Appeals Court Strikes Down the Individual Mandate

Dio pretty much had it. It was largely based on ideas developed by the Heritage Foundation. Individuals will be required to have health insurance, either from their employer or by purchasing it themselves. I think there’s supposed to be subsidies for those who can’t afford to buy a plan themselves. The reform also included a bunch of other reforms, including preventing insurance companies from denying people for having a pre-existing condition, and creating a federal review board to approve proposed rate increases (some states have such a review process, but not all states do). It was basically a big, messy, complicated compromise that sought to improve access and limit costs while not putting the private health insurance industry out of business.

Honestly, I support healthcare reform, and I understand why there has to be an individual mandate, but I’m against being required to purchase a health insurance policy from the private sector. Yeah, yeah, car insurance, I know, but I can go without a car if I want.

No, my view is that they have never given any kind of shit about health care reform at all and are completely in the pockets of the insurance companies. Still, they are the ones who first presented the plan passed under Obama and pretended to support it, so opposition now shows that they were lying the first time.

The thing is, people who can afford health care and don’t purchase it are basically choosing to suck off the public tit exponentially more when they do get sick, or get in a car accident or whatever. They aren’t off the grid just because they aren’t purchasing coverage. They’re just choosing to ride on the wagon instead of helping to push it.

Maybe, but how do you define “afford”? If most individually purchased policies are a ripoff, can we really blame people for wanting to risk it?

Supporters of the reform have all claimed that once it goes into effect and turns out to be not such a big deal to abide by, we’ll all look back and wonder what got us so worked up in the first place, which basically concedes that we’ll all have to see it to believe it. That doesn’t leave me feeling very hopeful.

Do you truly not understand how this works? When faced with something appalling, they reluctantly but honestly offered a compromise they truly would’ve preferred. They weren’t “lying the first time”; they weren’t pretending to prefer Option B if forced to choose between that and Option A, they were entirely serious. As it happens, they also preferred D to C, and C to B, sure as they preferred B to A; so what?

Let’s say you kidnap my child and offer me the classic choice: your kid dies unless you pay the ransom. In the face of something so appalling, I’d genuinely rather pay up – it’s the lesser of two evils – though I’d rather both options were off the table; ideally my kid would be fine and you wouldn’t get a nickel, but I’ll of course settle for B over A, even though C beats B sure as B beats A. Are you going to say I was “lying the first time” if my preferences work that way? Will you say I was pretending even though I can assure you I was sincere?

You see someone about to be punched in the face, and hear a scream to the effect of “at least hit me where the bruises won’t show.” Would they rather not be hit at all? Presumably. Are they lying when they express a preference for one blow over another? I just don’t see it.

Oh, but it will, in spades. Without the Individual Mandate, it’s a complete fiscal failure. Actually, it was anyway, but this is a faster resolution. At this point, it doesn’t really matter how you claim to “patch” it. Without the mandate, it’s not affordable.

I never understood the rhetorical advantage in this line of argument.

Diogenes tried it in a Pit thread recently. It was pretty clear what he was up to, but I don’t see how it makes any sense to use in a serious discussion.

I can’t believe you don’t really know the provisions of the bill. What do you think the appeals court was talking about?

Regards,
Shodan

That’s really a great question because too often the legislation is discussed in terms of this mandate that all individuals must have health insurance. If you look at the rest of the legislation, it requires a number of reforms; some of the best of these are:

  1. Expanded Medicaid eligibility
  2. Subsidizing healthcare premiums up to 400% of poverty level. Wikipedia provides an example table for a family of 4. $4000 a year for a family of 4 at $54,000 is competitive with what people get now through their employer. Most people making around $54,000 would be covered by their employer in this country. People making much less will get their insurance premiums covered via tax credit. Excellent.
  3. State health insurance exchanges.
  4. No consideration of most pre-existing conditions with premiums tied to age only.
  5. Preventative maintenance without co-pays.
  6. Removal of coverage caps.

Its not what most of the other great countries in this world (e.g. Canada) have, but its a great improvement over what we have now. The individual mandate only sweetens it because of the extra money rolling in to support the plan.

My personal legislative goal is to be taxed for my healthcare so that my only consideration when going to see the doctor is “Should I go see the doctor that I find conveniently located near me?”.

They weren’t faced with anything appalling. They were faced with a practical solution to a problem with which it was (and still is) in their own selfish interests to perpetuate. There’s no ideology behind their opposition, just self-serving greed and careerism.

In point of fact, there is no such thing as “Obamacare.”

Wow, this attempt to turn a plan the Democrats passed without a single Republican vote in the Senate into “a Republican Plan” tells me one thing - you guys are running from it as fast as you can because you know it’s a godawful mess.

To give a better answer to Brian Ekers, here are the fundamentals of the plan:

  1. The government sets up public insurance exchanges to cover people who can’t get health care insurance through their employers.

  2. The government disallows insurance companies from refusing anyone who has pre-existing conditions. Or perhaps that only applies to the exchanges - I can’t remember.

  3. The government fines employers who do not provide health care insurance for their employees $2000 dollars per employee, per year. This money helps finance the exchanges. Companies with fewer than 50 employees are exempt from this requirement.

  4. Punishment for weak employer plans. To prevent employers from offering very weak coverage insurance to avoid the penalties, the government stipulates that if even a single employee leaves an employer-provided plan for the exchanges, the employer can be fined $3000 for every employee - not just the one who left.

  5. Tax credit for employers. The government will provide up to $40 billion in tax credits to employers who want to offer health care coverage to their employees.

  6. Price Controls. A new health care advisory board will require all rate increases for insurers to be approved by them.

  7. Mandatory coverage. All citizens age 26 and above will be required to buy health insurance, either from a private insurer or from the exchanges. People below 26 years of age can seek coverage under their parent’s health plans.

  8. Low income aid: To allow people to afford the mandatory coverage, the government will provide financial aid for health insurance, indexed to income. People with incomes up to $80,000 will be eligible for health insurance supplements, but only if they get their insurance from the public exchanges. If their employer provides coverage, they get nothing.

All of this is promised to cost about a trillion dollars over ten years. And we all know government estimates of the cost of new programs are right on the money.

To pay for this new system, revenue will be raised in the following ways:

[ul]
[li]Broaden Medicare tax base for high-income taxpayers: $210.2 billion[/li][li]Annual fee on health insurance providers: $60 billion[/li][li]40% excise tax on health coverage in excess of $10,200/$27,500: $32 billion[/li][li]Impose annual fee on manufacturers and importers of branded drugs: $27 billion[/li][li]Impose 2.3% excise tax on manufacturers and importers of certain medical devices: $20 billion[/li][li]Require information reporting on payments to corporations: $17.1 billion[/li][li]Raise 7.5% Adjusted Gross Income floor on medical expenses deduction to 10%: 15.2 billion[/li][li]Limit health flexible spending arrangements in cafeteria plans: $13 billion[/li][li]All other revenue sources: $14.9 billion[/li][/ul]

That gets you almost half of the way there. The other half of the costs are supposed to be clawed out of the Medicare system in the form of cuts to doctor reimbursements and finding savings by cutting ‘waste, fraud, and abuse’. And we all know those kinds of promised cuts always happen.

If I were a Democrat right now, I’d be trying to accelerate this lawsuit to the Supreme Court, hoping that they strike down the whole mess. Because this bill is a disaster. It’s probably a major factor holding back job creation right now. Businesses are terrified of this, because it is just riddled with unknowns and is going to have a major distortionary effect on the economy.

Notice that there is $60 billion in taxes on insurance companies, plus they are being forced to accept people with pre-existing conditions, plus the cost of medical devices is going up by $20 billion and non-generic drugs by $27 billion, plus insurers will be forced to pay for the children of insurees up to the age of 26. These are all new cost drivers for insurance. How much are businesses that currently offer health insurance going to see their rates increase by? No one knows.

We do know that price controls are a giant fail. If the government caps the amount insurers are allowed to charge, but dumps new fees and mandates on them, it could drive the health insurance business underwater. Shortages are always the inevitable result of price controls. Some cynics have suggested that this is a back-door way to get to a single payer system - make everything except the government exchanges unaffordable. But even if that doesn’t happen, there could be shortages. Some companies may not be able to find insurance for their employees, which could open them up to fines.

This program is going to heavily distort the economy in strange ways. For example, if you’re a company with 49 employees, the marginal cost of that 50’th employee is through the roof because hiring that person will require that you then provide health insurance for everyone, or you’ll pay $40,000 per year in penalties (the law allows you to skip the charge for the first 30 employees, so you’ll pay $2,000 X 20, per year). That’s going to kill jobs in the very sector we rely on to create the most - growing businesses.

As another example: Let’s say you make skis. You have a large, labor-intensive manufacturing system, and you employ 1000 people. Your competitor invested a few hundred million in automation for his skis, so his capital costs are higher but he only employs 100 people. The two of you are competitive, and have about the same market share. But along comes Obamacare, and suddenly your company is hit by a fine of $2,000 per employee, so your bottom line costs just went up by $200,000, while your competitor’s only went up by $20,000. Now you can’t compete as well, and you lose market share.

Or, consider two large companies. One pays its employees on average $4,000 per month, plus health care benefits. The other has made a different deal with employees - it pays them an average of $4500 per month, but they pay for their own health care. But now, this company is also getting fined $2,000 per employee. Can it just roll back salaries to compensate? Probably not. Wages are sticky. People’s expenses grow to match their wages. It’s always hard to roll them back. So suddenly the second company is at a disadvantage, even though both gave their employees equal compensation before the health care law came along.

And so it goes. Companies with high income employees will be at a disadvantage over companies with low income employees, because the second company gets an implicit subsidy because the employees get tax credits for their health care. Even worse, these changes will affect prices in the supply chain, and since no one knows the details of their suppliers’ labor negotiations, no one really knows how this is going to change the price mix and their competitiveness and market share.

Then there’s the big unknowns. Let’s say you offer health care today. Is it good enough? It has to be good enough that none of your employees will seek out the exchanges, or you’re going to get hit with massive fines. But the health exchanges haven’t been set up yet, and the rules and coverage schedules haven’t been written, so no one knows.

Would you hire people today if you had no way of knowing if they were going to cost you $3,000 per year more in 2014? Would you increase your workforce now if you knew there was a chance that you were going to be put at a competitive disadvantage in the market in 2014, and that disadvantage will be worse with each employee you hire?

The CBO originally scored this as deficit neutral, but that’s no longer true. Actually it wasn’t true then either, because the Democrats cooked the books to get the CBO score by front-loading taxes and back-loading benefits. But it’s no longer true even under the CBO formulation. The 1099 form requirement has been dropped. The ‘gold-plated insurance’ plan has been dropped under pressure from the unions. No one believes the $500 billion in savings from Medicare will ever materialize. But even if that savings did, it could just as easily have been taken from there and applied to the deficit. What this plan does is soak up all the ‘low-hanging fruit’ where budgets could have been cut, making future budget reductions in health care that much harder.

Obama has already deferred the cuts to doctor’s payments twice. But if he does cut them, the net effect will be the same as what happened to medicaid - doctors will stop treating people who fall under this plan. Even worse (and the reason why various states are now returning the seed money for setting up exchanges), if the cuts completely go through, doctors would get paid more under medicaid. This means that more people may wind up being forced into medicaid to get treatment - and the states have to pay a big chunk of that. So the federal government’s books look okay, but the states get clobbered.

I could go on all day. This stupid plan is going to slam into the economy like a drunken sailor, causing unintended consequences everywhere. We’ve already seen it with the 1099 reporting. Boston Scientific, a medical device manufacturer, has already announced its closing its American manufacturing and moving it to China to avoid the mandates and new excise taxes. The Obama White House has already issued about a thousand temporary waivers to various businesses, because the rules set up for 2011, 2012, and 2013 turned out to be unrealistic.

Oh, and if the individual mandate is shot down by the courts, this thing is dead. Without that, a huge part of the funding mechanism for this - the requirement for healthy, young people to pay in - will vanish. If you can’t be turned away for pre-existing conditions and the amount insurance providers can charge is capped, the obvious strategy for everyone would be to go uninsured until they get sick or injured, then sign up. That destroys the entire insurance model.

It was Bob Dole’s plan, dude. Dole was a Republican. No attempt was made to pass a Democratic bill. There are no Democrats any more. Just Republicans, right wing Republicans and teabaggers.

You’re shifting the goalposts: the claim was that they were lying and pretending, not that they were acting in their own interests. (Though if you’re right about that, then aren’t you merely explaining why they would’ve found the alternative appalling?)

Was he the Republican who saved us from HillaryCare?

Things’ll get really, really interesting if activist judges strike down the individual mandate, but the rest of Gingrichcare stays intact. Since nobody will have any incentive to buy insurance until they need it, how will the insurance companies stay in business? Clearly, the insurance companies will want to avoid this situation, but how? Their pet legislators won’t be able to use their usual tactic of obstructionism, since if they do nothing, the insurance-killing goes into effect.

I’m Canadian, Yank. I have no memories of not having government health care, but I’ve noted that Americans on this board and on their various punditfests throw around the term “Obamacare” a lot and I figured it was high time I got a straightforward factual summary of what exactly it entails, and I thank Inbred Mm domesticus for giving me a starting point.

This is why I love you, Dio: your sense of humor. Oh, I know it’s not intentional. Well, the massive distortion field you maintain at all times in roder to get through the day is. But on the surface you actually believe it, and that’s hilarity for ya’s.

You’re welcome.

That is why I’m not sure a SCOTUS decision along the lines of the 11th Circuit’s thinking would be all that bad for Democrats. It could force Congress to revisit HCR while the provisions that were upheld could give Democrats a great position to bargain from. Break up the bill into it’s constituent parts and the bill, the mandate not withstanding, polled reasonably well. These are the parts the GOP would be having to oppose if the mandate is ruled severable and Republicans still insist on full repeal.

Sam Stone, you provide plenty of additional facts. Thank-you. Then you supply interpretation, which are all biased toward conservative talking points. Thanks for nothing. Here are all those clever talking points:

Nobody is making this attempt in the way you are interpreting it. Nobody is running from it, but it is criticized since it did not live up to what it could have been.

But we’ll get there somehow. Perhaps we can cancel the Joint Strike Fighter or some other massive waste of money. It’s a necessary reform and the benefits of it will make it obvious that it is worth paying for. It’s good that there are people willing to make this argument to keep the idealists honest.

Holding back “job creation”. You’d think businesses would be holding back “job creation” based on not needing employees to provide goods or services. So which businesses will not hire employees to supply goods and services, despite needing them, just because of unknowns about health insurance? Wouldn’t the market destroy such a company for failing to satisfy its customers? Wouldn’t a smaller company grow larger taking these customers?

Not sure if I disagree with this statement but then I don’t care about these companies’ profit margins anyway.

Or their profits will just shrink. Don’t buy health insurance stock.

Nice examples except that all of them ignore the actual fact that the types of businesses you are describing already supply health insurance (end of article). Who works at a job paying $4500/month that is not supplying health insurance? Between the tax credits provided to businesses and the health insurance exchanges where they can make plans with other small businesses, this plan is going to be a neutral to a win for a vast majority of these companies. Since most decent businesses are good at math, they already know it.

Most new insurance plans will be obtained by businesses via the exchanges. What the hell are you talking about? If true as stated, there are easy fixes anyway.

I, and an other rational creature, would hire people if their business required it and layoff people if it needed to shed jobs. Why would a business owner consider hiring if their sales or growth or whatever did not need it?

Maybe we could raise revenues or something and enjoy a higher standard of living through better availability of healthcare. I much prefer that than to raising revenues due to irresponsible tax cuts, wars on countries that are no threat to us, and poorly regulated financial services.

Could you just provide some cites? What I love most about politics is how a piece of legislation can be interpreted to have all these dire consequences by activists on the left and right but when you finally get your fingers on the actual facts of the matter, it turns out to be bunk.

Ok. It’s a flexible plan. This should ease transition well. I know Republicans would design legislation that would only take effect perfectly on time. Seriously, you are just typing any factoid about this plan and saying “Dire!” or attaching this factoid to something Boston Scientific did. Are they related or are you just attaching things together to make them sound bad - like an activist would?

It will not be dead unless the whole thing is shot down by the courts. It would be terrible if the budget conscious Republicans refused to do what was necessary to fund these aspects of the legislation and allowed our deficits to continue to skyrocket! They are budget hawks after all!