Can ObamaCare Survive Without a Mandate?
One additional note on the health industry Supreme Court brief I mentioned this morning: It's certainly telling that the industry seems willing to accept the law as long as the mandate holds. But on the other side of the issue, they're right. If the Supreme Court rules that the mandate is unconstitutional, then it ought to strike down the rest of the law in its entirety.
Because the law was written without a severability clause, judges are expected to determine whether Congress would have passed the rest of in the absence of any provision deemed unconsistitutional. Counterfactuals are of course unprovable, but it's tough to make a case that Congress believed the law would work without the mandate. The brief by America's Health Insurance Plans correcty points out that Congress was made well aware not only of the risks of passing the law's new insurance regulations without the mandate but also the failure of several state-level attempts to do require insurers to sell policies to all comers at rates that do not reflect an individual's health history. And given how badly the mandate polls (it's consistently the least popular provision in the law), it's hard to believe that members of Congress would have voted to pass the legislation if they thought it would work without the mandate. They wanted the law, though, and the mandate was the price.
Indeed, the administration, in arguing its case for the mandate, has confirmed its importance to the larger scheme. As Judge Roger Vinson noted in his decision to invalidate the entire law, the administration referred to the mandate as "essential" 14 times in its motion to dismiss.
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Uh.... no. It can't.
With PPACA, private insurance can't survive without the mandate.
I don't think they gave it any consideration at all.
The way the previous Congress acted reminded me of how legislators in Mexico acted during voting sessions: As long as they were still breathing and could still raise their hands, then any sort of bill presented to them by the Executive was passed with nary a whimper from anybody.
When Wal-Mart endorsed President Obama's health-care plan in 2009, CEO Mike Duke said it did so "to remove the burden that is crushing America's businesses and hampering our competitiveness in the global economy." That doesn't seem to be working out too well?for all Americans, and especially for Wal-Mart's employees.
Last week the largest private U.S. employer announced that it would no longer offer health coverage to part-time workers and would sharply increase premiums for its other "associates." Wal-Mart says the changes are a response to climbing health-care costs, not the Affordable Care Act per se, though even this is an indictment: The bill that the company claimed would help isn't helping. But Wal-Mart's errant political judgment is less important than what its crash benefits diet says about the future of employer-sponsored insurance.
Under the company's new policy, new workers who put in fewer than 24 hours a week on average won't qualify for any Wal-Mart health plan, while those under 33 hours won't be able to add a spouse. Other premiums and deductibles will jump in 2012, some by as much as 40%.
Lifted from the Wall Street Journal without attribution...
Not nice.
I had this discussion with a friend of mine who is finishing up his residency. He thinks the mandate is bullshit, but also thinks that insurance companies should HAVE to cover pre-existing conditions. It took a while for me to explain to him why not only would this not work, but insurance companies would basically be out of business instantly.
I, like others, have tried making analogies using car insurance, but even fairly intelligent people are too emotionally involved in the debate to see the financial side of the issue, which is JUST like any other type of insurance.
I'm not sure I want a doctor who doesn't understand the basic fundamentals behind insuring against risk.
The doctor sees people who don't have coverage and thus don't get the care they need. It also doesn't help that this guy is married to a girl who's dad was a farmer, and without a group plan, couldn't afford coverage for himself, which caused problems since he couldn't afford to pay for care.
Like I said, it's an emotional issue because you're talking about people's health, and lots of people know someone that couldn't get the care they needed (or were severely impacted by the bill) because of not having coverage.
What your friend doesn't seem to grasp, and it's not entirely his fault, as medical school does not teach economics per se, as is no emphasis on starting and maintaining a practice is part of most med schools' curriculum. The rote definition of insurance WRT medical care went the way of the dodo and have been replaced with the notion of insurance == payment assistance for basic care and elective procedures.
Pretty much the only economics being introduced these days in med schools are of the Marxist and Keynes variety.
lots of people know someone that couldn't get the care love and companionship they needed (or were severely impacted by the bill their personality) because of not having coverage money or good looks.
Is there now a right to sex and companionship provided at your neighbors expense? Since, yanno, sex is a right, just like medical care.
In my experience, that'd be most doctors. Not all, but most.
There is a signifcant portion of the population who, no matter how intelligent they are in the rest of life, immediately drop 60 IQ points when the subject of money comes up.
In other words, it is "necessary and proper" to the statute's regulation of interstate commerce.
You finally get it.
Thanks.
Buh-bye now.
"Buh-bye now."
Oh, how........................
adolescent.
Necessary does not imply proper.
Lots of things may be "necessary" to some larger piece of legislation that aren't appropriate subjects for regulation.
For example, it would sure help a conservation scheme a lot if everyone weatherized their homes or checked their tire pressure once a month. But I don't think anyone has suggested making these things mandatory, because they are necessary to helping the country reduce it's dependence on foreign oil.
Because positive mandates are a qualitatively different beast. And everyone recognizes this except people who are poltically wedded to the healthcare bill.
The administration has a penchant for emphatic repetition, for instance: "Pass this bill!"
Re: GW,
I seriously doubt that letting emotions override rationallity is evidence of intelligence, GW. You're being too kind.
Re: There is no "we",
Your lack of sophistication shows, TINW. The "necessary and proper" indication in Article 1 Sect 8 means to limit Congress to make laws for only those responsibilities enumerated previous to the so-called 'clause' and nothing else.
There's no interstate commerce clause. The article gives Congress the responsibility to keep commerce (i.e. trade) regular (i.e. free) between the states.
You're dumb and stupid, TINW. I am not even American yet I know the history and meaning of the Constitution ten scores times better than you.
severability was in the bill before it wasn't in the bill. That should be all the evidence the court needs to see that congress did it on purpose.
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A bit off topic, but why does everyone assume that the mandate is the way to successfully impose the guaranteed issue and community rating rules? Employer-based coveraged has had those rules for decades without a mandate and without a death spiral. They use techniques like open-season, where you can only switch or sign up for insurance at specified times of year (unless a life event exception applies). Medicare Advantage uses the same technique. Why wouldn't that work for Obamacare?
WHAT SHOULD HAPPEN
Congress and the White House should stop squandering the people's money. There are many places to cut, as discussed herein, and use savings to improve quality of basic invested entitlements. Congress should transition to improving the medical system. Vote opponents to this "out". Citizens come first.
It is time the U.S. reduces human rites and police activities for the World by lobbying the U.N., NATO, and Interpol to "take on more". 800 bases in 63 countries across the world should be reduced. Examples are fewer forces in, Bosnia, Germany, Philippines and Okinawa.
Starting with Iraq, only train for self reliance. In Afghanistan train and diminish corruption by requiring accounting practices for aid, substituting minerals mining and food crops for drugs. $34 billion lost in service contracts. Its time for oil producers to pay for military supplies and consulting.
Cut bloated federal bureaucracy and expenses. Combine CDC, EPA and FDA. Combine the FAA, NHTSA and DOT. Combine GAO and CBO. Eliminate "must spend all". Return "unused" yearly budget to the treasury. Cut budgets (other than entitlements) on an average of 10%. Implement GAO's report to Congress on eliminating duplication, overlap and fragmentation in 81 of the federal government's departmets, agencies, programs, offices and initiatives.
Eliminate all 32 czars Mr. President. Reduce your 469 member staff which makes nearly 39 million per year! Halt first lady $180,000 air force one vacation trips. Stop "multi million dollars per day" presidential-family foreign trips.
Contribute to only one of: The World Bank or International Monetary Fund or U.S. Agency for International Development and cut U.N. funding.
Reduce foreign aid bribery. For example, no aid to oil rich -Iraq. Halt $ 500 million yearly aid to Palestinians. Slash $1.3 billion annually to Egypt and Pakistan!
Charge bailed companies (TARP) for their huge executive bonuses and "golden handshakes" at taxpayer expense. Government should sell shares to recoup for taxpayer.
Congress should reduce "stimulus" expenditures by halting over budget and vote bribery "earmarks". Example: Stop "cow burp" and "drug smoking monkey" studies. Take back $13 billion unspent in states. Eliminate subsidies or tax credits that smell "earmark". Congress should not pay student loans for their staff or family from their operating budgets. Please- no renting of private or military aircraft. An example was Pelosi's family of $2.1 million for over 2 years. Congress should set commercial travel cost standards and controls.
Reduce medical cost by: allowing purchasing in any state, "tort reform", and reducing "red tape". Reduce Medicare fraud by expediting billing cost speed, and doctor/patient integrity screening within state controlled local provider groups.
Congress should enforce existing immigration laws and implement "no illegal birthrights". Entitlements or benefits should be for only citizens. Deport criminal "illegals". Only deportees and workers on Visa/Guest Programs qualify for needed medical benefits. Complete an improved fence. 56% of this border is uncontrolled.
Corporations and retirees should receive tax reductions for healthcare plans.
These actions will improve funding for:" Medicare", "Medicaid, and "Veteran's Affairs".
Healthcare quality can be at least that for Congress or the Federal Employee Health Benefits Program (FEHBP). Additional benefits are: dental coverage, improved visual coverage, no drug "donut hole", no pre-existing conditions, no deductibles and co-pays except for extended skilled level nursing.
Other benefits are aid for unemployment compensation and Social Security with reinstated realistic cost of living increases.