The following is from one of the DOJ briefs defending Obamacare. Less than 800 words that describe the whole law:
First, Congress made health insurance available to millions more low-income individuals by expanding eligibility for Medicaid. Beginning in 2014, Medicaid eligibility will extend to anyone under age 65 with income up to 133% of the federal poverty level. Currently, Medicaid beneficiaries are primarily children in low-income families, their parents, low-income pregnant women, and low-income elderly or disabled individuals. The newly eligible persons will consist primarily of low-income non-elderly adults without dependent children.
Second, Congress enacted taxing measures that encourage expansion of employer-sponsored insurance. The Act establishes new tax incentives for eligible small businesses to purchase health insurance for their employees. In addition, the Act’s employer responsibility provision imposes a tax liability under specified circumstances on large employers that do not offer adequate coverage to full-time employees.
Third, Congress provided for creation of health insurance exchanges to enable individuals and small businesses to leverage their collective buying power
and maintain health insurance at rates competitive with those charged for typical large employer plans.
Fourth, Congress enacted market reforms that will make affordable insurance available to millions who cannot now obtain it. Certain reforms have already taken
effect, including provisions that bar insurers from canceling insurance absent fraud or intentional misrepresentation and from placing lifetime caps on benefits, 42 In addition, the Act establishes medical loss ratios for insurers, i.e., minimum percentages of premium revenues that insurers must spend on clinical services and activities that improve health care quality, as opposed to administrative costs or profits. The Act also requires insurers providing family coverage to continue covering adult children until age 26, which has led to an additional 2.5 million young adults gaining coverage. Beginning in 2014, the Act will bar insurers from denying coverage to any person because of medical condition or history,
(guaranteed-issue provision), and from charging higher premiums because of a person’s medical condition or history, (community-rating provision).
Fifth, Congress enacted new tax credits, cost-sharing reduction payments, and tax penalties as incentives for individuals to maintain a minimum level of health insurance. The Act establishes federal premium tax credits to assist eligible individuals with household income up to 400% of the federal poverty level purchase insurance through the new exchanges. These premium tax credits, which are advanceable and fully refundable such that individuals with little or no income tax liability can still benefit, are designed to make health insurance affordable by reducing a taxpayer’s net cost of insurance. The credits will be available even to families with incomes at (and above) the median level, which, in 2010, was $75,148 for a family of four and $42,863 for an individual. For eligible individuals with income up to 250% of the federal poverty level, the Act also authorizes federal payments to insurers to help cover those individuals’ cost-sharing expenses (such as co-payments or deductibles) for insurance obtained through an exchange. CBO projected that 83% of people who buy non-group insurance policies through exchanges will receive premium tax credits, (20 million of 24 million), and that those credits, on average, will cover nearly two-thirds of the premium,
In addition to those incentives through tax and other subsidies to purchase health insurance, Congress assigned adverse tax consequences to the alternative of attempted self-insuring. Congress provided that, beginning in 2014, non-exempted federal income taxpayers who fail to maintain a minimum level of health insurance coverage for themselves or their dependents will owe a tax penalty for each month in the tax year during which minimum coverage is not maintained.
And, just for supporters of the law (I am one), here’s a short, brutal description of the opposing brief that you might find amusing:
The challengers to the health care mandate have filed their Supreme Court brief – the definitive statement of the case against the mandate, drawing on the strongest arguments that have been made against it by advocates and federal judges, and authored by conservative superlawyer Paul Clement. It is astoundingly thin and weak. A standard admonishment to young lawyers is that they should address the very strongest arguments on the other side, instead of substituting weak caricatures of their opponents’ views. Yet the brief does this repeatedly.
Now, it has been clear for some time that the most articulate opponents of the mandate (who include such formidable intellects as Richard Epstein, Randy Barnett, and Gary Lawson) have just this in mind. They despise the modern state and want to blow it up. But the Supreme Court has no such revolutionary ambitions. The challenge for the challengers of the law, then, is to come up with a theory that lets them win this case without committing the Court to the end of American civilization as we know it. Clement evidently could not figure out how to do that (other than – here he shows excellent sense – being coy about the implications of his argument). If you accept his brief’s logic, then it is not clear how, say, the Environmental Protection Agency could survive, since there is no enumerated power to keep the country’s air breathable or its water drinkable.
As I’ve noted in a different context, when a lawyer as good as Clement makes arguments this bad, it tells you a lot about how desperate his case is.