President Barack Obama won big when Congress passed his health care bill. But the administration made a serious mistake and now is trying to rewrite the law. Without going to Congress, as required by the Constitution.
The central feature of the misnamed Patient Protection and Affordable Care Act is the requirement that Americans buy health insurance, which Supreme Court Chief Justice John Roberts decided really wasn't a mandate in a bizarre opinion upholding the law. As important as that requirement are the exchanges through which people are supposed to purchase insurance.
PPACA includes tax credits and subsidies so people can afford insurance made more expensive by a gaggle of new federal requirements. Congress didn't just decide that people have to buy insurance. People must purchase insurance as determined by Washington. Or, more accurately, the Health and Human Services bureaucracy, which is empowered to decide every Americans' coverage.
However, Congress and the president tied federal tax credits and subsidies only to policies purchased through state-established exchanges. Apparently the administration did not imagine that anyone would defy Uncle Sam. However, so far only 14 states and the District of Columbia have created exchanges.
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