My family nervously awaits the Supreme Court's decision on the Affordable Care Act that will prohibit insurance companies from denying coverage to people with pre-existing conditions starting in 2014. A decision striking down the individual mandate, or worse still the entire law, will spell doom for my kids who are uninsurable in the individual insurance market because they are chronically ill with Type 1 diabetes and epilepsy.
Anyone following the case will remember Attorney General Donald Verrilli's rough start to the argument on the individual mandate. How could we forget the sips of water, the stumbling and coughs, then more sips and coughs, and finally, the stammering?
But between the coughing, stammering and stumbling was the beginning of a cogent explanation of how insurance reforms in the Act -- including the individual mandate -- will fix the vexing problem of insurance companies refusing to sell policies to people with pre-existing conditions.
General Verrilli didn't finish his explanation because Justice Scalia interrupted to ask the first question of the day. His question -- which went unnoticed by media -- betrayed something remarkable and shameful for a Supreme Court Justice deciding the destiny of more than 30 million Americans who will directly benefit from the law. The question exposed Justice Scalia's profound ignorance of Congress's rationale for the individual mandate.
Most Americans have no idea why Democrats imposed the exceedingly unpopular mandate - other than Republicans' claim that it's a government takeover of health care. This is no wonder because the Obama administration has treated its marquee accomplishment like a political hot potato and has failed abysmally to explain the mandate or promote its many benefits.
But Justice Scalia has no excuse. The individual mandate is the constitutional issue in the case. Didn't his clerks write a memo on this subject? Didn't he read the government's briefs?
Justice Scalia's telling question, paraphrased here, was: Why can't Congress simply require insurance companies to cover everyone regardless of whether they're sick and directly prohibit them from charging sick people more than healthy people?
The answer is a little complicated, which explains why the public believes the Tea Party's talking points. So here goes: The individual mandate is necessary to achieve a financially sound system of health care coverage. Without a mandate, healthy people won't buy coverage until they become ill. With only sick people in the pool, claims and premiums will skyrocket, leading the inevitable collapse of the entire system. There -- that explains it.
During the argument, the Court's conservative justices portrayed the mandate as coercing Americans to buy insurance they don't want or need. Justice Scalia joked that if the government can require citizens to have health insurance, it could force us to eat broccoli and go to the gym. I've come to expect this kind of hyperbole from Tea Partiers on Medicare and people like the justices who have great insurance and taxpayer-subsidized premiums through the Federal Employees Health Benefit Plan.
So who are the victims of the individual mandate? Why must the Supreme Court protect them from this tyrannical law? The conservative justices should know from the scores of briefs filed in the case that the vast majority of Americans -- an estimated 80 percent -- will automatically satisfy the individual mandate when it takes effect in 2014. This is because they already have coverage, which they can keep, through their employer, an individual health plan, Medicare or Medicaid. Millions more will be exempt for other reasons including their low income.
It turns out that the uninsured who will be "forced" to buy insurance are precisely the people who will benefit from the law, including the 13 million uninsured young adults. Justices Scalia and Alito presumed that young adults are healthy and don't want to spend their pennies on health insurance. But the fact is that young adults are disproportionately uninsured -- not by choice -- but because they work at low-paying jobs without benefits. Their health has suffered because they can't afford needed care, and many are saddled with crippling medical debt, according to a recent study.
The same is true for the rest of the 49 million uninsured. Most are working poor whose employers don't offer coverage. They want health insurance but can't afford it, a problem that will be solved by premium subsidies and the Medicaid expansion. Some 30 million of these uninsured Americans -- and many like my kids who have pre-existing conditions -- will breathe a collective sigh of relief if the Act takes full effect in 2014.
So it appears that the Court's conservative bloc is ready to gut the Act or toss the whole thing -- without concern for the health and financial well-being of millions who will benefit -- because of a mandate they have not taken the time to understand.
Prominent constitutional scholars, including Reagan's former Solicitor General Charles Fried, believe that Congress had ample authority under the Commerce Clause -- as interpreted by longstanding precedent -- to impose the mandate as part of a comprehensive scheme for regulating our health care markets. Many, many cases acknowledge Congress's plenary power (read: sweeping and nearly absolute) under the Commerce Clause.
Under our Constitution, Congress -- not the Supreme Court -- has the power and the responsibility to address national problems like our ineffective, unjust and staggeringly expensive health care system for our collective well-being. Perhaps cooler heads will pull back from jumping into Congressional sausage-making on the realization that health care is not broccoli, and access to health care is not a joke, except to some who have it.
The Court waded into presidential politics in Bush v. Gore to hand the election to George Bush and then went out of its way in Citizens United to open the spigot of corporate money into our electoral process. As a result, the Court's approval rating has plummeted. The justices have been forewarned: the public knows a power grab when they see one.
Follow Kathie McClure on Twitter: www.twitter.com/purplebuslady
As for clueless, many constitutional scholars believe the broccoli argument is a bunch of bunk. Scalia's broccoli buy-in says to me he's a fallible ideologue, even if a smart one.
http://www.nationmaster.com/graph/hea_spe_per_per-health-spending-per-person
https://www.cia.gov/library/publications/the-world-factbook/rankorder/2102rank.html
I want health care, not health insurance.
Also, your defense of the 1% is noble but I think you miss the point. We live in a supposed Democracy. But, the majority of the wealth in this country is controlled by a small minority, with much more influence over our Democracy than the 99%. Dough Boy Mitt, has not one clue about the lives of people who count their money in 20s,10s, 5s, 1s and change. Also, because your Gay why would I assume you wouldn't vote for a GOP ticket. Silly me, I generalized my point. I used a poor example of human behavior. If the bear wants to eat me, I resist waking into his jaws. They would jail you if they had the power to. They don't even pretend to like you or what they see as disgusting behavior on your part to have the audacity to love someone of your own gender. The Right which is currently pushing the GOP on social issues. Gay rights is a big social issue with the Right. Let's see what the SCOTUS does with Prop 8. My bet is they uphold the 9th circuit ruling. SCOTUS has set their own precedent on Gay Rights with Romer v Evans, which the 9th circuit cited quite a bit in their Prop 8 ruling.
I listened to those opposed to the reform law for many hours. Many challenged me over those five months. I cannot remember a single detractor knowing anything really about the law. They relied on talk radio one liners. And they spoke this misinformation with great emotion. They were not rational but rather "programmed" by hate speech talk radio whose purpose is to take down Obama not give correct information.
The cost of Health Care can be adjusted by targeting specific areas and addressing them, not dismantling the entire system and giving ultimate control to the Federal Government.Madison and Jefferson were brilliant men regarding history, society and government designed do be in the power of the people not the Government. BTW, I don't watch Fox News or listen to talk radio.Nor do I consider myself conservative. I know I'm scary, I think for myself.
I agree except for the second sentence. The problem is that if you force insurance companies to cover people with pre-existing conditions, it ceases to be insurance.
Insurance is used to cover the cost of risks. Risks are potential future events that may or may not happen. A person with a pre-existing condition isn't a "risk" they are a "liability" and covering their medical expenses isn't "insurance" it is "subsidization."
Mandating that healthy people buy "insurance" is really forcing them to subsidize other people's expenses.
As for your second sentence, this is a problem created by the law itself. Of course the big-government liberal solution to "making healthcare affordable" does nothing to bring down the cost of healthcare; it only spreads the growing cost around to more people. It forces insurance companies to cover people with expensive pre-existing conditions and forces healthy people to share the expense.
"So who are the victims of the individual mandate?" As with all entitlements, the victims are the people being forced to pay for it.
The difference is the CHOICE I have on whether or not to purchase insurance and the details of the coverage.
Here's some Insurance 201: The only insurance you are REQUIRED to purchase is that which covers OTHER PEOPLE'S property that you are liable for.
In the case of car insurance, you are generally required by your state to have insurance to cover damages to the other person's property and/or person; not your own. If there is a lein on you vehicle, you may be required by the leinholder to have collision and comprehensive insurance to cover your vehicle because they own a stake in it. If you own your car free and clear you do not have to insure it against damage; that is your choice based on your risk and ability to cover the expenses if necessary.
Similarly with home-owners insurance, you are required by the mortgage holder to have insurance to cover the property they have a stake in.
"Insurance is how our society spreads risks. Without it, we'd all go broke through one loss or another."
Maybe, maybe not. Again, a "risk" is something that MAY OR MAY NOT happen. It's up to each of us to decide how much risk we're willing to take and how much we should mitigate through insurance. If I choose to forgo insurance and go broke because of that choice, that's my problem.
Untrue. The premise is that everyone should have coverage --that they pay for to the best of their abilities-- so that the risks will be shared -- unless you want to live in a country where sick people are dying in the streets.
My hope is that with the Heritage Foundation "force the poor to buy something they don't want" plan (we want health care, not health insurance) overturned that single payer, either designed that way or through an expansion of Medicare, will finally bring health care costs into line with the other industrialized countries, especially Canada. Until then, I am willing to tough it out.
Governments rise, governments fall, normally politics will make unusual coalitions, and the political pendulum should be free to swing, but the few people on the right side of the swing seem to be very heavy in their part of the tug of war.