to comply with the expansion. Pp. 45–58.”
Here the ruling declares that the effort to “force” Medicaid expansion on the States through coercion and
extortion is also “unconstitutional,” stating in part;
“The legitimacy of Spending Clause legislation, however, depends on whether a State voluntarily
and knowingly accepts the terms of such programs.”
As 26 States immediately challenged the constitutionality of the terms of the program, it is a fair
assumption that at least 26 states do not voluntarily accept those terms.
Part 6 of the Ruling
“JUSTICE GINSBURG, joined by JUSTICE SOTOMAYOR, is of the view that the Spending
Clause does not preclude the Secretary from withholding Medicaid funds based on a State’s
refusal to comply with the expanded Medicaid program.
But given the majority view, she agrees with THE CHIEF JUSTICE’s conclusion in Part IV–B
that the Medicaid Act’s severability clause, 42 U. S. C. §1303, determines the appropriate
remedy. Because THE CHIEF JUSTICE finds the withholding—not the granting—of federal
funds incompatible with the Spending Clause, Congress’ extension of Medicaid remains available
to any State that affirms its willingness to participate.”
Again, the issue is booted to the States on a voluntary basis, and the Supreme Court has ruled that it is
“unconstutional” to “penalize” the State by withdrawing federal Medicaid funds in retaliation for the State
refusing to participate in ObamaCare.
So far, the first six parts of the Ruling have established that ObamaCare is indeed “unconstitutional” as it
was written and passed on a party line v**e by congressional Democrats.
“ROBERTS, C. J., announced the judgment of the Court and delivered the opinion of the Court
with respect to Parts I, II, and III–C, in which GINSBURG, BREYER, SOTOMAYOR, and
KAGAN, JJ., joined; an opinion with respect to Part IV, in which BREYER and KAGAN, JJ.,
joined; and an opinion with respect to Parts III–A, III–B, and III–D. GINSBURG, J., filed an
opinion concurring in part, concurring in the judgment in part, and dissenting in part, in which
SOTOMAYOR, J., joined, and in which BREYER and KAGAN, JJ., joined as to Parts I, II, III,
and IV. SCALIA, KENNEDY, THOMAS, and ALITO, JJ, filed a dissenting opinion. THOMAS,
J., filed a dissenting opinion.”
The Dissenting Opinions of Scalia, Kennedy, Thomas and Alito
On page 128; JUSTICE SCALIA, JUSTICE KENNEDY, JUSTICE THOMAS, and JUSTICE ALITO,
dissenting; we find the following…
“The case is easy and straightforward, however, in another respect. What is absolutely clear,
affirmed by the text of the 1789 Constitution, by the Tenth Amendment ratified in 1791, and by
innumerable cases of ours in the 220 years since, is that there are structural limits upon federal
power—upon what it can prescribe with respect to private conduct, and upon what it can impose
upon the sovereign States. Wh**ever may be the conceptual limits upon the Commerce Clause
and upon the power to tax and spend, they cannot be such as will enable the Federal Government
to regulate all private conduct and to compel the States to function as administrators of federal
programs.”
From page 131;
“We do not doubt that the buying and selling of health insurance contracts is commerce generally
subject to federal regulation. But when Congress provides that (nearly) all citizens must buy an
insurance contract, it goes beyond “adjust[ing] by rule or method,” Johnson, supra, or “direct[ing]
according to rule,” Ash, supra; it directs the creation of commerce. In response, the Government
offers two theories as to why the Individual Mandate is nevertheless constitutional. Neither theory
suffices to sustain its validity.”
From page 134;
“Congress has impressed into service third parties, healthy individuals who could be but are not
customers of the relevant industry, to offset the undesirable consequences of the regulation.
Congress’ desire to force these individuals to purchase insurance is motivated by the fact that
they are further removed from the market than unhealthy individuals with pre-existing conditions,
because they are less likely to need extensive care in the near future. If Congress can reach out
and command even those furthest removed from an interstate market to participate in the market,
then the Commerce Clause becomes a font of unlimited power, or in Hamilton’s words, “the
hideous monster whose devouring jaws . . . spare neither sex nor age, nor high nor low, nor
sacred nor profane.” The Federalist No. 33, p. 202 (C. Rossiter ed. 1961).”
From page 152, concerning the Anti-Injunction Act;
“Whether jurisdiction over the challenges to the minimum-coverage provision is precluded by the
Anti-Injunction Act, which provides that “no suit for the purpose of restraining the assessment or
collection of any tax shall be maintained in any court by any person,” 26 U. S. C. §7421(a) (2006
ed.). We have left the question to this point because it seemed to us that the dispositive question
whether the minimum coverage provision is a tax is more appropriately addressed in the
significant constitutional context of whether it is an exercise of Congress’ taxing power. Having
found that it is not, we have no difficulty in deciding that these suits do not have “the purpose of
restraining the assessment or collection of any tax.” 6”
From page 162;
“The question whether a law enacted under the spending power is coercive in fact will sometimes
be difficult, but where Congress has plainly “crossed the line distinguishing encouragement from
coercion,” New York, supra, at 175, a federal program that coopts the States’ political processes
must be declared unconstitutional. “[T]he federal balance is too essential a part of our
constitutional structure and plays too vital a role in securing freedom for us to admit inability to
intervene.” Lopez, 514 U. S., at 578 (KENNEDY, J., concurring).”
From page 188;
“Such provisions validate the Senate Majority Leader’s statement, “‘I don’t know if there is a
senator that doesn’t have something in this bill that was important to them. . . . [And] if they don’t
have something in it important to them, then it doesn’t speak well of them. That’s what this
legislation is all about: It’s the art of compromise.’ ” Pear, In Health Bill for Everyone, Provisions
for a Few, N. Y. Times, Jan. 4, 2010, p. A10 (quoting Sen. Reid).”
From page 190;
“This Court must not impose risks unintended by Congress or produce legislation Congress may
have lacked the support to enact. For those reasons, the unconstitutionality of both the Individual
Mandate and the Medicaid Expansion requires the invalidation of the Affordable Care Act’s other
provisions.”
Dissenting Summation
“The Court today decides to save a statute Congress did not write. It rules that what the statute
declares to be a requirement with a penalty is instead an option subject to a tax. And it changes
the intentionally coercive sanction of a total cut-off of Medicaid funds to a supposedly
noncoercive cut-off of only the incremental funds that the Act makes available. The Court regards
its strained statutory interpretation as judicial modesty. It is not. It amounts instead to a vast
judicial overreaching. It creates a debilitated, inoperable version of health-care regulation that
Congress did not enact and the public does not expect. It makes enactment of sensible health-care
regulation more difficult, since Congress cannot start afresh but must take as its point of departure
a jumble of now senseless provisions, provisions that certain interests favored under the Court’s
new design will struggle to retain. And it leaves the public and the States to expend vast sums of
money on requirements that may or may not survive the necessary congressional revision.
The Court’s disposition, invented and atextual as it is, does not even have the merit of avoiding
constitutional difficulties. It creates them. The holding that the Individual Mandate is a tax raises
a difficult constitutional question (what is a direct tax?) that the Court resolves with inadequate
deliberation. And the judgment on the Medicaid Expansion issue ushers in new federalism
concerns and places an unaccustomed strain upon the Union. Those States that decline the
Medicaid Expansion must subsidize, by the federal tax dollars taken from their citizens, vast
grants to the States that accept the Medicaid Expansion. If that destabilizing political dynamic, so
antagonistic to a harmonious Union, is to be introduced at all, it should be by Congress, not by
the Judiciary. The values that should have determined our course today are caution, minimalism,
and the understanding that the Federal Government is one of limited powers. But the Court’s
ruling undermines those values at every turn. In the name of restraint, it overreaches. In the name
of constitutional avoidance, it creates new constitutional questions. In the name of cooperative
federalism, it undermines state sovereignty.
The Constitution, though it dates from the founding of the Republic, has powerful meaning and
vital relevance to our own times. The constitutional protections that this case involves are
protections of structure. Structural protections—notably, the restraints imposed by federalism and
separation of powers—are less romantic and have less obvious a connection to personal freedom
than the provisions of the Bill of Rights or the Civil War Amendments. Hence they tend to be
undervalued or even forgotten by our citizens. It should be the responsibility of the Court to teach
otherwise, to remind our people that the Framers considered structural protections of freedom the
most important ones, for which reason they alone were embodied in the original Constitution and
not left to later amendment. The fragmentation of power produced by the structure of our
Government is central to liberty, and when we destroy it, we place liberty at peril. Today’s
decision should have vindicated, should have taught, this t***h; instead, our judgment today has
disregarded it. For the reasons here stated, we would find the Act invalid in its entirety. We
respectfully dissent.”
NOTE: You can review the entire 193 page ruling here;
http://hastings.house.gov/uploadedfiles/supreme_court_decision_6.28.12.pdf
SUMMARY OF RULING
The US Supreme Court finds that the Affordable HealthCare Act is “unconstitutional” in its current form.
According to the US Supreme Court ruling, the Act must be a “tax” in order to hold legal authority under
the constitutional power of the House of Representatives to “lay and collect taxes.”
However, as the Act was not written or passed into law as a “tax” – originating in the US Senate which
has no constitutional authority to “lay and collect taxes,” it is not a “tax” and therefore, it remains
“unconstitutional” in its current form.
To be clear, ObamaCare is “unconstitutional” as passed by congressional Democrats. To become
constitutional, it would have to be a “tax” and as a “tax” it would have to initiate in the House or
Representatives under the authority to “lay and collect taxes.”
As an “unconstitutional” piece of legislation, it has no legal force or effect. It is therefore
“unconstitutional” for the House of Representatives to “fund” an “unconstitutional” act of the Senate and
Executive Branch.
A Federal Extortion Scheme
The 113th Congress must now decide what to do with ObamaCare, knowing full-well that the Act is
“unconstitutional” as written and passed on a strict party line v**e in the dark of night, admittedly, before
any member of congress had even read the Act in its entirety.
Because the House of Representatives has the power of the checkbook within its sole constitutional
authority, the current House effort to derail “unconstitutional” ObamaCare via defunding it is a viable
strategy, in a broad sense.
However, to defund it (rather than delay it), the House need only eliminate all funding related to
ObamaCare from its final budget entirely. Due to the judicial activism on the subject, ObamaCare cannot
be funded as a standalone item. It can only be funded via the general revenue fund of the Federal
Government via Congress’s authority to “lay and collect taxes.”
This explains why Senate Democrats are stonewalling the House on every effort to separate the
ObamaCare funding from the general revenue budget of the Federal Government. As a standalone item,
ObamaCare has already been ruled “unconstitutional.”
The Role of the Government “Shut Down”
Democrat Senate leader Harry Reid (NV) is personally responsible for stonewalling the House effort to
fund all provisions of the Federal Government, except the “unconstitutional” ObamaCare Act. The “shut
down” of portions of the Federal Government is intended to threaten the peace and tranquility of every
American citizen and business, going so far as to close off access to open air sections of “public lands”
(belonging to the American people) upon which sits the War Memorials of those who have offered their
very lives in defense of Freedom and Liberty.
As “public lands” belong to “the people” of the United States, not the Federal Government, the Obama
Administration and Harry Reid have no legal authority to close public access to those areas. But in their
need to “cause harm” to as many citizens as possible, and a public display, creating fear and pressure
upon the citizenry and therefore a “forced compliance” with an Act deemed “unconstitutional,” the “shut
down” is a hammer used to coerce and complete the intent to extort private property from the citizenry
under extreme duress.
Federal cuts, areas of Federal spending deemed “non-essential” by the Obama Administration, are used to
“target” areas most likely to impact citizens in such a manner as to “force” them to comply with the
“unconstitutional” whims of the Federal Administration.
It is classic “extortion…” and nothing less.
Why it is Extortion
As the current Congress is made up of legislators in which only 6.8% of House members and 3% of
Senate members have any experience in the profession of Health Care, the goal is NOT as stated, to
provide quality health care to Americans who are otherwise without coverage today.
The goal is to seize control of 1/7th of the total U.S. economy, the Health Care industry, and all of that
revenue, taking it away from the private sector under the management of Health Care professionals and
placing it under the command and control of the Federal Government.
Because a majority of States, businesses and citizens oppose ObamaCare and the gross expansion of
Federal intrusions into the highly specialized field of health care, where matters of life and death are
beyond the constitutional authority of the Federal Government, ObamaCare was established as a means to
illegally force States, businesses and citizens to comply with the Federal seizing of 1/7th of the U.S.
economy, or face stiff “penalties” from the I.R.S. which are already ruled “unconstitutional” by the
Supreme Court.
Further, to coerce the American people to comply, the Obama Administration is using well-known tactics
to threaten, intimidate, coerce and otherwise force an unwilling society to accept socialized medicine or
face the consequences from an increasingly tyrannical government.
It is a blatant extortion racket… It is against the law…. It is unconstitutional on its face and the people
simply must deny the Obama Administration its will to destroy not only Health Care in America, but
freedom and liberty itself.
Every American is a Victim with Standing
Although the following post once found on the Affordable Healthcare Act Facebook page is not
confirmed with the author, who remains unknown at this moment, we believe that the post nonetheless
represents a real and accurate depiction of how ObamaCare is intended to work for the government, and
against the people of the United States.
“I actually made it through this morning at 8:00 A.M. I have a preexisting condition (Type 1
Diabetes) and my income base was 45K-55K annually I chose tier 2 "Silver Plan" and my
monthly premiums came out to $597.00 with $13,988 yearly deductible!!! There is NO
POSSIBLE way that I can afford this so I "opt-out" and chose to continue along with no
insurance. I received an email tonight at 5:00 P.M. informing me that my fine would be $4,037
and could be attached to my yearly income tax return. Then you make it to the
"REPERCUSSIONS PORTION" for "non-payment" of yearly fine. First, your drivers license will
be suspended until paid, and if you go 24 consecutive months with "Non-Payment" and you
happen to be a home owner, you will have a federal tax lien placed on your home. You can agree
to give your bank information so that they can easy "Automatically withdraw" your "penalties"
weekly, bi-weekly or monthly! This by no means is "Free" or even "Affordable.” (as posted on
the Facebook page without edit)”
Because every American, every State and every business is negatively affected by the “unconstitutional”
ObamaCare Act, each has “legal standing” to bring charges against the perpetrators, including criminal
charges related to extortion and fraud via the unconstitutional process used to place the Act in effect.
Under 1946 Rules of Procedure, both Criminal and Civil, the critical portions on “legal standing” follow;
 “The Supreme Court has developed an elaborate body of principles defining the nature and scope
of standing. Basically, a plaintiff must have suffered some direct or substantial injury or be likely
to suffer such an injury if a particular wrong is not redressed. A defendant must be the party
responsible for perpetrating the alleged legal wrong.”
 “Most standing issues arise over the enforcement of an allegedly unconstitutional statute,
ordinance, or policy. One may challenge a law or policy on constitutional grounds if he can show
that enforcement of the law or implementation of the policy infringes on an individual
constitutional right, such as Freedom of Speech.”
 “A significant economic injury or burden is sufficient to provide standing to sue, but in most
situations a taxpayer does not have standing to challenge policies or programs that she is forced to
support.”
As every State, individual and business is penalized, threatened and/or fined by the terms present in
ObamaCare, declared by the US Supreme Court as “unconstitutional” in its current form, every legal
American has proper “legal standing” for a cause of action against the perpetrators of a blatant intent to
coerce and extort private property under a massive abuse of government power.
Further, the courts effort to re-write the Act as a “constitutional” effort to “lay and collect taxes” is itself
“unconstitutional,” and the courts have no legislative authority whatsoever under Article III of the US
Constitution.
Violations of the Bill of Rights
ObamaCare violations of specific protections in the Bill of Rights are simply too numerous to list here.
However, most critical is the direct violations related to States’ Rights under Amendment X, individual
Rights under Amendment IX, the Right of the people to be secure in their property under Amendment IV
and the Right to due process under Amendment V, before being deprived of any Life, Liberty or Property.
ObamaCare is a “punitive” Act intended to coerce Americans into complying with a government seizure
of 1/7th of the US economy, resulting in government control over life and death decisions concerning the
private health interest of individuals. As such, it is an Act of extortion and every Citizen has the Right and
the Duty to rise up against it.
In the following remedy section of this document, we must begin with the general understanding that in a
Constitutional Republic such as ours, the States and the people are under no legal, moral or ethical
obligation to adhere to laws or government policies and mandates which are in themselves,
“unconstitutional” and at odds with the public interest as stated in our Charters of Freedom.
Remedy 1 – The House of Representatives
Because ALL bills pertaining to revenue via Congress’s power to “lay and collect taxes” must originate in
the House, ObamaCare originated in the US Senate as NOT a tax bill, ObamaCare was passed via
“unconstitutional” process and is VOID (without legal force) in its current form.
The current “shut down” of the Federal Government resulting from the Senate strategy to simply
stonewall the House, just as they did during the unconstitutional passage of ObamaCare, presents a
momentary window of opportunity to remedy the entire situation and hold people accountable for their
blatant effort to extort private property from the States, businesses and the American people.
To capitalize on this window of opportunity, House Republicans must be convinced to keep the Federal
Government “shut down” until such time that the Senate is forced to pass a budget which does not include
any funding for ObamaCare.
HOUSE DIRECTORY HERE - http://www.house.gov/representatives/
The debt ceiling battle will have to take place by or before October 17, 2013. It is the intention of the
Obama Administration and the Democrat led Senate to continue to stonewall the House on ObamaCare
until the House is up against the wall on the debt ceiling on the 17th.
House Republicans simply cannot fold like a cheap lawn chair this time. They must hold the line for the
American people and completely defund ObamaCare, not delay it.
NOTE: All information contained herein was researched and written by a professional team at The North
American Law Center. All legal points are quoted directly from the Supreme Court ruling on the subject,
and all legal claims and remedies have been carefully vetted by a team of Constitutional Lawyers and
Scholars at The North American Law Center. The North American Law Center is prepared to stand
behind everything presented in this document in its original form and context.

MarvinSussman

We should be spending a lot more money on entitlements and fixing bridges. With our fiat currency, US can never run out of money. All we have to worry about is inflation when we run into shortage of goods. And with 20 million Americans looking for full time work, there is no danger of a goods shortage.

Mom8052 Loc: Lost in the mountains of New Mexico

[quote=NAVSOG]now read the North American Law Center brief.

Shut Down of Federal Government Set to Uphold
Federal Health Care Extortion Scheme
ObamaCare declared “unconstitutional” by US Supreme Court
The Basis for this Brief
The current budget battle between the US House of Representatives and the US Senate is over the funding
or defunding of ObamaCare, which was in fact declared “unconstitutional” by the US Supreme Court in
its ruling dated June 28, 2012 – has resulted in an impasse and a partial “shut down” of the Federal
Government starting on October 1, 2013.
Despite numerous efforts by the House of Representatives to pass a budget funding everything except
ObamaCare, the Senate under the command and control of Democrat Senator Harry Reid (Nevada) has
rejected every effort to reopen all federal agencies on grounds that they intend to “extort” money illegally
and unconstitutionally from the American people under their Affordable Health Care Act in which the
Federal Government is attempting to seize control of the health care industry, namely ALL related
revenue.
This document is prepared for the American people and the several States because Republicans currently
in control of the House of Representatives are almost certain to cave to the extortion underway, led by
Senate Leader Harry Reid of Nevada, unless the States and the people directly engage. The people must
prepare to take appropriate measures in that event.
Before discussing the criminal nature of events surround the forced acceptance of ObamaCare, we must
first state that ObamaCare originated in the US Senate. As the Constitution rests all congressional power
to “lay and collect taxes” in the House of Representatives, from which all “tax” revenue related bills must
originate, the Senate bill known as ObamaCare denied that it was a “tax,” therefore allowing the bill to
originate from the Senate.
As you will see here, the courts then attempt to re-write ObamaCare, making it a “tax” in order to make it
appear “constitutional.” However, the bill in its current form is NOT a “tax” and if it is a “tax,” it could
only exist if originated in the House.
ObamaCare is in fact “unconstitutional” in its current form. But it is much worse that “unconstitutional,”
it is the greatest theft of private property, freedom and liberty in the history of the United States.
Extortion
The legal term “extortion” is defined in Common Law as – “a misdemeanor consisting of an unlawful
taking of money by a government officer. It is an oppressive misuse of the power with which the law
clothes a public officer.”
Extortion is further defined as follows;
“The essence of extortion by a public officer is the oppressive use of official position to obtain a
fee. The officer falsely claims authority to take that to which he or she is not lawfully entitled.
This is known as acting under color of office. The victim, although consenting to payment, is not
doing so voluntarily, but is yielding to official authority.”
“Extortion is generally punished by a fine or imprisonment, or both. When the offense is
committed by a public officer, the penalty may include Forfeiture of office. Under some statutes,
the victim of an extortion may bring a civil action and recover pecuniary damages.”
Not a Victimless Crime
In the case of the ObamaCare extortion, the victims are both the individual States, which are threatened
with the loss of federal funding if they refuse to accept the unconstitutional expansion of Medicare and
Medicaid within their State, private businesses forced to comply with unconstitutional ObamaCare
employer mandates or face extreme financial penalty, and the people of the United States, who are forced
to “opt-in” to ObamaCare or face extreme “fines” and “penalties” for “opting-out.” As every State,
business owner and citizen is a direct victim of this crime, each in and of themselves, has “legal standing”
to bring an action against the people involved in committing the crime.
The Supreme Court Ruling of June 28, 2012
Key parts of the decision rendered on 28 June, 2012 regarding the constitutionality of the ObamaCare
racket are vital to the defeat and defunding of the effort to extort revenue from the States, private
businesses and American citizens.
Specifically, the following parts of the 193 page decision written by Chief Justice John Roberts are as
follows.
1) Congress did NOT pass ObamaCare by constitutional legislative process, but rather by a heavyhanded
strictly partisan process which completely eliminated half of the US Representatives from
the process in the dark of night. Further, it did NOT pass as a “tax” bill under the Direct Tax
authority of congress, which must initiate in the House.
Preamble to the Ruling;
In 2010, Congress enacted the Patient Protection and Affordable Care Act in order to increase the
number of Americans covered by health insurance and decrease the cost of health care. One key
provision is the individual mandate, which requires most Americans to maintain “minimum
essential” health insurance coverage. 26 U. S. C. §5000A. For individuals who are not exempt,
and who do not receive health insurance through an employer or government program, the means
of satisfying the requirement is to purchase insurance from a private company. Beginning in
2014, those who do not comply with the mandate must make a “[s]hared responsibility payment”
to the Federal Government. §5000A(b)(1). The Act provides that this “penalty” will be paid to the
Internal Revenue Service with an individual’s taxes, and “shall be assessed and collected in the
same manner” as tax penalties. §§5000A(c), (g)(1). Another key provision of the Act is the
Medicaid expansion. The current Medicaid program offers federal funding to States to assist
pregnant women, children, needy families, the blind, the elderly, and the disabled in obtaining
medical care. 42 U. S. C. §1396d(a). The Affordable Care Act expands the scope of the Medicaid
program and increases the number of individuals the States must cover.
The Act increases federal funding to cover the States’ costs in expanding Medicaid coverage.
§1396d(y)(1). But if a State does not comply with the Act’s new coverage requirements, it may
lose not only the federal funding for those requirements, but all of its federal Medicaid funds.
§1396c. Twenty-six States, several individuals, and the National Federation of Independent
Business brought suit in Federal District Court, challenging the constitutionality of the individual
mandate and the Medicaid expansion. The Court of Appeals for the Eleventh Circuit upheld the
Medicaid expansion as a valid exercise of Congress’s spending power, but concluded that
Congress lacked authority to enact the individual mandate. Finding the mandate severable from
the Act’s other provisions, the Eleventh Circuit left the rest of the Act intact.
In short, as Democrats passed the Act through congress on pure partisan lines as a “fine” and/or
“penalty,” it was “unconstitutional” as written and passed, as any such Act falls beyond the scope and
power of congress and falls under the definition of “extortion.”
Part 1 of the Ruling
“CHIEF JUSTICE ROBERTS delivered the opinion of the Court with respect to Part II,
concluding that the Anti-Injunction Act does not bar this suit.
The Anti-Injunction Act provides that “no suit for the purpose of restraining the assessment or
collection of any tax shall be maintained in any court by any person,” 26 U. S. C. §7421(a), so
that those subject to a tax must first pay it and then sue for a refund. The present challenge seeks
to restrain the collection of the shared responsibility payment from those who do not comply with
the individual mandate. But Congress did not intend the payment to be treated as a “tax” for
purposes of the Anti-Injunction Act. The Affordable Care Act describes the payment as a
“penalty,” not a “tax.” That label cannot control whether the payment is a tax for purposes of the
Constitution, but it does determine the application of the Anti-Injunction Act. The Anti-Injunction
Act therefore does not bar this suit.”
This is of critical importance because today, the House of Representatives, States or the people could
petition the court for an injunction blocking the implementation and funding of ObamaCare on
constitutional grounds, as declared in Part 1 of the Supreme Court decision. In short, the text of
ObamaCare as passed by Democrats in congress is hereby deemed “unconstitutional” as is.
Part 2 of the Ruling
“CHIEF JUSTICE ROBERTS concluded in Part III–A that the individual mandate is not a valid
exercise of Congress’s power under the Commerce Clause and the Necessary and Proper Clause.
Pp. 16–30.”
This part of the ruling establishes that the Act as passed in original form by congressional Democrats is
beyond the scope and authority of congress under both the Commerce Clause (used by Democrats to pass
the Act) and the Necessary and Proper Clause, (used by Democrats to defend the Act). Once again, as
written and passed, the Act is ruled “unconstitutional” as-is under the constitutional authority granted in
these two clauses.
Part 3 of the Ruling
“CHIEF JUSTICE ROBERTS concluded in Part III–B that the individual mandate must be
construed as imposing a tax on those who do not have health insurance, if such a construction is
reasonable. The most straightforward reading of the individual mandate is that it commands
individuals to purchase insurance. But, for the reasons explained, the Commerce Clause does not
give Congress that power. It is therefore necessary to turn to the Government’s alternative
argument: that the mandate may be upheld as within Congress’s power to “lay and collect Taxes.”
Art. I, §8, cl. 1.”
The basis for passing the Act under the Commerce Clause failed the constitutional challenge on its
original foundations. Therefore, Democrats used an “alternate” argument in the lower Federal Courts that
even though they denied the Act was a form of “taxation” during the passage of the Act, they now claim
that it is a “tax” because what they had passed was unconstitutional on its face in its original form.
The alternate argument declaring the Act a form of “taxation” under Congress’s constitutional authority to
“lay and collect taxes” also fails the constitutional test however, as it violates numerous constitutional
protections for the States and the people, to include the General Welfare Clause which requires congress
to only pass laws that serve the best interest of the general population without singling out any individual
for special treatment, taxation, fines, penalties or directives in which all citizens are not treated equally.
The lower Federal Courts had already issued and upheld rulings separating the individual mandate out
from the balance of the Act, deeming that particular clause “unconstitutional.” By the time the case
reached the Appellate Review of the US Supreme Court, the court was forced to review and rule on the
basis of the lower court rulings.
Original Jurisdiction
A purposeful judicial error was made when 26 states joined a suit in lower Federal Court challenging the
constitutionality of ObamaCare. Stated in Article III – Section II – Clause II of the US Constitution is the
“original jurisdiction clause,” which reads as follows;
“In all cases affecting ambassadors, other public ministers and consuls, and those in which a state
shall be party, the Supreme Court shall have original jurisdiction. In all the other cases before
mentioned, the Supreme Court shall have appellate jurisdiction, both as to law and fact, with such
exceptions, and under such regulations as the Congress shall make.”
The US Supreme Court has two types of jurisdiction, a) appellate review over lower court decisions; b)
original jurisdiction; intended to bring cases directly before the US Supreme Court for adjudication in
case where a State (in this case 26 states) and the Federal Government are in dispute over the
“constitutional authority” between the Federal Government and the State.
Original Jurisdiction is defined as – “A court's power to hear and decide a case before any appellate
review.” – “The original jurisdiction of the Court is laid out by statute in 28 U.S.C. § 1251. Section
1251(a) provides that with one type of dispute (disputes between states), the Court's jurisdiction is not
only "original," it is exclusive.”
This means that the lower Florida Federal Court in which the 26 States originally filed their joint claim
had NO legal jurisdiction over the matter of “constitutionality” concerning ObamaCare. The case should
have never been filed anywhere but in the US Supreme Court, which holds “original jurisdiction” on all
cases involving a dispute between a State and the Federal Government, especially when the case is based
on the “constitutionality” of a Federal act.
The Florida Federal Court should have dismissed the case filed by the 26 States on the grounds of
“improper jurisdiction” – the US Supreme Court holding “original jurisdiction” on the matter at hand.
Instead, the Florida court acted beyond its constitutional jurisdiction by hearing and ruling on a case in
which only the US Supreme Court has jurisdiction under Article III.
The Appeals Review also acted beyond its constitutional authority in its review and upholding of the
lower court’s opinion in Florida.
As a result, by the time the case reached the US Supreme Court, precious time and taxpayer resources had
been wasted in courts with no jurisdiction, and the judicial activism in both lower court rulings,
essentially re-writing the “unconstitutional Act” from the bench in an effort to make it constitutional
under Congress’s power to “lay and collect taxes,” the US Supreme Court was now playing an “appellate
review” role as opposed to their constitutional role under original jurisdiction.
Part 4 of the Ruling
“CHIEF JUSTICE ROBERTS delivered the opinion of the Court with respect to Part III–C,
concluding that the individual mandate may be upheld as within Congress’s power under the
Taxing Clause. Pp. 33–44.
The Affordable Care Act describes the “[s]hared responsibility payment” as a “penalty,” not a
“tax.” That label is fatal to the application of the Anti-Injunction Act. It does not, however,
control whether an exaction is within Congress’s power to tax. In answering that constitutional
question, this Court follows a functional approach, “[d]isregarding the designation of the
exaction, and viewing its substance and application.” United States v. Constantine, 296 U. S. 287,
294. Pp. 33–35.
(b) Such an analysis suggests that the shared responsibility payment may for constitutional
purposes be considered a tax.”
The problem with what the courts are doing here is that they are re-writing the Act from the bench to suit
the Democrats who illegally passed an unconstitutional Act. The court has no such constitutional
authority, to write or re-write legislation from the bench, making an Act which is “unconstitutional” on its
face “constitutional” by perverted judicial fiat.
Had Democrats tried to pass the Act as a “tax” – it would have had to meet conditions of the General
Welfare Clause for starters, and it would NOT have passed even by a strict party line v**e. By altering the
Act at the court, the American people are misled into believing the Act in its true form is “constitutional”
when in fact all three courts ruled it “unconstitutional” in its legislative form.
The courts then exceed their constitutional authority by issuing rulings they have no constitutional
authority to issue, and re-writing the legislation from the bench to keep the effort to extort assets from the
States, businesses and the people intact.
Part 5 of the Ruling
“CHIEF JUSTICE ROBERTS, joined by JUSTICE BREYER and JUSTICE KAGAN, concluded
in Part IV that the Medicaid expansion violates the Constitution by threatening States with the
loss of their existing Medicaid funding if they decline to comply with the expansion. Pp. 45–58.”
Here the ruling declares that the effort to “force” Medicaid expansion on the States through coercion and
extortion is also “unconstitutional,” stating in part;
“The legitimacy of Spending Clause legislation, however, depends on whether a State voluntarily
and knowingly accepts the terms of such programs.”
As 26 States immediately challenged the constitutionality of the terms of the program, it is a fair
assumption that at least 26 states do not voluntarily accept those terms.
Part 6 of the Ruling
“JUSTICE GINSBURG, joined by JUSTICE SOTOMAYOR, is of the view that the Spending
Clause does not preclude the Secretary from withholding Medicaid funds based on a State’s
refusal to comply with the expanded Medicaid program.
But given the majority view, she agrees with THE CHIEF JUSTICE’s conclusion in Part IV–B
that the Medicaid Act’s severability clause, 42 U. S. C. §1303, determines the appropriate
remedy. Because THE CHIEF JUSTICE finds the withholding—not the granting—of federal
funds incompatible with the Spending Clause, Congress’ extension of Medicaid remains available
to any State that affirms its willingness to participate.”
Again, the issue is booted to the States on a voluntary basis, and the Supreme Court has ruled that it is
“unconstutional” to “penalize” the State by withdrawing federal Medicaid funds in retaliation for the State
refusing to participate in ObamaCare.
So far, the first six parts of the Ruling have established that ObamaCare is indeed “unconstitutional” as it
was written and passed on a party line v**e by congressional Democrats.
“ROBERTS, C. J., announced the judgment of the Court and delivered the opinion of the Court
with respect to Parts I, II, and III–C, in which GINSBURG, BREYER, SOTOMAYOR, and
KAGAN, JJ., joined; an opinion with respect to Part IV, in which BREYER and KAGAN, JJ.,
joined; and an opinion with respect to Parts III–A, III–B, and III–D. GINSBURG, J., filed an
opinion concurring in part, concurring in the judgment in part, and dissenting in part, in which
SOTOMAYOR, J., joined, and in which BREYER and KAGAN, JJ., joined as to Parts I, II, III,
and IV. SCALIA, KENNEDY, THOMAS, and ALITO, JJ, filed a dissenting opinion. THOMAS,
J., filed a dissenting opinion.”
The Dissenting Opinions of Scalia, Kennedy, Thomas and Alito
On page 128; JUSTICE SCALIA, JUSTICE KENNEDY, JUSTICE THOMAS, and JUSTICE ALITO,
dissenting; we find the following…
“The case is easy and straightforward, however, in another respect. What is absolutely clear,
affirmed by the text of the 1789 Constitution, by the Tenth Amendment ratified in 1791, and by
innumerable cases of ours in the 220 years since, is that there are structural limits upon federal
power—upon what it can prescribe with respect to private conduct, and upon what it can impose
upon the sovereign States. Wh**ever may be the conceptual limits upon the Commerce Clause
and upon the power to tax and spend, they cannot be such as will enable the Federal Government
to regulate all private conduct and to compel the States to function as administrators of federal
programs.”
From page 131;
“We do not doubt that the buying and selling of health insurance contracts is commerce generally
subject to federal regulation. But when Congress provides that (nearly) all citizens must buy an
insurance contract, it goes beyond “adjust[ing] by rule or method,” Johnson, supra, or “direct[ing]
according to rule,” Ash, supra; it directs the creation of commerce. In response, the Government
offers two theories as to why the Individual Mandate is nevertheless constitutional. Neither theory
suffices to sustain its validity.”
From page 134;
“Congress has impressed into service third parties, healthy individuals who could be but are not
customers of the relevant industry, to offset the undesirable consequences of the regulation.
Congress’ desire to force these individuals to purchase insurance is motivated by the fact that
they are further removed from the market than unhealthy individuals with pre-existing conditions,
because they are less likely to need extensive care in the near future. If Congress can reach out
and command even those furthest removed from an interstate market to participate in the market,
then the Commerce Clause becomes a font of unlimited power, or in Hamilton’s words, “the
hideous monster whose devouring jaws . . . spare neither sex nor age, nor high nor low, nor
sacred nor profane.” The Federalist No. 33, p. 202 (C. Rossiter ed. 1961).”
From page 152, concerning the Anti-Injunction Act;
“Whether jurisdiction over the challenges to the minimum-coverage provision is precluded by the
Anti-Injunction Act, which provides that “no suit for the purpose of restraining the assessment or
collection of any tax shall be maintained in any court by any person,” 26 U. S. C. §7421(a) (2006
ed.). We have left the question to this point because it seemed to us that the dispositive question
whether the minimum coverage provision is a tax is more appropriately addressed in the
significant constitutional context of whether it is an exercise of Congress’ taxing power. Having
found that it is not, we have no difficulty in deciding that these suits do not have “the purpose of
restraining the assessment or collection of any tax.” 6”
From page 162;
“The question whether a law enacted under the spending power is coercive in fact will sometimes
be difficult, but where Congress has plainly “crossed the line distinguishing encouragement from
coercion,” New York, supra, at 175, a federal program that coopts the States’ political processes
must be declared unconstitutional. “[T]he federal balance is too essential a part of our
constitutional structure and plays too vital a role in securing freedom for us to admit inability to
intervene.” Lopez, 514 U. S., at 578 (KENNEDY, J., concurring).”
From page 188;
“Such provisions validate the Senate Majority Leader’s statement, “‘I don’t know if there is a
senator that doesn’t have something in this bill that was important to them. . . . [And] if they don’t
have something in it important to them, then it doesn’t speak well of them. That’s what this
legislation is all about: It’s the art of compromise.’ ” Pear, In Health Bill for Everyone, Provisions
for a Few, N. Y. Times, Jan. 4, 2010, p. A10 (quoting Sen. Reid).”
From page 190;
“This Court must not impose risks unintended by Congress or produce legislation Congress may
have lacked the support to enact. For those reasons, the unconstitutionality of both the Individual
Mandate and the Medicaid Expansion requires the invalidation of the Affordable Care Act’s other
provisions.”
Dissenting Summation
“The Court today decides to save a statute Congress did not write. It rules that what the statute
declares to be a requirement with a penalty is instead an option subject to a tax. And it changes
the intentionally coercive sanction of a total cut-off of Medicaid funds to a supposedly
noncoercive cut-off of only the incremental funds that the Act makes available. The Court regards
its strained statutory interpretation as judicial modesty. It is not. It amounts instead to a vast
judicial overreaching. It creates a debilitated, inoperable version of health-care regulation that
Congress did not enact and the public does not expect. It makes enactment of sensible health-care
regulation more difficult, since Congress cannot start afresh but must take as its point of departure
a jumble of now senseless provisions, provisions that certain interests favored under the Court’s
new design will struggle to retain. And it leaves the public and the States to expend vast sums of
money on requirements that may or may not survive the necessary congressional revision.
The Court’s disposition, invented and atextual as it is, does not even have the merit of avoiding
constitutional difficulties. It creates them. The holding that the Individual Mandate is a tax raises
a difficult constitutional question (what is a direct tax?) that the Court resolves with inadequate
deliberation. And the judgment on the Medicaid Expansion issue ushers in new federalism
concerns and places an unaccustomed strain upon the Union. Those States that decline the
Medicaid Expansion must subsidize, by the federal tax dollars taken from their citizens, vast
grants to the States that accept the Medicaid Expansion. If that destabilizing political dynamic, so
antagonistic to a harmonious Union, is to be introduced at all, it should be by Congress, not by
the Judiciary. The values that should have determined our course today are caution, minimalism,
and the understanding that the Federal Government is one of limited powers. But the Court’s
ruling undermines those values at every turn. In the name of restraint, it overreaches. In the name
of constitutional avoidance, it creates new constitutional questions. In the name of cooperative
federalism, it undermines state sovereignty.
The Constitution, though it dates from the founding of the Republic, has powerful meaning and
vital relevance to our own times. The constitutional protections that this case involves are
protections of structure. Structural protections—notably, the restraints imposed by federalism and
separation of powers—are less romantic and have less obvious a connection to personal freedom
than the provisions of the Bill of Rights or the Civil War Amendments. Hence they tend to be
undervalued or even forgotten by our citizens. It should be the responsibility of the Court to teach
otherwise, to remind our people that the Framers considered structural protections of freedom the
most important ones, for which reason they alone were embodied in the original Constitution and
not left to later amendment. The fragmentation of power produced by the structure of our
Government is central to liberty, and when we destroy it, we place liberty at peril. Today’s
decision should have vindicated, should have taught, this t***h; instead, our judgment today has
disregarded it. For the reasons here stated, we would find the Act invalid in its entirety. We
respectfully dissent.”
NOTE: You can review the entire 193 page ruling here;
http://hastings.house.gov/uploadedfiles/supreme_court_decision_6.28.12.pdf
SUMMARY OF RULING
The US Supreme Court finds that the Affordable HealthCare Act is “unconstitutional” in its current form.
According to the US Supreme Court ruling, the Act must be a “tax” in order to hold legal authority under
the constitutional power of the House of Representatives to “lay and collect taxes.”
However, as the Act was not written or passed into law as a “tax” – originating in the US Senate which
has no constitutional authority to “lay and collect taxes,” it is not a “tax” and therefore, it remains
“unconstitutional” in its current form.
To be clear, ObamaCare is “unconstitutional” as passed by congressional Democrats. To become
constitutional, it would have to be a “tax” and as a “tax” it would have to initiate in the House or
Representatives under the authority to “lay and collect taxes.”
As an “unconstitutional” piece of legislation, it has no legal force or effect. It is therefore
“unconstitutional” for the House of Representatives to “fund” an “unconstitutional” act of the Senate and
Executive Branch.
A Federal Extortion Scheme
The 113th Congress must now decide what to do with ObamaCare, knowing full-well that the Act is
“unconstitutional” as written and passed on a strict party line v**e in the dark of night, admittedly, before
any member of congress had even read the Act in its entirety.
Because the House of Representatives has the power of the checkbook within its sole constitutional
authority, the current House effort to derail “unconstitutional” ObamaCare via defunding it is a viable
strategy, in a broad sense.
However, to defund it (rather than delay it), the House need only eliminate all funding related to
ObamaCare from its final budget entirely. Due to the judicial activism on the subject, ObamaCare cannot
be funded as a standalone item. It can only be funded via the general revenue fund of the Federal
Government via Congress’s authority to “lay and collect taxes.”
This explains why Senate Democrats are stonewalling the House on every effort to separate the
ObamaCare funding from the general revenue budget of the Federal Government. As a standalone item,
ObamaCare has already been ruled “unconstitutional.”
The Role of the Government “Shut Down”
Democrat Senate leader Harry Reid (NV) is personally responsible for stonewalling the House effort to
fund all provisions of the Federal Government, except the “unconstitutional” ObamaCare Act. The “shut
down” of portions of the Federal Government is intended to threaten the peace and tranquility of every
American citizen and business, going so far as to close off access to open air sections of “public lands”
(belonging to the American people) upon which sits the War Memorials of those who have offered their
very lives in defense of Freedom and Liberty.
As “public lands” belong to “the people” of the United States, not the Federal Government, the Obama
Administration and Harry Reid have no legal authority to close public access to those areas. But in their
need to “cause harm” to as many citizens as possible, and a public display, creating fear and pressure
upon the citizenry and therefore a “forced compliance” with an Act deemed “unconstitutional,” the “shut
down” is a hammer used to coerce and complete the intent to extort private property from the citizenry
under extreme duress.
Federal cuts, areas of Federal spending deemed “non-essential” by the Obama Administration, are used to
“target” areas most likely to impact citizens in such a manner as to “force” them to comply with the
“unconstitutional” whims of the Federal Administration.
It is classic “extortion…” and nothing less.
Why it is Extortion
As the current Congress is made up of legislators in which only 6.8% of House members and 3% of
Senate members have any experience in the profession of Health Care, the goal is NOT as stated, to
provide quality health care to Americans who are otherwise without coverage today.
The goal is to seize control of 1/7th of the total U.S. economy, the Health Care industry, and all of that
revenue, taking it away from the private sector under the management of Health Care professionals and
placing it under the command and control of the Federal Government.
Because a majority of States, businesses and citizens oppose ObamaCare and the gross expansion of
Federal intrusions into the highly specialized field of health care, where matters of life and death are
beyond the constitutional authority of the Federal Government, ObamaCare was established as a means to
illegally force States, businesses and citizens to comply with the Federal seizing of 1/7th of the U.S.
economy, or face stiff “penalties” from the I.R.S. which are already ruled “unconstitutional” by the
Supreme Court.
Further, to coerce the American people to comply, the Obama Administration is using well-known tactics
to threaten, intimidate, coerce and otherwise force an unwilling society to accept socialized medicine or
face the consequences from an increasingly tyrannical government.
It is a blatant extortion racket… It is against the law…. It is unconstitutional on its face and the people
simply must deny the Obama Administration its will to destroy not only Health Care in America, but
freedom and liberty itself.
Every American is a Victim with Standing
Although the following post once found on the Affordable Healthcare Act Facebook page is not
confirmed with the author, who remains unknown at this moment, we believe that the post nonetheless
represents a real and accurate depiction of how ObamaCare is intended to work for the government, and
against the people of the United States.
“I actually made it through this morning at 8:00 A.M. I have a preexisting condition (Type 1
Diabetes) and my income base was 45K-55K annually I chose tier 2 "Silver Plan" and my
monthly premiums came out to $597.00 with $13,988 yearly deductible!!! There is NO
POSSIBLE way that I can afford this so I "opt-out" and chose to continue along with no
insurance. I received an email tonight at 5:00 P.M. informing me that my fine would be $4,037
and could be attached to my yearly income tax return. Then you make it to the
"REPERCUSSIONS PORTION" for "non-payment" of yearly fine. First, your drivers license will
be suspended until paid, and if you go 24 consecutive months with "Non-Payment" and you
happen to be a home owner, you will have a federal tax lien placed on your home. You can agree
to give your bank information so that they can easy "Automatically withdraw" your "penalties"
weekly, bi-weekly or monthly! This by no means is "Free" or even "Affordable.” (as posted on
the Facebook page without edit)”
Because every American, every State and every business is negatively affected by the “unconstitutional”
ObamaCare Act, each has “legal standing” to bring charges against the perpetrators, including criminal
charges related to extortion and fraud via the unconstitutional process used to place the Act in effect.
Under 1946 Rules of Procedure, both Criminal and Civil, the critical portions on “legal standing” follow;
 “The Supreme Court has developed an elaborate body of principles defining the nature and scope
of standing. Basically, a plaintiff must have suffered some direct or substantial injury or be likely
to suffer such an injury if a particular wrong is not redressed. A defendant must be the party
responsible for perpetrating the alleged legal wrong.”
 “Most standing issues arise over the enforcement of an allegedly unconstitutional statute,
ordinance, or policy. One may challenge a law or policy on constitutional grounds if he can show
that enforcement of the law or implementation of the policy infringes on an individual
constitutional right, such as Freedom of Speech.”
 “A significant economic injury or burden is sufficient to provide standing to sue, but in most
situations a taxpayer does not have standing to challenge policies or programs that she is forced to
support.”
As every State, individual and business is penalized, threatened and/or fined by the terms present in
ObamaCare, declared by the US Supreme Court as “unconstitutional” in its current form, every legal
American has proper “legal standing” for a cause of action against the perpetrators of a blatant intent to
coerce and extort private property under a massive abuse of government power.
Further, the courts effort to re-write the Act as a “constitutional” effort to “lay and collect taxes” is itself
“unconstitutional,” and the courts have no legislative authority whatsoever under Article III of the US
Constitution.
Violations of the Bill of Rights
ObamaCare violations of specific protections in the Bill of Rights are simply too numerous to list here.
However, most critical is the direct violations related to States’ Rights under Amendment X, individual
Rights under Amendment IX, the Right of the people to be secure in their property under Amendment IV
and the Right to due process under Amendment V, before being deprived of any Life, Liberty or Property.
ObamaCare is a “punitive” Act intended to coerce Americans into complying with a government seizure
of 1/7th of the US economy, resulting in government control over life and death decisions concerning the
private health interest of individuals. As such, it is an Act of extortion and every Citizen has the Right and
the Duty to rise up against it.
In the following remedy section of this document, we must begin with the general understanding that in a
Constitutional Republic such as ours, the States and the people are under no legal, moral or ethical
obligation to adhere to laws or government policies and mandates which are in themselves,
“unconstitutional” and at odds with the public interest as stated in our Charters of Freedom.
Remedy 1 – The House of Representatives
Because ALL bills pertaining to revenue via Congress’s power to “lay and collect taxes” must originate in
the House, ObamaCare originated in the US Senate as NOT a tax bill, ObamaCare was passed via
“unconstitutional” process and is VOID (without legal force) in its current form.
The current “shut down” of the Federal Government resulting from the Senate strategy to simply
stonewall the House, just as they did during the unconstitutional passage of ObamaCare, presents a
momentary window of opportunity to remedy the entire situation and hold people accountable for their
blatant effort to extort private property from the States, businesses and the American people.
To capitalize on this window of opportunity, House Republicans must be convinced to keep the Federal
Government “shut down” until such time that the Senate is forced to pass a budget which does not include
any funding for ObamaCare.
HOUSE DIRECTORY HERE - http://www.house.gov/representatives/
The debt ceiling battle will have to take place by or before October 17, 2013. It is the intention of the
Obama Administration and the Democrat led Senate to continue to stonewall the House on ObamaCare
until the House is up against the wall on the debt ceiling on the 17th.
House Republicans simply cannot fold like a cheap lawn chair this time. They must hold the line for the
American people and completely defund ObamaCare, not delay it.
NOTE: All information contained herein was researched and written by a professional team at The North
American Law Center. All legal points are quoted directly from the Supreme Court ruling on the subject,
and all legal claims and remedies have been carefully vetted by a team of Constitutional Lawyers and
Scholars at The North American Law Center. The North American Law Center is prepared to stand
behind everything presented in this document in its original form and context.[/quote]

So, why can't they do something to shut ACA down, if it is uncontitutional? Oh wait, they need to be paid....go figure.