The Obamacare Outcome Matrix

Tyler Durden's picture


With the Supreme Court likely to announce its decision on the constitutionality of Health Care Reform Law this Thursday, BofA outlines five possible scenarios and their potential impact across the healthcare sectors. They base the likelihood of their scenarios on a review of the March oral arguments, previous circuit court decisions, as well as surveys of legal experts and former Supreme Court clerks. Everything you need to know about the possible outcomes and actions to take.


Supreme Court upholds the Individual Mandate: In this case, the Court would uphold the Affordable Care Act, and the next catalyst would be the upcoming elections. In addition, there remain questions as to whether the health reform law can be implemented by 2014 as many states have delayed implementation awaiting the court’s decision, and the federal government may not be able to implement exchanges in all of those states. This scenario would be positive for the hospital sector, in our view.

Supreme Court strikes the Individual Mandate, but, upholds the rest of the law: In this scenario, the Court would strike the individual mandate, but, keep in place the rest of the law, including all of the health insurance provisions. We would view this scenario negatively for the managed care sector.

Supreme Court strikes the Individual Mandate, along with related health insurance provisions (guaranteed issue, community rating, etc.): In this scenario, the Court would strike the individual mandate, along with several related health insurance provisions – particularly guaranteed issue and community rating provisions, as the Obama administration also recommended striking these down if the mandate were struck. This scenario would result in fewer covered lives (16 million vs. 32 million) according to the Congressional Budget Office, but, would maintain the Medicare payment reforms and payment reduction provisions.

Supreme Court strikes down the entire Health Care Law: In this scenario, the court would find the individual mandate unconstitutional, and not severable. This scenario would be a negative for hospitals, in our view, but generally viewed positively for managed care (other than Medicaid managed care).

Supreme Court strikes down the Medicaid expansion: In this scenario, the Court finds that the mandated expansion of Medicaid to all beneficiaries below 133% of poverty is coercive to the states, but, would leave a significant hole in coverage for low income individuals, that would need to be addressed by Congress.


Source: Bank Of America Merrill Lynch

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Mon, 06/25/2012 - 21:35 | 2560188 bigkahuna
bigkahuna's picture

Strike it down.

Mon, 06/25/2012 - 21:38 | 2560198 ACP
ACP's picture

...and Chancellor Obama's next Executive Order will be out Friday morning...

Mon, 06/25/2012 - 21:45 | 2560223 nmewn
nmewn's picture

...saying any medical student who agrees to give four years of "service to the state" will have their student loans forgiven.

Suck it up some more med students...for da faddah land ;-)

Mon, 06/25/2012 - 22:58 | 2560428 FrozenOut
FrozenOut's picture

...saying that any MD that desires to have a license must accept medicare patients

Mon, 06/25/2012 - 23:54 | 2560528 Nothing To See Here
Nothing To See Here's picture

SCOTUS knows that FDR's court packing attempt was small fries compared to what Obama will attempt if they attack his empire. They won't go very far, if they even do anything. My two cents.

Tue, 06/26/2012 - 01:39 | 2560639 Freddie
Freddie's picture

I tink you may be right and they do a halfway measure and kill the mandate.  They will punt.  The expedited the AZ case but this took forever to get there.   Illegals get higher priority than the citizenry.  Goldman Sachs loves the illegals and has even said so because it makes everyone a serf.  Open borders leads to serfdom.

Washington and the elites are so evils especailly the Dems.

Tue, 06/26/2012 - 04:07 | 2560720 HungrySeagull
HungrySeagull's picture

No must. Call it how stress free it must be to stop practicing and go fishing.

Tue, 06/26/2012 - 12:07 | 2561906 Papasmurf
Papasmurf's picture

Blackmarket healthcare for blackmarket gold.  That is the trend.  Where to invest?

Mon, 06/25/2012 - 23:44 | 2560510 Zionist Jew
Zionist Jew's picture

Chancellor Obama?


Our chocolate  muppet does as it's told.  It is quite amusing to watch the goy beasts focus on the D/R puppet show, while we siphon off the last remnants of wealth before the dollar goes supernova.


Nation Destroyers Bitchez!

Tue, 06/26/2012 - 00:19 | 2560559 Oracle of Kypseli
Oracle of Kypseli's picture

Hugo Cha-bama

Tue, 06/26/2012 - 02:53 | 2560684 malikai
malikai's picture

The difference is, at least, Chavez, love him or hate him, is about 10000% more genuine than the Teleprompter-in-Theif.

Mon, 06/25/2012 - 21:57 | 2560263 Bill D. Cat
Bill D. Cat's picture

Strike it down now .... it will only come back stronger .

Mon, 06/25/2012 - 22:46 | 2560403 Dr. Engali
Dr. Engali's picture

I don't know why so many junks. After all it's a movie line response with a great deal of accuracy. These statist will never give up the fight to control our lives. They will keep coming back for more. They just regroup and figure out another tactic.

Mon, 06/25/2012 - 23:13 | 2560457 iinthesky
iinthesky's picture

Hang em from the lamp posts lining pennsylvania ave.

Tue, 06/26/2012 - 09:59 | 2561339 DanDaley
DanDaley's picture

Just remember that it was the statist NAZIs who used Junkers a lot, too.  I think it's them.

Mon, 06/25/2012 - 21:37 | 2560191 disabledvet
disabledvet's picture

they could also "strike down the penalty for not paying into the plan" and leave it at that. the idea is a stupid one: the healthy and responsible pay for the unhealthy who probably won't even pay into the system until they are sick? whatever transpires it's more than enough to sink the Obama Presidency. Why not arrest people instead? Anywho hopefully we really do have a full fledged deflation in medical care upon us. My plan is "take the money into the program but only pay the care givers in booze and fried chicken."

Mon, 06/25/2012 - 22:02 | 2560277 Bill D. Cat
Bill D. Cat's picture

These are not the premiums you are looking for ....

...obligatory sweeping arm fuck off to anyone close by . 

Mon, 06/25/2012 - 23:01 | 2560435 FrozenOut
FrozenOut's picture


If I refuse to pay this tax will they put me in jail? And if they do, will I get healthcare at the expense of the state? So the ultimate sanction to somebody who refuses to provide for their own coverage includes providing coverage for them?

Tue, 06/26/2012 - 01:54 | 2560651 Freddie
Freddie's picture

It is even worse that that.  It is the first Jizya in U.S. history or an Islamic tax.   You do know that muslims are exempt as well as Amish and his union buddies plus Congress.   Is is a tx on the dhimminis or infidels aka a Jizya.

Tue, 06/26/2012 - 09:51 | 2561317 Raymond K Hessel
Raymond K Hessel's picture

Can you provide a reference that says who will be exempt from the tax?  I don't doubt you.  I want to see it for myself.

Tue, 06/26/2012 - 11:35 | 2561749 BooMushroom
BooMushroom's picture
RELIGIOUS CONSCIENCE EXEMPTION — Such term shall not include any individual for any month if such individual has in effect an exemption under section 1311(d)(4)(H) of the Patient Protection and Affordable Care Act which certifies that such individual is a member of a recognized religious sect or division thereof described in section 1402(g)(1) and an adherent of established tenets or teachings of such sect or division as described in such section.

Snopes says this may or may not exempt Muslims. I guess all it would take is for a couple of Imams to officially say "no" and they'll be exempt. We know DHHS will say OK in a heartbeat if they do.

Mon, 06/25/2012 - 21:38 | 2560196 bigdumbnugly
bigdumbnugly's picture

scenario 6:

scotus finds obammycare unconstitutional and while they're at it declare 90% of his executive orders unconstitutional as well.

unperturbed, obammy immediately gives executive order instituting obammycare.

Mon, 06/25/2012 - 21:42 | 2560209 francis_sawyer
francis_sawyer's picture

scenario 7

using the NDAA as a cover, Obama orders a 'hit' on all the SCOTUS justices who vote it down...

Mon, 06/25/2012 - 21:58 | 2560270 Jena
Jena's picture

...allowing him to appoint replacements.

Mon, 06/25/2012 - 22:03 | 2560279 TrainWreck1
TrainWreck1's picture

scenario 8     

SCOTUS smacks it down, Obama has a nervous breakdown, and Jumpin Joe Biden takes over and unexpectedly turns the country and dare one say the world into a new continuum of harmony and prosperity.



Mon, 06/25/2012 - 22:04 | 2560286 Conrad Murray
Conrad Murray's picture

Scenario 0

It doesn't matter what happens, you're gonna get fucked in the end.

Barry "BOHICA" Soetoro 2012!!!!

Mon, 06/25/2012 - 22:15 | 2560335 Jena
Jena's picture

Conrad, you're right of course because on a long enough timeline, etc.


"BOHICA".  Good to know - saves time.

Mon, 06/25/2012 - 22:04 | 2560288 Jena
Jena's picture

I like the delusion but I think you've had too much.

Mon, 06/25/2012 - 22:21 | 2560353 Dr. Engali
Dr. Engali's picture

Scenario 9 SCOTUS declares the Kenyan unconstitutional and we have a constitutional crisis. The house impeaches Obummer With the expectations that Romney will be a shoe in. But Ron Paul shocks the world in a three way run off against the inept Biden and the Wall street puppet Romney.

Mon, 06/25/2012 - 21:39 | 2560200 Whiner
Whiner's picture

I need more free-cheap stuff from gubmint. Healthcare must include abortions, ED remedies, boob jobs, rehab, methadone, and face lifts. And I don't want to wait in no damn lines. You hear dat, Obammy?Get me my stuff before 20014.

Mon, 06/25/2012 - 22:05 | 2560291 TrainWreck1
TrainWreck1's picture

20014? Not sure that the country can withstand 18,000 years of Obama. Plus by then, Michelle will be the size of Saturn.


Mon, 06/25/2012 - 22:21 | 2560354 TrainWreck1
TrainWreck1's picture

Sasquatch espies a vat of Almas Beluga...

Mon, 06/25/2012 - 22:41 | 2560394 Tegrat
Tegrat's picture


Tue, 06/26/2012 - 09:34 | 2561270 CoolBeans
CoolBeans's picture

...and that's on a good day.

Coffee came out of my nose.  Thanks for posting that link!!


Mon, 06/25/2012 - 22:27 | 2560371 GMadScientist
GMadScientist's picture

Start a bank and buy it all yourself, aptronymic.

Mon, 06/25/2012 - 21:40 | 2560205 francis_sawyer
francis_sawyer's picture

Sharia Law considers insurance a form of gambling which is forbidden...

So what? Are Muslims going to be exempt from being a part of this system?

Tue, 06/26/2012 - 02:07 | 2560658 KowPie
KowPie's picture

So how do Muzzies following blind faith sucker law drive cars or get mortgages? Never mind, answered my own question (foot power and mud huts!)

Tue, 06/26/2012 - 05:52 | 2560772 Maghreb
Maghreb's picture

If you crash the car you have to pay for it. Its not a revolutionary concept. As for Mortgages they don't do interest anyways. Besides community is supposed to look out for one another especially if someone's house burns down.

Mon, 06/25/2012 - 21:47 | 2560233 Atomizer
Mon, 06/25/2012 - 21:47 | 2560234 toomanyfakecons...
toomanyfakeconservatives's picture

Implementing Omamacare would be like putting a torch to grass hut states. Under Obamacare, the states are expected to shoulder an every increasing propotion of a monumental tab. It's a big joke and it's not happening. Instead, handcuffs and orange jumpsuits for Obama, Brenanke, and all the other traitors, before s-election time, is what's coming...

Mon, 06/25/2012 - 21:48 | 2560236 Cabreado
Cabreado's picture

"BofA outlines..."

I'd prefer that BofA stay out of my healthcare.

Perhaps you might, too.

When will "mission creep" finally scare a critical mass...

Mon, 06/25/2012 - 21:52 | 2560251 nmewn
nmewn's picture

I'd prefer the government stay out of the payment method between me and my doctor.

But thats just me.

Mon, 06/25/2012 - 21:57 | 2560261 The Gooch
The Gooch's picture

Or me and EVERYBODY, for that matter.

Mon, 06/25/2012 - 21:58 | 2560268 knukles
knukles's picture

I dunno. 
That single payer whorehouse that takes SNAP cards in intriguing...

Mon, 06/25/2012 - 22:07 | 2560297 bigdumbnugly
bigdumbnugly's picture

don't go there knuck.  it's a snapclaptrap.

Mon, 06/25/2012 - 22:14 | 2560331 Conrad Murray
Conrad Murray's picture

Snapper is supposed to be that good good. Let's not confuse it by having SNAPper as well.

Mon, 06/25/2012 - 22:50 | 2560362 bigdumbnugly
bigdumbnugly's picture

yeah that SNAPper is only good until a miniature phyllis diller head looking thing starts growing off the side of your shank.    then you'll wish you just paid up cash money for the call girl service.


Mon, 06/25/2012 - 21:52 | 2560252 slewie the pi-rat
slewie the pi-rat's picture

i'm ready to say, personally, that i want to hear what angela says about this before i make up my mind about anything

Mon, 06/25/2012 - 21:57 | 2560262 knukles
knukles's picture

Who gives a rats ass?
Plan all the scenarios one wants, but it's just jerk-off time a-wastin'.
The system is still broken and the Scotus decision one way or the other does not change the longer term view.
We're still fucked.
No matter who gets into which elected office, the rot will still remain.
Won't change my asset allocation one iota.

What will sure change is the rancor, pabulum, noise, talking heads; BS and who claims victory and defeat. ... the dialogue will change.
Oh it will create jobs.... new assignments for the spin meisters, talking heads, PR firms and perceptions management shops.
Nothing more.

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