Health care reform (the Patient Protection and Affordable Health Care Act, aka, "PPCA") is President Obama's most important domestic achievement, providing a means to ensure health care coverage for an estimated 92 percent of non-elderly Americans while reducing costs in the health care system.
The individual mandate, the focus of the right-wing attack against the PPCA, was originally proposed by the very conservative Heritage Foundation in 1989; it was introduced into Congress by the late Republican Senator John Chafee (R-RI) in 1993, with such conservative co-sponsors as Orrin Hatch (R-UT) and Charles Grassley (R-IA).
President Obama reluctantly embraced the individual mandate as other more straightforward solutions, such as "Medicare-for-all" or the "public option," faced obstruction in the Senate.
This coming week the Supreme Court is expected to hand down its decision on the constitutionality of the individual mandate, as well as other provisions of the PPCA. The betting in legal circles is that the Court will strike down the mandate, and leave the rest of the law intact. [We make no predictions, and believe the Court should uphold the law in its entirety both for the health of our citizens and fealty to the Constitution. The mandate and the law are clearly constitutional; but, who can determine the jurisprudential integrity of this Court?]
In conservative policy circles, the idea of a mandate is not unique to the purchase of private health insurance for those under 65. For example, the Ryan budget calls for ending Medicare in favor of vouchers, and for the elderly to use those vouchers to purchase health care from private insurers ("Voucher-Care"). How is this different from the PPCA, other than that Voucher-Care would cover those 65 and over? Indeed, Ezra Klein, provides this description of the Ryan plan:
The federal government subsidizes Americans to participate in health insurance markets known as 'exchanges.' Inside these exchanges, insurers can't discriminate based on pre-existing conditions. Individuals can choose to go without insurance, but if they do so, they pay a penalty. To keep premium costs down, the government ties the size of the subsidy to the second-least-expensive plan in the market -- a process known as 'competitive bidding,' which encourages consumers to choose cheaper plans.
Sound familiar? It should. It is what Romney passed in Massachusetts, what President Obama and the Democrats passed for the under-65's, and what Ryan would like to impose on the 65's and over who today, thanks to Medicare, have single-payer, universal health care.
So, if the individual mandate is declared unconstitutional by the Supreme Court, then so are the radical right's plots to undermine Medicare and replace it with Voucher-Care.
Or, consider the radical right's ambition for Social Security. They want to privatize it, i.e., have the payroll tax contributions that currently go to the Trust Funds, instead flow into private, individual accounts, earning interest from private banks and/or invested in private stocks and bonds that, the proponents concede, must be limited to minimize capital risk. Again, as with Voucher-Care, this would have to be mandated so the money is unavailable to the owner until age 65, and then paid out in monthly amounts. How is this not an individual mandate?
Thus, both the Ryan plan for Voucher-Care, and the radical right's ambition to privatize Social Security depend on individual mandates.
If the Supreme Court decides to invalidate the individual mandate in the PPCA -- which has to be the most benign mandate one can imagine, with penalties being small fines and with prison terms being specifically excluded -- the Court will also have eviscerated the core of the radical right wing domestic agenda to undo our Social Security and Medicare systems.
Let us be clear. If the Supreme Court upholds the PPCA, including the individual mandate, it does not mean that Voucher-Care or Social Security privatization are good policies -- indeed, they are each very bad policy -- only that, to be consistent, they would not be prohibited by the Constitution.
Prior to the rise of the modern radical right, there had not been a concerted strategy by any faction to control the court politically. Conservative presidents chose Republican-leaning justices and liberal-presidents chose Democratic-leaning justices, but, to a remarkable degree, when the justices assumed their positions, they interpreted the law as they saw it, in light of text, history, precedent, logic and their own experiences.
By contrast, the modern radical right is implementing a plan to take over the judiciary so that it can obtain rulings that fit a pre-determined ideology. Thus, the selection of Justice Scalia, with his own peculiar notion of jurisprudence, was not viewed in isolation, but rather part of a long-term strategy to seize control of the judiciary. The nomination of Harriet Myers (the woman who considered George W Bush the "smartest man she ever knew") was attacked by the right wing because she had not been nurtured through the "Federalist Society" that told judges and justices how they were expected to decide cases. Even President George W. Bush's assurance that he knew that she would never change her mind about anything was not enough to convince them that she would not vote independently once she ascended to the Court.
Now, their own Justices, without even realizing it, are poised, if they can convince swing-Justice Anthony Kennedy, to strike a dagger into the heart of radical right wing domestic policy. In a way, they should have realized this, because the president's individual mandate arose from their own institutions. Funny, hatred and fervor can be so blinding.
Could it be that the radical right has been "too-clever-by-half," and that President Obama has snookered the conservative Justices to destroy the very ideology they were sent to the Court to champion?
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Why not allow insurance companies to sell across state lines? Why not pass legislation forcing them to keep high risk clients and also refuse to grant licence to operate in states where they do. Create high risk pools like the auto insurance industry for those who are obese, smoke or participate in high risk life styles. Why must I or the government subsidize laziness and bad habits or encourage it for that matter.
There is no reason on earth that I should feel obligated or required to support freeloaders or illegal immigrants.
I was taught how to make my own way in life, pay my own freight and that only I am responsible for me!
2. Your questions are "why must the government do this or that?". You are quite correct. There is no compulsion to do it. The Constitutional question is whether it has the power to do so if it decides to do it. In the case of health care, it plainly does.
3. Insurance companies selling across state lines solves nothing! Why? Because it will cause all insurance companies to locate in the state with the most lax standards. Then, if your state has higher standards, you are screwed.
4. Question: the Food and Drug Administration regulates about 35% of the US economy. It is responsible for keeping your food safe, drugs that are pure and do what they say, and cosmetics from causing problems as rashes and scarring. If it did not exist today, and a bill to create it were proposed, what would you say?
Thanks for your comments.
2. Where is this "plain" power?!? If it were plain it would say "to regulate health care and require minimum standards of health care insurance for individuals" I don't see that "plain" language anywhere. I mean, "plainly" pigs can fly, therefore, I am correct. Because, that's the game, right, who has the wildest unprovable assertion?
3. Actually, if the insurance crosses state lines THEN it can be regulated under the commerce clause constitutionally. Or do you prefer to break the law when you regulate?
4. I'd say "where's your amendment, "constitutional scholar"? Did you go to the Obama school of "WTH is Constitutional Law"?
I want to run my own life and not have some bureaucrat calling the shots for me! I pay my freight and because of need to feel good about themselves Liberals I have to pay for the lazy and the leeches. Tell me what gives me or anyone the incentive to continue to support themselves when good-hearted people like yourselves are willing to share what you have without complaint?
Craven here likens the necessities to stimulate commerce in what was a free market that provided income to a nation to supporting social leeches.
You both don't get it!
My objection is not what government does to advance commerce and increase jobs and business in a free market. I object to supporting those who refuse to support themselves! I object to those who come here illegally to feed off of the American taxpayer.
I witnessed four generations of welfare recipients feed off the Government teats, from Johnson to Clinton.
I watched the government dip their hands in SS in the seventies, never to be repaid.
It's likely it will fail and not because there's to many baby boomers either!
If you place your trust in government to do the right thing and properly manage a social project that involves your own personal health and that of your family's then you're a fool!
The only consistent principle these justices adhere to is: If it helps corporations, it's constitutional. If it hurts corporations, it's unconstitutional.
But unless the court is even stupider than I think, they're not going to overturn the mandate while keeping the rest of the law. Without the mandate, having to abide by the rest of the law would put the insurance companies out of business. It would cost them more without adequate revenue to cover those costs. My sense after listening to all three days of oral arguments was that the court would uphold the law 6-3. But I'd say they'll uphold the whole thing or overturn the whole thing.
YES, the govt. can "mandate" that you pay your taxes, etc.
That is NOT the same thing as a "mandate" in this case.
And the "mandate" has ZERO to do with those GOP plans, since they rely on taxes, not mandates.
This is a sad, straw-grasping argument.
Wouldn't it be amusing if, after their decades of planning and plotting, all their machinations blow up in the far right's collective faces orchestrated by their groomed stooges (Roberts, Alito, Scalia, Thomas et.al.)?
LOL. James Taranto wrote a piece about a year or so back as to your assertion to the origins of the I/M. You should read it and then perhaps you might drop that canard after finding out how ridiculous you sound.
as is 1994_personal_responsibility_freedom_and_mandates.pdf by Robert E. Moffitt
available on The Heritage Foundation's own website is 1992_heritage_consumer_choice_health_plan.pdf by Dr. Samuel Butler
All three substantiate that the individual mandate was proposed under The Heritage Foundation's auspices
Additionally, the following is the summary of a Republican health care bill introduced in 1993 by John Chafee; Title I, Subtitle F of the bill includes the individual mandate. Of the 21 co-sponsors, 19 were republicans. Other bills were introduced based on the Heritage Foundation's work in the 90s; I had a list, but I'd have to hunt for the file on my PC.
when one-payer, medicare for all, whatever facilitates sustainable change is back on the table, then we can see a bit of progress....we pay more for less, and make nobody happy except the sellers of the steamer we call health underwriting.
That, in fact, is exactly what that retirement fund is: insurance against your lack of resources, otherwise, to support yourself in retirement.
Besides, the whole mandate thing being unconstitutional is nonsense, unless they want to strike down the auto liability laws in all fifty states along with it.
There is not one word in the Constitution that specifies or limits the type of law the federal government can enact, as long as (a) it has jurisdiction and (b) complies with the rest of the Constitution.
If you are in a car wreck in the next state, and get your broken leg treated there, are you covered?
BINGO! Interstate commerce.
I could go on, but will leave it at that.
Besides, one block of the Gang of Five's owners, the insurance industry, will be pissed, if they lose all that fresh meat delivered up to 'em by the ACA.
Also, there have been too many right-wing agenda items implemented that have proven to be false and harmful to the people, but their echo chamber and corporate sponsors have convinced the American people that their agenda is the correct way to govern this country.
Who would be against providing health care coverage for all Americans. Some people are, and those people have convinced many others to be against this too. But this is the 'right-wing' ideology - you are on your own folks.
Then, only extreme liberals need to be put in before January. Stonewalling them in the House should result in 1 republican arrested every day they stall. There are no shortage of criminal conservatives a 6 year old could prosecute.
Sound partisan? No. It's enforcing the law.as written, as has existed for hundreds of years. The only thing they understand is punishment and pain, and they will cry martyrdom every time regardless of win or lose. If you're going to do the time in political purgatory, may as well commit the non-crime.
principles, encourage corruption, beat on the poor to the advantage of the super-rich, and make common sense and fairness blush!
The law is supposed to be blind, but it isn't. It never is. It is ALWAYS interpreted, because there is no other way to do it. If no interpretation is required, there is no need for a court.
Unfortunately, I suspect that MY Constitution is radically different from the one in YOUR universe.
That is why we have a SCOTUS, and THAT is why THEY interpret the Constitution to come up with answers we have to live with until they are overturned or subverted sometime in the future by some later court's interpretation.
But interpret they do. And THAT is the law.
Repos have stonewalled Demo appointments and fast-tracked their own when the power was in their hands (Demos actually look at the qualifications of the candidate), so the general bias throughout the system is Repo-leaning. This makes a Federalist Society slant on decisions relatively safe from being overturned, irrespective of the merits or consistency with the Constitution.
I'll leave up to your imagination what I think should be done about this.