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Edward Zelinsky

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The Individual Mandate Won't Work

Posted: 07/03/2012 1:16 pm

The individual health care mandate won't work.

As almost every American today knows, the individual mandate is a central feature of the health care law recently upheld by the Supreme Court. The mandate requires most Americans to carry "minimum essential" health care coverage. President Obama and the law's supporters claim that this measure will radically reduce the number of uninsured Americans.

It won't.

Even before the Court's decision, the Obama Administration projected that 4 million Americans would pay the penalty tax of the new law, rather than acquire health insurance. In the wake of the Supreme Court's decision, it is clear that the health care mandate will not increase insurance coverage by anywhere near the numbers forecasted by President Obama. There are three reasons the individual mandate won't work as touted.

First, many uninsured Americans will pay the tax rather than purchase health care insurance because the tax will be substantially less than the premiums they would have to pay for insurance. Indeed, the Court's opinion, written by Chief Justice Roberts, is virtually an invitation to Americans to pay the cheaper tax rather than the more expensive premiums for insurance coverage.

In the words of the Chief Justice: "Under the mandate, if an individual does not maintain health insurance, the only consequence is that he must make an additional payment to the IRS when he pays his taxes." And, the Chief Justice further notes, "for most Americans the amount due will be far less than the price of insurance." Thus, in a highly public way, the nation's highest judge legitimated the choice of paying the tax rather than buying insurance.

The second reason the mandate will fail is that, even when Americans eschew insurance coverage, the IRS has limited authority to enforce the resulting tax. Congress' misgivings about the mandate were so great that, when it passed the law, it specifically prohibited the IRS from proceeding against taxpayers' assets if they refuse to pay the tax. The IRS can withhold the mandate tax from a taxpayer's refund. If, however, there is no such refund, the IRS is powerless to enforce the tax.

Thus, many Americans will neither purchase insurance nor pay the tax -- and nothing will happen to them.

In theory, Congress could give the IRS full authority to enforce the individual mandate tax. In practice, this is unlikely.

If stronger IRS enforcement authority is unlikely, the third reason the mandate will fail is that enforcement of the mandate by other government agencies is permanently off the table as a result of the Court's decision. That decision, while sustaining the individual mandate as a constitutional exercise of Congress's taxing power, rejected the mandate as an exercise of Congress's authority under the Commerce Clause. Under the Constitution, the Commerce Clause is the national legislature's prime source of regulatory authority.

Suppose, for example, that a future Congress, more supportive of the individual mandate than is the current Congress, decides on stronger enforcement of the mandate through federal criminal law. Suppose, for example, that this future Congress wants to declare the willful failure to obtain insurance a federal misdemeanor.

Under the Court's decision, this future Congress could not proceed in this fashion since such a criminal law would be an exercise of the Commerce Clause power and the Court has held that the mandate is not a valid exercise of that power.

At the end of the day, the individual mandate will disappoint its proponents as many Americans will pay the tax rather than obtain insurance -- and many Americans won't even bother paying the tax because they will face no consequences from nonpayment. Future generations will look back on us and wonder what the fuss was about.

 
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The individual health care mandate won't work. As almost every American today knows, the individual mandate is a central feature of the health care law recently upheld by the Supreme Court. The mand...
The individual health care mandate won't work. As almost every American today knows, the individual mandate is a central feature of the health care law recently upheld by the Supreme Court. The mand...
 
 
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HUFFPOST SUPER USER
PARepublican
Advocate for personal responsibility
06:30 PM on 07/05/2012
If you are paying cash, my local Hospitol cuts your bill by 50%.
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HUFFPOST SUPER USER
PARepublican
Advocate for personal responsibility
06:29 PM on 07/05/2012
Then why did the Obama administration argue that without the mandate ACA will fail?
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HUFFPOST SUPER USER
lrobb
Gold Standard = four paws and a tail
06:44 AM on 07/05/2012
The interesting question is what will constitute proof that a taxpayer and every member of his/her family has health insurance?

Mortgage lenders have to report mortgage interest payments to the federal government with a copy to the mortgagor. This one requirement adds a certain amount of cost to doing business and it is passed along to borrowers. What will be the cost of this new requirement to in some way report insurance?

If you don't have insurance, you will not be getting an insurance confirmation from your carrier. States do not require auto insurance companies to provide a notice of coverage to the regulators, but they do require a notice when insurance is cancelled. Do you have any idea how many people simply lie on their tag renewals and list a false insurer when they don't want to pay for minimum auto coverage? Obviously, the state will never get a cancellation notice for something the driver never had in the first place.

How many additional IRS agents will be required to enforce the mandate and where will their pay come from? This whole mandate enforcement thing is going to be a cluster foobis of the first order.
12:37 AM on 07/05/2012
Of course this author is correct. Anyone following the deliberations about Obamacare knew this would be the case. As long as people can't be turned away at emergency rooms and as long as the "penalty/tax" is so much cheaper than the insurance, many people will not buy insurance. Hospitals will continue to treat millions of illegal aliens and uninsured for nothing and cost shifting will continue. In addition, the shifting of cost from Medicare/Medicaid's paltry reimbursements to the private insurance market will continue.

The only thing that will change is we will have large new taxes on medical devices, drugs and insurance that will be passed through to inflate medical cost even further, and we will have a lot of 20-30 year olds whose insurance is now being paid for by parents that will become the burden of the taxpayer.

Obamacare will become another huge entitlement that does nothing to change cost drivers, in fact lights a fire under them.
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KarmaPatrol
Riverboat Gambler, satellite whisperer. Independe
01:08 PM on 07/04/2012
At a certain point, we need to treat individuals who do not purchase like Appalachian snake handlers .. do what you want, just don't show up to the emergency room expecting free care or much sympathy.
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guveqzero
Inventor and Innovator
06:54 AM on 07/04/2012
Yea, we live in a country of tax cheats. Like, the big corporations.
Goaheadmakemyday
Tennessee tuxedo will not fail
04:59 PM on 07/04/2012
Or Rangal, or Geithner.
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HUFFPOST COMMUNITY MODERATOR
SShaw490
A man hears what he wants and disregards the rest
10:03 PM on 07/03/2012
When I was in college, we looked at theory and then we looked at experimentation. If experiments disproved theory, then the theory was flawed. Well, the experiment in Massachusets shows that less than 2% of the state is going without insurance in a near-identical structure - meaning that the theory in this article is baloney.
05:41 AM on 07/04/2012
The Massachusetts mandate is half the cost of insurance (that's greater than the US version), and the government there actually has the power to garnish your wages and such if you refuse to pay the fine. The employer side is also a lot more effective.

Sure the US would probably behave similarly to Massachusetts if the national health care law was identical to the Mass health reform law, but it's not even close.
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BBackSoon
Hello, I must be going.
10:07 AM on 07/04/2012
Yet.
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HUFFPOST SUPER USER
MarkInEugene
A blasphemy a day keeps the deities away.
09:43 PM on 07/03/2012
That's ok if it doesn't work. But what's not ok is for Congress to not act to plug the whole. All doctors and hospitals should stop charging 40% less to their non-insured patients who have incomes that can afford to buy insurance. We have got to stop giving them a free ride. And emergency rooms should require everyone to be insured and bill them for their services at the same rate that they do insured people.

It's not to burn uninsured people, it's to protect insured people from getting burned by those who refuse to take care of themselves....when they have the means.
05:44 AM on 07/04/2012
I'm sure the uninsured would absolutely love if emergency rooms charged them only as much as they charge insurance companies. I have no idea where you live that uninsured get a discount (most places that would violate the contracts doctors have with insurance companies and Medicaid), but the national statistics are very clear that uninsured get charged far more than insurance companies. And the nonpayments by the uninsured also account for less than 1% of the health care market, which is pretty low considering they get charged more to begin with.
01:12 PM on 07/04/2012
You're wrong.
Uninsured ER charges are far less than insurance billings. Try consulting an uninsured ER patient and checking. The difference between an insured billing and an uninsured's charge can be as high as 65%. Common sense should indicate avoiding middleman insurance processing costs reduces cost of service. No insurance has zero relation to Medicaid--contracts and otherwise. That's why it's termed no insurance, which means, er, none. Zero. Zip. There is private insurance, there is Medicaid/Medicare, then there is no insurance. Get your head out of your statistics, however sourced, which by your conclusions, are flawed, and and try doing bona fide research. Unless, of course, the intent is to mislead by asserting flawed conclusions, rather than inform. A caveat willfully overlooked is there is upwards of 30 million uninsured, who know your assertions are bunk.
12:40 AM on 07/05/2012
The LA Times just ran a major story reporting how much less you are charged if paying in cash than if the insurance company is paying.
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HUFFPOST SUPER USER
richard in obihiro
translator
09:04 PM on 07/03/2012
The SCOTUS was able to twist the meaning of the 2nd Amendment by pretending the reference to "a well-regulated militia" did not exist, thereby making sure people in the US will continue to kill each other in larger numbers than in Afghanistan, but couldn't find the part that gave Congress the power to tax and provide for the general welfare just because the Commerce Clause is supposed to be the legislature's only source of regulatory authority? And all this in the name of "freedom"?.
There's got to be something seriously wrong with this picture.
08:39 PM on 07/03/2012
Willful failure to pay a tax is a misdemeanor punishable by a fine up to $25K and/or imprisonment for up to 1 year. 26 U.S.C. § 7203.

A Democratic President faced with a Republican Congress that refuses to allow the IRS to take civil actions to collect from people who fail to pay the penalty tax for not getting health insurance still has the power to instruct the Department of Justice Tax Division to make prosecution of willful failure to pay cases a priority.
05:49 AM on 07/04/2012
PPACA specifically disallows criminal prosecution for failure to pay the individual mandate penalty. No president can instruct the DoJ to prosecute something that Congress said cannot be prosecuted.
04:14 PM on 07/05/2012
Citation please?
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HUFFPOST SUPER USER
J T K
Quis custodiet ipsos custodes?
07:56 PM on 07/03/2012
I have a solution, repeal EMTALA, ban insurance, and make it so everyone has to pay for their own care via cash, check, or credit before treatment if able or after treatment if unable to pay beforehand.

Some people still couldn't be able to afford care and they'd be reliant on charity or out of luck but for everyone else prices would go way down.
07:39 PM on 07/03/2012
"As almost every American today knows, the individual mandate is a central feature of the health care law recently upheld by the Supreme Court."

Nope it's a side show. Just as the GOP not expanding Medicaid is a joke. If hospitals, clinics and doctors continue to be required to treat ever more unisured, they'll close or go bankrupt. Or raise prices for the insured, which will lead to ever larger premium increases for less care for the insured.

States like Vermont that go Medicare for all and use ALL the available money from the Federal Gov. will lower the premiums by broadening the base of paying customers.

The end result is that those states with quality and affordable medical infrastrurcture will attract the high paying quality jobs and those that don't the lower paying ones.
zinxeb
Empathy ends cruelty
06:47 PM on 07/03/2012
So, Mr. Zelinsky?

Does that mean that the ACA should not have been attempted? People have waited decades for SOMETHING in the way of healthcare reform, and every year, premium rates have been going up and up, so that coverage became more and more unaffordable for more and more people...a really sweet setup for insurance companies, but not such a good deal for us.

The longer we had to wait for something to be done, the less of a chance there was of something actually being done. Now that it IS actually done, we can put it into effect, and start working the "bugs" out of it...just like we did with Social Security and Medicare.
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Gestas
Mountain Man
06:34 PM on 07/03/2012
It's a Penalty , not a tax....Even the God Father of ROMNEYCARE says so. It's not nice to mess with ROMNEYCARE.
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10:17 PM on 07/03/2012
Either way - its more control.
06:26 PM on 07/03/2012
I don't think you understand the mandate. It's purpose is not to increase coverage. Not denying coverage to those preexisting conditions, keeping children on insurance until 26, and other aspects of the ACA are designed to do that. The mandate is designed to pay for that increased coverage by ensuring that sufficient people participate in the insurance pool to offset the cost of taking care of preexisting conditions, etc. Which is why it was assumed that at least 4 million wouldn't participate. And the penalty is an effort to further offset healthcare cost incurred by people's non-participation in the insurance market.

I don't think the mandate is the most efficient way to deal with costs, but there's no point in misrepresenting its role.
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10:19 PM on 07/03/2012
We further mandate that the drinking of soda should cease as we have determined that it poses a national risk to the economic stability of the health insurance industry.