[jeffkrol]

Maybe we should buy them one way bus tickets to Canada.

cold...........

[mikemike]

but like Virginia, you just pay a "fee" for not being covered.. you can avoid it.
pop of US 307,006,550 (includes all even under 15 or whatever)
vehicles.....246,000,000
optional, not real likely in the real world......

That includes second cars for lots of reasons like a beater to drive in the winter, a truck for hunting or fishing, RVs, hobby cars, collector cars, etc. It also includes fleet vehicles like police cars, company cars, rental cars, delivery vehicles, etc. There are lots of people who get along just fine without a car and without facing an auto insurance mandate. If I was a little bit tougher I would get rid of one of my cars and commute by bike through the hottest months of the summer, the coldest days of winter, and in the rain... but I am too much of a pansy for that and only do it when the weather is nice.

cold...........

Your right, they probably live in AZ because they don't like cold weather... so Cuba or Venezuela.

With so many countries with easy access to high quality socialized medicine I don't understand why people faced with a life or death choice of staying here and being uninsured and unable to pay or emigrating and being able to access these great systems in other countries and live choose to stay and die here. If I was in their situation I would scrape together my bottom dollar and hit the road for the closest hospital across the Canadian border.

[Parallax]

IF the mandate doesn't pass what happens to "mandated" auto ins. in the states???
................

Not even close to the same thing.
No state in this country requires you to have auto insurance simply because you exist.

[Nesster]

That is not equivalent... you can avoid it by not owning a car. The health insurance mandate is unavoidable.

However, even if you don't own a car but are hit by one, you are better off if the driver has insurance.

The insurance mandate isn't the best part of the bill, unfortunately it's the one that could get passed across industry lobbying, Republicans, and the more conservative Democrats.

The basic concept of insurance is that you spread the cost across a very large population in order to pay for the few who need it. Our insurance business does a fair job at this - yet, if you allow the large population to = US population, and remove the profit overhead (and even with gov't inefficiency, surely the administrative overhead is less than the dozens of private companies all doing the same back office work - and paying several layers of bosses in the several companies big bucks)... surely the risk is spread out further and thus the overall cost is lower.

The issue then is how to argue with the medical industry: machinery makers, drug companies, doctors, over what is a reasonable price for each item. Somehow Siemens, pick a large Euro drug company, and European doctors manage to make a living.

[SteveM]

That is not equivalent... you can avoid it by not owning a car. The health insurance mandate is unavoidable.



Maybe we should buy them one way bus tickets to Canada.

Won't help here either unless they have insurance (or Visa). Canadians (in my neck of the woods at least) are not forced to pay for insurance. Mind you, insurance is reasonably priced (single insurer) so you would be insane not to have it. First thing you'll be asked for at the Dr's office or hospital is for your "medical card" aka insurance.

cold...........

I guess depending on where you live in the States, it rains a lot where I live in the winter.

[jeffkrol]

Not even close to the same thing.
No state in this country requires you to have auto insurance simply because you exist.

Tell me by what "right" (constitutional or otherwise) allows a state to "mandate" any insurance....
http://heinonline.org/HOL/LandingPage?collection=journals&handle=hein.journa...v=22&id=&page=
http://content.healthaffairs.org/content/26/6/1612.full.pdf+html

PROLOGUE: Massachusetts policymakers have painstakingly crafted interlocking
health insurance initiatives and mandates, including an unprecedented individual
mandate, in hopes of achieving near-universal coverage. Underscore
“hopes,” because predicting a target population’s response to a mandate is, at best,
an inexact science. As the first efforts to require motorcycle helmet use illustrate, a
single miscalculation can doom an otherwise almost perfect mandate.
The 1966NationalHighway Safety Act (NHSA) contained a proviso intended to
reduce catastrophic head injuries from motorcycle accidents: States not requiring
that all riderswear helmets would become ineligible for certain highway funds. By
1975, forty-seven states had universal helmet laws in place, compliance neared 100
percent, and the number of fatal head injuries plunged. Later that year, Congress
voided the NHSA proviso. Helmet laws were quickly repealed or downgraded to
less easily enforced partial-use laws in twenty-eight states; in those states, motorcycle
accident deaths rebounded as helmet use fell to approximately 50 percent.
Why the turnaround? For a vocal minority of riders, the perceived cost of compliance—
loss of personal liberty—far exceeded the putative cost—the price of a helmet.
Even as they donned helmets, antihelmet activists lobbied vigorously for repeal
of the NHSA proviso and suedmandating states for infringing on their rights.
They lost almost every constitutional challenge but succeeded in wearing down
the states, and in winning Congress’s sympathy.

[mikemike]

Tell me by what "right" (constitutional or otherwise) allows a state to "mandate" any insurance....

The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

-The Tenth Amendment

Which is why insurance markets are regulated on a state by state basis. It is also why Romneycare is okay for MA but Obamacare is not okay for the whole USA.

[jeffkrol]

-The Tenth Amendment

Which is why insurance markets are regulated on a state by state basis. It is also why Romneycare is okay for MA but Obamacare is not okay for the whole USA.

US fed can just use the bully pulpit.. no health care mandate per state .. no fed funding......... simple

“If Congress can compel the purchase of insurance from a for profit insurance company, it can compel the purchase of any commodity if there is an arguable public policy to support it.

Yet states can do just that........................funny

Predictions as to where the current Supreme Court would come down vary. I find Laskin’s arguments the most persuasive. Here’s a lengthy two-sided debate and here are the cherry-picked opinions offered by Sen. Max Baucus (D., Blue Cross Blue Shield).

Is mandated health insurance commerce? It is not, like all other commerce, something that can be resold. It is not, like all other commerce, optional, if you force everyone to purchase it.

Is it interstate? That concept has perhaps been loosened enough to cover anything that counts as commerce, and the new legislation may allow the sale of health insurance across state lines despite candidate Obama’s argument that doing so would create a race to the bottom in quality and accountability.

But you can’t have interstate commerce with something that isn’t commerce at all.

Is mandated health insurance a tax? President Obama swears it isn’t. He calls its enforcement mechanism a “fine.”

But perhaps that’s for public consumption, whereas courts will be told it’s a tax. Is it? How can it be, when it is not a payment to the government? If it is, there is the problem that Article I requires that “imposts and excises shall be uniform throughout the United States” which this would not be.

But the Constitution forbids the ongoing warrantless spying programs. The Constitution does not allow presidents to launch wars. In the Constitution everyone has the right to habeas corpus.

We have cases in which the Supreme Court has ruled our general public practices unconstitutional, and yet they blissfully proceed. Ultimately, the question is whether we will stand for fascistic policies or fascistic interpretations of the Constitution. Personally, I will not stand for either.

http://pubrecord.org/commentary/6386/legal-challenges-health-reform/

Is an Individual Health Insurance Mandate Constitutional?

David Rivkin and Lee Casey this week argued in a Wall Street Journal opinion piece that the mandatory insurance provision in Senator Baucus's health reform bill is unconstitutional.

The argument goes like this:

1. Congress lacks authority under the Commerce Clause to require individuals to purchase insurance, because a "health-care mandate would not regulate any 'activity.'" The authors reference United States v. Lopez and Gonzales v. Raich.

2. Because Congress can't do it under the Commerce Clause, Baucus (and other supporters of an individual mandate) have called it a tax. (Baucus's bill refers to the penalty for failure to insure an "excise tax," to be administered and collected by the IRS.)

3. But this "excise tax" is plainly a penalty, pushing the bounds of the Supreme Court's Taxing Clause jurisprudence. The authors: "The Supreme Court has never accepted such a proposition, and it is unlikely to accept it now, even in an area as important as health care."

The authors are wrong on two counts. First, an individual mandate is almost certainly the kind of economic activity that the Court would uphold under Congress's Commerce Clause authority under Raich, Lopez, and United States v. Morrison. These cases allow Congress to regulate activities that have a "substantial effect" on interstate commerce, and they look to the commercial nature of the activity and to the connection between the activity and interstate commerce (among other considerations). An individual mandate is almost surely commercial in nature--in requiring folks to buy health insurance, it requires a commercial exchange. Rivkin and Casey argue that the mandate is not commercial in nature, because it's triggered simply by "being an American." This may be true, but it misses the point of the regulation: It requires Americans to engage in a commercial exchange. This is the definition of commerce.

Moreover, the individual mandate is closely related to interstate commerce. The whole argument for an individual mandate is to get health care consumers to internalize their costs, and not spread them to the larger interstate economy. A health insurance mandate is almost certainly within Congress's Commerce Clause powers, whether Congress calls it an "excise tax" or something else.

Second, Rivkin and Casey misunderstand the Taxing Power. Congress can adopt an excise tax to an end that is within its other constitutional powers, as here. But even if Congress is acting outside its other articulated powers, the Court has interpreted the Taxing Power quite broadly, all but eliminating any distinction between a "penalty" and revenue-producing "tax." See United States v. Kahriger (upholding a federal tax on gambling under Congress's Taxing Power) (overturned on other grounds).

The Supreme Court may be on a path to limiting congressional authority under the Commerce Clause, the Taxing Clause, or any clause. But even so, the individual mandate all too squarely falls within the recent and settled jurisprudence.

We've posted on similar constitutional issues in the health care reform debate here, here, and here.

http://lawprofessors.typepad.com/conlaw/2009/09/is-an-individual-health-insu...itutional.html

Given the reality of federal supremacy, the expansive federal authority under the Commerce Clause, and a sprawling health care system that pervades the national economy (isn't that exactly the problem?), the state efforts to limit federal health care reform and the arguments that federal health care reform exceed the federal government's powers have no real traction in our federal constitutional system. But they seem to have garnered enough of a following to at least signal that some number think, on principle or merely because of politics, that the federal government has no business in health care reform.

And back to the auto ins. thing......

In contrast, congressional regulation of the health care industry does not violate state prerogatives. To be sure, much regulation of insurance occurs at the state level. But that's because Congress has chosen by statute to defer to state regulation. The Constitution does not prevent Congress from revoking its statutory grants to state governments.

http://www.huffingtonpost.com/david-orentlicher/an-individual-mandate-to_b_391810.html
Counterpoint
http://www.heritage.org/research/reports/2009/12/why-the-personal-mandate-to...constitutional

[mikemike]

US fed can just use the bully pulpit.. no health care mandate per state .. no fed funding......... simple

Thats how they did medicaid but it took 17 years before 100% of states participated in medicaid.

How long do you think it will take Texas, the state with the highest percentage of population uninsured to sign up?

Or California with the highest number of people that are uninsured to sign up, especially if signing up requires the state to chip in some money?

How do you think states like CA, TX, AZ, and NM will handle tax payer subsidized insurance for illegals.

[Nesster]

Jeez, reading this thread is like watching a car wreck... bums me out big time.

[jeffkrol]

why they really don't like it..................
Why Republicans really want to repeal health reform - CSMonitor.com

What Republicans really oppose about the health reform law is the tax increases that do most of the deficit reduction in the law. These aren’t just random tax increases, though. These are the kind of tax increases (or reductions in health insurance tax expenditures) necessary to bring out-of-pocket health costs more in line with true economic costs, to reduce the excess demand for health care that drives up the market price of health care. It’s not that Republicans oppose the idea of making health care markets more efficient. It’s probably that they don’t like the idea of any kind of tax increase, and especially not the kind of tax increase that would be paid disproportionately by higher-income households, who they emphasize are the “engine of economic growth” in our economy–you know, the “job creators.”

So that’s how this bill to repeal the health reform law becomes characterized as a way to eliminate a “job-killing” law, and how the proposal is really perfectly consistent with the Republican supply-side ideology that says that tax increases, no matter of what variety, hurt the economy and reduce jobs, and deficits, if they come from tax cuts rather than spending increases, don’t matter.

[Parallax]

Tell me by what "right" (constitutional or otherwise) allows a state to "mandate" any insurance....

I don't believe they have any. The Constitution gives Congress the authority to regulate interstate commerce, but I can't find anything in it that gives Congress the authority to compell commerce.

[Wheatfield]

Maybe we should buy them one way bus tickets to Canada.

Pity you are so incapable of looking after your own poor, or ill people that loading them onto boxcars and sending them to a foreign country looks like a viable option.

With so many countries with easy access to high quality socialized medicine I don't understand why people faced with a life or death choice of staying here and being uninsured and unable to pay or emigrating and being able to access these great systems in other countries and live choose to stay and die here. If I was in their situation I would scrape together my bottom dollar and hit the road for the closest hospital across the Canadian border.

The hospitals in southern Saskatchewan do get a number of cross boarder health care cases every year from North Dakota and Montana.
While I appreciate your sentiment, you really shouldn't be pushing the responsibility for caring for your sick people onto other countries.

[jeffkrol]

Thats how they did medicaid but it took 17 years before 100% of states participated in medicaid.

How long do you think it will take Texas, the state with the highest percentage of population uninsured to sign up?

Or California with the highest number of people that are uninsured to sign up, especially if signing up requires the state to chip in some money?

How do you think states like CA, TX, AZ, and NM will handle tax payer subsidized insurance for illegals.

Just for fun another example of 2 faced hypocrisy......

"You're saying: 'Let's repeal this bill. We don't have a replacement. Trust us,' " said Rep. Jim McGovern (D-Mass.). "So much for the open process. There is none."

Speaking to reporters elsewhere at the Capitol, Boehner countered: "I promised a more open process. I didn't promise that every single bill was going to be an open bill."

and the usual.. la,la,la,la eyes closed......

"CBO is entitled to their opinion," House Speaker John A. Boehner (R-Ohio) said. "I do not believe that repealing the job-killing healthcare law will increase the deficit."


The closely watched CBO, an agency that lawmakers from both parties have historically relied on, is considered one of the most important independent sources for information about the effect of proposed legislation.

MORE on that:http://voices.washingtonpost.com/ezra-klein/2011/01/omnibus_post_on_the_gimmicks_i.html


Healthcare law repeal: Congressional Budget Office projects federal deficits would grow by $230 billion - latimes.com

[jeffkrol]

Have at it................

It's clear that there is no promise the Republicans won't break, no principle they won't sacrifice and no fact they won't ignore in order to let the insurance companies off the hook and strip consumers of important protections like the ban on denying care to people with pre-existing conditions.

The Republicans are trashing the nonpartisan CBO report simply because it's inconvenient. Instead they cooked up their own numbers about the ACA costing money when it really saves $230 billion in the first 10 years and $1.2 trillion in the second decade.

And the impact of repeal on the federal deficit is only part of the problem. The Republicans insist on calling the ACA "job-killing." It's exactly the opposite - it creates jobs. A report out today by Harvard economics professor David Cutler concludes that repeal would destroy 250,000 to 400,000 jobs annually. Over the next decade, that's up to 4 million jobs killed by repeal.

The Republicans' reckless repeal bill will put insurance companies back in charge of our health care and restore the 'anything-goes' premium rate hikes that are crushing consumers and businesses. The health insurance companies are certainly getting what they paid for in the 2010 elections.

And what do the Republicans want to replace the new law with? Nothing. They're referring that question to House committees that will deliberate for months and play political football with our lives and health. Repeal means letting the insurance companies deny care to people with pre-existing conditions and run roughshod over consumers.

When the Republicans vote for repeal on Jan. 12, they'll be telling seniors they have to pay back the $250 donut hole checks they received to help buy prescription drugs. They'll be booting young adults off their parents' health plans. They'll be taking away people's newly won freedom from fear of insurers denying their care, dropping people who get sick and imposing double-digit premium hikes with impunity. The Republican repeal plan will force nearly 900,000 American families to go bankrupt because of huge medical bills.

We've finally gotten the insurance companies off our backs, and the first thing the Republicans want to do is put them back in charge.

Ethan Rome: Boehner's Fantasy Math on Health Care Repeal
http://www.bepress.com/ev/vol7/iss5/art2/

A successful repeal of health care reform would revert us back to the old system for financing and delivering health care and lead to substantial increases in total medical spending. The consequences of this spending increase would be far reaching. It would hurt family incomes, jobs, and economic growth.

Repealing health reform would:

* Increase medical spending by $125 billion by the end of this decade and add nearly $2,000 annually to family insurance premiums
* Destroy 250,000 to 400,000 jobs annually over the next decade
* Reduce the share of workers who start new businesses, move to new jobs, or otherwise invest in themselves and the economy

http://www.americanprogress.org/issues/2011/01/jobs_health_repeal.html