I have listened to people’s hysteria over ACA for several years now. Part of it escapes me–the hysteria that is. Health care is horribly expensive. Insurance companies rip people off all the time and often one’s treatment depends on what is deemed appropriate by the insurance company, not by the medical community and the patient. People are excluded from health care because of pre-existing conditions. All the things I have mentioned are not good for the average person.
So I am looking for the cause of the hysteria. As I look, I am reminded of the vicious attacks on Hillary Clinton almost 20 years ago over health care. Again, the same conditions existed. Both Clinton and Obama were reviled by the same set of people. (they are 20 years older now) I am wondering if these same people are going to turn down Medicare?
It seems to me that the most obvious answer is to get in there and let it roll. If there is something objectionable, fix it. Why are we treating ACA like it is etched in stone like the 10 Commandments? There is plenty of time to look things over and to see obvious, glaring problems. In fact, democrats and republicans could become heroes. they could go get in there and fix things up legally by working together towards a common goal, sort of like Hatch and Kennedy used to do. Now there is a novel idea.
Additionally, I keep reading that this conservative or that conservative has called Roberts a traitor. Why is he a traitor? Does he not have free will to think for himself? Why must ever justice have an ideology on every topic? There is something refreshing about someone like Sandra Day O’Connor. She thought for herself. She surprised us. You knew that she thought things through.
@Morris Davis
I have the syllabus up at my site, if you’re interested.
http://unitedconservatives.blogspot.com/2012/06/syllabus-of-decision.html
The tortuous route to Robert’s goal is obvious.
The present challenge seeks to restrain the collection of the shared responsibility payment from those who do not comply with the individual mandate. But Congress did not intend the payment to be treated as a “tax” for purposes of the Anti-Injunction Act. The Affordable Care Act describes the payment as a “penalty,” not a “tax.” That label cannot control whether the payment is a tax for purposes of the Constitution, but it does determine the application of the Anti-Injunction Act. The Anti-Injunction Act therefore does not bar this suit. Pp. 11–15. (IT’S A PENALTY.)
CHIEF JUSTICE ROBERTS concluded in Part III–A that the individual mandate is not a valid exercise of Congress’s power under the Commerce Clause and the Necessary and Proper Clause. They gave Congress the power to regulate commerce, not to compel it. Ignoring that distinction would undermine the principle that the Federal Government is a government of limited and enumerated powers. The individual mandate thus cannot be sustained under Congress’s power to “regulate Commerce.” Pp. 16–27.
(b) Nor can the individual mandate be sustained under the Necessary and Proper Clause as an integral part of the Affordable Care Act’s other reforms. Even if the individual mandate is “necessary” to the Affordable Care Act’s other reforms, such an expansion of federal power is not a “proper” means for making those reforms effective. Pp. 27–30.
(UNCONSTITUTIONAL UNDER THESE REASONS.)
3. CHIEF JUSTICE ROBERTS concluded in Part III–B that the individual mandate must be construed as imposing a tax on those who do not have health insurance, if such a construction is reasonable.(SO THE MANDATE IS ILLEGAL. BUT WE’LL TAX YOU IF YOU DON’T HAVE INSURANCE SO GO BUY IT.)
(HERE’S WHERE HE GETS CONFUSING AND CONTRADICTORY BY JUST DECIDING THAT THIS IS A TAX ON HIS OWN.)
4. CHIEF JUSTICE ROBERTS delivered the opinion of the Court with respect to Part III–C, concluding that the individual mandate may be upheld as within Congress’s power under the Taxing Clause. Pp. 33–44.
(a) The Affordable Care Act describes the “[s]hared responsibility payment” as a “penalty,” not a “tax.” That label is fatal to the application of the Anti-Injunction Act. It does not, however, control whether an exaction is within Congress’s power to tax. In answering that constitutional question, this Court follows a functional approach,“[d]isregarding the designation of the exaction, and viewing its substance and application.” United States v. Constantine, 296 U. S. 287, 294. Pp. 33–35.
(b)
Such an analysis suggests that the shared responsibility payment may for constitutional purposes be considered a tax. The payment is not so high that there is really no choice but to buy health insurance; the payment is not limited to willful violations (OF COURSE NOT. YOU CAN BUY INSURANCE AND PAY THE “TAX), as penalties for unlawful acts often are; and the payment is collected solely by the IRS through the normal means of taxation. Cf. Bailey v. Drexel Furniture Co., 259 U. S. 20, 36–37. None of this is to say that payment is not intended to induce the purchase of health insurance. But the mandate need not be read to declare that failing to do so is unlawful. Neither the Affordable Care Act nor any other law attaches negative legal consequences to not buying health insurance, beyond requiring a payment to the IRS. And Congress’s choice of language—stating that individuals “shall” obtain insurance or pay a “penalty”—does not require reading §5000A as punishing unlawful conduct. It may also be read as imposing a tax on those who go without insurance. (WHAT THE HELL? THIS IS WHERE HE STRETCHES THE LOGIC. ITS NOT A PENALTY. YOU ARE JUST FORCED TO PAY THE IRS FOR NOT BUYING INSURANCE.)
So…according to the Anti-Injuction Act…this is not a tax. But it’s a tax because …..it’s not a penalty because he says so?
Here’s the pdf of the entire decision: http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf Be aware – 193 pages.
Neat. Now we can get canned Supreme Court decisions, all neatly decided and spit out, binary fashion. That’s better than one of them bibles with red letters for what Jesus said and words running along the side.
I expect pretty soon the justices can just play angry birds during the hearings. Just type the question into the program and let the Justice BS program just whirl away and come up with THE decision.
I wish everyone would give Citizens United this thorough of a going over. I think the results will be much more far reaching than what ever this one’s name is. I wish I would see the same outrage.
Some folks don’t like the country being run by silent, anonymous rich people.
Funny how all the R’s are on message that this is a tax. They are all saying it. But, when the likes of BOCS drops the rate, but raises the assessment, they tell me that is a tax cut. Then they impose court fees on tickets, they tell me that is so taxes do not go up. When they raise park usage fees, mortgage fees, records fees, etc – they tell me that is a tax cut.
In order to fix this mess – what Congress needs to do, is undo the Labor Act that forced Hospital to give out services with no regard to payment – they will allow them to make a financial decision as to if someone has the right coverage or rating to get the care.
This is the Conservative way – get free riders out of the system, have people pay for private insurance – if you do not like your insurance company, go get another. The Conservative way would not be for free riders to get care when they cannot pay. The Conservative way would not force a private entity to give away services. There are many complaining about the Fed’s telling me to pay for the sake of breathing, well, the Fed’s are telling private entities (I guess the R’s call a private entity a person), that they need to give out services.
@Pat Herve
Absolutely right.
Of course, politicians being cowards, and usually take an authoritarian view of “helping people,” ie. “YOU go help that person.” and all of them loving to spend other people’s money to fix problems, we won’t fix that.
Fees are different than taxes. BUT, in the spirit of the thing…they are a type of tax increase.
@Pat Herve
R’s get quite odd and strange about being conservative in my mind. How conservative is it to tell another person what they can and cannot do with their own body? hmmmmmm
How strange is it to, by default, encourage unwanted pregnancy?
In a civilized society, we don’t let people die on the street. We don’t dole out services based on one’s ability to pay, especially when the end result could be death. That’s just not how America works. That’s now how modern countries work. I think that it becomes an unrealistic conversation when we start going down that slippery slope.
Its just much easier to require everyone to have insurance. Those for whatever reason can’t pay can get assistance. It wont be cheaper at first but it will become cheaper.
Unfortunately, this political question boils down to folks finding it acceptable to have 40-50 million uninsured people living here. Now who pays?
If you are poor, you are covered. If you are rich you are covered. so, again, who gets slammed? The lower middle class, the unemployed, the service industry.
Please just look at the reality of the situation and take off the stupid middle class I GOT MINES blinders.
Cargo, seriously…lets personalize this. What if someone like you got terminally ill. He gets treated in some public hospital. He runs hundreds of thousands of dollars run up and then he croaks. Who has this bill? His survivors. His family is saddled with this bill forever. If the wife ever signed one thing…the guarantor gets it. I knew someone this happened to. There was no way out.
Nothing can flatten a family’s finances like medical bills.
real estate taxes are only tax increases when the rate goes up? Bull crap.
Real estate taxes go up when yo upay mor ethan yo did the year before, regardless of what shell game is played.
Why are tax increases always bad? I don’t consider them bad if the revenue is needed to improve quality of life and how the money is being spent is transparent.
@Moon-howler
And your point is?
Yes. This is bad. It happens with insurance companies too. That’s the price for not getting insurance.
Lack of fire insurance means that a family will still owe thousands for their home, if they let it lapse. Lack of liability insurance means that they owe millions if their child kills someone negligently.
But the alternative is giving the power to the government to tell us to buy anything that the government deems valuable. Furthermore, you are still subsidizing the “free riders.” All those poor people get government money to “buy” insurance. I’m not sure where I fall in the ratings, but a family of 4 with an income less than 88K per year, gets subsidized with tax money. We’re a family of 3 with 50K.
Yes, medical bills can be crushing. So can other bills. If you state that all can get insurance regardless of condition, then you are mandating that a 3rd party pay your bills for you. Its no longer insurance. Its something else.
As written, this will fail. Nothing prevents people from paying the tax until their bills + tax are greater than an insurance premium. They then get insurance and that company has to pay the bills. They are free riding on the insurance company. Insurance companies will drop policies and if they are forced to cover everyone…they will either raise rates exorbitantly or go out of business.
The point is, we need to have health care reform that involves everyone. Let’s look at insurance. If you have a mortgage, you have fire insurance. If you don’t and chose not to have fire insurance, then you are stupid or very rich. I never carried liability insurance hoping my kid didn’t kill someone. I guess I lucked out. I carried automoibile insurance. Glad I did also.
I am not paranoid about giving the governement power. It is what it is. Of course we are subsidizing free riders, in every aspect of life. I don’t know what to do about it. I am sure none of my answers would be socially acceptable to do so we won’t go there. People have rights. I could violate an awful lot of rights in just 15 minutes if I set my mind to do so.
However, those on medicaid are on a controlled free load rather than some wild, out of control medical free for all. If everyone has insurance of some sort, then it is a controlled situation.
Now, all these governors who are saying they aren’t going to do this or that part ACA make me smile. they are the very ones who were squealing and bellowing about RULE OF LAW just last week. How quaint. Am I to understand that Rule of Law only applies if one likes the law? Hypocrites!
Medical bills….medical bills have always had to ability to destroy a family. I worked at the University Hospital many years ago, in the business office. We had judgement cards even back then. People had to pay each week as a rule. There was one person who owned quite a bit of money for that day and who sent in a dollar a week. It always began with, “Take this you skunks…” Funny how things stick in your brain. I used to have to write the judgements…which were on green cards.
Medical bills can run into the millions and run up on a family a lot quicker than most other kinds of liability. I believe the free riders left our local hospital with about $50 million in unpaid debt last year. That’s a lot of money that our insurance companies will eventually be charging us for. I would require EVRYone to have insurance, including illegal immigrants. Charge them twice as much if it bothers people. Make it a surcharge. Not allowing them to purchase is just asking for people to walk on these bills.
Meanwhile, there is no comparison to other types of insurance. There just isn’t.
How do you force illegal aliens to get insurance? They are already here illegally. They are not getting insurance through work….that’s the point of hiring illegal aliens.
And, again, you will be paying for the poor people anyway. Subsidized health insurance.
As for the governors, the ability to be exempted is part of the law, apparently. Just like all those waivers that the Obama administration handed out.
Rule of Law is simply a bumper sticker slogan for them.
Don’t you think the illegal aliens would buy in if they could, especially if they thought they would not get let in a hospital without insurance of some kind?
There are so so so many undocumented people in the US that have insurance coverage – just because someone is not legal, does not mean they are not in the system. They pay taxes, pay into SS, and get health benefits. And, no one wants to fix the issue.
@Moon-howler
You know that they can get into a hospital. THAT law has not been repealed. All it takes is for one news story about a sick kid…..
@Pat Herve
And so many that don’t.
cargo – do you know any US Citizen that works for cash, and does not pay taxes, ss, medicare, is on food stamps, is a free rider on health insurance, etc.
I do.
I try to fathom why people want to protect the insurance companies so much and so hard – yet not want to protect the very hospitals that provide us care. I guess they are not aware that hospitals do go out of business all the time. Just wait until “THAT law” is challenged. Rightly so, the Feds should not be able to tell a business to give away services without expecting to be paid. Why do we have that law? Because hospitals were dumping people – really driving them away from the ER, and dumping them on the street. I find it hard to believe that real Conservatives think that is OK – to force a company, oops a person, to give away their services.
Excellent point! I had not thought of that one. But that is exactly what is happening!
@Pat Herve
And that is the point.
The federales should NOT be able to tell a private service to accept people, either in hospitals or insurance.
Now, IF, in our generosity, we decide we want to provide for the poor and indigent at medical facilities, we need to decide how to pay for it. Forcing a third party to pay for it is also wrong. As citizens, if a majority decides that tax money can pay for it…and its constitutional..then tat would be the law.
THIS is the problem. We want to help people that cannot afford the care. Hospitals are going out of business due to costs. Insurance companies, though profit monsters now…mainly due to a LACK of competition, will also start changing their ways or go out of business. Getting THEM to pay for medical care regardless of pre-condition is not “insurance.” I don’t see it as “protecting” insurance companies. I see it as keeping a private option open.
Because once the insurance companies stop making a profit…then what? Government runs the health care business. Universal, gov’t run health care is the goal. Obama and other Democrats said so. Why shouldn’t I believe them?
So, since I don’t want that…and the only way to get medical care to poor people, is to lower the costs. What does that? The only thing that works is Supply and demand.
Increase the supply. Increase the number of doctors, medical facilities, nurses, etc. Give more power to trained nurses. Get the AMA out of the the business of limiting medicial school slots and restricting the number of doctors. Reform the insurance/gov’t/medical triangle and simplify it. ACR does not simplify a thing.
Cargo, you are seriously off base. There is plenty of insurance competition out there. Why do you think there is not? Without ACA I doubt if squiddette will ever be insurable. That just isn’t right.
There is plenty of profit. CEOs are usually paid $10 million bux annually. Hard to feel sorry for them. Obama and “other democrats” haven’t said Universal govt run health care is the goal. having all Americans insured is the goal.
I am no fan of the AMA but…they are professionals and have the right to organize as a professional organization. So I think we won’t be getting them anywhere. Their rights to organize surpass your wants. You are mighty quick to try to strip othrs of their rights, all while protecting the free riders. 🙄
Supply and demand? You will always have sick people.
Ooops: http://www.youtube.com/watch?v=fpAyan1fXCE
Four Pinocchios..
5 Pinochios for you , Cato. Single payer is not necessarily Universal govt run health care. Know anything about medicare?
What other democrats and I am not sure that is even Obama. He wasn’t president when that was said, regardless of who it was.
I suggest you do a little compare/contrast on medicare, medicaid and say NHS (UK).
Currently Medicare is but one of many payers in the U.S. healthcare system.
If you have a true single payer, the following would be true:
1.) There is only one payer, therefore only one customer of those whom provide medical services.
2.) This one customer would then stipulate services they would pay for and how much they would pay for them, instituting price controls.
3.) Assuming the single payer was the government, you would have a de facto universal government run health care system.
(that’s called deductive logic, BTW)
But you got me on the video clip. I confess I hired a body double with identical physical features and speech patterns to those of the President and paid him 50 bucks to make a 54 second video clip just so I could post it on a local blog.
Medicare is medicare. You are a little too full of yourself and way too smug.
It might be time to consider self-deportation.
Meanwhile, live with what’s there.
Here is just one of the many problems of the Healthcare system in the US – http://vimeo.com/12208795 – too bad they missed the co-pay.
@Moon-howler
I’m really glad I don’t live in Pat Herve’s world. It must be a cold, dark place full of trolls.
Well, I guess I have to ask why, George. I usually agree with Pat 90% of the time so I guess my place is full of trolls too. [looking around]
The same with Cargo. The two of them and their little narrow minded world are incomprehensible.
@Moon-howler
I’m really glad I don’t live in Pat Herve’s world. It must be a cold, dark place full of trolls.
@Cargosquid
Increase the supply. Increase the number of doctors, medical facilities, nurses, etc. Give more power to trained nurses. Get the AMA out of the the business of limiting medicial school slots and restricting the number of doctors. Reform the insurance/gov’t/medical triangle and simplify it. ACR does not simplify a thing.
Cargo–your ignorance is unbelievable! And don’t forget, you took advantage of a pretty damned good “government run” medical program until you quit or whatever happened to you and the Navy.
@George S. Harris
My ignorance? Then, good sir, please enlighten us as to YOUR solution to the problems of supply and demand. How do YOU lower the cost of a commodity? Either you increase supply or decrease demand. Please, enlighten our ignorance as to exactly HOW ACR simplifies medical care and lowers costs. You know, in the face of reports from the CBO and other experts.
Go ahead….we’re waiting.
Oh, and I retired from the Navy after 25 years. They decided to high year tenure me. That means that I could have continued to serve without pay or promotion for points.
I didn’t TAKE ADVANTAGE of anything. There’s a reason why many dependents would rather spend their own money than go to Navy docs and dentists on base.
If you mean my active duty medical…that was the ONLY program. And our “nurses” acted as doctors. We had 4 corpsmen on our ship. NO doctors. When deployed, we, at one time, had ONE corpsman for two shifts on two separate ships we were unloading.
When we got back and I was placed on medical hold…that medical care that was “pretty damned good” took over a month to take a look at me for my INITIAL evaluation. And then decided it couldn’t help me and sent me to go to the VA. When deployed, the doctors decided,even after numerous visits, that I only had pulled muscles, instead of an almost ruptured disk. They didn’t want to risk an MRI because then they might have to send me home. After 3 months, and I return after six week from an in-country deployment…I go over there to raise unmitigated hell. Only to find that those idiotic doctors, that refused to actually examine me, had rotated home. The NEW doctors examined me personally, asked me why I hadn’t had an MRI, said…”oh. Never mind.” Sent me to get one… and guess what? It was exactly what I had told the first docs.
Now I’m at the VA. The VA is… adequate. Unless you need an appointment this week or next week. Medicines are limited. Treatments are limited. You get what they have available.
So you can take your condescension and …..
cargo – I will give you one way that HCR reduces costs – it allows people affordable insurance, so the can see a PCP, instead of the high cost ER for routine care.
It also starts the change in how the Providers are reimbursed – today there is Zero (actually negative) incentive for a Hospital or other provider to cut costs, as they do not get Any of the savings.
It provides for wellness care to keep you healthy – birth control for unwanted pregnancy, check ups, mammograms, cancer screening – being able to talk to your doctor about end of life (so called death panel).
etc. Learn what is in the law.
cargo – another thing – doing nothing is not an option – but it is what many want. We have a deficit, debt, rising health care costs, rising college costs, and it is all getting out of hand. Pretty soon, we will be in the ancient times again – where the wealthy are the only ones to afford and education, healthcare and a decent life.
HCR is not perfect – but it is the first HCR since Clinton tried – and no one liked that either, but did NOThing in the mean time while the costs rise 15-20% per year.
Allows people affordable insurance…. so who pays the subsidies? Is there real savings? SOMEONE is paying.
A change in the way Providers are re-imbursed. That part I’ll take your word for it.
Provides wellness care to keep you healthy….. Great. Who pays? Birth control? Really? Contraceptive devices are that expensive? The check ups etc…great. Who pays? If someone cannot afford the healthcare insurance….up to 400% of the poverty level…the taxpayer pays.
My point is that overall, while there are some good things in there… that can be addressed individually, there is nothing in there worth the intrusion of the federal gov’t into our lives via the IRS and the now expanded powers of the govt to tax you for breathing.
The CBO says that it will increase costs. 900 billion in costs. Insurance rates are already going up or plans dropped.
I would love to learn what’s in the law except parts of it have not been written yet.
The point is that the federal government has no business in doing this in the first place.
@Pat Herve
Pat, I’m not going to try and compete with you on expertise on health care and health care law. I’ve learned the law as best that I can while being a “civilian” in the fight. 3000 pages of minutiae and some of the regulations are still not written.
Doing nothing is always an option. Just because there’s a problem…doesn’t mean that the federales need to be involved. Doing something for the sake of “doing something” is never a good idea. HCR is there so that Congress does not have to do the hard work of examining where IT went wrong in the first place. Example: Health insurance tied to employment – for tax reasons. Unintended consequences, anyone?
I mean, the gov’t can’t even tell people the proper diet to lose weight. And yet they want to add THESE bureaucrats to the mix. Added complexity does not add to simplicity.
http://www.qando.net/?p=13345
Let’s take your points.
Deficit: directly the result of the feds wanting to fix everything.
Debt: see Deficit
rising heath care costs: combination of many things, some the direct result of government involvement. Part of it is increased demand due to the baby boomers, part insurance laws, part the forced acceptance of all patients, part the demand of patients to get the best health care for little cost, ie third party is paying….so why NOT get everything. Do you really think that Congress can fix this?
rising college costs: expansion of administration, easy money for college, culture of “college is absolutely necessary for success in life, etc… Google college bubble. If you have increased demand and limited supply…
Yes…its all getting out of hand. Adding yet another layer of intrusive bureaucracy is NOT going to help matters.
This says it better than I can:http://www.qando.net/?p=13346
__________________________________________________________________
IRS officials on background tell FOX Business the U.S. Supreme Court ruling on health reform gives the IRS even more powers than previously understood.
The IRS now gets to know about a small business’s entire payroll, the level of their insurance coverage — and it gets to know the income of not just the primary breadwinner in your house, but your entire family’s income, in order to assess/collect the mandated tax.
Plus, it gets to share your personal info with all sorts of government agencies, insurance companies and employers.
And that’s just the tip of the iceberg. “We expect even more lien and levy powers,” an IRS official says. Even the Taxpayer Advocate is deeply concerned.
As government takes more and more control of your lives, it intrudes deeper and deeper into them:
The TAO [Taxpayer Advocate Office] says that the “IRS will need to determine a taxpayer’s compliance with the individual [insurance] mandate and assess a penalty if coverage is inadequate.”
However, the penalty isn’t based on just your personal net income. The penalty will be based on an entirely different number that is more than just your paycheck earnings — your ‘household income.’
“This determination is based on a concept of ‘household income,’” TAO has said, adding, “this may differ from the income reported on the taxpayer’s return, because it is a composite of all of the income reported by members of a taxpayer’s household — information that may not be readily accessible to the IRS.”
If the IRS finds you have fallen short of the law, it would hit you with a penalty tied to your household income (which may be that of an individual or several family members).
Under the new health law, the IRS penalty would be based on “modified adjusted gross income,” not adjusted gross income that you normally report at the bottom of the first page of your tax form 1040, before you take deductions or personal exemptions.
The modifications add back in things like non-taxable interest and excluded foreign income to this number.
Meaning:
Health reform’s insurance mandate says if you do not have “adequate” insurance, you’ll have to pay a fine as part of your tax return. If your business doesn’t provide “affordable” coverage, that business may have to pay a fine to the IRS, too, as part of its tax return filings.
The TAO has noted Americans must now tell the IRS under the new law:
*Insurance plan information, including who is covered under the plan and the dates of coverage;
*The costs of your family’s health insurance plans;
*Whether a taxpayer had an offer of employer-sponsored health insurance;
*The cost of employer-sponsored insurance;
*Whether a taxpayer received a premium tax credit; and
*Whether a taxpayer has an exemption from the individual responsibility requirement.
The TAO has warned: “This is different from the type of information the IRS typically deals with, and some taxpayers may feel uncomfortable about sharing it with the IRS.”
In fact, it is incumbent upon you to prove to the IRS that you have “adequate coverage”, whatever that ends up meaning. And:
The TAO has also reported that “obtaining this new information will require the IRS to communicate with entities and government agencies that it may not deal with now,” including:
*New state-run insurance exchanges;
*Employers;
*Insurance companies; and
*Government insurance programs.
But remember the sales pitch – government will make health care simpler, more cost effective and better.
_______________________________________________________________________
Heh. This isn’t going to end well.
The IRS, Health and Human Services and many other agencies will now write thousands of pages of regulations — an effort well under way:
“There’s already 13,000 pages of regulations, and they’re not even done yet,” Rehberg said.