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Jamie Court

Jamie Court

Posted: December 13, 2010 02:24 PM

If anything can save Democrats now, it's populism -- the notion that standing with 80 percent of Americans is real power. That's why the White House and progressives should be cheering the decision by a conservative Virginia judge to strike down the highly-unpopular federal mandate to purchase health insurance and preserve the rest of the federal health care reform law.

Conservatives have tried to repeal the mandate that everyone must buy health insurance as a way of taking out the full law in the court. Today's ruling makes clear that the popular and progressive parts of health care reform could go forward without the big sop to health insurance companies -- mandatory purchases without regulated premiums.

Why would a progressive like me support repeal of mandatory health insurance purchases?

70 percent of Americans consistently oppose mandatory health insurance purchases.

If the last two elections have taught Washington a lesson, it's that we can do anything if 70 percent of Americans agree and do nothing if a majority cannot agree.

Most of the progressive parts of health care reform -- subsidies to buy insurance for the poor and rules to make the marketplace fairer -- enjoy 60 percent to 70 percent public support. Mandatory purchases, however, will consistently suffer the public's wrath because of popular distrust of the insurance industry and the high cost of health insurance premiums. Congressional refusal to limit how much health insurance companies can charge will ensure Americans' distaste only grows.

This issue is a ticking time bomb for Democrats and the courts may yet defuse it.

Beneath the polling, of course, is a strong social mores that the government should not be forcing Americans to buy health insurance that they cannot afford.

As a candidate, President Obama agreed with this popular sentiment. He argued, in stark contrast to Hillary Clinton, that, "The reason people don't have health insurance isn't because they don't want it, it's because they can't afford it." Once in office, Obama conceded to the Washington wisdom that government cannot force insurance companies to sell policies to all
citizens without requiring that everyone have to buy it.

The notion that mandatory insurance is necessary for a "take-all-comers" law to succeed, like so many assumptions in the Beltway, needs to be reexamined. Fear of gaming by those who won't buy insurance until they are sick can be alleviated by creating greater carrots for buying coverage and less severe deterrents for failing to, such as a limited national open-enrollment period.

Current law now requires Americans to spend 8% of their income on health insurance by 2014 or face fines. Sliding scale subsidies would assist a family of four up to $88,000, but the $7,000 the family would have to pay could not even buy a policy likely to meet their needs, since the average policy for the family costs more than $12,000 today.

Mandatory health insurance has not produced lower premiums or health care budget savings in Massachusetts, the laboratory for the experiment. Massachusetts recently adopted strong premium regulation to give consumers relief from the highest health insurance rates in America.

New York, which has a take-all-comers law, is often cited as the disastrous consequence of the failure to enact mandatory purchases. But the empire state also is embarking on tough premium regulation to deal with its problems -- which still rank it lower than Massachusetts in premium prices. Premium regulation is the key.

This principle set me on my journey as a consumer advocate more than twenty
years ago. Californian endured double-digit premium hikes on their auto insurance under mandatory auto insurance laws imposed in 1986. This sparked a voter revolt in 1988 led by the founder of the consumer group I now head, Consumer Watchdog. Proposition 103, passed via ballot measure, created the nation's toughest premium regulation. A 2008 report by the Consumer Federation of America found California motorists have saved $62 billion on their auto insurance bills. Congress has no such appetite for tough regulation, however.

Driving is discretionary, so you can always take the bus rather than buy auto insurance. Breathing and not having to pay more than 8 percent of your income are the only requirements for the 2014 federal insurance mandate. When the public feels that blow, the backlash will make the midterm election look like a baby shower.

There's a lot worth saving in the health care reform overhaul, including provisions I fought for to limit out-of-pocket costs and force insurers to be fairer. Democrats should want to repeal the mandate because otherwise the most progressive parts of health reform could be lost. Laws tend to be repealed based on their most objectionable provisions.

Despite their moral objections to the mandate, Republicans may not want to diffuse the ticking time bomb of mandatory health insurance before it blows up on the Democrats. But they should be wary of standing too close when the bomb goes off. Narrowly repealing mandatory health insurance is something the public and many Democrats agree with, it's the common ground that Americans overwhelming stand on. The political establishment should join
them.

________________________________________________________________________

Jamie Court is the president of Consumer Watchdog and author of The Progressive's Guide To Raising Hell: How To Win Grassroots Campaigns, Pass Ballot Box Laws And Get The Change We Voted For (Chelsea Green)

 

Follow Jamie Court on Twitter: www.twitter.com/RaisingHellNow

 
 
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HUFFPOST SUPER USER
sjcarl
06:18 PM on 12/19/2010
Watch what you eat, exercise, seek out qualified alternative medicine practitioners and opt out of our corrupt health care system as much as possible.
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HUFFPOST PUNDIT
marco01
04:52 PM on 12/19/2010
Of course without the mandate, health care premiums will EXPLODE.

Maybe then Americans will be ready for Single Payer, but probably not. They will probably listen to the "heath" insurance industry and support abolishing all provisions of this health care act.
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Bellanova
I'm nobody. Who are you?
05:26 PM on 12/19/2010
Premiums will rise with or without the mandate. They always have and the industry has and will use any and all opportunities to justify these increases.

But I do get your point.
04:05 PM on 12/19/2010
The government defines what counts as insurance, compels insurers to ignore risk in pricing coverage, imposes price controls on coverage, and then forces everyone to buy the resulting insurance products.
After all, why pay for coverage when you don’t need it if you can just buy it for the same price when you do need it? Of course, no insurance system could survive if only the sick bought coverage. So Obamacare simply orders everyone to buy insurance. Having taken the economic logic out of insurance, the law’s champions had to take away the public’s freedom to choose whether to be covered or not.
Drudge
03:44 PM on 12/19/2010
That was the only part Conservatives actually liked about the bill.
03:35 PM on 12/19/2010
But, but, but car insurance....
03:46 PM on 12/19/2010
Exactly!
Pauline Jaing
Artist, worker, mother
07:24 PM on 12/19/2010
I don't have a car. I chose not to have a car because I could not afford it.

I cannot choose not to be sick. This is a PREPOSTEROUS argument!

Furthermore, if I bought a car I'd have a freaking car. If I am forced to buy health insurance, all I have is insurance!

I was unemployed and offered COBRA, for SIX HUNDRED DOLLARS a month! I got around $325 a week from Unemployment, which is the high end -- which would not even pay the rent!

I chose not to get the COBRA and prayed. Now I'd have to get it or pay a fee tax time.

This is MONSTEROUS! I cannot express how much I hate it.
03:05 PM on 12/19/2010
GOOd piece, thanx. (Maybe 'diffuse' in the top line of the last paragraph oughta be defuse.)
01:37 PM on 12/19/2010
The US already has a universal health plan that is working fine, it's called medicar. All that needed to be done, was to remove the age requirment and increase the taxes to pay for it.
01:26 PM on 12/19/2010
This is nothing but a windfall for the insurance industry.
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HUFFPOST PUNDIT
marco01
04:53 PM on 12/19/2010
Actually no, that is a big part of it, but it is not the only thing.

There are many great provisions in the bill, that is undeniable.
01:20 PM on 12/19/2010
I agree. I supported Obama in the last general election, primarly on single payer health care. Which would mean that our taxes would increase to pay for it. But the Government would not have had to increase our taxes, but not as much as the cost that we are paying for private (for profit)health insurance. But to make it mandatory for a individual to pay to a private for profit insurance company for health coverage, I think would be unconstitutional.
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HUFFPOST PUNDIT
marco01
04:55 PM on 12/19/2010
?

Obama never campaigned on Single Payer, he barely mentioned the Public Option.
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Bellanova
I'm nobody. Who are you?
05:29 PM on 12/19/2010
Not so "barely," really. He touted PO in his speeches and on his website. That was the reason I voted for him (that, and the McCain/Palin disaster if he didn't win).
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01:15 PM on 12/19/2010
Let's be clear: Whatever you think of whichever specific parts of the "Affordable Care Act" (another Orwellian title), it was NOT either "reform" or an "overhaul" of the existing system. The original outcry was to have health care (NOT health insurance, an entirely different thing) declared a basic human right that could not legally be denied to anyone in need. Instead, Obama declared that a single-payer system was off the table on Day One, and the "debate" became all about how to get everyone to buy insurance, affordable or not, and how certain details could be tweaked to be slightly more fair to consumers. Some of those tweaks were worth doing, but it quickly became obvious that the centerpiece of Obama's plan was the mandate to purchase insurance. To that end, the White House consistently and deliberately used "health coverage" and "health care" interchangeably, as if having insurance were a guarantee of access to affordable health care. It wasn't then, it isn't now, and it won't be under the new law.

Maybe we did have to pass some bill, any bill, to keep our foot in the door on changing the system at all, but I'm rather dismayed by all of the "progressives" who decry the ruling that the mandate is unconstitutional. Forcing us to pay more than we can afford for insurance that is not required to pay claims or charge affordable premiums is NOT something we should all be fighting to preserve.
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05:07 PM on 12/19/2010
Well said. I knew the mandate was a gift to the insurance providers and a victory for the republicans. As with everything the president has done, it always favors the powers on the right more.

I would like to see the other 20 states do the same. Progressives need to do their homework so they know what's really going down in Washington and therefore vote accordingly.
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Bellanova
I'm nobody. Who are you?
05:30 PM on 12/19/2010
Thank you, Susan. My thoughts, too.

Fanned.
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WaveRhydr
DIEBOLD-WE VOTE SO YOU DONT HAVE TO
11:47 AM on 12/19/2010
Its pretty simple...if insurance co's were GOOD, and people LIKED them, we wouldnt need to be forced to buy their rotten product.
11:46 AM on 12/19/2010
Wrong. The key to providing health care for all Americans is to get rid of the health insurance companies completely, and go to the only real reform that can control costs - single payer. Every other industrialized nation in the world has done so and they all have better health care at less than 1/2 our cost.
Today the essence of insurance is the collection of premiums and making money on the investments. Many insurance companies actually contract out both underwriting and claims handling; their sole interest being collecting the premiums and investing them.
The insurance robbers made an evil pact (sometimes merely tacit, sometimes more formal) with drug companies and medical care providers and some, but by no means all, doctors, to have the costs of care escalate constantly and the cost of insurance increase astronomically to create a larger float for obscene profit for all. Some useful dupes were found in labor unions who began seeking health insurance for their members in lieu of wages and because of some taxation sleight of hand, bought from a willing Congress, employers went along happily.
Health insurancet is simply a case of rapacious gamblers using their political clout to fleece the unsuspecting public through employer, private and government premium money. In return, the insured gets nothing but false promises and the continuing opportunity for medically induced bankruptcy.
Thank you Obama and Dems for preserving this pernicious system and feathering your own financial nests along the way!
04:18 PM on 12/19/2010
Disagree but give you a fan..You want the cluster foxtrot government to run healthcare­? They can't pour water out of a boot if the instructio­ns were written on the sole..
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HUFFPOST PUNDIT
marco01
04:32 PM on 12/19/2010
Nothing but a tired old conservative myth here. Government can and has done many things very well. Governments all around the world run highly effective health care systems that serve their entire populations at half the cost of our market driven system.
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Bellanova
I'm nobody. Who are you?
05:31 PM on 12/19/2010
Fanned/faved, J, big time.
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nastywolf
...to promote the general welfare...
11:40 AM on 12/19/2010
Let each state decide how it wishes to implement health care reform, backed up by federal dollars. It used to be that credit card firms AND banks were regulated by each state. After lobbying Congress and suing for years, both industries were removed from state controls and governed by federal regulations and could do business anywhere they wanted. The result was that financial firms immediately gravitated to the one or two states that would give them carte blanche in their dealings with customers. Everyone's rates went up from 6.9% to 14.9% to 24.9% within a couple of decades.

A public option would be GOOD but federal control over the administration of health coverage is BAD. History has proven that as segments of our economy are placed under the control of the feds, states lose their ability to regulate those firms doing business within their borders. Eventually those firms all move to NDak or some other consumer-unfriendly state, rates go up dramatically while service suffers equally.
sanevoter
never missed a vote since 1965
12:12 PM on 12/19/2010
Please justify how fed control over adm. of health coverage is bad. Administration overhead is way lower than others and they process millions of claims for service each year. The new healthcare bill also removes some of the roadblocks to chasing and catching people committing fraud.
HUFFPOST SUPER USER
myth buster
03:38 PM on 12/19/2010
Show me where in the Constitution the Feds have jurisdiction over this matter.
11:39 AM on 12/19/2010
This is a good observation and may be an important factor. Other countries that have mandatory health insurance purchase (not the best choice, IMHO) at least have a fixed minimum benefit package that all health insurance sellers must offer to all citizens at the same price. This plan left the consumer to guess what benefit package they need and left the companies free to charge what ever they wanted. No direct comparison was possible, so no competition.

To compare the mandated health insurance purchase to a forced automobile purchase: You are required to buy an automobile that you must guess how far you will drive ahead of time, you will pay additional costs every time you actually use it and the it will cost you more to buy it if you are older or need to go farther. Plus, you don't actually get to see the car in action ahead of time, but you can buy a different car next year, if you can prove you bought one this year, otherwise it will cost you more. If your car is not expensive enough, based on your income, we will fine you. Can't see how anyone would stand still for buying a car that way.
sanevoter
never missed a vote since 1965
11:11 AM on 12/19/2010
This is a good time to replace the mandate to purchase insurance component with a new law requiring everyone without health insurance to pay their entire hospital and doctors bills or go to jail. There can be no negotiating for lower charges, but people could negotiate a payment schedule. This way they retain the right to care and lose the right to freeload off the rest of us. Or we could just expand Medicare to everyone, which we should have done in the first place.