Northwest Voices | Letters to the Editor
U.S. Supreme Court upholds Obamacare
Disappointed with conservative justices
As a conservative, I was disappointed with the 5-4 vote upholding Obamacare, and like many others, I was very surprised and disappointed with conservative Chief Justice John Roberts who “crossed over” and voted with the four liberal Justices [“Defining decision,” page one, June 29].
Roberts said that the reason why he voted that way was because he did not believe Obamacare violated the U.S. Constitution. How refreshing!
I have always been uncomfortable with the knowledge that one could look at an issue before the U.S. Supreme Court and predict how each justice would vote, not because of the merits, but because of their political beliefs.
Up until the Obamacare vote, the sole exception seemed to be Justice Anthony Kennedy who, although considered a conservative, appeared to vote on the constitutional merits of each case. Unfortunately, I don’t believe that you will ever see any of the four liberal justices on the Supreme Court (especially the three pathetic female justices), vote on an issue based solely on the question as to whether the U.S. Constitution was violated, and that is sad.
— Richard King, Seattle
A physician’s perspective
As a family physician, I have struggled to help my patients get necessary health services, but with Thursday’s Supreme Court ruling upholding the health-care-reform law, my patients and millions of Americans have improved access to health care.
The Affordable Care Act (ACA) provides insurance security for everyone; no longer will health-care access be determined by how much you earn, where you live or what you look like.
Under the ACA, insurance companies are required to use more of your premium on insurance benefits instead of salaries and administrative costs. Insurers must cover everyone, regardless of pre-existing conditions, and are no longer able to impose yearly or lifetime caps for needed services. Adult children can stay on parents’ insurance plans until they turn 26. Preventive care is available to all Americans without co-pay, allowing health-care providers to detect illnesses before significant harm is done. The ACA expands access to Medicaid for our nation’s poorest citizens and strengthens Medicare to protect seniors.
With the Supreme Court’s ruling, now we can put patients ahead of politics, and Americans can realize all the benefits of the Patient Protection and Affordable Care Act (PPACA).
— David Evans, M.D., Seattle
Just like the Postal Service
What have the Supremes wrought? The Post Office all over again.
By redefining mandates as taxes, Chief Justice John Roberts and his court have done for health care what previous courts did for post offices and post roads.
Congresses and presidents now have license to enrich themselves politically and financially as they have handsomely done with post offices and post roads over the past two centuries. The Postal Service everyone loves to hate began life as giving Congress the authority to construct horse stables (post offices) and roads for “posters” (letter carriers), who transported official government communications between government offices/officials. The old Post Office was for government mail, not for yours and mine.
Coming to a neighborhood near you is a medical-care facility — for them, not you.
— Gordon WIllsey, Bothell
Where is the precedent?
In the article “Defining Decision,” The Times says Chief Justice John Roberts has said that the penalty for those who refuse to purchase health-care insurance is “valid as long as it is simply considered a tax.”
As far as I can tell, taxes have always been applied to something that has been received by an individual or a corporation — you don’t pay income tax if you receive no income. Capital-gains taxes are only levied when capital gains are realized and not before, and use taxes are only levied when you use something. Real and personal property taxes and exercise taxes are only levied on something you own, not on something you don’t own.
Where is the precedent for taxing something you don’t own? Does this mean that the government can tax capital gains when they occur rather than when they are actually realized? Does this mean that the state of Washington can tax drivers who choose not to use toll roads like the 520 bridge or the new Highway 99 tunnel?
It is scary to think of all the possibilities this decision has opened up for new taxes.
— Frank Lippman, Seattle
Uncertainty vanquished and certainty restored
We have all seen the cost of medical insurance rise rapidly for years now, and the underlying cause for this is the rising costs of medical care. But in the last few years, other drivers have included the outsized compensation packages of health-care executives and the need of “for-profit” health-care organizations have to meet the obscene profit targets Wall Street sets.
An added force in Washington state has been the fact that several providers have jacked their reserves up to way past mandated requirements. Anyone tapping into Republican rhetoric in the last couple of years is familiar with the “uncertainty” argument: “Uncertainty is bad for business and increases costs,” they have opined on numerous occasions. And in the context of the legal challenges to Obamacare, this actually makes sense.
The one thing everyone agreed on was that overturning Obamacare would have thrown the whole health-insurance market into chaos, likely driving costs way up while the mess was sorted out. Well, we now have certainty — we are now certain what the legal framework for this industry will look like for the next several years.
Republicans should be happy to see uncertainty vanquished and certainty restored. Providers now don’t have the “uncertainty” argument to justify the high level of their reserves. State regulators need to push back hard at the rate increases requested by providers with high reserves.
— Patrick J. Russell, Seattle
The right decisions need to be made
The Supreme Court upheld the health-care law, states will begin implementation and states will also decide whether or not to expand state Medicaid rolls. The ruling permits states to opt out of that expansion without losing all federal Medicaid supplemental funding, and some states will decide whether to expand solely on ideological grounds with “conservatives” opposing and “liberals” supporting.
The decision must instead be made by each state based on its ability to raise revenues to support expansion according to its taxpayers’ ability to pay that revenue. Further, that ability-to-afford decision must consider the future when federal funding of Medicaid expansion declines.
States must also look beyond existing state population. States must concurrently strengthen state residency and eligibility requirements, to avoid a massive influx of people who’ll lack the same Medicaid coverage in their states. Usually homeownership and good jobs prevent many people from moving when they’d like. Many who lack both can, and do, move frequently, to find jobs or to obtain public benefits.
California is an example — once a rich state with high employment and a population of talented people who voted themselves generous unemployment and welfare benefits. From the late 1950s onward, its become a magnet for people from states lacking jobs and meager public-welfare benefits; its experienced a massive exodus of the middle class, making California unable to keep up with the resulting tax burden. California today is a state of some very rich and many low-income residents, unable to pay obligations, divided in wealth and politically polarized.
— Marilyn Martinetto, Steilacoom