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Kimberley A. Strassel: Why Romney Chose Ryan

2:01 pm in bold ideas, Elections, intense focus, medicare reforms, mr ryan, Paul Ryan, randolph macon college, romney campaign, running mate, signature legislation, tracking polls by PinkTeaPatriot

Mitt Romney and Paul Ryan at Randolph-Macon College in Ashland, Va., Aug. 11.

His running mate offers Romney the opportunity to explain to Americans that they have a choice between national stagnation and renewal.

By: Kimberley Strassel

Posted: Aug. 12th, 2012

Mitt Romney did much more this weekend than announce a running mate. He unveiled a significant change in strategy. The 2012 election is now a choice, not just a referendum.

Conservatives have spent much of this summer reassuring themselves. They’ve pointed out the extraordinary sums President Obama has thrown at crippling Mr. Romney. They’ve noted how ugly and brutal those attacks have been. They’ve comforted themselves that, for all the smears, Mr. Romney is within a few points of the incumbent in national tracking polls.

Yet the same can be said on the other side. The economy is teetering, the deficit exploding, the nation unhappy with his signature legislation. Daily, Mr. Romney beats the White House with these failures. But he has barely moved the polling dial.

Mr. Romney’s choice of House Budget Chairman Paul Ryan, one of the party’s star reformers, is an attempt to break out of the stalemate, change the dynamic. It was foremost a shrewd acknowledgment on Mr. Romney’s part that his path to the White House is going to take more than pointing out the obvious. He needs to run on bold ideas, as Mr. Ryan has, and convince Americans those ideas are the way to prosperity.

In fairness, the Romney campaign had the elements in place. It’s taken some time, but Mr. Romney today is sporting a fairly bold reform agenda, from his tax cuts to his Medicare reforms, to his vow to end ObamaCare. And the candidate has been dutifully repeating that this election is a choice between two very different futures for the country. Yet his policy and his words were largely lost amid his campaign’s intense focus on the president.

Mr. Ryan provides the crucial shift in emphasis, the opportunity to go on offense. We will now have a focus on, and explanation of, the choice between stagnation and renewal. This is what Mr. Ryan excels at—not just crafting ideas, but explaining them in a positive and serious way. This ability is why the congressman—despite his supposedly extremist reform blueprint and budget (says the left)—has continued to win a district that in 2008 went for Mr. Obama.

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It’s the Economy, Stupid. So why bother Attacking ObamaCare?

10:57 am in 103rd congress, blame president bush, economy continues to be a festering mess, elections president, independent senators, Issues, Obama's birth documentation, ObamaCare has already hurt the economy, Obamacare Report, organizational purposes, Republican Party, senate seats, signature legislation, spotlight, stagnant economic environment, substantial majorities, us manufacturing sector, victor davis hanson by danmillerinpanama

ObamaCare has already hurt the economy and
its effects will continue to worsen until repealed. To ignore ObamaCare would be like noticing only the coarseness of the rope with which one is being hung.

The economy continues to be a festering mess.

The economy continues flailing about and has by no means improved as substantially as promised under President Obama’s “wise” (we are told) leadership. It is doing so even though his party had substantial majorities in both the House (256 Democrat vs. 175 Republican or 59.4 percent Democrat) and the Senate (51 Democrat vs. 41 Republican or 55.4 percent) from January of 2009 until January of 2011 and still retains control of the Senate. At least until January of last year, President Obama was able to push through legislation and did, including his “signature legislation” ObamaCare, pretty much on request. Among other disasters, ObamaCare included the “individual responsibility” medical insurance mandate which the Supreme Court on June 28th of this year deemed to be a tax rather than a penalty so that it could thereby deem it constitutional. Whether called a tax or a penalty, it remains a recipe for worsening economic calamities.

President Obama’s party also had control of the Congress during President Bush’s last two years in office. From January of 2007 until January of 2009,

The Democratic Party controlled a majority in both chambers for the first time since the end of the 103rd Congress in 1995. Although the Democrats held fewer than 50 Senate seats, they had an operational majority because the two independent senators caucused with the Democrats for organizational purposes. No Democratic-held seats had fallen to the Republican Party in the 2006 elections.

President Obama campaigned against the economic (and other) problems he attributed to President Bush and has continued to claim that the economy is still “Bush’s fault.” Yet as noted last year by Victor Davis Hanson,

to the degree that economists fault Bush for the financial meltdown of 2008, they have cited his excessive federal spending, government intrusion into the housing market, and chronic budget deficits — just those areas where Obama has trumped Bush and turned his misdemeanors into felonies.

Those “misdemeanors” were committed when the Democrat Party controlled the Congress.

In addition to telling us still to blame President Bush, President Obama’s administration has told us, for the last three years, not to “read too much” into monthly jobs data when they are bad. After three years, we (and President Obama as well) should pay substantial attention to them and to the undesirable cumulative trends they show. President Obama himself, along with his party, should also take “individual responsibility” for the dire economy rather than blame it on others.

On July 6th of this year, the United States’ employment situation remained “stagnant” at 8.2 percent — except that the percentage of Blacks worsened to 14.4 percent, for women it worsened to 8.0 percent and for Latinos it remained stagnant at 11 percent. However, it’s worse even than that:

The real [overall] unemployment rate – the number that includes part time and discouraged workers – is now at 14.9%. That’s the highest it’s been in two years. It has also been the weakest quarter for job growth in two years.

And,

A record of 8,733,461 workers took federal disability insurance payments in June 2012, according to the Social Security Administration. That was up from 8,707,185 in May.

Even these figures understate the sad reality.

In May, the economy created just 69,000 jobs. The government has been in the habit of releasing a number and then later revising it down, so today’s 80,000 number may not stand for long. Economists expected 90,000 jobs to be created in June. A healthy economy would be expected to create north of 200,000 jobs.

Despite President Barack Obama’s claim Thursday that manufacturing is “coming back,” the US manufacturing sector actually shrunk in June. Retailers also reported a “stagnant” economic environment in June.

Time reports that one-third of the new June jobs are barely jobs, they’re at temp agencies. Retail, manufacturing and the housing sector all saw no job growth at all.

The president and the White House got their communications lines crossed in response to the numbers, with the president saying that they show a “step in the right direction” while the White House warned not to “read too much” into the June report. (Emphasis added)

Manufacturing is “coming back” and doing “just fine” in only one respect:

©2012 Eric Allie, Caglecartoons.com

So the big issue is the economy, Stupid. What could ObamaCare possibly have to do with that? Plenty. Even though some five new or improved species of higher taxes are scheduled to go into effect due to ObamaCare after this year’s election, the impact is already being felt. With thirteen thousand pages of new Federal ObamaCare regulations already written and more on the way, the private sector that President Obama says is “doing fine” can have no reasonable expectation of the degree of certainty needed to stimulate private investment, and therefore hiring as well, in order even to begin “doing fine” — assuming a definition of “fine” not created by the Roberts Court Humpty Dumpty or his apparent kinsman, President Obama. Neither can consumers have sufficient confidence in their own economic security to buy more of the goods and services they want and which would be offered by the private sector if it could offer them. The effects of such persistent lacks of confidence reinforce each other.

These new taxes, along with some significant tax breaks that may expire this year, will force more people to spend more money on things they don’t want to spend it on, leaving them less to spend on things they do want and that the private sector could and would provide in a more certain and better business environment. These problems will continue to fester and worsen as long as President Obama remains in office and gains “more flexibility” to do whatever he pleases.

However, the ObamaCare problems go well beyond additional taxes. President Obama said, “If you like your health care plan, you’ll be able to keep your health care plan, period.However,

Research continues to show that as many as 30 percent of employers will dump their employees from their existing health care coverage. The Administration itself has admitted that “as a practical matter, a majority of group health plans will lose their grandfather status by 2013.”

The linked article illustrates many other ways in which the public will face higher medical insurance costs, more limited options and declining medical service.

What should Governor Romney do?

Governor Romney should focus his campaign on the economy and on ObamaCare’s consequences for it. Due to ObamaCare’s substantial adverse impact on the economy, he does not need to choose between them. Too few in the media have provided even the highlights of the large and adverse impact that ObamaCare has already had and will have in the future unless repealed. Not only should Governor Romney emphasize these things, he must.

Should Governor Romney be concerned that ObamaCare and RomneyCare are fungible? Unlike ObamaCare under the Federal Constitution, enactment of Romney Care’s individual mandate was clearly within the constitutional regulatory authority of Massachusetts. Nor are RomneyCare and ObamaCare fungible in other respects. That point in particular should be emphasized. For example,

The Massachusetts law contained an individual mandate (which states, unlike the federal government, are allowed to impose). But it did not consist of 2,700 pages of new regulations; 159 new boards and commissions; more than $500 billion in new taxes (and counting); the Independent Payment Advisory Board, a rationing board whose decisions are unreviewable by the courts and practically untouchable by Congress itself; restrictions on religious liberty; Medicare cuts; affirmative-action mandates for medical and dental schools; huge new authority over one-seventh of the U.S. economy for the secretary of health and human services, and open-ended regulations of the way doctors and others perform their jobs.

Governor Romney vetoed major parts of it, such as

the employer mandate, coverage for illegal aliens, the creation of a new bureaucracy to be called the Public Health Council, a provision limiting improvements to Medicaid, and another provision expanding Medicaid coverage to include dental care. His vetoes were overridden.

Beyond that, a glance at the history of Romneycare in Massachusetts shows that Romney’s instincts and initiatives were for free-market reforms. An 85 percent Democratic legislature thwarted his best efforts, and a Democratic successor as governor twisted the law’s trajectory dramatically.

Before Romney’s time, Massachusetts had enacted a number of laws that made its health-care system needlessly expensive. All policies offered in the state were required to cover expensive treatments like substance-abuse counseling and infertility. In 1996, the state passed a law requiring “guaranteed issue” and “community rating” — meaning people could wait until they got sick to purchase health insurance. Naturally, rates skyrocketed. In addition, a 1986 federal law required hospital emergency rooms to treat all patients, regardless of ability to pay.

Romney’s idea was to permit Massachusetts insurers to sell catastrophic plans. As Avik Roy explained in Forbes, “Shorn of the costly mandates and restrictions originating in earlier state laws, these plans, called ‘Commonwealth Care Basic,’ could cost much less. Romney also proposed merging the non-group and small-group markets, so as to give individuals access to the more cost-effective plans available to small businesses.” Romney’s plan would also have involved a degree of cost sharing, so that those receiving subsidies would have an incentive to minimize their consumption.

Romney agreed to the mandate believing that Massachusetts citizens would get the opportunity to purchase inexpensive, catastrophic plans. But the legislature, together with Romney’s successor as governor, Deval Patrick, changed the law to require insurers to offer three tiers of coverage — all of them far beyond catastrophic care. Perhaps Romney ought to have foreseen what future legislatures and governors would do — but that’s a far cry from the accusation that Romneycare was indistinguishable from Obamacare. (Emphasis added.)

Governor Romney can and must explain these differences and must do so clearly yet simply. He can also explain his vision for Federal interventions in medical care as shown by the things he tried to bring — and tried not to have brought — to Massachusetts. Just as “it’s the economy, Stupid,” so it is imperative to “keep it simple, Stupid.” Whether the media, and therefore enough people, will pay attention is unknown. Perhaps if the points are made simply, clearly and often enough they will.

Nevertheless, the ObamaCare issue with the greatest “sex appeal” lies in its adverse economic effects; that is what Governor Romney should emphasize the most. In doing so, he should point out that President Obama has indeed been a transformational President; far too transformational in the wrong directions and hence far too damaging to the nation.

First published at Dan Miller’s Blog.

Supreme Court Chief Justice John Roberts on a Gut Shot Draw Against Barack Obama’s Pocket Aces in a High Stakes Game of America Hold’em

2:23 pm in 9 supreme court justices, Charles Krauthammer, Chief Justice John Roberts, conservative argument, Editorials, john roberts, judicial activism, legislative language, liberal wing, political power brokers, signature legislation, supreme court chief justice, supreme court chief justice john roberts, supreme court justices, Washington Post by Kevin A. Lehmann

Justice John Roberts

In a full ring game of high stakes political poker (9 Supreme Court Justices and the President), at the end of the day it came down to a heads up competition between two deep stacks – Chief Justice John Roberts and President Obama. While the left clearly won a major victory, the right is claiming the river card has yet to be dealt.

In other words, Obama’s pocket aces survived the flop and are in the lead at the turn, but according to political power brokers like Krauthammer, Erickson and Morris, Roberts dealt a turn card that clearly gives America multiple outs and favorable pot odds to draw to a victorious hand at the river in November.

How? By Roberts rewriting the legislative language to deem Obamacare a massive federal tax and therefore painting Barack Obama as a flagrant liar!

Before I pontificate on the clear violation of judicial activism on Roberts’ part, let’s examine the claim from pundits that this was a shrewd move that sets up a victorious showdown in January assuming Romney eeks out a narrow victory in November and repeals Obamacare right from the git-go.

Charles Krauthammer’s Washington Post column today . . .

“It’s the judiciary’s Nixon-to-China: Chief Justice John Roberts joins the liberal wing of the Supreme Court and upholds the constitutionality of Obamacare. How? By pulling off one of the great constitutional finesses of all time. He managed to uphold the central conservative argument against Obamacare, while at the same time finding a narrow definitional dodge to uphold the law — and thus prevented the court from being seen as having overturned, presumably on political grounds, the signature legislation of this administration.”

He goes on to write . . .

Why did he do it? Because he carries two identities. Jurisprudentially, he is a constitutional conservative. Institutionally, he is chief justice and sees himself as uniquely entrusted with the custodianship of the court’s legitimacy, reputation and stature.

As a conservative, he is as appalled as his conservative colleagues by the administration’s central argument that Obamacare’s individual mandate is a proper exercise of its authority to regulate commerce.

That makes congressional power effectively unlimited. Mr. Jones is not a purchaser of health insurance. Mr. Jones has therefore manifestly not entered into any commerce. Yet Congress tells him he must buy health insurance — on the grounds that it is regulating commerce. If government can do that under the commerce clause, what can it not do?

“The Framers . . . gave Congress the power to regulate commerce, not to compel it,” writes Roberts. Otherwise you “undermine the principle that the Federal Government is a government of limited and enumerated powers.”

That’s Roberts, philosophical conservative. But he lives in uneasy coexistence with Roberts, custodian of the court, acutely aware that the judiciary’s arrogation of power has eroded the esteem in which it was once held. Most of this arrogation occurred under the liberal Warren and Burger courts, most egregiously with Roe v. Wade, which willfully struck down the duly passed abortion laws of 46 states. The result has been four decades of popular protest and resistance to an act of judicial arrogance that, as Justice Ruth Bader Ginsburg once said, “deferred stable settlement of the issue” by the normal electoral/legislative process.

Obamacare is now essentially upheld. There’s only one way it can be overturned. The same way it was passed — elect a new president and a new Congress. That’s undoubtedly what Roberts is telling the nation: Your job, not mine. I won’t make it easy for you.”

 

Dov Fischer wrote on American Thinker . . .

“Long after many of us are gone, this 5-4 opinion finally setting limits on the reach of the Commerce Clause will continue to affect American lives and protect private citizens from Washington’s intrusions.
It is understandable that most Americans, who are not law school graduates, do not think in these terms, nor do most pundits outside the legal community who interpret news. However, attorneys and certainly law professors get it. We know what happened on Thursday. It was subtle and below the radar, like a tsunami beginning in the middle of an ocean, still days away from the shore. Only the trained insiders know what that rumbling will cause in the future. This was a tsunami, finally giving us our first Supreme Court precedential holding in nearly a century that reins in the federal government’s unbridled abuse of the Constitution’s Commerce Clause. And the liberals, excited as they understandably are by the temporary survival of ObamaCare, do not even realize what has happened to a pillar of their enterprise. And that is fine.
Secondly, Chief Justice Roberts has punted the whole ninety yards, so to speak, with the expertise of a professional football kicker whose team has the ball on its own 8-yard-line, then punts ninety yards, pinning the other team on their own two-yard-line. Had Chief Justice Roberts sided completely with his four conservative colleagues, Obamacare now would be off the political table for the November elections. Obama would be campaigning and mobilizing his troops’ passions, arguing an urgent need to reconfigure the Court. Romney, by contrast, would be trying to mobilize passion for a lackluster campaign that is impelled legitimately by one crying urgency: jobs and the economy.”

 

Erick Erickson of Red State wrote . . .

“It seems very, very clear to me in reviewing John Roberts’ decision that he is playing a much longer game than us and can afford to with a life tenure. And he probably just handed Mitt Romney the White House.”

 

I couldn’t disagree more with these political prognosticators!

If anything, what John Roberts did was allow his ego to get in the way of his jurisprudence and vote to throw the American people, along with the Constitution, under the bus.

It was the height of judicial activism (judicial tax-writing). Judicial malfeasance would be more accurate — a sitting Supreme Court Chief Justice playing short-stacked political poker out of position against a deep-stacked worthy opponent with pocket rockets on the button who’s willing to ride them all the way to the river.

While Roberts may see it as a long term utility value play with positive expectation (a galvanizing of the conservative base and clarion call for them to rally around Mitt Romney and repeal Obamacare in January), five months is a lifetime in politics. Walking back a mammoth bill like Obamacare with more far-reaching tentacles than an octopus on steroids is akin to stopping a run away locomotive with your bare hands. It was a negative expectation bet on Roberts’ part and a costly one to the American taxpayer.

Obama’s willingness to aggressively bet his pocket aces (a bipartisan healthcare bill approved by both houses and passed into law) is clearly the stronger move with positive expected value.

Even with a favorable board, e.g. an up and down straight draw with a backdoor flush possibility and seventeen uncounterfeited outs to eclipse Obama’s aces on the river, America is still a 1.8 to 1 underdog.

Considering the fact that Roberts already put us “all in,” the odds are not in our favor.

In his high stakes game of political poker with President Obama, Roberts failed to counterfeit a few of his outs by underestimating how this colossal victory for the president would reenergize Obama’s moribund base. It’s the hope and change that many of his awol dissenters were looking for — socialized medicine and a step closer to an entitlement addicted nanny state.

Bottom line: The middle class just received the largest tax increase ever foisted upon the American people with this monstrosity of an unconstitutional bill that will absorb a full 1/6th of our GDP.

More importantly, it opens the floodgates for complete statist control of every aspect of our lives. The government now chooses the winners and losers of economy and penalizes those who don’t comply with their purchase mandate as we rapidly evolve into at best a plutocracy and at worst a socialist state headed by a despot that’s guided by his Marxist worldview.

The biggest cost of healthcare is obesity, so what’s next? A mega tax on salt? A surtax on specific fast food restaurants like McDonald’s, Wendy’s and Burger King? Maybe I should open a health club that’s subsidized by Uncle Sam and ask him to penalize those members who don’t come in at least three times a week to keep from being a burden on our system of socialized medicine.

What’s to keep the government from mandating that I buy an electric car in the near future and if not, be taxed for contributing to “global warming?”

The answer is not a burgeoning interventionist federal government that stifles the private sector, puts medical practitioners out of business, decreases the quality of healthcare and stunts economic growth by making it cost prohibitive for companies to provide health insurance for their workforce.

The real solution is less burdensome regulation, lower taxes, more competition, including the ability to purchase insurance across state lines (interstate commerce) and the biggest grand daddy of them all, drum roll please . . . Tort Reform!

Go after the high priced lawyers and limit the ungodly amount of punitive damages that line the pockets of ambulance chasers at the expense of the hard-working middle class tax payers. That’s when you will drive down the cost of healthcare.

Spin it any way you want, but the fact of the matter is the GOP, Tea Party and Conservatives got our balls handed to us courtesy of John “Judas” Roberts — Chief Justice of the United States Supreme Court. He may know policy, but he doesn’t know poker.

Roberts got stacked by Obama and we got sacked by the largest single tax increase ever foisted upon the American people, a mere appetizer before taxmageddon when the Bush tax cuts expire at the end of the year.
Until next time . . . Wake Up America!

Kevin A. Lehmann

Catch Kevin.com

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ANALYSIS: What the Supreme Court Decision Means

2:56 pm in bill mccollum, Chief Justice John Roberts, federal health law, john roberts jr, julie appleby, justice roberts, legal uncertainties, Legislation, medicaid expansion, News Feed, Obamacare Report, signature legislation, universal health coverage, Verdict by PinkTeaPatriot

Sketch of the Supreme Court justices hearing the health care reform case in March by Bill Hennessy.

By: Julie Appleby of Kaiser Health News

The U.S. Supreme Court today upheld the landmark federal health law, affirming its mandate that nearly all Americans carry coverage and retaining sweeping changes to the health industry.

Chief Justice John Roberts Jr. joined the liberals on the court in upholding the mandate, deciding the penalty for not carrying insurance is a tax and therefore falls within Congress’ taxing power. But the justices voted to set limits on the law’s expansion of Medicaid, the federal state program for the poor, leaving up to states to decide whether to participate.

While the decision bolsters the Obama administration’s signature legislation, it complicates efforts to create nearly universal health coverage if states opt out of the Medicaid expansion. Many Republican governors had hoped the court would strike the Medicaid expansion.

The decision leaves intact the remainder of the 2,700 page law, which requires insurers to accept all customers regardless of their health status, provides tax credits to those who need help to buy coverage, fines some employers who don’t offer insurance and provides billions to expand Medicaid to include many people not currently covered in many states. Those provisions go into effect in 2014.

“I’m disappointed and shocked that Justice Roberts led the charge to uphold the constitutionality of the mandate and called it a tax,” said Bill McCollum, who filed the first state lawsuit against the act when he was Florida’s attorney general. “I certainly don’t think it’s a tax. It’s a sad day for the American people.”

Long in the making – at least five previous presidents tried and failed to pass legislation with similar aims – the law remains controversial two years after its passage.

While the ruling removes some legal uncertainties, a slew of political and technical challenges remain. The law and today’s decision are sure to feature prominently in the run-up to the November elections and the law’s fate could well hinge on the outcome. If Democrats retain the presidency and control of the Senate, implementation will likely move forward. If Republicans sweep one or both, efforts to repeal or defund are sure to gain steam. Presumptive GOP presidential nominee Mitt Romney has vowed to repeal the law if elected.

“The election is two or three times the importance of court decision,” said Robert Laszewski, a consultant to the industry and former insurance executive.

While the majority opinion upheld the law’s requirement that nearly all Americans carry health coverage or pay a penalty, polls show the mandate remains hugely unpopular. Without that provision, however, most experts say that young and healthy people would forego insurance, leaving primarily sick and older people needing expensive medical care in the pool, and driving up the cost of premiums for everyone. The issue is likely to become fodder for the campaign trail.

Democrats “will try to use this to segue from ‘it’s legal,’ to ‘it’s great, even the court thinks so’,” said David Merritt, a senior advisor with Leavitt Partners, a health consulting firm founded by former Bush administration cabinet member Michael Leavitt.

Republicans, Merritt said, “will use it to try to raise the stakes of the election: ‘This is the last chance we have to repeal this thing.’”

Florida’s McCollum predicted the law’s survival would energize attempts to defeat Obama in November elections and repeal it.

“If the president is re-elected, then this law will go forward,” he said. “If he isn’t, then I think there will be a different outcome in the health care arena.” Impact Of Medicaid Ruling

State politics, meanwhile, will come into play on the ruling on the Medicaid expansion. The ruling gives states the option not to expand eligibility without losing funding for their existing program. They would, however, lose billions in additional federal funding that would have covered newly eligible residents up to 133 percent of the federal poverty level, or about $30,000 for a family of four. Today, about 60 million people are enrolled in the program.

Sara Rosenbaum, health policy professor at George Washington University, said she expects “the overwhelming number of states” to adopt the Medicaid expansion. “The pressure to participate will be enormous from health care providers and communities,” she said. “The majority of states will not want to have its poorest residents without coverage.”

Signed into law March 23, 2010, after being passed without a single Republican vote, the health care legislation was promptly challenged, with 27 states filing or joining lawsuits challenging its constitutionality. Republicans argued the law was an overreach of federal authority and that its new taxes and fees would hurt the economy. Democrats said that slowing health care spending with provisions such as a powerful advisory board to curb Medicare costs and the so-called “Cadillac tax” on high-cost insurance benefits, would boost the economy. At the same time, the law would provide relief to millions who could not afford or qualify for insurance coverage.

The Congressional Budget Office, a nonpartisan government agency, estimated it would add up to 33 million people to the insurance rolls by 2016. Still, about 26 million people are expected to remain uninsured, many of them undocumented immigrants.

The law makes few changes for people who get their coverage through their jobs, which is the main way most insured people currently receive insurance. Most employers who provide coverage say they will not drop it in 2014, even though the $2,000 to $3,000 in penalties on those who don’t offer affordable coverage is less than what many pay for insurance.

Still, the CBO estimates that about 3 million to 5 million people who otherwise would have had employer coverage will lose it. Some of those workers will be eligible to buy insurance through new state marketplaces, some with subsidies to help them pay for it.

Implementing the law is estimated to cost about $1 trillion over nine years, much of that for the insurance subsidies and expansion of Medicaid, according to the CBO. That is slated to be paid for through savings wrung from Medicare, along with new taxes on industry and high income earners.

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