# 6th Circuit Court of Appeals upholds Affordable Care Act **URL:** \ **Category:** Great Debates\ **Created:** [June 30, 2011, 12:00am UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331 "2011-06-30T00:00:13Z")\ **Posts on this page:** 20\ **Page:** 2
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [June 30, 2011, 11:26pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/21 "2011-06-30T23:26:35Z")
Like has been pointed out to you before, you can choose not to buy a car. You _can’t_ choose never to need health care. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 30, 2011, 11:35pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/22 "2011-06-30T23:35:14Z")
> [@Mr\_Smashy](#): > > Like I’ve pointed out before on these lefty boards, would it be constitutional for the Feds to force people to buy cars, if they thought that would be good for the economy? Or eliminate the free-rider syndrome (in this case, literally) by obviating the need to build mass transit? > > Or would that be an abuse of Congress’ powers, of overreaching? (and probably as blatantly against the 10th amendment as it gets) They force us to pay for roads, highway patrol, and public transit via taxes on local, state and federal levels. Not that I’m complaining. But we already are forced to pay for transportation expenses via taxes. ---
**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\ **Post date:** [June 30, 2011, 11:39pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/23 "2011-06-30T23:39:39Z")
> [@ElvisL1ves](#): > > Like has been pointed out to you before, you can choose not to buy a car. You _can’t_ choose never to need health care. Plus me not buying a car doesn’t increase the cost of buying a car to you. It costs about $1000 in premiums per insured family (out of roughly 12k a year in premiums) to cover the cost of the uninsured when they can’t pay medical bills and the costs are distributed across the medical spectrum to other people. ---
**Author:** ![BrightNShiny](https://avatars.discourse-cdn.com/v4/letter/b/7bcc69/32.png) [@BrightNShiny](https://boards.straightdope.com/u/BrightNShiny)\ **Post date:** [July 1, 2011, 1:13am UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/24 "2011-07-01T01:13:13Z")
Re: the tax issue, rather than getting into this argument again, I’ll just post excerpts from the [concurrence](http://www.ca6.uscourts.gov/opinions.pdf/11a0168p-06.pdf): > [@](#): > > ``` > That Congress placed responsibility for enforcing the penalty with the IRS does > > ``` > > not make the minimum-coverage provision a tax. The IRS enforces other regulatory > penalties, see, e.g., 26 U.S.C. § 9707 (penalty for mining operators who fail to pay > retirement health benefit premiums); § 5761(c) (penalty for domestic sales of tobacco > labeled for export); § 527(j) (penalty for failure to make required election-related > disclosures), yet that does not transform them all into taxes. Congress, at any rate, had > practical reasons for housing enforcement of the mandate in the IRS. The IRS already > has an enforcement regime in place, under which individuals must file returns once a > year, creating a ready-made vehicle for annual reports about whether they have > purchased the requisite insurance. Whenever Congress creates a new penalty, it need not > create a new federal agency to enforce it. > > ``` > Even then, the Act does not treat the mandate like a tax, as it prohibits the IRS > > ``` > > from using its most salient enforcement tools in collecting the penalty. The IRS may not > place a lien on the property of an individual who does not comply with the mandate and > does not pay a penalty. See id. § 5000A(g)(2)(B). Not so for individuals who fail to pay > their taxes. See id. § 6321. The IRS may not use its “levy” authority, prohibiting it from > garnishing wages or seizing property from individuals who fail to obtain insurance. See > id. § 5000A(g)(2)(B). Not so for individuals who fail to pay their taxes. See id. § 6331. > And the IRS may not initiate a criminal prosecution against individuals who fail to buy > insurance. See id. § 5000A(g)(2)(A). Not so for individuals who fail to pay their taxes. > See id. § 7201. As it turns out, all the IRS may do to enforce the penalty is set off unpaid > penalties against an individual’s refund (if there is one) or launch a civil action against > the individual. See id. §§ 6402(a), 6502(a), 7401 et seq. The government does not > traditionally collect taxes in this way. (p. 32-33) (I’m not doing formal legal citations) ---
**Author:** ![BrightNShiny](https://avatars.discourse-cdn.com/v4/letter/b/7bcc69/32.png) [@BrightNShiny](https://boards.straightdope.com/u/BrightNShiny)\ **Post date:** [July 1, 2011, 1:16am UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/25 "2011-07-01T01:16:11Z")
Just for completeness, I did strip out a cite from the above quote, for formatting reasons. Now, for a little bit more: > [@](#): > > That Congress has a “comprehensive” and “plenary” power to tax, U.S. Br. at 58, > shows that, if the legislature had used taxes in this part of the Affordable Care Act, the > Act likely would be constitutional. Unfortunately, there’s not a full analysis in the concurrence of this part of the tax issue. ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [July 1, 2011, 1:48am UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/26 "2011-07-01T01:48:24Z")
> [@ElvisL1ves](#): > > Like has been pointed out to you before, you can choose not to buy a car. You _can’t_ choose never to need health care. You can choose to never need health insurance. Warren Buffet could self-pay. ---
**Author:** ![Johnny\_L.A](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/johnny_l.a/32/1084_2.png) [@Johnny\_L.A](https://boards.straightdope.com/u/Johnny_L.A)\ **Post date:** [July 1, 2011, 1:54am UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/27 "2011-07-01T01:54:19Z")
> [@jtgain](#): > > You can choose to never need health insurance. But you cannot choose to never need health care. If someone chooses not to have insurance, then he is choosing theft. I thought Conservatives were against theft. ---
**Author:** ![Blalron](https://avatars.discourse-cdn.com/v4/letter/b/35a633/32.png) [@Blalron](https://boards.straightdope.com/u/Blalron)\ **Post date:** [July 1, 2011, 2:58am UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/28 "2011-07-01T02:58:26Z")
> [@jtgain](#): > > You can choose to never need health insurance. > > Warren Buffet could self-pay. That’s not relevant from a legal standpoint. > [@Judge Sutton](#): > > The courts do not apply strict scrutiny to commerce > clause legislation and require only an “appropriate” or “reasonable” “fit” between means and ends. United States v. Comstock, 560 U.S. \_\_, 130 S. Ct. 1949, 1956–57 (2010).Regulating all of the self-insured together does not cross these lines. **The Commerce Clause permits Congress to make flawed generalizations, and that at most is what might be said about the overbreadth of this law.** [emphasis mine] ---
**Author:** ![UltraVires](https://avatars.discourse-cdn.com/v4/letter/u/ecccb3/32.png) [@UltraVires](https://boards.straightdope.com/u/UltraVires)\ **Post date:** [July 1, 2011, 11:50am UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/29 "2011-07-01T11:50:22Z")
> [@Blalron](#): > > That’s not relevant from a legal standpoint. Understood. I was countering the arguments above that it is utter impossible to go through life without health insurance. The follow up was that it was “theft” to do so. Not so. You can self-pay for health insurance if you are wealthy enough/borrow enough/take a chance that you won’t get that sick and get hit by a bus and killed instantly at age 55. Even if you did freeload, it is no more theft than taking food stamps or Medicaid benefits. And another poster makes a good point. Never mind whether you NEED a car or not, that would not legally matter either I suppose, but could Congress under the guise of regulating interstate commerce, pass a law requiring citizens to buy a car? a house? a boat? a swimming pool? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 1, 2011, 1:13pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/30 "2011-07-01T13:13:07Z")
> [@jtgain](#): > > You can choose to never need health insurance. > > Warren Buffet could self-pay. If that’s what it takes for you, then thanks for concurring. > [@](#): > > Never mind whether you NEED a car or not, that would not legally matter either I suppose 'Course it would. That’s how you define participation (or not) in a market, under the Commerce Clause. ---
**Author:** ![Mr\_Smashy](https://avatars.discourse-cdn.com/v4/letter/m/2bfe46/32.png) [@Mr\_Smashy](https://boards.straightdope.com/u/Mr_Smashy)\ **Post date:** [July 1, 2011, 1:44pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/31 "2011-07-01T13:44:31Z")
> [@Wesley\_Clark](#): > > They force us to pay for roads, highway patrol, and public transit via taxes on local, state and federal levels. Not that I’m complaining. But we already are forced to pay for transportation expenses via taxes. Again, there’s a big difference between taxing for the common good, and the forced purchase/commerce we’re talking about in this thread. Ie, one is constitutional, and one is not. ---
**Author:** ![Mr\_Smashy](https://avatars.discourse-cdn.com/v4/letter/m/2bfe46/32.png) [@Mr\_Smashy](https://boards.straightdope.com/u/Mr_Smashy)\ **Post date:** [July 1, 2011, 1:46pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/32 "2011-07-01T13:46:57Z")
> [@ElvisL1ves](#): > > Like has been pointed out to you before, you can choose not to buy a car. You _can’t_ choose never to need health care. How do you figure that? That’s only because the Government has decided to adopt the crazy payment scheme for the poor/deadbeats. Fix that problem, don’t create another one. (If you wanted to do it with taxes, then fine, do it that way. But run on your tax raises honestly, not Democrat-style). ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [July 1, 2011, 2:25pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/33 "2011-07-01T14:25:09Z")
> [@Mr\_Smashy](#): > > How do you figure that? That’s only because the Government has decided to adopt the crazy payment scheme for the poor/deadbeats. Fix that problem, don’t create another one. What “crazy payment scheme”? ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [July 1, 2011, 2:48pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/34 "2011-07-01T14:48:53Z")
> [@Mr\_Smashy](#): > > How do you figure that? That’s only because the Government has decided to adopt the crazy payment scheme for the poor/deadbeats. Fix that problem, don’t create another one. IOW, before ObamaCare, nobody ever needed health care. 😃 ---
**Author:** ![Mr\_Smashy](https://avatars.discourse-cdn.com/v4/letter/m/2bfe46/32.png) [@Mr\_Smashy](https://boards.straightdope.com/u/Mr_Smashy)\ **Post date:** [July 1, 2011, 3:50pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/35 "2011-07-01T15:50:28Z")
> [@ElvisL1ves](#): > > IOW, before ObamaCare, nobody ever needed health care. 😃 Well, if in your mind it’s the Government’s job to pay for healthcare for everyone, then yes, your snark makes sense (to you). ---
**Author:** ![Mr\_Smashy](https://avatars.discourse-cdn.com/v4/letter/m/2bfe46/32.png) [@Mr\_Smashy](https://boards.straightdope.com/u/Mr_Smashy)\ **Post date:** [July 1, 2011, 3:51pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/36 "2011-07-01T15:51:55Z")
> [@Really\_Not\_All\_That\_Bright](#): > > What “crazy payment scheme”? That you would pay for the healthcare services for those who cannot afford it by taking money through higher insurance payments and fees for services rendered from those who can afford it. Rather than do it the more honest way, through taxes (not that it would be good policy - it would be terrible policy since the country is broke and sliding towards Greece-like finances… but it would at least be constitutional that way). ---
**Author:** ![Blalron](https://avatars.discourse-cdn.com/v4/letter/b/35a633/32.png) [@Blalron](https://boards.straightdope.com/u/Blalron)\ **Post date:** [July 1, 2011, 4:00pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/37 "2011-07-01T16:00:59Z")
> [@Mr\_Smashy](#): > > How do you figure that? That’s only because the Government has decided to adopt the crazy payment scheme for the poor/deadbeats. You know that ObamaCare is very similar to a previous Republican proposal, right? Would you honestly prefer being forced into a single government plan, instead of having several insurance options to choose from? ---
**Author:** ![Blalron](https://avatars.discourse-cdn.com/v4/letter/b/35a633/32.png) [@Blalron](https://boards.straightdope.com/u/Blalron)\ **Post date:** [July 1, 2011, 4:21pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/38 "2011-07-01T16:21:40Z")
> [@jtgain](#): > > And another poster makes a good point. Never mind whether you NEED a car or not, that would not legally matter either I suppose, but could Congress under the guise of regulating interstate commerce, pass a law requiring citizens to buy a car? a house? a boat? a swimming pool? I think they could, if it were part of a broader regulatory scheme that would be undercut if they didn’t require those purchases. But just like the Affordable Care Act, they couldn’t literally require _everyone_ to buy a car. In addition to being completely asinine to require every person living in Manhattan to buy a car, it’s probably impossible for most New Yorkers to obey such a law due to lack of space to park them. I’m no Constitutional expert, but I imagine there has to be some principle that prohibits the government from enforcing laws against people not capable of obeying them. We obviously can’t require those below the poverty line to buy something they can’t afford (unless we give them subsidies). And those with religious objections might argue that it violates their First Amendment rights, so they’d be exempt too. This is all purely academic speculation, because there’s zero chance Congress is going to require everyone to purchase a car or a home. It is only because of the special nature of the health care system that their unique solution (the insurance mandate) was imposed on us. ---
**Author:** ![Really\_Not\_All\_That\_Bright](https://avatars.discourse-cdn.com/v4/letter/r/e8c25b/32.png) [@Really\_Not\_All\_That\_Bright](https://boards.straightdope.com/u/Really_Not_All_That_Bright)\ **Post date:** [July 1, 2011, 4:29pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/39 "2011-07-01T16:29:57Z")
> [@Mr\_Smashy](#): > > That you would pay for the healthcare services for those who cannot afford it by taking money through higher insurance payments and fees for services rendered from those who can afford it. > > Rather than do it the more honest way, through taxes (not that it would be good policy - it would be terrible policy since the country is broke and sliding towards Greece-like finances… but it would at least be constitutional that way). So how would you alleviate the problem of poor people dying on the streets? Don’t even try that bad policy stuff. It’s very clear that universal healthcare produces equal or better objective outcomes for a fraction of the cost of our private system. ---
**Author:** ![Mr\_Smashy](https://avatars.discourse-cdn.com/v4/letter/m/2bfe46/32.png) [@Mr\_Smashy](https://boards.straightdope.com/u/Mr_Smashy)\ **Post date:** [July 2, 2011, 1:56pm UTC](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331/40 "2011-07-02T13:56:03Z")
> [@Really\_Not\_All\_That\_Bright](#): > > So how would you alleviate the problem of poor people dying on the streets? > > Don’t even try that bad policy stuff. It’s very clear that universal healthcare produces equal or better objective outcomes for a fraction of the cost of our private system. Why is it the government’s job to alleviate every possible bad outcome in life? Why do we put no faith in the ability of Americans to earn their own money to pay for their own healthcare? **RNATB** , you and I probably couldn’t be more different politically, but generally you speak reasonably in your posts (unlike several others here). Is there not enough evidence out there that the US simply cannot afford this larger government intrusion into our lives? That we’re broke and busted and putting the bills on the credit card for the children? I hate to threadjack but take a look at the front page of the [Washington Post](http://www.washingtonpost.com/business/economy/minnesota-government-shutdown-reflects-widespread-budget-paralysis/2011/07/01/AGPWkNuH_story.html?hpid=z1) today - a very lefty-friendly publication. They talk about the consequences of governments living beyond their means, and the chaos that ensues when the bill comes due, since people come to be dependent on the greater government footprint and lose the motivation to work hard for themselves to earn the benefits. As the WaPo puts it, “There is a giant gap between what many of the world’s governments have promised and what they can afford.” So, to answer your question, what would I do about the poor dying in the streets? Create a network of basic care clinics, funded honestly through taxes and not some unconstitutional bullshit reading of the Commerce clause that have the founders spinning in their graves, and tell the truth to the American people: we don’t have unlimited resources, and poor people won’t get care equal to what rich people can afford. This is the truth with every other good and service, why not health care. It’s not some made-up ‘right’ - rights don’t have to be paid for by others - it’s a service like any other. I hate it when I hear things like ‘life is priceless’. Bullshit. If it were, the speed limit would be 5 MPH nationally. [Previous page](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331.md?page=1) [Next page](https://boards.straightdope.com/t/6th-circuit-court-of-appeals-upholds-affordable-care-act/587331.md?page=3)