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0 pointsdragonwriter9y ago0 comments

> If Obamacare is repelled at the Federal level, could a state just implement its local ACA?

Some parts of the ACA could be implemented in state law, some would be either illegal or impractical at the state level. It's also likely that a repeal would be accompanied or followed by federal policies which would make state-specified versions of the ACA less practical than they are now.

> what prevents California for instance of giving health coverage for its residents?

California already provides state-run send healthcare beyond the requirements of the federal programs it participates in.

0 comments

5 comments · 2 top-level

vmarsy9y ago· 3 in thread

> Some parts of the ACA could be implemented in state law, some would be either illegal or impractical at the state level.

That's my poor understanding of U.S. Federal vs State government that fails me here: what exactly would be illegal, what would be impractical? If a state ACA is challenged in court, couldn't they use the supreme courts rulings of Obamacare as a strong defense?

Other comments here mentions that Massachusetts already had it (and I assume would likely keep it even after Obamacare is repealed), Couldn't California copy the Massachusetts implementation?

> California already provides state-run send healthcare beyond the requirements of the federal programs it participates in.

But I assume those state-run programs aren't providing as strong of a coverage as Obamacare was? Now would seem a good time to update it to match Obamacare?

toomuchtodo9y ago

> That's my poor understanding of U.S. Federal vs State government that fails me here: what exactly would be illegal,

Mandating coverage, which is basically a requirement of affordable universal healthcare.

"What happens if I don't pay the fee?

The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee."

https://www.healthcare.gov/fees/fee-for-not-being-covered/

amalcon9y ago

Massachusetts did this in the program that Obamacare was modeled after, so clearly that's not (currently) illegal at the state level.

The fee structure is different (just a missed deduction on the state taxes, not a separate monthly charge), but it still works.

1 more reply

elastic_church9y ago

States have granted themselves their own taxing authority, and have autonomy in doing so.

You wouldn't just copy and paste "IRS" into the state law that a state might decide to create. You would use the state's taxing authority.

Yes, state sanctions don't generally sting as much.

But each state would have to independently decide, with its own constituents, if it could economically offer subsidized health care for all of its residents.

Many states already have some form of parallel subsidized/free health care system for certain segments of the population. Like their school teachers and their children as an example.

Anyway, hope that helps.

1 more reply

dionidium9y ago

I think this presents an unnecessarily complicated view of things. The simple answer here is that California absolutely could develop its own healthcare system.

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0 comments

5 comments · 2 top-level

vmarsy9y ago· 3 in thread

> Some parts of the ACA could be implemented in state law, some would be either illegal or impractical at the state level.

Other comments here mentions that Massachusetts already had it (and I assume would likely keep it even after Obamacare is repealed), Couldn't California copy the Massachusetts implementation?

> California already provides state-run send healthcare beyond the requirements of the federal programs it participates in.

But I assume those state-run programs aren't providing as strong of a coverage as Obamacare was? Now would seem a good time to update it to match Obamacare?

toomuchtodo9y ago

> That's my poor understanding of U.S. Federal vs State government that fails me here: what exactly would be illegal,

Mandating coverage, which is basically a requirement of affordable universal healthcare.

"What happens if I don't pay the fee?

The IRS will hold back the amount of the fee from any future tax refunds. There are no liens, levies, or criminal penalties for failing to pay the fee."

https://www.healthcare.gov/fees/fee-for-not-being-covered/

amalcon9y ago

Massachusetts did this in the program that Obamacare was modeled after, so clearly that's not (currently) illegal at the state level.

The fee structure is different (just a missed deduction on the state taxes, not a separate monthly charge), but it still works.

1 more reply

elastic_church9y ago

States have granted themselves their own taxing authority, and have autonomy in doing so.

You wouldn't just copy and paste "IRS" into the state law that a state might decide to create. You would use the state's taxing authority.

Yes, state sanctions don't generally sting as much.

But each state would have to independently decide, with its own constituents, if it could economically offer subsidized health care for all of its residents.

Many states already have some form of parallel subsidized/free health care system for certain segments of the population. Like their school teachers and their children as an example.

Anyway, hope that helps.

1 more reply

dionidium9y ago

I think this presents an unnecessarily complicated view of things. The simple answer here is that California absolutely could develop its own healthcare system.

j / k navigate · click thread line to collapse