Obamacare

Problem: ObamaCare's Mandate Won't Work? Solution: Make It Stronger!

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Last year, ObamaCare's health insurance mandate, which requires most everyone to carry health coverage or pay a tax, survived a Supreme Court challenge when a 5-4 majority ruled it was constitutionally permissable as a tax. At the time, many of the provision's defenders argued that it was necessary in order to make ObamaCare's preexisting condition restrictions viable: With no mandate, individuals would have the option to buy coverage only when sick or in need of care. But if insurers had to sell to everyone at regulated rates regardless of health history, that would mean that people could wait until getting sick or needing care to purchase insurance. 

Now, however, it seems that some folks are worried that the mandate still won't work. They worry that the penalty it imposes is too weak, which may result in the same sort of insurance market meltdown that the mandate was supposed to prevent.

And so they want to make it stronger. Politico reports

Here's the catch: The individual mandate penalties will be pretty weak as they are phased in over two years — only $95 when they start in 2014, much less than it costs to buy insurance. And yet, everyone with pre-existing conditions will have to be accepted for coverage right away.

That's why insurance companies are telling the administration the mandate won't be enough for the first two years. They want more incentives — such as a late enrollment fee — to get healthy people to sign up quickly. Without getting the healthy folks in, the fear is that everyone's health insurance premiums could shoot through the roof when all those sick people get their coverage.

Politico reports that the idea is being called "mandate plus," and that insurers are asking for even greater penalties to inflict on those who don't get coverage. 

"The key really is, how do you get younger people to buy coverage?" said Justine Handelman, vice president for legislative and regulatory policy at the Blue Cross and Blue Shield Association. "If you can jump in and out every time you need services, costs will go up."

The mandate is the "stick" that's supposed to prevent that, by making people pay a penalty (or as the Supreme Court called it, a tax) if they don't get health coverage when they're eligible. When the mandate is at full strength in 2016, people will pay $695 or 2.5 percent of their income, whichever is greater.

But from a practical perspective, it's really not that much of a stick in the first two years. Next year, if you don't get health insurance, you'd pay $95 or 1 percent of your income — a little less than you might pay for an iPod Nano. In 2015, you'd pay $325 or 2 percent of your income.

"Certainly, we are concerned that the penalty is just $95 in the first year, which is far below the cost of coverage," Handelman said

The Obama administration isn't saying that it plans to beef up the mandate, at least not yet, but according to Politico the Department of Health and Human Services requested suggestions for expanded mandate enforcement late last year. It's a remarkable strategy, really: Fight tooth and nail to pass the mandate, knowing it won't be effective, and then use worries about its ineffectiveness as an excuse to make it stronger. 

NEXT: Morgan Stanley's Ruth Porat Reportedly Obama's Pick for Deputy Treasury Secretary

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  1. Well, now that Obama thinks he’s the God Emperor, why not nationalize healthcare right now? I mean, this minute.

    1. What, and admit that Obamacare didn’t work?

      1. It’s not supposed to work, anyway. He should admit that now and move on to single-payer. The election is over and the next one is far away. He should make the move now.

        1. This is just the first of many unworkable issues. I shudder to think what it will look like when the dust clears. Maybe the dust will never clear.

          1. unworkable issues are a feature; so is the dust never clearing. What, you thought govt would pass a law and then stop?

    2. This is what I don’t get. If the government is going to take care of the sic– the end, es todo, no mas, el punto finale–then why are we messing with these mandates? Just hand everyone a nat’l id card which will be accepted at any clinic, nationwide, and be done with it.

      1. But we’re supposed to pretend that Obama isn’t a socialist.

        1. If Obama’s not going to pretend, then I won’t either.

        2. How dare you sir! The correct term is ‘Progressive’ and I have been assured by the left that they have nothing in common with Socialists. Any suggestion otherwise are just the ramblings of extreme rightwing racists and cornball brothers.

          1. The correct term is corporatist.

  2. The key really is, how do you get younger people to buy coverage?

    Now, I’m just spitballin’ here, but maybe if you sell them coverage they need at a price they can afford, that would be a start?

    1. Whoa, slow down there, Adam Smith. You can’t just go around offering goods and services for market clearing prices without a regulatory board’s ok. That’s tantamount to anarchy, which is the same as chaos.

      1. If people were allowed to do that, they might charge people who are more likely to get sick more in premiums.

        And that would be unfair.

    2. No, no, RC, you’re going about this all wrong. You get them to buy coverage by forcing them too. Don’t you get this “government” stuff at all?

    3. Of course, they don’t want young people to buy coverage. They want young people to pay exploition-level prices so they can cross-subsidize old people.

      1. It’s just a way of indirectly raising taxes for young working and middle class people without SAYING that you’re raising taxes for young working and middle class people.

        1. Look, a few of the people who fought WWII are still living. Surely those who benefited from their sacrifice can pay a little back? All the other piece of shit oldsters who are looting current and future generations? Carousel.

      2. Say, that’s a great idea for a retirement program!

    4. I think the argument goes that the coverage the some people need can’t be afforded.

      1. Fortunately, very few people are in that situation. So few that it could be easily handled by charity. So why pass a law that effects everyone?

        1. Because a law that only hurts some people isn’t fair. The law should hurt as many people as possible.

    5. that’s just crazy talk.

    6. Perhaps you could try charging them an amount that is commensurate with the actual risk of their using medical services.

      Just a thought.

      1. Perhaps you didn’t get the memo. Birth control costs $3000 a year.

        1. Well duh! My Goldschlager brand condoms with real gold inlay don’t come (hey) cheap.

  3. “…insurers are asking for even greater penalties taxes to inflict on those who don’t get coverage.”

    Ahem.

  4. At the time, many of the provision’s defenders argued that it was necessary in order to make ObamaCare’s preexisting condition restrictions viable

    Nothing can make this law viable. Case closed.

  5. insurers are asking for even greater penalties to inflict on those who don’t get coverage.

    You could try the novel idea of letting insurers not cover conditions that existed before people bought coverage.

    1. You heartless monster, I suppose you also want insurance companies not to have to insure houses that are already burning down.

    2. Hazel, you are TOO funny. I commend your sane line of thinking. Are you running for any office i might vote for?

  6. Finally, will you libertarian extremists admit that the free market in health care doesn’t work and that we need to adopt single payer?

    1. What free market in health care?

    2. Single-payer legal care. Because no lawyer does anything worth more than minimum wage.

      1. [Loads high-capacity magazine. Squints meaningfully at Ted.]

  7. When the insurance companies were writing the law, did they not know they taking part in phasing in single payer?

    1. they saw millions of people required by law to purchase their product. and the government paying for those who couldn’t afford it on their own.

      1. Exactly. Short-sighted opportunism is short-sighted.

        1. There is good money in ropes.

    2. They working on the age old hope that the crocodile will eat them last.

    3. Sure they did. That’s why they wrote the law so that their rise in short-term profits outweighs the fall in their going-concern value.

    4. When the insurance companies were writing the law, did they not know they taking part in phasing in single payer?

      I think they see having a hand in a single payer program. I doubt the US will have a HNS style system for decades. Why bother when you can have an ugly stepchild public/private system where you get fucked out of money by rent-seeking corporations at the point of the government’s gun?

      1. I think they see having a hand in a single payer program.

        Bingo. Medicare hands out nice, fat administration contracts to “fiscal intermediaries”. After OCare completes the cartelization of health insurance, tehy will transition into quasi-public “partners” of the fed single-payer program.

        All the profits, without the risks and headaches of being private-sector.

  8. There must be a point at which the “penalty” ceases to be a tax and becomes a penalty, right? It will be interesting if it goes back to the Supreme Court in a few years when the fine is $250K.

  9. Oddly enough, a nice lady from my insurance agent called me the other day to warn me the next bill will be ~15% higher.

    What a surprise.

  10. Why don’t we just make it so that if you get sick and don’t have insurance, your insurance coverage you buy later doesn’t cover your illness. That way people won’t game the system and buy insurance after they get sick and even if they do, it won’t cost insurance companies.

    It is so crazy, it just might work.

    1. That would be inhuman. Far better to subject to them to all sorts of financial penalties, and when it turns out lots of people don’t pay them, to jail terms.

    2. Why don’t we just make it so that if you get sick and don’t have insurance, your insurance coverage you buy later doesn’t cover your illness.

      Or, the way “pre-existing condition” exclusions used to work.

      You could get insurance even if you had a pre-existing condition all along. It just wouldn’t cover your pre-existing condition.

  11. maybe if you sell them coverage they need at a price they can afford

    That’s ridiculous; why not suggest subjecting health care providers to the discipline of the marketplace, while you’re at it?

    1. /starts CPR on AMA and AHA lobbyists.

    2. Hey, let’s not let state governments get off scot free. They’ve enacted, like, 2,000 mandated coverages.

      After all, those damn insurance companies better cover the costs of my hair prostetics, midwifery, and gastric pacemaker!!!

      1. you have a gastric pacemaker? Next thing, you’ll want free monocle replacement for life. And polishing. And slave labor to bring you puppies to kick as a means of preventive mental health care.

        1. I’m sold. How much for this policy?

  12. In the sidebar I have an ad for a book from Cato called “False Idol” referring to Obama’s cult of the presidency.

    I wouldn’t call Obama a false idol, he’s very much a real idol.

    1. Just not an American Idol! 😉

  13. The cruelest aspect of this is the Medicaid expansion. they’re going to give people coverage that fewer and fewer docs are going to accept.

    1. Tru dat. Fewer doctors are becoming GPs, too. Can’t have preventive care for all if you don’t have the docs.

      1. oh, they’ll bake in some means of coercion, like med school loan reimbursement or loan forgiveness.

        1. We need laws to place similar coercion on new lawyers. Watch the lawyer-legislators have a conniption fit.

  14. New York: Boldly making new firearms restrictions that will be praised to no end, but will do dick, and all while stomping all over the 2A.

    New definition of the completely made up “Assault Weapon” (though how they’re changing it remains to be seen).
    7 bullet mag restriction down from 10.
    Tougher penalties for gun crimes.
    Requires background check for all private transfers.
    Some other useless shit that will only serve to further erode the 2A for law abiding citizens.

    1. Try not to act surprised.

      1)7 bullet mag restriction down from 10.

      Check

      2) Tougher penalties for gun crimes.

      Check

      3) Requires background check for all private transfers.

      Check

      4) Some other useless shit that will only serve to further erode the 2A for law abiding citizens.

      Check and double check.

      It’s all playing out according to script. The next time these “fixes” don’t stop a massacre the Feinsteins, Schumers and Bradys of this world will ascend a new pile of corpses that they’ll get it right the next go around.

      1. Shit!

        a new pile of corpses ……that they’ll get it right

        ….and say….

        Fucking ADD.

    2. Post McDonald, all of that shit is going to end up in Federal court anyway, so hopefully a judge issues an injunction against enforcement.

      1. The really big one for me is the mag restrictions. I will not be mandated to be at a disadvantage in the event I were to ever ned to defend my home and family against invaders.

        I’m sure that in the event a mag restriction comes in to play, people will go to jail for the horrible crime of having too many bullets in their gun while repelling an intruder. It’s fucking sick.

        1. I’m sure that in the event a mag restriction comes in to play, people will go to jail for the horrible crime of having too many bullets in their gun while repelling an intruder. It’s fucking sick.

          If you can’t hit the intruder with 7 shots, what makes you think you can hit him with 10?

          /gun grabber

        2. Not only that, but it will be an excuse to search the home. Find a joint in the sock drawer and there’s a mandatory 25 years for being a drug addict with a gun. Find a couple more guns and now it’s life in prison.

          They would rather you die with a phone in your hand than live with a gun in your hand.

        3. I’m sure that in the event a mag restriction comes in to play, people will go to jail for the horrible crime of having too many bullets in their gun while repelling an intruder.

          Unless you are a TEAM player like David Gregory in which case it is A OK!

    3. CA and NY are engaging in the low-capacity race. I wonder which one is going to restrict semiautomatic magazine capacity to 1 round first.

      1. http://www.cga.ct.gov/2013/TOB…..R00-SB.htm

        CT legislator has proposed just that.

      2. Lever actions for everybody! FORWARD to the 19th century. Commissar Obozo will repeal your bourgeois industrial revolution and end the infamy of semi-automatic weapons (except for the state, of course.)

    4. I have a question for you guys. I don’t know anything about guns. Never cared cause I figured if the shit hit the fan, I’d get one then. Now I’m pretty sure they want to set up a database so they can confiscate later down the road, and I want to get one now before they do that. But I don’t want to go to the local Gander Mountain since I’ve read that if they do a background check, the retailers have to keep records of that for 20 years, and I’m pretty certain the gov’t will just force them to hand over that info when they start confiscating.

      So is it possible to buy a gun legally without a background check?

      1. Why buy it legally? But it illegally.

        That way there’s no chance it can be traced to you.

        1. I hope you’re joking, sarc.

          1. No, I’m not. Pay cash to a private party and give them a fake name. No way the gun grabbers will ever know.

            1. Even a private party is supposed to get ID to determine whether the person really is from the same state.

              1. supposed to

                Start waving around the Benjamins and people tend to forget such things.

                1. Except the state is waving around mandatory minimum prison sentences to help them remember.

                  If a stranger comes to me with no ID asking to buy a gun, I’m assuming it’s for a bad reason. Not “fear of confiscation”. And that bad reason can get me in a shitload of trouble if I go through with it.

              2. Yeah, but do they have to keep a record of it? That would seem outlandish but like I said I’m a complete n00b. I certainly wouldn’t mind presenting an ID.

                1. They don’t have to keep a record, though for their own sake they probably should write your info down in case the gun is later used in a crime. But they don’t have to.

                  1. That’s probably good enough. My guess is once they start confiscating, “records” like that will find their way into the trash can if the person gives a shit at all about the 2nd amendment.

                    1. If something blatantly unconstitutional like confiscation began I would be OK with lying to govt agents about such things. But we’re not at that point yet, and hopefully not ever. So abide by the law.

                    2. Oh, I know we’re not at that point now. But 10 years from now, who knows? I’m thinking more about the records. 10 years from now they still have the records from today.

                    3. If something blatantly unconstitutional like confiscation began I would be OK with lying to govt agents about such things.

                      Best not to leave them a paper trail if it can be avoided. Don’t make their job easy.

      2. If you buy from someone within your state of residence, maybe. Depends on the state.

        Buying from a person outside your state needs to go through an FFL, so that won’t work.

        1. It’s Tennessee. I assume they’re relatively lax here, but that’s just a guess. Any suggestions about how to find private sellers?

          1. I have no idea about TN’s laws. PA has fairly lax gun laws in general, but some weird quirks like requiring that handgun sales go through an FFL or a sheriff’s office. So don’t assume.

            Gun ranges have private seller ads on their clubhouses sometimes. There are some state-specific websites too. I use PAFOA’s classifieds occaisionally.

            1. Thanks. There’s one near my house. I’ll try that. Hopefully I can work something out but it seems like people are hoarding right now.

              1. They’re only hoarding certain things, like AK and AR type guns, and large capacity magazines. Plus some savvy folks have realized they can get a pretty penny for the semiauto rifle they barely use (the market at work!).

                If you want a bolt-action rifle, long barrel shotgun, or single-action revolver, those are still the usual prices and widely available. Of course they’re not the best defense options if that’s what you’re looking for.

                1. “They’re only hoarding certain things, like AK and AR type guns…”

                  Yeah, well, that was kind of my thought, actually. If for no other reason than it might not be an option soon. I looked at some briefly like 6 months ago but passed because I didn’t want to drop the $2,000 at the time and I figured I’d wait until I had more time to go to a range and learn how to use it. This is what I get for putting it off…

                  1. Yeah, well, that was kind of my thought, actually. If for no other reason than it might not be an option soon. I looked at some briefly like 6 months ago but passed because I didn’t want to drop the $2,000 at the time and I figured I’d wait until I had more time to go to a range and learn how to use it. This is what I get for putting it off…

                    $2K for an AR? There’s no reason why an AR should cost you more than $900 6 months ago. Many for even less than that.

                    1. I never really got far enough to have a model picked out. But all the assault rifles seemed to be $1500-$2000 plus we have a 10% sales tax here.

              2. Hopefully I can work something out but it seems like people are hoarding right now.

                That is true, but I’m counting on some of the people who have been snatching up guns over the last six months to need a quick cash infusion that will benefit my desire to purchase a gun without leaving a paper trail.

        2. Buying from a person outside your state needs to go through an FFL, so that won’t work.

          Only if you get pulled over and searched while driving home.

      3. Yes. In most states you can buy a gun from another private party with no checks of any kind.

      4. This is why we need a gun mandate with a “tax” for noncompliance: to stop people from waiting until after shit hits the fan to buy a gun and force the rest of us to subsidize their defense.

      5. So is it possible to buy a gun legally without a background check?

        Yes.

        Just not a new one (or not one that has never had another owner anyways). You can go straw buyer route, but there’s no need for that.

        For instance, if you came to my house right now, I could legally sell you any gun in my collection, and you can walk out the door with a shred of paper for the government to follow.

        1. So, madL, maybe you can help me. I’m looking at an M4 with 900 rounds of ammo. Guy says make an offer. Says he has $2100 in the gun right now. What should i offer?

  15. And right after that, they need to fix the problem of companies reducing workers’ hours to avoid having to pay for their heath insurance by redefining full time to be 5 hours a week.

  16. My favorite gun is my 1911, so I can’t get too overwrought about seven round mags.

    However, the Beretta and the S&W 5900(I think that’s what it is- I’m not going over there and fish it out of the pile to double check.) are both at least 14 rds. I should get at least one more mag for each of them at the gun show.

    1. I just bought an FN FNX-45 Tactical which is 15 rounds of 45 ACP goodness. I bought it right after Newtown specifically because I thought hi-cap magazines would be their target.

      I refuse to be legally handicapped by the government while protecting my home. The government can go fuck itself.

  17. Any suggestions about how to find private sellers?

    The want ads.
    Seriously; most newspapers in places where private sales are not locally restricted/prohibited have guns for sale in a “sporting goods’ or even “guns/ammo” section.

    You could try the gun club or gun shop, but they might think you are working on behalf of Mayors Against Legal Guns, and tell you to go fuck yourself.

  18. …”a 5-4 majority ruled it was constitutionally permissable as a tax”…
    That has to be embarrassing.

  19. If a stranger comes to me with no ID asking to buy a gun, I’m assuming it’s for a bad reason.

    We already knew that, Sally Kneeknocker.

    1. And what assurances do you gain, exactly, if he shows you his driver’s license?

  20. If I am not mistaken, the fact that the mandate was so small and ineffectual as a penalty was central to John Roberts’ reasoning – such as it was – in determining that it was a tax, and not a penalty. Given that, I can’t see how they can possibly do anything to strengthen the mandate without subverting Roberts whole argument and rendering it – at least in John Roberts’ mind – an unconstitutional penalty, and not a constitutional tax.

  21. If you are strong, then you should be work.

  22. Remember though, people are fundamentally nice! chat

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