flusterbunny: (karl pilkington)
[personal profile] flusterbunny
Howdy. Long time no post.

Okay, so my very knowledgable friend had this explanation of my biggest qualm about the health care bill.

I want universal health care. But I'm told this bill contains a provision where Americans will be REQUIRED to purchase health care, and will have their payments subsidized by the government. If they don't purchase health care, they will be fined.

However, REQUIRING someone to purchase health care at all seems completely wrong to me. You can just choose not to drive a car for car insurance and the like, but you can't choose to not be alive - suicide is illegal.

So my friend seems to think that people are champing at the bit to be the first one raising a legal challenge to being REQUIRED to buy health care. Which in a few years will reach the Supreme Court, which will then be overturned because it's unconstitutional to REQUIRE this. His thinking is when that happens, the entire health care reform package will also be overturned with it, thus rending ALL THIS SHIT MOOT.

Someone tell me this isn't true. Someone tell me this wasn't a bunch of painful shit for no net gain.

Date: 2010-03-24 06:38 am (UTC)
From: [identity profile] alryssa.livejournal.com
Here is what that "mandate" means:

Starting in 2014, most Americans will be required to buy health insurance or pay a penalty. (key word, MOST)

* The penalty will be phased in, starting at $95 or 1 percent of income in 2014, whichever is higher, and rising to $695 or 2.5 percent of income in 2016. But families would not pay more than $2,085.

* American Indians don’t have to buy insurance. Those with religious objections or a financial hardship can also avoid the requirement. And if you would pay more than 8 percent of your income for the cheapest available plan, you will not be penalized for failing to buy coverage.

* Those who are exempt, or under 30, can buy a policy that only pays for catastrophic medical costs. It must allow for three primary care visits a year as well.



Of course, this is subject to whatever changes may arise between now and then (I don't know precisely what's in the reconciliation bill), and I don't know how they plan on enforcing it precisely.

Full rundown on everything this current legislation means is up here:

http://www.nytimes.com/interactive/2010/03/21/us/health-care-reform.html


Also, Federal law supercedes that of the states, so the likelihood of this becoming a Supreme Court issue is rather slim. After all, if you own a car, you're mandated to buy car insurance from a private company. If you buy a house, you need homeowner's insurance. This isn't unprecedented by any stretch of the imagination. I don't particularly care for this compulsory element of it, to be honest; not without the benefit of a public option and some real, actual competition.

Date: 2010-03-24 06:39 am (UTC)
From: [identity profile] autobotsrollout.livejournal.com
I want universal health care. But I'm told this bill contains a provision where Americans will be REQUIRED to purchase health care, and will have their payments subsidized by the government. If they don't purchase health care, they will be fined.

However, REQUIRING someone to purchase health care at all seems completely wrong to me. You can just choose not to drive a car for car insurance and the like, but you can't choose to not be alive - suicide is illegal.


Look at it like this. I live in a country with universal health care.

The benefit of universal health care is lower cost. You get lower cost because you get a bigger risk pool: IE, everybody. That's how health insurance works, after all: healthy people subsidize the costs of sick people, assuming that some day they will get sick and then it will be up to other healthy people to subsidize them, and so on and so forth.

But the requirement of universal healthcare is universal enrolment. I don't get to say "welp I feel pretty good right now so I'ma skip paying my healthcare taxes this year." And I shouldn't, because my healthiness is subsidizing somebody who needs help a lot more than I do.

The individual mandate is what you have to have if you want universal coverage - or the "nearly there" coverage that the HCR bill provides. Without an individual mandate it simply doesn't work. Period. Now, the government's provided in the HCR bill for people who might have trouble purchasing insurance by including a number of measures to help cover poorer people: subsidies for purchasing insurance, increased access for poor people to Medicaid, a poverty exemption if you just can't afford to buy insurance, et cetera.

(And frankly, given that the law now forbids insurers from refusing to cover you because of a pre-existing condition, one might consider the fine for not having insurance the cost you pay for being able to get insurance later when you suddenly feel a bit of an odd pain in your side one day, go to the doctor and then find out you have stage II cancer all of a sudden.)

As for your friend's concern, tell him not to worry. The Supreme Court might have a slightly more conservative view of the Commerce Clause right now than previous Supreme Courts, but all of this was essentially put into the tax code explicitly to prevent constititional challenges. Any challenge that overturned HCR would essentially overturn 150 years of federal division of powers law in the USA; even Scalia isn't gonna go that far.

Date: 2010-03-24 06:45 am (UTC)
From: [identity profile] lithera.livejournal.com
*points up*

As usual, Mr. Prime here says it all better and faster than I can manage.

Date: 2010-03-24 07:09 am (UTC)
From: [identity profile] flusterbunny.livejournal.com
Ah, thank you both. I was concerned about whether or not there were poverty exemptions and the like, because I know how much of a cornholing I got from having to buy COBRA coverage during my unemployed year. It seemed sort of oxymoronic to say 'let's cover these poor people by forcing them to buy health care.' Obviously, I've not done my homework.

If, by chance, a challenge DID go to the Supreme Court, do they have the option of essentially 'line-item overturning' one aspect of the HCR bill, or is it all or nothing?

Date: 2010-03-24 02:30 pm (UTC)
From: [identity profile] candidgamera.livejournal.com
Obviously, the leader of the Autobots will have a more nuanced legal opinion than I, but the Supremes can invalidate portions of a law without affecting the substantive whole, should they choose to do so.

Everything I'm seeing from people with credible legal opinions is that this law is not unconstitutional; we have numerous similar examples of things in this country, none of which have been invalidated.

http://www.fivethirtyeight.com/2010/03/constitutionality-of-mandatory.html - more info.

Date: 2010-03-24 02:31 pm (UTC)
From: [identity profile] ahumblepen.livejournal.com
Alas, I think not having done one's homework is a pretty systemic problem in the country these days; somebody hears some somebody else that they're going to be forced to buy healthcare and they get all riled up and frothy and refuse to hear reason before they ever bother to actually read the facts. Luckily you are not one of them folks.

Also I have no idea if you can only turn over bits of a bill instead of the whole thing, this comment is largely a useless one! Whee!

Date: 2010-03-24 08:32 pm (UTC)
From: [identity profile] alryssa.livejournal.com
I wouldn't be surprised if COBRA is either changed significantly or falls by the wayside in the wake of this.

Date: 2010-03-24 01:00 pm (UTC)
From: [identity profile] vazjr.livejournal.com
I don't remember El-Jay skills to hyperlink this right now, but try this copy/pasting this addy if you want more education on the Reconciliation Act:

http://www.kff.org/healthreform/upload/housesenatebill_final.pdf


Focus on the left column. It's sponsored by the Kaiser Family Foundation. Not aware of any left or right bias they might have, but I've been relying on their chart comparisons to help me get a clue as to what's going on.

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June 2010

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