Supreme Court: Affordable Care Act Is Constitutional 2416
This morning the U.S. Supreme Court ruled 5-4 that the Affordable Care Act is constitutional. The health insurance mandate, also known as "Obamacare" was found to be "permissible under Congress's taxing authority." The full ruling (PDF) is now available, and the court's opinion begins on page 7. Amy Howe from SCOTUSblog summarized the ruling thus:
"The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding."
Further coverage is available from CNN, the NY Times, and Fox.
Re:Public option (Score:5, Informative)
It took a lot of political capital to even get this passed. The public option was removed to make it passable.
Re:Odd reasoning (Score:5, Informative)
I find it interesting that it was found Constitutional under taxing power. I don't recall anyone pushing that angle to support the law in the court of public opinion.
There, FTFY.
Good question (Score:5, Informative)
The individual mandate was designed (by Republican think tanks) to avoid freeloaders, who we've all been paying for when they show up in the emergency room.
I also have insurance and the 2 big things it does for me are that it'll be tougher for an insurance company to deny benefits based on a pre-existing condition (which has been interpreted ludicrously loosely at times) and that if I (or someone close to me) ever does have huge medical bills, it will be less likely to bankrupt me.
Re:Odd reasoning (Score:5, Informative)
Re:Odd reasoning (Score:5, Informative)
It was argued as a side argument at SCOTUS. basically the argument was that 'this is permissible under the Commerce Clause, but oh, even if it isn't then it is a tax and is permissible as that'. Always smart to give the court multiple possible reasons something can be constitutional as this case clearly shows.
Re:Now to understand what it means (Score:5, Informative)
In Texas the state created a socialist program in which everyone who drives a car has to have insurance. The argument that having a car is a choice was hogwash, you have to have a car in texas. The government basically decided the insurance companies were to profit, but did crate a pool that one could use for insurance of last resort. The result is a new $400 expense to owning a car. The other result is that uninsured motorist insurance is very cheap, and I am not paying for others people accidents. If it is good in TX, it is good everywhere.
It's not a mandate (Score:5, Informative)
You can get a tax break for having your own insurance, as proof that you won't be costing taxpayers anything when you end up defaulting on $200k of hospital bills after an accident.
I don't know why the democrats couldn't shape the message that way. That's really what it is, and sounds better than "pay up or pay up".
Re:So from here on out ... (Score:5, Informative)
The majority of the country didn't want this legislation.
Yeah, funny thing about that.
When people were polled about specific parts OF the bill, with the exception of the mandate, everything had a solid majority of support.
Of course, the mandate is the keystone that pays for the rest of the parts people like.
So, all that really proves is people want the great taste WITH less filling, which isn't how economics works.
It's more of a pudding after meat situation.
Re:Now to understand what it means (Score:5, Informative)
Odds are your taxes will go up to support enforcing this program, as will your health insurance costs as they struggle to compete with it.
Insurance rates will likely go up LESS fast since those WITH health insurance have ALWAYS been paying for those WITHOUT. Now we will no longer have to do that in many cases. Of course, healthcare and insurance being what they are, insurance will still go up, just not as fast.
At this point most of the law has already been priced in insurance anyway.
Re:So from here on out ... (Score:5, Informative)
The majority of the country, however, wanted every single major provision of the legislation. The hate is more of a result of a concerted PR campaign. Many Americans, like myself, wanted something better, more efficient, and more forward-thinking in scope, but that was "double socialism" or some such.
Re:Tax?? I Call Bullshit (Score:5, Informative)
Wrong. The tax is the PENALTY if you do not get insurance, not the insurance payment.
Re:SCREW EVERYONE ELSE (Score:5, Informative)
I got MY healthcare.
You and your family can take a FLYING LEAP.
The most selfish American generation says SCREW YOU!!
Thanks for sharing the GOP platform on this.
Re:Tax?? I Call Bullshit (Score:5, Informative)
As the mandate is to give money to private insurers, and not the government itself.
No, there is a fine if you don't don't have insurance, which does go to the government. This is the tax in question and the Supreme Court held it to be valid. Given the all the millions of other special cases that our tax code includes, all of which penalize people for not doing what the government wants, this isn't surprising. If the bill made it a crime with criminal penalties for not holding insurance, then the Supreme Court may have ruled otherwise, but it didn't. You still have the full right to not hold insurance, you will just be taxed up the wazoo for it.
Re:So from here on out ... (Score:5, Informative)
The majority of the country didn't want this legislation. It was voted down in congress and they had to resort to some trick to pass it.
Uhhhh...
1) The majority of the country has no idea what's even in the bill. Vast majorities of America (even conservatives) support its provisions, however. http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does/
2) Congress passed the law with a majority vote. And now it's been proven constitutional. Do you have a suggestion how to make laws more democratically?
you already are taxed for this (Score:5, Informative)
have been for decades
when someone uninsured shows up at the hospital with a broken arm, then avoids the bill or declares bankrupcty, we bail out the hospital from bankrupcty and you pay the bill
the only thing that has changed is that irresponsible people, people who think freedom means not to taking responsible for their healthcare, now have to do that, and stop freeloading off of us
Re:So from here on out ... (Score:4, Informative)
fine, if you're not a wage slave and don't want to buy your own insurance, then don't. but if you get really sick or injured don't expect much care because i don't want to pay for it. and don't expect the best hospitals to take care of you. send you to the county/city run hospital where you will be lucky if they change you after lying in your own filth
choose wisely.
Re:If it's a tax then everyone should pay it (Score:4, Informative)
I don't see why people that get government approved insurance don't pay it. If it's a tax and not a shitty way to coerce people into the program then it should apply to everyone.
To only apply it to people that don't get the policies is a bill of attainder.
You are nuts. There are GOBS of taxes that not everyone pays. Do you pay Alternative Minimum Tax? How about the Luxury Tax? Estate tax? etc., etc., etc.,.
Get a clue.
Re:So from here on out ... (Score:5, Informative)
First, Obama and the Dems sold this as not a tax. So they lied. Obama is now responsible for raising taxes on all Americans to the tune of over a trillion dollars.
Second, it's a tax on you. Not what you earn, not where you live, not what you own, but you.
So they got their technical win. Doesn't make it right though.
Bullshit. The tax is only on those who refuse to get insurance. That will be an infinitisimally small number of Americans.
Re:Public option (Score:5, Informative)
Interestingly, the right's opposition is purely an ideological objection to "Obamacare". Opposition is 56% to 44% BUT if you ask about the different pieces (Reuters-Ipsos poll), 80% of Rebublicans favor creating "insurance pools", 52% favor letting kids stay on their parent's healthcare until age 26, 78% favor banning insurance from denying coverage for "pre-existing" conditions and 82% favor banning insurance companies from dropping sick people. The numbers are, of course, much higher amongst independents/democrats.
So, the right wing objects to Obamacare while favoring all the major provisions.
Re:Now to understand what it means (Score:5, Informative)
So, will this actually change anything for people like me?
Like anything else complicated, it depends. Some things it does that could affect you:
* If you have any kids ages 18-26 you have the option of putting them on your group insurance plan, which you couldn't always do before this was passed.
* If you work full-time for a company that has more than 25 employees, they have to offer you health insurance benefits. If you don't work for that kind of company, they're setting up an insurance exchange where you can easily compare and buy insurance.
* If it does what the people who designed it think it will do, it will reduce the number of people who show up at ERs without insurance, and significantly increase the chance of poorer people getting preventative care.
* It prevents your insurance company from refusing to cover something by claiming it's a pre-existing condition, and from cutting you off because you got sick.
* The part that people are up in arms about is that if you don't somehow acquire health insurance, you pay a tax penalty.
* If you were poor, the government would pay for your health insurance. I doubt this is relevant to you.
This is more-or-less identical to the plan passed in Massachusetts several years ago, and signed into law by one Mitt Romney. The studies vary as to how useful it was (mostly depending on the political slant of those doing the study).
Re:So from here on out ... (Score:5, Informative)
Re:So from here on out ... (Score:4, Informative)
1. Government makes decision.
2. Money leaves my pocket.
How is this not a tax? We can nit pick the details about what level it comes out of, but a tax is a tax is a tax. Nothing's free!
Re:Public option (Score:4, Informative)
the public opinion of those who want to freeload off the rest of us because they think freedom means they don't have to pay for their healthcare, we do?
You do realize that a society full of sick people is just one step from a plague, right? There is a threshold beyond which even people who receive medical care can be affected.
So get over it -- yes, tax dollars should be used to keep people alive and healthy, just like tax dollars are used to keep roads paved. We spend huge amounts of tax money funding paramilitary police forces and keeping millions of people incarcerated (more prisoners than any other country by orders of magnitude); how about we take the money out of those programs and use it to pay for health care?
Re:So from here on out ... (Score:5, Informative)
(quoting from memory) - "There is nothing more natural than to start with a general phrase and then limit it with a list of specifics. The "general welfare" is qualified and limited by the list of powers immediately following it. To ignore this enumeration would be to create a central government of unlimited power, minus a few peculiar exceptions (Bill of Rights), and there is a whole host of proofs that was never intended by the framers or myself.
"The Congress is one of limited powers while the bulk are reserved to the States and the People, respectively (10th amend.)." - James Madison, author of the Constitution.
Re:So from here on out ... (Score:5, Informative)
Meanwhile, everyone ignored the actual universal healthcare bill [wikipedia.org] that would have paid for itself, not with a fundamental, constitutionally questionable mandate / giveaway to insurance companies, but, shock and appall, a tax. Can't have that! Let's just force people to pay for it directly, except that they have to buy it from private insurance companies who can still dictate their care or lack thereof. It's not a tax if the forced payment of money doesn't go to the government!
But I'm not bitter. Not at all.
When this blows up in everyone's faces in a couple of presidencies (you know, after insurance premiums shoot through the roof and price fixing is commonplace), don't say I didn't say I told you so.
The really annoying thing to me is that this is still probably the closest Obama could have got to universal care in the current political climate. I don't even really blame him.
Re:Excellent decision (Score:5, Informative)
At least the ACA forces private health insurance companies to spend 85% of the premiums they receive on health care and limits overhead to 15%. A lot of people received rebates from their insurers this year because of that provision.
Re:So from here on out ... (Score:3, Informative)
"The SCOTUS labeled it a tax after the fact."
No Obama's lawyers TOLD the Supreme Court it's just a tax, and therefore should be legal. Go review their arguments. The grandparent poster was correct: Obama and his lawyers lied and said "it's not a tax" back in 2009/10, but in 2012 his lawyers argued it was in order to make it pass the court.
Re:So from here on out ... (Score:5, Informative)
It's cheaper for my employer to drop my insurance *now* and pay *zero* tax, but they haven't because they use it as an incentive to keep me around. Your argument is a completely moot point.
--Jeremy
Re:Now to understand what it means (Score:4, Informative)
Forty percent of the people in the US pay ZERO federal taxes. It's a free ride for them on my back!
Payroll taxes are federal taxes. Retired people drawing on SS already paid their taxes ....
Oh, why bother. Reason and logic won't sway you.
Re:So from here on out ... (Score:5, Informative)
1. Congress has the right to force citizens to enter into commerce, under the commerce clause -- the mandate penalty was just that, a penalty.
2. Congress has the right to tax any behavior it sees fit -- the mandate penalty was, for this purpose, a tax.
SCOTUS rejected the first claim (proving that they do see limits to the commerce clause sometimes), and accepted the second claim. SCOTUS did not create the idea that it was the mandate was a new tax -- the government did.
Re:Now to understand what it means (Score:5, Informative)
Whether insurers pass these cost savings to individuals is a craps shoot.
One provision of the ACA is that insurance companies must spend at least 85% of the premiums they receive on actual health care, not overhead. A bunch of people have received rebate checks from their insurance companies this year because of that provision.
Re:Roberts said... (Score:3, Informative)
So who's job is it to look out for the best interests of the country? Is that one of those mystery jobs that Americans just don't want to do?
Well as I understand it if this is a tax, then Congress has the right to collect taxes so if people aren't happy with the way they're being taxed they should elect a different Congress. I think this mystery job is called "voting". As for the majority imposing their taxes on the minority that's probably most of them. You don't expect the SUV owners to approve of gas taxes do you? And so the people that have no health insurance obviously oppose a tax on people that don't have health insurance. Congress collect taxes with consent of the people, not consent of the taxed.
Re:First dissent (Score:5, Informative)
The government is offering health insurance that I can buy? Since when?
There's Medicare, which I pay into despite not being eligible for and won't be for another 30+ years. There's the VA system, but I have to serve in the military to be eligible for that. I make too much money to be eligible for Medicaid. My tax money goes to pay for both of those, too.
So I'm being forced to pay for three services I can't even use. I would LOVE for there to be a government option, then I could actually get the services my taxes pay for.
(This is not a complaint about paying taxes, BTW - I'm happy that the relatively low amounts I pay help veterans, impoverished people and the elderly.)
=Smidge=
Re:So from here on out ... (Score:4, Informative)
Really? I'm not in the 1% and I have no difficulty affording my health insurance. Exaggerate much?
Re:So from here on out ... (Score:5, Informative)
Actually, Obama's lawyers told the Court that, firstly, it was not a tax but a valid use of the government's Commerce-Clause powers. Then they outlined two alternative arguments:
Alternative A: Even if the Court finds it was not within the scope of the Commerce Clause, the ACA is nonetheless Constitutional under the Necessary and Proper clause, because the insurance mandate is both necessary and proper to enacting Congress's reform scheme.
Alternative B: Even if the Court finds it is neither within the scope of the CC or the N&P clause, the ACA should nonetheless be upheld because it is functionally equivalent to a tax, and if treated as a tax, is within Congress's powers under the Tax Clause.
The Court rejected Obama's lawyers' primary and Alternative A arguments, but accepted Alternative B. This is fairly common in legal cases. You first say what you think is true, but then you go through several alternatives that argue that, even if the Court disagrees with you in some way, you should nonetheless win for several backup reasons.
Actually no. (Score:5, Informative)
Obama's lawyers said that it is independently authorized under both the commerce clause and the taxing authority, and then made the case [with precedent] that in cases where a law would be constitutional under one clause of federal authority but unconstitutional when read under another clause of federal authority then the Supreme Court is obligated to interpret under the clause which renders the law constitutional, regardless of the language within the law or political verbage utilized when debating the law outside the courtroom.
The majority opinion said that it was unconstitutional under the commerce clause, but clearly constitutional under the taxing authority, regardless of the labels used.
That argument makes a lot of sense to me as an engineer who is far more concerned with mechanics than with labels.
Re:So from here on out ... (Score:5, Informative)
Bullshit. The tax is only on those who refuse to get insurance. That will be an infinitisimally small number of Americans.
What about those who would like to have insurance but still can't fucking afford it? That's the question I would like answered as it pertains directly to me and yet I can find no discussion of it.
Maybe you misunderstand why insurance is being offered to those who can't afford it. It is a cost savings plan.
Every state already has laws to the effect that you must treat an emergency prior to ascertaining ability to pay. The poor know this, so when they get sick, they cannot sechedule a doctor's appointment (because the doctor will ascertain ability to pay prior to treatment). Instead they go to the local emergency room.
The hospitals then get stuck with a bill that cannot be paid by the individual. Laws to prevent individuals from being forced to file bankrupcy can also limit the rate at which the cost can be recovered to less than the person's disposable income. Many large bills are being paid back at a rate fo $10 a month (or less).
Hospitals cannot operate with such legally mandataed losses, so they bill the state governments, which in turn designate "charity" hospitals which cannot turn away the indigent but are paid by the state for treatment.
In effect, you were already paying for the poor, just you were guaranteeing payment instead of providing insurance. With the "insurance plan" dressing on the previously guaranteed support, at least now the poor can go to clinics, reducing the bill significantly. This means that cheaper treatement plans are at least now possible, and two radically different billing systems (bill the state / bill insurance) can be reduce to one system (bill insurance), with a single new insurance provider.
The main problems in perception revolve around the populace not realizing that they had already been paying for free healthcare to the indigent. They think the new plan offers more to the poor, and in a way it does (clinic visits, etc); but, it only does so by forcing them to abandon the use of the most expensive medical treatement plan possible (go the ER for all healh issues).
Of course the bill is laden with other items, like requiring insurance providers to not drop the insured after they are discovered to require an expensive treatment; but, don't let that get in the way of a good rant that your money might actually keep someone else alive (which is probably the most noble thing your tax dollars could go to.).
Re:So from here on out ... (Score:5, Informative)
It was disconnected until 1973 (or so) when the government required large businesses to offer it.
Actually, that wasn't the first step-it really came from wage controls during WW2. You couldn't give someone a raise past X dollars, but you could offer them extra benefits, such as health care.
Now it's morphed into a horrible mess which has unintended consequences such as what you mentioned above. But there are too many moneyed interests being enriched by the current system to pass any real change.
Single-payer Canadian style healthcare would be better for doctors and employers...a huge pool of healthy people would drop health care costs significantly, and employers would no longer have to offer a health care benefit. But of course the drug companies and health insurance companies would lose out, so they'll fight tooth and nail to keep their broken system.
Re:Justice Roberts Gem (Score:3, Informative)
The ruling explicitly discusses Wickard v Filburn and explains why it does not apply in this case. To summarize, you can regulate activity people are engaged in, but you can't use the commerce clause to force people to engage in an activity. However, you can use taxes to encourage people to participate in an activity.
Re:So from here on out ... (Score:4, Informative)
That in my mind is money I never had, so I don't think about it, if I get some back at tax time, it is just a bonus to me.
And that sort of programmed thinking is why they can get away with it.
Re:So from here on out ... (Score:4, Informative)
You do realize that Romney drafted a very similar plan?
Re:So from here on out ... (Score:5, Informative)
Holy cripes, man! "...money you never had?!?" It was money that was forcibly removed from you before you ever saw it!
Like the man said, it is money he never had.
Add up that missing 1/3 from your paycheck. What could you do with that?
If he could somehow evade paying taxes, his lifestyle would improve. If everybody else could do it too, his lifestyle would get much worse. Any furthur questions?
Re:Public option (Score:5, Informative)
Good thing the bill has a provision that "Insurers must spend a certain percent of premium dollars on eligible expenses, subject to various waivers and exemptions; if an insurer fails to meet this requirement, there is no penalty, but a rebate must be issued to the policy holder." IIRC the percentage is 85%, so 85% of premiums can't go into pockets in the insurance company, and need to be spent on healthcare, or else they go back to subscribers.
Re:First dissent (Score:3, Informative)
Begging your pardon, but that entire post reads like FUD.
Re:Excellent decision (Score:4, Informative)
OK, since you asked... (Score:2, Informative)
It takes considerably less money to give money to the poor to spend on preventive care and ordinary medical care than it does to have them wait until they are really, DESPERATELY sick, quite likely beyond hope of avoiding or reducing the impact of an illness, and then use an emergency room, without warning and at the general public's expense, to attempt to fix their problems before they become abruptly fatal.
Yes, money is still being spent on the poor under the health care act, but considerably less money than is currently the case. So it is a net savings to the general public.
Re:So from here on out ... (Score:5, Informative)
Really? I'm not in the 1% and I have no difficulty affording my health insurance. Exaggerate much?
Lemme guess - you don't a) have a "pre-existing condition" that insurance companies find unprofitable to deal with and b) you don't take expensive medications (which have risen in cost at a strong multiple of inflation for the past 10 years and will continue to rise in cost).
Thing is, both of these conditions can change - suddenly. When you can be revoked at any time, Insurance doesn't really give you much assurance.
Your current state (and even precautions you take) doesn't have a definitive outcome on whether you will or won't draw an unlucky card next year or decade.
Re:First dissent (Score:5, Informative)
"that's precisely what this law is: a government mandated fee (NOT a tax, that's also BS) for simply being alive."
Yes, it's a fee. It's a fee for a financial risk-mitigating service. It's also a fee I've been paying (in the form of higher premiums) for people who want to be alive and not pay their own bills for the services (in the emergency room, of all places) of people who keep them alive, working, having bratty kids, etc. It's also a fee that I've been paying for people who don't have the good sense to get regular medical checkups and screenings at a clinic pr Dr's office when they're well, so that their chronic diseases can be managed such that they don't have to go to the emergency room and be admitted to treat conditions that could have been prevented or controlled.
As it happens, I pay other fees for other people to be alive (for water treatment and sewer service, for public schools, for bridges and infrastructure, for firefighting coverage), but I get to share in those benefits, too, so these are fees that I pay in the form of taxes, because the good is public.
I'm quite tired of having me and every other insured person having to foot the bill so that libertarians and objectivists can enjoy some kind of idealistic existence.
I met a guy, a guy who owned his own construction business, who refused to get health insurance. He always went to the ER when he was sick, and only when he was very sick or injured. Never paid a single medical bill. He had a really nice power boat -- a big cabin cruiser. I asked him why he didn't buy insurance and he said that he could not afford to carry it for his company, and that even if he could afford it, he had concluded that he would only end up paying more than he would get out of it, should he have to rely on it. If he was deathly sick or fatally injured, nobody was going to be able to make him pay when he was dead. He said that by not paying a bill he didn't have to pay it permitted him more money to do things he liked -- like his boat. I said, "so, because I pay my insurance, you got free health care and also that boat." and he looked me straight in the eye and said "yeah, exactly".
Now that guy has to pay -=something=-, and I feel a little better about having to share air with him.
Re:So from here on out ... (Score:3, Informative)
When the fire department puts out a fire, they stop all the other houses in the neighborhood from burning down. Is this a concept you find too difficult to understand? That's a serious question, because your statement boggles my mind.
The police "don't have a duty to protect you" and "the courts have stated this" in the sense that you can't sue the police when somebody robs you. That is a circumstance unrelated to the fact that the police do, in fact, for the most part prevent and investigate crimes. Once again, is that a concept you have never considered before now?
You use the local school system even when you aren't enrolled it, and even when your children aren't enrolled in it, by enjoying the social and economic benefits of an educated citizenry. Public education is the number one most beneficial government program in the history of humanity, literally, bar none. Most people agree that we can do even better, but only a jackass would consider razing it because it is short of perfection. You didn't suggest razing it, so I am not calling you a jackass.
My friend died that way. (Score:3, Informative)
We had a good friend, Ilona Daukiene, who died that way. She was a very gracious hostess, and the beloved wife of an amazing man. We enjoyed his "Freedom in English" camps in Lithuania.
The story is here [ideasinactiontv.com].
Yes, global warming plays into the story. But a huge part is the destruction that planned economies create.
No, the tea-baggers aren't exaggerating. What they've been saying is real.
Re:First dissent (Score:5, Informative)
Re:If $3000 is the societal cost to you not (Score:4, Informative)
Another bullshit hit piece on CFLs.
1 penny per month a normal rate (10 cents per kWh) is 100Wh. A typical incandescent bulb is 60W, a similar CFL is 15W. That saves 45W. So if you replace a single 60W light bulb with a CFL and it's used 3 hours per month, you've already saved more than a penny per month.
I'm guessing you have more then a single 60W light bulb and that you use it for more than 3 hours per month.
I could talk about how actual tests show that CFLs last way longer than incandescent bulbs, or that most CFLs are crushed and recycled in the USA, or that shipping things "25000 miles from China" (it's closer to 7500 miles; no point is "25000" miles away) is actually not all that energy intensive.
But I don't think your rant is based on facts. It's based on a need to be contrarian, to be seen as anything but "green", and to oppose environmental regulations.
We can have a legitimate discussion about whether the government has the right to enact environmental regulations, about whether they are effective, and about whether they are necessary. But if you start with information that is wrong, we can't really discuss anything.