No Good Options: Picking Up the Pieces After King v. Burwell

If the Supreme Court rules against the government in King v. Burwell, insurance subsidies available under the Affordable Care Act (ACA) will evaporate in the thirty-four states that have refused to establish their own health-care exchanges. The pain could be felt within weeks. Without subsidies, an estimated eight or nine million people stand to lose their health coverage. Because sicker people will retain coverage at a much higher rate than healthier people, insurance premiums in the individual market will surge by as much as fifty percent. Policymakers will come under intense pressure to mitigate the fallout from a government loss in King. But the Republican-controlled Congress has already ruled out a surgical fix, and recent reporting suggests that Congress will be hard-pressed to develop an alternative reform proposal that could meet with the White House’s approval. Even a temporary extension will meet with fierce resistance from legislators who will see an extension as a tacit concession that the subsidies, in some form, are here to stay. All eyes will turn to the Obama administration and to the states. Yet public debate about their post-King options has been limited. Part of the reason is strategic: the government’s supporters fear that discussing fixes might signal to the Supreme Court that eliminating the subsidies would not do much damage. The Obama administration, for example, has declined to tell Congress whether it even has a contingency plan. And while the ACA’s opponents suggest that the King aftermath might not be so bad, they have generally declined to endorse specific fallback plans. In this Essay, we take a hard look at some potential options available both to the administration and to the states to mitigate the fallout of a government defeat in King. Some are straightforward and noncontroversial; others will face intense political resistance and press up against legal boundaries. Taken together, we believe these options might enable policymakers to moderate, at least somewhat, the consequences of a government loss in King

Predicting the Fallout from King v. Burwell - Exchanges and the ACA

The U.S. Supreme Court\u27s surprise announcement on November 7 that it would hear King v. Burwell struck fear in the hearts of supporters of the Affordable Cara Act (ACA). At stake is the legality of an Internal Revenue Service (IRS) rule extending tax credits to the 4.5 million people who bought their health plans in the 34 states that declined to establish their own health insurance exchanges under the ACA. The case hinges on enigmatic statutory language that seems to link the amount of tax credits to a health plan purchased through an Exchange established by the State. According to the plaintiffs in King, that language means that consumers who buy insurance through federally run exchanges don\u27t qualify for subsidies. The Court\u27s decision to hear the case without a split between appellate courts suggests that at least four justices harbor serious doubts about the IRS rule\u27s validity

Predicting the Fallout from King v. Burwell - Exchanges and the ACA

The U.S. Supreme Court\u27s surprise announcement on November 7 that it would hear King v. Burwell struck fear in the hearts of supporters of the Affordable Cara Act (ACA). At stake is the legality of an Internal Revenue Service (IRS) rule extending tax credits to the 4.5 million people who bought their health plans in the 34 states that declined to establish their own health insurance exchanges under the ACA. The case hinges on enigmatic statutory language that seems to link the amount of tax credits to a health plan purchased through an Exchange established by the State. According to the plaintiffs in King, that language means that consumers who buy insurance through federally run exchanges don\u27t qualify for subsidies. The Court\u27s decision to hear the case without a split between appellate courts suggests that at least four justices harbor serious doubts about the IRS rule\u27s validity

Diffusion in multiscale spacetimes

We study diffusion processes in anomalous spacetimes regarded as models of quantum geometry. Several types of diffusion equation and their solutions are presented and the associated stochastic processes are identified. These results are partly based on the literature in probability and percolation theory but their physical interpretation here is different since they apply to quantum spacetime itself. The case of multiscale (in particular, multifractal) spacetimes is then considered through a number of examples and the most general spectral-dimension profile of multifractional spaces is constructed.Comment: 23 pages, 5 figures. v2: discussion improved, typos corrected, references adde

Coherent Lidar Turbulence Measurement for Gust Load Alleviation

Atmospheric turbulence adversely affects operation of commercial and military aircraft and is a design constraint. The airplane structure must be designed to survive the loads imposed by turbulence. Reducing these loads allows the airplane structure to be lighter, a substantial advantage for a commercial airplane. Gust alleviation systems based on accelerometers mounted in the airplane can reduce the maximum gust loads by a small fraction. These systems still represent an economic advantage. The ability to reduce the gust load increases tremendously if the turbulent gust can be measured before the airplane encounters it. A lidar system can make measurements of turbulent gusts ahead of the airplane, and the NASA Airborne Coherent Lidar for Advanced In-Flight Measurements (ACLAIM) program is developing such a lidar. The ACLAIM program is intended to develop a prototype lidar system for use in feasibility testing of gust load alleviation systems and other airborne lidar applications, to define applications of lidar with the potential for improving airplane performance, and to determine the feasibility and benefits of these applications. This paper gives an overview of the ACLAIM program, describes the lidar architecture for a gust alleviation system, and describes the prototype ACLAIM lidar system

Urolithiasis location and size and the association with microhematuria and stone-related symptoms.

PURPOSE: To conduct a study to assess the association between calculus location and size and the incidence of both microhematuria and symptoms of urolithiasis in a urology office environment. PATIENTS AND METHODS: After Institutional Review Board approval, a prospective study was conducted with data from 100 consecutive patients who presented to our office with documented urolithiasis. The location (caliceal, pelvic, or ureteral) and size ( RESULTS: A total of 111 stones were found in the study population resulting in a 45.9% incidence of microhematuria. In patients with renal pelvic and ureteral stones, 67.6% demonstrated microhematuria vs 36.4% with caliceal stones, P=0.0035. For stones ≥ 8 mm, 62.5% were positive for microhematuria vs 29.1% of stones \u3c8 \u3emm, P=0.0006. Ureteral or renal pelvic stones caused the most symptoms (70.6%) compared with caliceal stones (16.9%), P=0.0001. In those patients who reported pain associated with urolithiasis, 65.6% had concomitant microhematuria vs 36.8% in those without pain, P=0.0097. CONCLUSIONS: Urinary calculus location and size are associated with the incidence of microhematuria and stone-related symptoms. Pain related to urolithiasis may be a positive predictor for the presence of microhematuria

Electrical properties of a-antimony selenide

This paper reports conduction mechanism in a-\sbse over a wide range of temperature (238K to 338K) and frequency (5Hz to 100kHz). The d.c. conductivity measured as a function of temperature shows semiconducting behaviour with activation energy $\Delta$E= 0.42 eV. Thermally induced changes in the electrical and dielectric properties of a-\sbse have been examined. The a.c. conductivity in the material has been explained using modified CBH model. The band conduction and single polaron hopping is dominant above room temperature. However, in the lower temperature range the bipolaron hopping dominates.Comment: 9 pages (RevTeX, LaTeX2e), 9 psfigures, also at http://pu.chd.nic.in/ftp/pub/san16 e-mail: gautam%[email protected]