By RICARDO ALONSO-ZALDIVAR
Associated Press
WASHINGTON (AP) - It sounds like a silver lining. Even if the Supreme Court overturns President Barack Obama's health care law, employers can keep offering popular coverage for the young adult children of their workers.
But here's the catch: The parents' taxes would go up.
That's only one of the messy potential ripple effects when the Supreme Court delivers its verdict on the Affordable Care Act this month. The law affects most major components of the U.S. health care system in its effort to extend coverage to millions of uninsured people.
Because the legislation is so complicated, an orderly unwinding would prove difficult if it were overturned entirely or in part.
Better Medicare prescription benefits, currently saving hundreds of dollars for older people with high drug costs, would be suspended. Ditto for preventive care with no co-payments, now available to retirees and working families alike.
Partially overturning the law could leave hospitals, insurers and other service providers on the hook for tax increases and spending cuts without the law's promise of more paying customers to offset losses.
If the law is upheld, other kinds of complications could result.
The nation is so divided that states led by Republicans are largely unprepared to carry out critical requirements such as creating insurance markets. Things may not settle down.
"At the end of the day, I don't think any of the major players in the health insurance industry or the provider community really wants to see the whole thing overturned," said Christine Ferguson, a health policy expert who was commissioner of public health in Massachusetts when Mitt Romney was governor.
"Even though this is not the most ideal solution, at least it is moving us forward, and it does infuse some money into the system for coverage," said Ferguson, now at George Washington University. As the GOP presidential candidate, Romney has pledged to wipe Obama's law off the books. But he defends his Massachusetts law that served as a prototype for Obama's.
While it's unclear how the justices will rule, oral arguments did not go well for the Obama administration. The central issue is whether the government can require individuals to have health insurance and fine them if they don't.
That mandate takes effect in 2014, at the same time that the law would prohibit insurance companies from denying coverage to people with existing health problems. Most experts say the coverage guarantee would balloon costs unless virtually all people joined the insurance pool.
Opponents say Congress overstepped its constitutional authority by issuing the insurance mandate. The administration says the requirement is permissible because it serves to regulate interstate commerce. Most people already are insured. The law provides subsidies to help uninsured middle-class households pay premiums and expands Medicaid to pick up more low-income people.
The coverage for young adults up to age 26 on a parent's health insurance is a popular provision that no one's arguing about. A report last week from the Commonwealth Fund estimated that 6.6 million young adults have taken advantage of the benefit, while a new Gallup survey showed the uninsured rate for people age 18-25 continues to decline, down to 23 percent from 28 percent when the law took effect.
Families will be watching to see if their 20-somethings transitioning to the work world will get to keep that newfound security.
Because the benefit is a winner with consumers, experts say many employers and insurers would look for ways to keep offering it even if there's no legal requirement to do so. On Monday, UnitedHealth Group Inc., the nation's largest insurer, is announcing that it will continue to offer coverage to young adults even if the health care law is struck down.
But economist Paul Fronstin of the Employee Benefit Research Institute says many parents would pay higher taxes as a result because they would have to pay for the young adult's coverage with after-tax dollars. Under the health care law, that coverage now comes out of pre-tax dollars.
Fronstin says there's no way to tell exactly how much that tax increase might be, but a couple of hundred dollars a year or more is a reasonable ballpark estimate. Upper-income taxpayers would have a greater liability.
"Adult children aren't necessarily dependents for tax purposes, but an employer can allow anyone to be on a plan, just like they now allow domestic partners," said Fronstin. "If your employer said, 'I'm going to let you keep this,' it would become a taxable benefit for certain people."
Advocates for the elderly are also worried about untoward ripple effects.
If the entire law is overturned, seniors with high prescription costs in Medicare's "donut hole" coverage gap could lose annual discounts averaging about $600. AARP policy director David Certner says he would hope the discounts could remain in place at least through the end of this year.
Yet that might not be possible. Lacking legal authority, Medicare would have to take away the discounts. Drugmakers, now bearing the cost, could decide they want to keep offering discounts voluntarily. But then they'd risk running afoul of other federal rules that bar medical providers from offering financial inducements to Medicare recipients.
"I don't think anyone has any idea," said Certner.
A mixed verdict from the high court would be the most confusing outcome. Some parts of the law would be struck down while others lurch ahead.
That kind of result would seem to call for Congress to step in and smooth any necessary adjustments. Yet partisan divisions on Capitol Hill are so intense that hardly anyone sees a chance that would happen this year.
Copyright 2012 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
Source: www.msnbc.msn.com
Romney keeps secrets _ unless law says he can't - The Guardian
KASIE HUNT
Associated Press= BOSTON (AP) — Keeping his secrets, Mitt Romney tends to lift the veil on his finances and campaign only if the law says he must.
The Republican presidential candidate refuses to identify his biggest donors who "bundle" money for his campaign. He often declines to say who's meeting with him or what he's doing for hours at a time. He puts limits on media access to his fundraisers. And he resists releasing all of his tax returns, making just a single year public after facing pressure to do so.
"We've released all the information required by law and then some," Romney said last month about his tax returns.
He's indicated that part of the reason for his secrecy is to avoid political problems in his race against President Barack Obama.
He has said of his election foe: "He's going to try and make this campaign about the fact that I've been successful, that I've made a lot of money. So he wants to be able to get all the details on each year and how much money I made this year and that year. I'm not going to get into that."
Not that Obama has been totally open, either.
For example, the Democrat also limits media access to some parts of his fundraisers, though he allows cameras into larger events and will bring a small contingent of reporters into private residences. Reporters are promptly ushered out ahead of question-and-answer sessions with donors. Some fundraisers are closed entirely because the campaign says Obama is not making any formal remarks.
But Romney, whose views have been shaped both by his years in politics and his nearly three decades in private business, has made a keep-it-under-wraps approach a hallmark of his campaign. He's often broken precedent set by presidential candidates of both parties.
"He is reluctant to disclose information that is standard for disclosure and has become the norm," said Angela Canterbury, policy director for the Project on Government Oversight. And she and others say there's no reason to think that style would change if Romney becomes president.
There's a short-term political benefit, to be sure, in keeping a lid on everything from campaign appearances to the names of big donors. It means Romney can more easily control his campaign message, rather than getting knocked off course by Democratic hecklers at events or by unflattering media stories. And it can prevent providing fodder for political rivals to use against him.
But there also are risks, not the least of which is that Romney could appear to be hiding something, further irking voters already suspicious of politicians.
Romney has had the Republican nomination locked up for months, but he has yet to start traveling daily with the journalists who are assigned to cover him. He hasn't agreed to what's called a "protective pool" of reporters, who go wherever a candidate goes. Romney aides fear the arrangement would push the candidate off the message of the day, so they are loath to agree to it until they absolutely must.
Obama's traveling press corps was with him virtually at all times starting in June 2008, just three weeks after he triumphed over Hillary Rodham Clinton to become the presumptive Democratic nominee. Republican nominee John McCain didn't officially have a "protective pool" until August but he had a familiar relationship with his traveling press corps, and journalists almost always traveled on his campaign plane in the months after he clinched the nomination in March 2008. News organizations pay the cost of reporters who travel with presidential campaigns.
On the campaign trail this year, Romney's aides have at times tried to limit reporters from approaching him when he shakes hands with voters at events. And his aides often don't allow a camera and microphone on stage to record those interactions — though that's been customary in past campaigns.
Also, Romney's schedule is closely held — and his campaign typically won't say what he's doing when he's not at one of the few public events he holds each week. Even public appearances often are announced less than a day in advance — or not at all. Recently he rode to the site of the failed energy company Solyndra on the unmarked press bus, leaving the logo-plastered Romney for President bus behind at his hotel. Aides said the campaign was concerned the Obama administration would work with local officials to prevent Romney from holding an event there.
Romney's campaign also usually won't disclose with whom the candidate meets — regardless of whether they are high-ranking officials or simply voters. He kept reporters away from a private meeting with Senate Minority Leader Mitch McConnell last month, and says he regularly holds "off the record" meetings with middle class families, though he won't say who they are.
Obama's public schedule tends to list more Oval Office meetings than President George W. Bush did, but many of his sessions are not divulged. The White House does release Obama's visitor logs, and they are open on the White House website.
On his possible policies as president, Romney has been more upfront with audiences behind closed doors than he has been when the media are present.
At fundraising events not witnessed by reporters, donors are sometimes given access to policy roundtables with top staff, and Romney himself gave donors in West Palm Beach, Fla., a more detailed outline of which federal departments he plans to cut than is part of his normal campaign speech. That address was overheard by reporters who stood outside on a sidewalk.
Romney has suggested he's purposefully vague when he talks to the media — and, therefore, the general public — about his policy plans. Asked recently why he hasn't released more specifics, he compared his approach to New Jersey Gov. Chris Christie.
"The media kept saying to Chris, 'Come on, give us the details, give us the details,'" Romney said. "'We want to hang you with them.'"
In the aftermath of the Florida event, Romney agreed to allow a handful of reporters to attend just a few of the many finance events he holds each week. Still, his campaign refuses to say how much money each event raises, and doesn't regularly release a full schedule of the events from which reporters are barred. Romney's campaign expanded the number of people allowed into the fundraisers beginning this week, allowing three news service reporters instead of one and also allowing a TV network representative in, though without a camera. Reporters are still barred from covering fundraisers at private homes.
Romney's secrecy goes beyond the details of his campaign schedule or his policy proposals.
He has been selective at best in providing public records from his 2003-2007 term as Massachusetts governor.
Late last year, he acknowledged that just before he left office he authorized a sweeping purge of electronic data from his executive office, allowing top aides to purchase and remove their computer hard drives. He also benefited from a law that widely exempted the governor's office from state public records disclosure requirements. His campaign aides point to more than 600 boxes of materials that were sent from his office to the Massachusetts archives, but a week-long examination of the Romney records now in those archives by The Associated Press did not turn up a single email or internal document either authored by or sent to Romney. Some such emails have since surfaced in connection with public records requests.
Obama, Romney's rival, entered office pledging to create the most transparent administration in American history. But while some open- government groups give him credit for trying, aspects of his administration remain closed or inaccessible to the public eye. A review this year by the AP found that federal agencies had improved their response to requests under the Freedom of Information Act but still had had sizable backlogs.
In his campaign, Romney has limited the release of documents and information that in the past often have become part of the public record.
He is the first winning candidate of either party in more than a decade to refuse to give the public a list of the people who tap their business and social networks to raise tens of thousands of dollars for him. In 2008, Obama and McCain both released lists of bundlers. Bush released his in 2000 and 2004.
The names Romney has released so far are those required by law. Campaigns have to disclose anyone who bundles money if they have also registered as a federal lobbyist.
Federal laws also require Romney to release a broad portrait of his personal finances — disclosures that showed he was worth up to $250 million in 2011.
Candidates aren't required by law to release their personal tax returns, despite longstanding precedent for doing so — set by Romney's father, George Romney, who ran for the Republican nomination in 1968. In 2008, Obama released seven years' worth of returns. McCain released two years' worth.
In January, Romney released his 2010 return under pressure from Republicans. That forced him to amend the personal financial disclosures he had filed earlier in the year because those documents didn't mention a Swiss bank account or a series of funds that were set up in foreign countries. Romney has yet to release his 2011 tax returns; he filed for an extension. His advisers say he'll release them before the Nov. 6 election.
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Associated Press writers Jim Kuhnhenn and Stephen Braun in Washington contributed to this report.
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Follow Kasie Hunt on Twitter at http://www.twitter.com/kasie.
Source: www.guardian.co.uk
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