Justices signal possible trouble for health insurance mandate

I realize the discussion has moved on - but are you familiar with the current US Senate? Even if you assume the Democratic caucus held together (never a good bet), they never could have overcome a filibuster.

I don’t know how you would know this. I guess there are occasions where someone might mention it, and I guess I don’t know offhand why I would doubt them if they said it, but… no, I don’t know anyone like that.

Wait, how is it a poll tax? They don’t stop you from voting because of health insurance, or fees for the lack of it.

A poll tax, also known as a head tax, is a taxed placed on individuals for… existing, I guess.

No it’s not. Wow, these unfounded assertions are fun!

No, you must either buy health insurance or pay the government to cover the costs of your potential future inability to pay.

But this isn’t an either/or proposition. We’re both using different ways of describing the same thing in an effort to make a point. If you only focus on the individual mandate and ignore all the rest of the legislation, you’re description could be apt. But if you actually consider the legislation as a whole (which is what a deferential Supreme Court would do) and you actually consider the purpose of the individual mandate (hint: it’s not to force people to buy health insurance, it’s to regulate interstate commerce), then I’m much closer to the mark.

"[T]he individual responsibility requirement provided for in this section. . . is commercial and economic in nature, and substantially affects interstate commerce.”

"22(G) Without the requirement created by this Act, many individuals would wait to purchase health insurance until they needed care. By significantly increasing health insurance coverage, the requirement, together with the other provisions of this Act, will minimize this adverse selection and broaden the health insurance risk pool to include healthy individuals, which will lower health insurance premiums. The requirement is essential to creating effective health insurance markets in which improved health insurance products that are guaranteed issue and do not exclude coverage of pre-existing conditions can be sold.

(H) Administrative costs for private health insurance, which were $90 billion in 2006, are 26% to 30% of premiums in the current individual and small group markets. By significantly increasing health insurance coverage and the size of purchasing pools, which will increase economies of scale, the requirement, together with the other provisions of this Act, will significantly reduce administrative costs and lower health insurance premiums. The requirement is essential to creating effective health insurance markets that do not require underwriting and eliminate its associated administrative costs.
(I) The great majority of people living in the United States will require medical services provided by doctors, hospitals, or health clinics. This is especially true of persons as they age. Many of these health care consumers are uninsured. The number of these uninsured persons continues to rise each year. These uninsured consumers are a great drain on the nation’s economy."

Congress made these findings that the individual mandate was essential to making the other parts of the ACA work. The fact that some persons may buy health insurance and never use it does absolutely nothing to disprove that.

No, it’s not. WHEEEEE!!!

No, you must show you are able to pay for future health care through insurance or pay the government to offset the costs if you can’t afford it. Again, we can play this game all night if you want, where you focus only on the individual mandate and ignore the actual legislation and it’s purpose and I keep reminding you, but I tire of it.

The fact that it is possible to envision someone, somewhere who won’t ever use health care or, if they do, they can pay for it, does nothing to take regulating health care and health insurance out of interstate commerce. (Although I did get a perverse chuckle out of the lead individual plaintiff in one of the cases saying she didn’t need health insurance and then declaring bankruptcy because of medical bills. I’m a bit evil that way.)

Why are you not concerned about the tyranny of the judiciary in second guessing how Congress should regulate health care? What of the will of the people? Judicial activism ring a bell?

Health care, health insurance, and lack of health insurance, has a profound effect on interstate commerce. Congress is empowered to regulate interstate commerce and economic activity that has an effect on interstate commerce. Pursuant to that, they adopted the individual mandate, calling it essential to the program they are creating. Simple as that.

I went to school with a couple of kids whose parents did not believe in modern medicine. The kids were pulled out of elementary school to be “home schooled” when the parents refused to have them vaccinated. These were very backwater country people who didn’t own a car and all lived and worked on the family farm. I went to the funeral of 1 of the kids a few years ago (died at age 34 of pneumonia…) and his brother told me about their views on medicine when I asked about how his brother died, and he related that neither his deceased brother nor himself had ever seen a doctor or used prescriptions and said that his brother wanted to die at home since that was where he was born. I suppose he could have been lying, but knowing the kind of people they are, I saw no reason to doubt him.

These people are obviously misguided, and I agree that only a very small percentage of people will never participate in the health care system in some fashion. It just bothers me when people use absolutes when discussing any topic, as saying the “vast majority” would be more accurate than saying “everyone”.

Except I didn’t just make the claim and leave it at that. I offered an explanation with it. There’s a difference. If you’re unable to understand it or choose to ignore it, I have no interest discussing this with you.

You’re AGREEING with me in that the government is forcing someone to either buy health insurance (which you just admitted) or pay a penalty. Go read the Supreme Court transcripts. There was much discussing the “penalty”.

Well. I’m talking about things how they actually are: the government is mandating people buy (as you admitted) health insurance, and if they don’t, they pay a penalty. Those are simple facts. As well-intenioned, smart, brilliant, or dumb as they may be. Not conceding that that is what we have is disingenuous. Whether it’s a good idea or not is a different argument. It’s another argument still whether or not it is allowable under the ICC, and another still as to whether, assuming that it is okay under the ICC, whether that means that the unconstitutionality of the mandate then can, or should, become moot.

(bolding of parts of the law mine)

Correct. The government is mandating that you must either buy health insurance or pay a penalty. I think it is telling how stridently you seek to run away from these facts. But keep acknowledging them.

I’m not ignoring the purpose of the legislation. In fact, I applaud the purpose of it. But just because you might have a noble goal does not mean that you can use any mechanism to achieve those goals. And the Constitution gives the federal government no authority to mandate that a person buy a product. And then assess them a penalty of they do not. It’s simply not there.

The mandate is unconstitutional. It’s as simple as that. If the mechanism by which they paid for it was through taxes, then that problem goes away. I don’t mind them regulating health care. I mind them conjuring up new mechanisms through which they can extract money from the populace.

Yep. Simple as that. But, again, just because the goal may be attractive doesn’t mean they can take any road they want to get there.

In both of the above cases, you claimed Magellan was making unfounded assertions–and then went on to immediately quote and respond to the support he gave for those assertions.

Hey Bricker–I was thinking about this overnight and I’m genuinely curious:

What’s the remedy for a totally fucked-up ruling with sixty years of precedent?

Take Dred Scott since it’s universally agreed to be a crappy decision. Let’s say it stood for 60 years. What then? Is it the law of the land forever because a bunch of Justices made crappy decision? How do you fix it?

At one point in this thread, you agreed with the idea that “For Every Wrong, the Law Provides a Remedy”–what’s the remedy for a terrible decision with years of precedent? It can’t possibly be entrenched forever (can it?)

No, they’re not facts. They’re one way, a way that completely ignores the rest of the legislation, of describing a huge legislative action by breaking it down into talking points for people too distracted or too unconcerned for real, in depth discussions of health care. I attempted to drag the discussion into that deeper realm, where the realities of the legislation and it’s rationale were much more important, but apparently we’re stuck simply repeating talking points.

I’m prescient.

“Health care, health insurance, and lack of health insurance, has a profound effect on interstate commerce. Congress is empowered to regulate interstate commerce and economic activity that has an effect on interstate commerce. Pursuant to that, they adopted the individual mandate, calling it essential to the program they are creating. Simple as that.”

The individual mandate is an essential part of legislation that regulates interstate commerce. The Constitution gives the power to regulate commerce. To use your repeated comments, it may not be a good idea, but it’s a Constitutional one.

And the road that Congress decided to take is constitutional. I understand that you want the tyranny of the judiciary to ignore the will of the people and be activist in overturning Congress’ manner it chose to regulate interstate commerce. (I’m actually with you on that to a point, but the irony is amusing to me)

But setting standards regarding the timing and manner in which people will have to pay for health care is part of the regulation of commerce allowed in the Constitution. Making people chose to either buy health insurance or pay into the government for the costs if they can’t afford it later as part of a larger program to regulate the health care industry is regulating commerce.

You lost me. What happens if I pay for health care with cold hard cash, neither buying insurance nor paying the government for the costs?

Well, one big deal would be that they’re legislating from the bench. In Wickard they created a principle. To do what you say now, they’d be creating an additional, highly artificial and results-driven principle.

And it would raise further questions – where is the line? How can you tell? What guidance does Congress have?

The Court would be arrogating to itself the role of super-legislator; a reviewing body for acts of Congress based on an extremely arbitrary line.

No, for a couple of reasons. One is that there was not a vast framework of regulatory law and funding associated with Pace.

The second is that the Fourteenth Amendment had to mean something. Taken literally, its text is unhelpful. “The equal protection of the laws” cannot be meant to outlaw prisons, yet it’s beyond cavil that a prisoner can be treated unequally under the law compared to someone not convicted of a crime. There therefore must be a framework to hang that “equal protection” on.

The obvious framework was the time in which the Fourteenth Amendment was passed and the ills it meant to cure. Yes, I am a textualist, but when the text is either meaningless or unworkable when taken literally, external factors can be used to construe it.

Pace could be overruled because the Fourteenth Amendment was passed to eliminate invidious classification by race.

Amending the Constitution comes to mind.

That is, in fact, exactly how the Dred Scott crappy decision was eliminated.

I would absolutely jump for joy to see the Constitution amended in a way that made clear Congress’ power under the Commerce Clause was not nearly so far-sweeping. I would ring doorbells to get people on board to lobby my state legislature to ratify.

If you don’t show the government that you can afford health care by buying insurance or having it through your place of work, you will be subjected to an additional tax to the government. That money is obstensibly to cover the costs of your health care if you don’t have all your cash in the future.

But, as has come up in this thread – and myriad others – isn’t the whole reason the Supreme Court was talking up “commerce clause” this and “broccoli” that because the whole thing ostensibly isn’t a naked exercise of the power to tax, but rather an exercise of the “commerce clause” power to compel a purchase? That, if it had been set up as an ordinary tax, the whole argument about it being unconstitutional would have gone out the window?

Have there not been lots of 5-4 decisions that have a ton of standing case law with which to back those 5-4 decisions?
I’m not necessarily arguing for or against your stance as I happen to agree but 5-4 still means settled in the eyes of the US anyway.

There is a whole nother argument that the individual mandate is a Constitutional exercise of Congress’s power to tax (an argument I think I’ve supported here before). The government has argued both sides (and out of both sides of its mouth) that the mandate is both a valid exercise of Congress’ power to regulate interstate commerce and that it is a valid exercise of Congress’ taxing power.

Bricker –

You’ve made the case repeatedly that a ruling upholding this law would flow logically from Wickard; I tend to agree. But I don’t see why Wickard requires upholding, and most of the analyses I read say that even if the court does uphold, it will be with a “this far and no further” ruling. Can you explain why you feel so strongly that the precedent of Wickard must be extended out, and how far?

Again – I’m not asking what doors Wickard opens; I think the answer is pretty obviously “all of them.” I’m asking what doors you think Wickard requires subsequent courts to walk through should congress ask them?

As to the taxing power…

Art I, Sec. 9, limits the taxing power: “No Capitation, or other direct, Tax shall be laid, unless in Proportion to the Census of Enumeration herein before directed to be taken.”

This would not be in proportion to the census, right? Of course, that language also forbids an income tax, which the feds learned after trying one and getting slapped down. So we also have the Sixteenth Amendment: “The Congress shall have power to lay and collect taxes on incomes, from whatever source derived, without apportionment among the several States, and without regard to any census or enumeration.”

Would this be a tax on income?

Or am I missing another taxing framework?