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Howard Fineman

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Health Care Law: All Hail The Failure Of Conventional Wisdom

Posted: 06/28/2012 10:42 am

WASHINGTON -- Is this a great country or what? Not because the U.S. Supreme Court upheld the overall scheme of the president's health care law. That is an ordinary question, no matter how much money was at stake. It is a great country because the workings of our carefully wrought system of government are not predicated on punditry, predictions or polls.

Defying the expectations, Chief Justice John Roberts -- said to be a relentless conservative activist -- joined the court's liberal wing in saving the law by grounding the individual mandate" not in the power of Congress to regulate commerce, but in its taxing power. As I suggested yesterday, the court essentially said that Congress could not require people to buy something in the private economy, but they could fine them if they didn't. The court found that power to fine, in the taxing power of Article I. Now the president will have to figure out a way to make the fines in the law -- which are weak and toothless -- real.

The idea to require all Americans to buy private health insurance was hatched in a conservative think tank, first deployed by a Republican governor (Mitt Romney) and at first opposed in the Democratic 2008 presidential primaries by candidate Barack Obama. But as soon as he had he vanquished Hillary Clinton - a proponent of the mandate -- he privately decided to support it. "I kind of think Hillary was right," he told an aide in the summer of 2008, according to Princeton professor Paul Starr. There were those -- including Starr -- who had publicly and privately warned that the mandate was a risk, but once in the White House Obama and his aides (many, ironically, Clinton veterans) ignored the warnings.

The obvious big political winner, at least initially, is President Obama. Had the court thrown out the core mechanics of the law, his signature accomplishment would have been in shambles. He can take to the campaign trail with the backing of none other than George W. Bush appointee Roberts. His polls were on the upswing and may get a boost. There are troubles down the road. He has to make the fines real. Most people don't like the mandate, no matter what it is grounded on. Republicans and Romney, their presumptive nominee, will make overturning the law their crusade for the campaign, and they will have the polls on their side.

Beyond the political back-and-forth, the 5-4 ruling is an example of the durability of our system, and of Roberts' desires to protect the reputation of the institution as the one place in the country that is above politics. The court is the most essential part of our system of government by the rule of law. It takes the place in our system of faith or royalty as the ultimate arbiter of Truth in the public realm. Roberts understood that, and protected it.

Now it is clear why Justice Scalia went on his rampage yesterday. He doesn't like Roberts' institutional vision of the court.

 

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WASHINGTON -- Is this a great country or what? Not because the U.S. Supreme Court upheld the overall scheme of the president's health care law. That is an ordinary question, no matter how much money w...
WASHINGTON -- Is this a great country or what? Not because the U.S. Supreme Court upheld the overall scheme of the president's health care law. That is an ordinary question, no matter how much money w...
 
 
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DrAWNiloc
Lies tell us twice as much as the truth.
12:14 AM on 07/03/2012
Everyone agrees: "Obamacare is better than nothing."

People just parse the statement differently.

***
11:45 AM on 06/29/2012
Does Roberts' role in affirming America's Affordable Care Act confirm that our High Court is "the one place in the country that is (generally) above (improper considerations)"? Contrary to what some may think, this question is NOT a call for judge and legal system haters to spew disdain for and mistrust of everyone with a law degree. Instead, it is a reminder that in October 2011, international human rights activist Matthew Fogg, assembled representatives of all the key players in America's legal system (i.e. litigants, lawyers, law professors, and judges) to consider whether appropriate adherence to stare decisis (a/k/a the doctrine of precedent) and the rule of law is reasonably assured in America given the: (1). considerable discretion vested in federal trial judges through the “plausibility pleading” requirements of Bell Atlantic Corp. v. Twombly and Ashcroft v. Iqbal; (2). dynamics of judicial self-discipline; and (3). impediments to effectively challenging apparent judicial motives and / or bias, including limitations on lawyer free speech rights.

The debut report on Fogg’s historical program series has been transformed into a nonfiction book that will be in bookstores this summer. Please visit, “like”, and join our discussion on Facebook: https://www.facebook.com/FoggEvent
iflew
Pro Publiae Bonae
11:09 AM on 06/29/2012
Speed limits and stop signs are not well enforced and fined either. They do however cause the drivers to exercise some care because they don't want to be inconvenienced for the length of time needed to get their ticket and go on their way. Even when no enforcement is obvous it helps keep drivers mostly under 40 or so MPH above the speed limit, or when running a stop sign. If extended toward the health care situation the traffic fine system in comparison has helped even if not well enforced.

Actually it's all up in the air until the dust settles. If it stays in place it will get alterations and tweaks so congress can their have show and tell sessions for future campaign times.
09:19 AM on 06/29/2012
It looks like the U.S.Supreme Court has decided another Presidential Election.Thanks to the confused interpretation of Obama's Healthcare Law now Tax by Chief Justice John Roberts.The Court was not supposed to be political but is assured that it is. The backlash most likely giving Mitt Romney the White House in November.Forcing Americans to buy Health Insurance is unconstitutional especially when the Federal Government is playing the middleman for private companies who profit from it. The equivalent of paying money to a protection racket. It could only be a tax if the Govt controlled and ran the Healthcare Industry and served the people it taxed which it does not. Therefore it is a product not a tax and forcing people to buy it is against the Constitutional Bill of Rights.What this is really is a forced entitlement program on the American Taxpayer making them responsible for others Healthcare costs Unlike Social Security where it is earned Taxation with representation.A act that will cause major financial problems for all aspects of everyone who is involved or not.What this country really needs is a President who will fight for working people and protect our country from Corporations that send jobs and industry overseas for profit without any punishment or tariffs on their products whatsoever. The Healthcare Law must be changed and the mandate stricken making it optional to Americans.
10:24 AM on 06/29/2012
I disagree entirely, and I expect the decision will benefit Obama's reelection.
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10:42 AM on 06/29/2012
You have some misinformation here. I think it would be good to check out this link which outlines the ACA provisions as they are implemented: 
http://www.healthcare.gov/law/timeline/full.html
09:18 AM on 06/29/2012
Your essay starts off with a fallacy. This is NOT a great country. It has become fouled by the ruling elites. The ultra-rich would who see us dead rather than lose a single penny. We have a Con-gress who is so infatuated with re-election money that they sell their souls and integrity to the highest bidder. Our medical care is substandard, with an agenda to "manage disease" rather than actually cure it! Children are being taught to be robots and dumbed down intentionally. Can't have any real thinking going on, else we understand how we're being screwed by the globalist rich cats.There is irrefutable evidence of free energy, yet we still burn coal and oil. Fluoride is added to the water, making people apathetic, just like the Russians did (fact!). Our food supply is poisoned, and processed to a near worthless state. Pollution is rampant. Infrastructure is collapsing. Electric grid is ancient and about to fail. And on and on and on.

Great country my skinny butt!
09:02 AM on 06/29/2012
5-4 Decision. On the most significant ruling in the recent history of the Country? The Supreme Court is the US is "split". Wow, that really gives me great confidence in the law!!! And, far less in the Wisdom of the Court.
08:59 AM on 06/29/2012
Someone help me out, here. A below poverty line family cannot afford health insurance, so they get fined by the IRS $275 a month. Now they have no insurance, no credit and, of course, cannot pay the fine, which is increasing each month, so they file for bankrupcty (or already have). But bankruptcy exempts IRS bills, which are piling up, and the family still has no health insurance.

Certaintly, there is a safety net I am missing. What is the plan for that situation?
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demisfine
Often correct, NEVER right.
09:05 AM on 06/29/2012
No.
But you knew that.
People below the poverty level (percentage below decided at each state, BTW) will receive help in the form of rebates or riders, to buy into group pools with the coverage levels they choose.
10:07 AM on 06/29/2012
Thank you.
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09:35 AM on 06/29/2012
People are understandably scared of the idea that they have to buy health insurance or be fined, and as a hard-working, tax-paying American, I get it. But here's how it works:
1) You have enough money to afford health insurance. No fine.
2) You can't afford health insurance. You get tax breaks that are equal to, or greater than, the cost of the insurance you buy. In NO CASE does this end up being less than the amount you pay for insurance, so you lose nothing. Plus, your family is not one accident or disease away from homelessness, from paying medical costs out of pocket.
3) You can afford afford insurance, but choose not to buy it. You're fined in the form of a tax. This is projected to be 3 to 5% of the population, but there are many filthy-rich deadbeats out there - some rich people stay rich by working the broken system (one example: Romney's offshore tax-dodges).
The individual mandate was developed by a conservative think tank. Romney passed the first version of it when he was the Gov. of Mass. Think about the system now: Insured folks pay outrageous premiums to cover those who don't have/can't afford to have health insurance. Overwhelmed ERs are the de facto doctor for millions.
This really is a very good thing for the poor and middle-class.
10:13 AM on 06/29/2012
Sarah, Just letting you know that you pegged me exactly right. I voted for Obama, from the position of Independent. Not happy with everything; but that was not a factor in my sincere question. Thank you for taking the time to respond this way. Ben
08:53 AM on 06/29/2012
If you oppose Obamacare, I do, and decry Roberts's opinion, you have missed completely what just happened. This is a brilliant example of intellectual honesty and a fine moment in the history of the Supreme Court of the US. Be positive for a second and applaud a man who just chose principle over politics.
09:43 AM on 06/29/2012
You are correct. He is a honest man who did not betray himself and that is good for all of us.
10:29 AM on 06/29/2012
I wanted a single payer plan, and everyone else should too. ACA is better than nothing, but it was written by the healthy insurance industry, and that's who benefits most.

Roberts ruled in favor of the insurance industry. That was the principle he upheld. Hooray. What a mensch.

Now the conventional wisdom will be that Roberts and the Roberts court are neutral, non-partisan, non-activist...

I'm glad ACA survived, but the ruling only makes me more cynical.
01:11 PM on 06/29/2012
You want a single-payer system when there is no basis for a belief it would work. no government plan in the historyn of the US has come in at the projected cost. Never, ever. And save the it-works-in-Holland nonsense.
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HUFFPOST SUPER USER
The Grouch
Seeing the world thru a warped prism ...
08:24 AM on 06/29/2012
Here's an angle to the decision that I'm not seeing mentioned in the media coverage: Roberts is getting a lot of the credit (or blame) for this decision, but I'm thinking the only reason Obamacare won is because we now have three women on the Supreme Court. Does anyone really think it would have passed if there were nine male justices? Just a theory.
schatsie
Wall Street is Worse than Vegas
08:31 AM on 06/29/2012
Yes, it would have passed, another justice from the 'right' side would have voted for it.....Don't doubt that for a minute.... this is a red flag....
10:31 AM on 06/29/2012
Yes, Roberts ruled for the insurance industry. I predicted it, but it should seem obvious in hindsight.
08:33 AM on 06/29/2012
Three women and not one Protestant Judg on the court. Chief Justice Roberts is just another example of a so-called Conservative Catholic who once he gets to DC, becomes all squishy on social issues and votes with the Liberal members.

The US is 51% self declared Protestants and not one judge represents half of the country with those religious beliefs.
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HUFFPOST COMMUNITY MODERATOR
DCinFrance
As a matter of fact, it's all dark.
08:45 AM on 06/29/2012
What, did you just hope off your dinosaur to write that post? And, since when were Mormans anything but a cult to you Protestants?
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demisfine
Often correct, NEVER right.
09:12 AM on 06/29/2012
Wow.
Conspiracy theory and victim mentality.
Do you follow SP on Twitter?
08:08 AM on 06/29/2012
The weak link are the insurance companies and they will fail, they will not be able to keep up with their obligations to that many people. When that happens, will Obama do 1. National Health Insurance or 2. Nationalize insurance companies.

Replies welcome from those with more than nonsense to share...
schatsie
Wall Street is Worse than Vegas
08:33 AM on 06/29/2012
The Insurance Companies are already regulated by the states and you can see exactly how effective that has been.... anywhere from $20,000 for an outpatient heart cath to 70 grand for a stent and a one night stay in the hospitall.....Next thing we know the Hospital Corporation will be building hospitals in Cuba and endorsing medical tourism because the charges in Cuba will be less than the copay, deductibles and coinsurance in to good old US of ARISTOCRAPS.....
10:41 AM on 06/29/2012
I hope you're right! A national single payer plan, like medicare for all, would be better for almost everyone, the only exception being the very very rich who can afford whatever they want on the side anyway. So who suffers? It would be great - every other country on earth does it that way for a reason.

But I know you're wrong, for many reasons.
1. Obama never wanted to and never will want to nationalize anything, or even try for a single payer plan. He's no radical; he's not even in the liberal mainstream. I don't know why it's so hard to see that he's a centrist corporatist, and so are most of the dems in congress. Tune out the partisan noise and think about it...
2. Even if Obama and the democrats wanted it, it's politically impossible because of entrenched interests. If ACA did fail, it would be withdrawn not expanded.
3. The insurance industry wrote ACA! It's a gold mine for them. Fail? The only thing they were worried about was losing the mandate in SCOTUS, otherwise they're in love with it. Of course.
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08:07 AM on 06/29/2012
My only problem with this bill is NOT the individual mandate, but that it is not a single payer system. I don't agree that most people don't like the individual mandate. They're just the more vocal critics.
schatsie
Wall Street is Worse than Vegas
08:35 AM on 06/29/2012
Exactly! not just more vocal, they have 10 times the money to spend and it is totally tax deductible as a socalled charity or business expense AND they get the advertising at lower rates.....
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08:44 AM on 06/29/2012
l've heard TBaggers comment "How dare he make me buy insurance," but that is currently what they are doing. Then they comment about people not pulling their own weight. Well making all people purchase their own coverage now is making people more responsible in my opinion.
10:43 AM on 06/29/2012
I forget the numbers, but the tea-dance-partiers are mostly older and on Medicare. They just say crazy stuff they get from Frank Luntz via email, it doesn't even make sense most of the time. But it doesn't have to.
08:03 AM on 06/29/2012
Again, realize this fact: Not one vote--not ONE--of a SINGLE US voter--not ONE SINGLE VOTE--was cast in favor of ANY candidate who promised the ACA, or anything resembling the ACA.

NO CANDIDATE, House, Senate, President--NO CANDIDATE spoke of or promised ANYTHING resembling the ACA. NOT EVEN CLOSE.

WE DID NOT VOTE FOR THIS THING. CORPORATE AMERICA SHOVED IT DOWN OUR THROATS, BECAUSE THEY REALLY RUN THINGS.

The rest of it has been a giant PR campaign, conducted especially in the so-called "liberal" press, to fool so-called "liberals" into thinking the ACA has ANYTHING to do with liberalism, and ANYTHING to do with Democracy.
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08:51 AM on 06/29/2012
Yah, how dare Pres O try and curb costs and make coverage affordable for those that don't currently have coverage. He also took away my right to lose my house if I had a medical catastrophe. How dare he!!
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demisfine
Often correct, NEVER right.
09:13 AM on 06/29/2012
We have representative government for that very reason.
You would never get 300 million people to agree on anything.
And Karl Rove will only allow a small percentage of those 300 million Americans to cast a vote.
07:47 AM on 06/29/2012
Roberts had no choice. He did it to save his legacy
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08:52 AM on 06/29/2012
It is a big start.
11:27 AM on 06/29/2012
That was a fringe benefit. He did it mainly to serve the corporations that got him his many fancy jobs. Now he's got plenty of political cover to rule for them in the future, because people are so dense they don't see it for what it is.
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engard
7 billion & counting. Too many people, less jobs.
07:44 AM on 06/29/2012
What we see and what we are told is not what we get. More than likely, a deal was cut. Obama saves face by winning this one, and loses in November to $Rmoney who will dismantle this whole deal once in office. It's all smoke and mirrors for We The People.
schatsie
Wall Street is Worse than Vegas
08:16 AM on 06/29/2012
Nope, this is going to be the issue that SAVES and ELECTS Romney.... How in the sam hill are over 50 milllion people who are on food stamps going to pay for HEALTHCARE? This is another stab in the back against the middle class who have already taken the hit for the WAR on IRAQ and Afghanistan and the so called Medicare Part D.....Expect your SS rates to double over the next 4 years in the name of AUSTERITY or (shove it up the Middle Class one more time).
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HUFFPOST COMMUNITY MODERATOR
DCinFrance
As a matter of fact, it's all dark.
08:50 AM on 06/29/2012
LOL...you people really are in lala land. This decision just handed the President a victory in November. The middle class? You mean the middle class on food stamps, or the middle class that are middle class because they have jobs and are already paying for death panels in private insurance companies through their work plan?
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09:12 AM on 06/29/2012
But your boy Romney was the guy who helped invent the health-care individual mandate/tax. As Gov. of Massachusetts, he got his state version of it passed, and if you care to look on YouTube, you can see many of the TV spots he had made, crowing about what a great thing the individual health care mandate was for the people of Mass. The whole idea was invented by conservatives, in a conservative think tank. Romney's stance on it now - that he'll roll it back and that it's the worst thing ever - is a cynical pose, an outright hypocritical lie to get himself elected. Romney was the first governor in this country to pass a law with the same individual mandate in it. Don't fall for the Fox News hype. The ACA is not the horrible thing you might think it is.
07:28 AM on 06/29/2012
This is a great country because we are forcing people to pay a tax to buy health insurance from a for profit corporation? Because the government is going to spend your tax dollars to hire people to force you to pay that tax? Because the corporation sets the tax rate you will pay and determines the benefits you will receive with NO democratic recourse?

This is corporate tyranny. This is a terrible, terrible day for America. The spin around this thing is exactly like the spin during the lead up to the Iraq War, and THIS LAW WILL FAIL JUST AS MISERABLY.
07:52 AM on 06/29/2012
Yes indeed. The people crying the hardest now are the same people who reject single payer which would have put those big bad corporations out of business. Republicans got exactly what they wanted all along and now we will suffer the economic consequences of employer based health care for the next century. This is a Republican plan that is now opposed by the right wing fanatics because the president is black and they hate him.
11:34 AM on 06/29/2012
They only pretend to oppose it. They want the base all riled up for the congressional elections. Mostly the president's race is the same - Exxon doesn't really care what color he is. It's fodder for the masses.
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08:04 AM on 06/29/2012
Who would be against keeping people on their insurance if they become seriously sick?
schatsie
Wall Street is Worse than Vegas
08:23 AM on 06/29/2012
Duhhh, the insurance companies.... heck there was a young man who had one episode of viral meningitis and now he is refused healthcare insurance.....