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Health Care Law Individual Mandate Ruled Unconstitutional By Appeals Court

Obama Health Care Law Ruling

GREG BLUESTEIN   08/12/11 09:57 PM ET   AP

ATLANTA — A federal appeals panel struck down the centerpiece of President Barack Obama's sweeping health care overhaul Friday, moving the argument over whether Americans can be required to buy health insurance a step closer to the U.S. Supreme Court.

The divided three-judge panel of the 11th Circuit Court of Appeals concluded Congress overstepped its authority when lawmakers passed the so-called individual mandate, the first such decision by a federal appeals court. It's a stinging blow to Obama's signature legislative achievement, as most experts agree the requirement that Americans carry health insurance – or face tax penalties – is the foundation for other parts of the law.

Chief Judge Joel Dubina and Circuit Judge Frank Hull found in a 207-page opinion that lawmakers cannot require residents to "enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die."

In a lengthy dissent, Circuit Judge Stanley Marcus accused the majority of ignoring the "undeniable fact that Congress' commerce power has grown exponentially over the past two centuries." He wrote that Congress generally has the constitutional authority to create rules regulating large areas of the national economy.

The White House argued the legislative branch was using a "quintessential" power – its constitutional ability to regulate interstate commerce, including the health care industry – when it passed the overhaul law. Administration officials said they are confident the ruling will not stand. The Justice Department can ask the full 11th Circuit to review the panel's ruling and will also likely appeal to the Supreme Court.

"Individuals who choose to go without health insurance are making an economic decision that affects all of us – when people without insurance obtain health care they cannot pay for, those with insurance and taxpayers are often left to pick up the tab," said White House adviser Stephanie Cutter.

The 11th Circuit's ruling, which sided with 26 states that had sued to stop the law from taking effect, is the latest contradictory judicial opinion on the health care debate. The federal appeals court in Cincinnati upheld the individual mandate in June, and an appeals court in Richmond has heard similar challenges to the law. Several lower court judges have also issued differing opinions on the debate.

Legal observers long expected the case would ultimately land in the Supreme Court, but experts said Friday's ruling could finally force the justices to take the case.

"There needs to be a pronouncement that's nationwide," said Carl Tobias, a professor at the University of Richmond School of Law. "It would be almost impossible to implement it if we have splintered decisions from different geographic circuits. The Supreme Court may feel now it has to take it."

J. Peter Rich, a Los Angeles-based health care attorney, said the Supreme Court had never weighed in on an issue such as the provision requiring individuals to buy health insurance.

"They have never ruled on this specific issue," he said. "This really is a case of first impression, although the Obama administration may try to argue otherwise."

Rich said it's not unconstitutional for individual states to have such requirements, noting that Massachusetts has a similar law in place. However, the high court has yet to weigh in on whether a federal requirement passes muster.

It's the latest hit the president's taken in what's been a rough month that's included humiliating blows on both the economy and in Afghanistan, while polls show deteriorating public support for both him and Congress.

Obama has been criticized by his Democratic base for his failures, which include dropping his push for tax increases as part of last week's compromise to raise the government's debt ceiling and his inability to let the Bush tax cuts for the wealthy to expire at the end of last year.

The Atlanta-based court is considered by many observers to be the most pivotal legal battleground yet because it reviewed a sweeping ruling by U.S. District Judge Roger Vinson, who not only struck down the individual mandate but threw out other provisions ranging from Medicare discounts for some seniors to a change that allows adult children up to age 26 to remain on their parents' coverage.

His reasoning was that the insurance requirement was "inextricably bound together" with the rest of the law, but the 11th Circuit concluded Vinson went too far. The panel's ruling noted that the "lion's share of the act has nothing to do with private insurance, much less the mandate that individuals buy insurance."

The provision requiring all Americans to carry health insurance or face a tax penalty has been at the center of the legal debate. The law does not allow insurers to turn away the sick or charge them outrageous premiums. To cover their health care costs, others – particularly the young and healthy – will need to pay premiums to keep costs from skyrocketing. The potential tax penalties are meant to ensure they will do so.

The Obama Administration also has a little-known fallback if it loses the court battle. The government can borrow a strategy that Medicare uses to compel consumers to sign up for insurance.

Medicare's "Part B" coverage for doctor visits carries its own monthly premium. Yet more than nine in 10 seniors sign up. The reason: Those who opt out when they first become eligible face a lifelong tax penalty that escalates the longer they wait.

The key difference is that the Medicare law doesn't require that seniors buy the Part B coverage. Experts say Obama's overhaul could also be changed in a similar fashion.

The states had urged the 11th Circuit to uphold Vinson's ruling, saying in a court filing that letting the law stand would set a troubling precedent that "would imperil individual liberty, render Congress's other enumerated powers superfluous, and allow Congress to usurp the general police power reserved to the states."

The Justice Department countered that Congress had the power to require most people to buy health insurance or face tax penalties because Congress can regulate businesses that operate across state lines, including health care providers.

The reaction was swift and celebratory from the states that filed the lawsuit.

Michigan Attorney General Bill Schuette called the decision a "huge victory in the fight to protect the freedom of American citizens from the long arm of the federal government." Alabama Attorney General Luther Strange called it a "monumental case" for individual liberty. And Texas Attorney General Greg Abbott declared: "'Obamacare' is closer to an end."

A separate legal ruling Friday also buoyed critics of the law. The Ohio Supreme Court appeared to clear the way for voters there to decide whether to reject parts of the health care law in November with a unanimous ruling that rejected a liberal policy group's challenge of the so-called Health Care Freedom Amendment.

But the administration did get a small dose of good news Friday. The federal appeals court in San Francisco found that a former California lawmaker and a legal foundation could not file another challenge on the overhaul.

The 11th Circuit's ruling in Atlanta didn't come as a complete surprise. During oral arguments in June, each of the three judges repeatedly raised questions about the overhaul and expressed unease with the insurance requirement. And each judge worried aloud if upholding the landmark law could open the door to Congress adopting other sweeping economic mandates.

The arguments took place in what's considered one of the nation's most conservative appeals courts, but the randomly selected panel represents different judicial perspectives.

None of the three is considered either a stalwart conservative or an unfaltering liberal, but observers were quick to point out that the decisive vote came from a Democrat appointee. Hull, a former federal judge in Atlanta, was tapped by President Bill Clinton.

___

Associated Press Writer Ricardo Alonso-Zaldivar in Washington contributed to this report.

___

Bluestein can be reached at http://www.twitter.com/bluestein

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ATLANTA — A federal appeals panel struck down the centerpiece of President Barack Obama's sweeping health care overhaul Friday, moving the argument over whether Americans can be required to buy ...
ATLANTA — A federal appeals panel struck down the centerpiece of President Barack Obama's sweeping health care overhaul Friday, moving the argument over whether Americans can be required to buy ...
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Itaught30yrs
A proud American teacher for over 30 years.
01:34 PM on 09/13/2011
A president that actually tried to do something to improve our healthcare system. Totally blocked and obstructed by Republicans.

And now they want to repeal it.

How awesome could this have been for us if the Republicans cared?

They don't... and we continue to lose.... It is all about 2012.
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Zeroes
11:24 AM on 08/18/2011
It's ashame America's first black president has had such a disasterous term.
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HUFFPOST SUPER USER
Jack Cox
Telling it like it is.
10:04 AM on 08/17/2011
I used to think this was unconstitutional, then I remembered that if the United States Government can force people to buy Car Insurance they can most certainly force them to buy health insurance.
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HUFFPOST SUPER USER
Quotidien
11:04 AM on 08/17/2011
Exactly, it's in the public interest.

And without it, there is added financial burden on everyone.
03:48 PM on 09/08/2011
That financial burden will be directly placed upon those who take better care of themselves, do not have pre-existing conditions,have ELECTED not to have children ect. How long will it be before you and your government tells me that I can not drink alcohol, smoke, go skiing, eat red meat or salt, I have to buy broccolli, have sex, and with whom? " I have seen your future, it is a 30 year old virgin in a gold kamona singing I'm an oscar meyer wiener". I know, you're in total denial. You'll tell me that those things will never happen. I dont believe you, you obvously do not have any understanding of human nature, because If I have to pay for your healthcare, I am going to MAKE sure that you take better care of yourself ie if you weigh more that 300 pounds, I want legislation passed to take food away from you!
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onionboy
Blessed are the Cheese Makers
06:41 PM on 08/17/2011
But DO they force them to get car insurance? Or is it merely a requirement to get a driver's license? In which case, no one's forcing anyone to get the license. I can get an ID without a license and I won't be required to get the car insurance.

Frankly, I'd prefer a single payer system over a mandatory insurance system. The health insurance companies should be out of the mix.
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HUFFPOST SUPER USER
topgearrt
RYAN.....republican
04:45 PM on 08/16/2011
OK,this is my last comment on this blog.....I want all of you to do well in life and live to be very old.I want you to have healthy lives as well as the people in your family.I honestly dont think forcing people to buy expensive health insurance is the answer.If you had the money to buy it you would have already done it.Good luck to everyone and I hope you get what you want.......
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onionboy
Blessed are the Cheese Makers
06:42 PM on 08/17/2011
Yes. Better the government set up a healthcare system and provide healthcare to all of its citizens...free of health insurance companies.
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HUFFPOST SUPER USER
OneManRoaring
Tech specialist, former educator & active citizen!
09:37 AM on 08/24/2011
I think you miss the point. The system being proposed is an attempt to prevent health insurance and healthcare from being too expensive. I hope you never need it, but my wife has survived two different cancers and w/o insurance we would now be bankrupt. One medicine was $1,500 per injection and she received it often.

We are trying to create a system that works for the end user and not big PHARMA and their investors!
03:56 PM on 09/08/2011
Your current solution will not work, for a pleathora of reasons. Are you prepared to have your children go through genetic screening before they can purcahse a permit to have children? This is the road you are heading down. the fact that you cant see this, is scary. By the way if you advocate such genetic screening and birth permits, I will gladly allow you to force me to buy insurance, even though it goes against the very grain of the principles this nation was founded upon.
01:23 AM on 08/16/2011
Obama's provision to require everyone to purchase health care insurance or pay a fine is unfathomable. Thank God it's been ruled unconstitutional. I don't know law but I do have common sense and that provision never made sense. I assume Obama has common sense so I wonder why he wasn't able to figure how inane this provision is/was. My assumption is is that it was just another way for the federal govt to take our $. That provision benefits NO ONE except the federal govt and insurance companies. It would increase insurance premiums, not reduce them because insurance companies could charge whatever they want because they know it's a must have. The UNinsure are the unemployed, the poor and the self employed. And out of those 3 groups the only group capable of paying a federal penalty for not having insurance is the self employed. The unemployed and poor have no $ to pay a penalty. It's NOT possible for an educated man like Obama to NOT realize this. So what is his motivation? The answer is more revenue for the federal govt. All of this man's policies focus on generating more $$ for the federal govt. ....plain and simple. He's GOTTA go!!!
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BdoMcGregor
01:31 AM on 08/16/2011
I don't agree with the individual mandate however if you had read the bill, the creation of insurance pools would have made the pricing very competitive and the "fines" basically amount to a tax and not a very big tax at all.

We already pay anytime an uninsured person becomes sick. Doctors cannot refuse to save someones life because they can't pay. And what ends up happening is health care costs go up to make up for the people who do not pay into the system at all.

I am in favor of a public option. Insurance companies got us into this mess and they do not deserve mandatory business.
04:01 PM on 09/08/2011
Generalizations are the sign of a weak mind, and make an even weaker arguement. I dont not believe in insurance, nor do many others ie Amish, Menonites ect. I have had some medical prodcedures and many doctors visits and YOU have never paid for any of them!
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topgearrt
RYAN.....republican
07:19 AM on 08/16/2011
Doc.....all these dems LOVE the idea of being forced to do business with the insurance companies they say ARE the problem,how wierd is that?
12:43 AM on 08/17/2011
I know. And many want a socialized govt in the US.
11:33 PM on 08/15/2011
If they can force you to buy healthcare, why couldn't they force you to buy other things? Make people buy a new car every other year (from the highest campaign donor), force people to exercise or join weight watchers if they are overweight, if a business doesn't hire their quota every year to keep employment high, throw the officers in a work camp. Ban beans, alcohol, soda, chips, fresh fruit and green vegetables to cut greenhouse gasses. Its the American Dream!
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ChasG
Unborn, unchanging, undying Universe
06:24 PM on 08/17/2011
Comparing healthcare mandate to your imagined mandate to buy a car is a false equivalence. The reason that the mandate was upheld by the 6th circuit is virtually everyone will use healthcare services in their lifetimes whether or not they are insured, and those who are not insured will receive care paid by those who are insured. You cannot say the same thing about owning an automobile. Your other analogies are so completely irrational as to not warrant comment.
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HUFFPOST BLOGGER
Jeff Norman
09:14 PM on 08/17/2011
Based on the government's logic, a mandate to buy a car would be constitutional because everyone requires transportation.
04:09 PM on 09/08/2011
Really? Who uses more healthcare a 350 lbs gluton or someone with 5 children, or me by myself? Do you think that I am going to allow you to weigh 350 or have 5 children if I have to pay for your healthcare, which I hardly use at all? You have got a lot to learn. You obviously have NO idea what a can of worms you are opening.
11:18 PM on 08/15/2011
All I know is that before the government became so involved in health care it was very affordable! If there is no limit to what the government can do, we'll lose all freedom and choice. Politicians will decide health care, what you can eat, how much you exercise, how many kids you have, what you do in your free time....
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BdoMcGregor
01:33 AM on 08/16/2011
You know this? Please google Nixon's Plan for Health Reform in His Own words.

You people...are so opinionated but never bother to do any research.
04:18 PM on 09/08/2011
You are so right, we are opinionated, when last I looked, the constitution guaranteed that. It also guaranteed that your opinion carried no more weight than mine. so perhaps you can tell me, at what point , in your life, you discovered that you know what is best for everyone and at what point you decided that you have should have the power to force your ideas upon anyone else? Majority rule? Is that what you want? Are you sure? When that majority turns upon you, what will you say then? Its like a murderer who begs for mercy!
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HUFFPOST PUNDIT
ChasG
Unborn, unchanging, undying Universe
01:57 AM on 08/16/2011
Health care reform hasn't had a significant impact on the health insurance industry yet. Prices were skyrocketing before the law took affect, and most of the law has not yet taken effect. The reason rates have gone up so much is that insurance companies have monopoly pricing power. My health insurance increase 130% over the last three years-- and it's a group policy, not individual-- that had nothing to do with ACA.
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ChasG
Unborn, unchanging, undying Universe
10:54 PM on 08/15/2011
Beginning January 1, 2012, insurers must comply with the loss ratio rule in ACA. This rule requires at least 80 cents of every dollar of insurance premium be used to pay for the actual delivery of health care services. This is one counter-balance to the increase in buyers of health insurance. And when more people are removed from the emergency ward care system to preventive care mandated under ACA, a healthier population will theoretically reduce total health care expenditures, thereby automatically reducing health insurance premium rates while maintaining the industry's maximum gross profit margin of 20% for administration and profit. The industry hates this. Killing the mandate is a back-door strategy to have all of ACA declared unconstitutional because the law lacks a severability clause. Even if the mandate is severable and declared unconstitutional, it will effectively kill ACA because of the new prohibition against denying coverage or increasing rates based upon pre-existing conditions. If the mandate is struck down, people will be able to wait till they get sick or injured to buy health insurance to pay major medical costs, then drop the insurance when they have recovered. This will cause an upward spiral in rates for everyone that does not game the system in that way. _________________________________________________________________________ Public option anyone?
01:31 AM on 08/16/2011
That 80 - 20 rule could easily be manipulated by the insurance companies and would not reduce premiums.
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ChasG
Unborn, unchanging, undying Universe
01:52 AM on 08/16/2011
The potential for manipulation has been understood and strict definitions and accounting rules are underway to prevent that. And the insurance companies will be subject to both state and federal examinations, and are already required to have their financial statements independently audited.
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drleebrew
Humanity deserves the care of every human.
10:18 PM on 08/15/2011
Until we move toward a socialist model as in Britain or Canada, where the care of the individual is a role of the state, there will be no universal health care. To try and create an unmanageable hybrid of state/private enterprise coverage is simply unworkable. The fraud and mismanagement that this plan would engender would dwarf even what is already seen in medicare.
11:20 PM on 08/15/2011
Its not working so well in Britain. Have you lived there? Cuba has universal coverage which means everyone is covered but very little healthcare is available.
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drleebrew
Humanity deserves the care of every human.
11:30 PM on 08/15/2011
Don't misunderstand: I am not advocating the plan, merely considering the only ways it could be implemented.
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BdoMcGregor
01:37 AM on 08/16/2011
I have lived in Britain and Australia. You people have never set foot outside your country. I can garuntee that. Conservatives are too afraid to travel the world and learn anything from anyone else. Which is why you are able to be so easily lead.

People in the UK complain about their health care not beaues they want our model, but because ithey believe it is a public service and that the service should be improved.

However, when I lived there I did get sick. And the doctor came to my house. And it cost me nothing. ddarkury you love to comment on health stories with all these little catch phrases and grandstanding but you don't know what you are talking about.
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07:23 PM on 08/15/2011
There are several death threats to conservative SCOTUS justices in this thread. They have been flagged as well as reported as abusive profiles. HP has allowed them to remain for over 48 hours . I must assume the HP agrees with these threats. I have captured images of the threats and emailed them to the FBI and the US Marshals service.
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HUFFPOST SUPER USER
topgearrt
RYAN.....republican
09:29 PM on 08/15/2011
Im sure the FBI hears things like this 10000 times a day and Im pretty sure they will ignore everything you send to them.
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BdoMcGregor
01:38 AM on 08/16/2011
I'm sure you would have overreacted if it had been liberal SCOTUS being threatened as well. Your sense of outrage compliments your bias perfectly.
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HUFFPOST SUPER USER
topgearrt
RYAN.....republican
04:55 PM on 08/15/2011
Buy you some insurnace,dont want to,dont.You cant make me buy ANYTHING I dont want to buy,no chance,not going to happen ever as long as I live.Now,if you want others to pitch in and help pay for your healthcare then you are shameful.So NO,I dont want actual universial healthcare either and I will never use that in my life either.I pay my own way.
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07:24 PM on 08/15/2011
You do realize that it is up to the IRS to make sure that you are buying health insurance? If you do not buy a policy then you will be fined. If you are fined and do not pay then you can be imprisoned.
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HUFFPOST SUPER USER
topgearrt
RYAN.....republican
09:26 PM on 08/15/2011
You know what?This so called healthcare thing IS a tax scam and NOTHING MORE.BO added 15 taxes to it and as you said if you dont buy a private product from a private company the government raises your taxes,and thats got NOTHING to do with the health of people in the USA...as for going to jail,NO,Ill just go out in a blaze of glory before that happens.
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Gestas
Mountain Man
12:40 PM on 08/15/2011
OK...then lets back out the Saint Ronald law that makes every hospital treat EVERYONE that comes into the Emer. Room....That should give the, What would Jesus do Party,, a little something to chew on.
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HUFFPOST SUPER USER
topgearrt
RYAN.....republican
04:48 PM on 08/15/2011
they already do that here and Im sure jesus is fine with that.
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MovieGuy2010
You can't fight in here..this is the war room!
06:31 PM on 08/15/2011
Yes, that is the Republican Way, screw over the middle class Taxpayers for the rich. that WAS the point of Ronnies law, hide the problem, protect the rich.
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BdoMcGregor
01:41 AM on 08/16/2011
Jesus is ok with people dieing? And Doctors not helping the sick?
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07:26 PM on 08/15/2011
I agree. We should rescind "Saint Ronalds" law that requires every hospital to treat everyone. It is a bad law.
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spoonbill1963
12:38 PM on 08/15/2011
Yippee!
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Tootsie56
help fellow travelers along the way, it comes back
12:35 PM on 08/15/2011
Two words: Single Payer. Same treatment for everyone. No jumping the line cause your rich, no buying a kidney cause you have the money to. SAME FOR ALL!
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spoonbill1963
12:40 PM on 08/15/2011
No way, Toots. I used to better than average care. I've been getting it all my life and I'm not going to stop now. I pay plenty for it and I don't want the same level of care as common riff raff.
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Tootsie56
help fellow travelers along the way, it comes back
12:54 PM on 08/15/2011
I pay plenty for mine too. But I believe everyone deserves the best medical care they can possibly get. You sound like the greediest of the greedy. Good luck with that when you need blood sometime!
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BdoMcGregor
01:43 AM on 08/16/2011
You sure your not common riff raff yourself spoonbill? Your name and grammar make me think you are.
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HUFFPOST SUPER USER
topgearrt
RYAN.....republican
04:58 PM on 08/15/2011
forget it...just like my house or my car or my vacations,mine might be better than yours and you get what you pay for.Socialism and everything that goes with it does make people equal,equally poor.Same thing with this healthcare stuff,if you have the money to buy that liver you need with cash,bet you get before the person that doesnt.
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Tootsie56
help fellow travelers along the way, it comes back
12:12 AM on 08/17/2011
Don't put words in my mouth! I never said I was a socialist nor did I refer to Socialism. You've been listening to your hero Ryan and his conspiracy theories too long. A quick note: Are you even aware that your hero received government assistance for years? Yeah, he did.
ajwriter
Healthy equilibrium, healthy democracy
12:04 PM on 08/15/2011
Why do you keep censoring this, censors? You let me post the first half -- what's wrong about the 2nd half? It defies stereotypical left-right pidgeonholing?

That's what Democrats get for making that pact with the devil just to get something passed.

As usual, the rightwing spin on this and the motivation for the suits is just plane l00ney, but I am relieved at the decision and frankly find the court's reasoning very reasonable.

Instead of fighting this, I hope the Obama administration will rethink the problem, without the benefit of the insurance interests whispering in his ear.
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HUFFPOST COMMUNITY MODERATOR
Carpetbagger 68
I see my micro bio as half-full.
01:22 PM on 08/15/2011
My analogy is this: Obama's including an individual mandate to get the insurance industry's agreement not to fight the rest of the bill is like me telling my kids that if they clean their rooms, they can have cake for breakfast tomorrow. Unfortunately for them, their rooms will be clean, and I'll be at work, so now they have to convince MOM to let them eat cake.
ajwriter
Healthy equilibrium, healthy democracy
01:51 PM on 08/15/2011
I'm afraid I don't get the analogy.

I think a closer analogy is if the police extract a promise from an organized crime syndicate to stop extorting money from people here and there with brass knuckles and billyclubs if in exchange the police just make everyone pay, all the time.
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BdoMcGregor
01:45 AM on 08/16/2011
I agree.