VA Senate bans health insurance mandates

[Wild Cobra]

"If it's found to be cons utional."

mandate is "promoting the general welfare", so it's Cons utional.

Yes BD... Promote.

Promote is not provide. Promote is to dictate. Promote is not force.

You promote by making it more appealing to buy. Not by mandating it.

Ways to promote:

Kill the trial lawyers... (wait... that may be a bit overboard)

Let the free market work by relaxing some regulations.

Stop taxing medical professionals at 35%.

I'll let others add from here.

[Mr. Peabody]

Well thats one silly-ass way of characterizing it.

How bout this?

The Federal government forcing its citizens by law to pay for healthcare out of their own pockets. BTW, it isnt like theyre mandating everyone gets a raise from the employer who provides it now. No, no, no. You still make the same amount of money, but now you have a new car payment every month.

By Federal law.

Its ing bull .

I dont want to assume anything about you, but I pay for my employee's healthcare. Its $1000+ per family and $750+ per single.

I imagine a Federal program would bring about some discount in price. But even being optimistic at say, a 30% reduction in cost, youre looking at a single individual getting a new $525 monthly bill mandated by law (in Michigan, anyway). All this with no raise, 15-20% unemployment, businesses shuttering left and right and people losing their homes.

Oh yeah, I am suuuuuuure this is going to work swimmingly.

Score one for insurance companies, yeah! How unethical, right? So we keep privatized insurance companies, but mandate everyone pay for insurance. This sint like car insurance because owning a car is optional.

This isnt a choice. There is no option. You will be fined or go to jail if you do not have (or provide) health insurance.

What about the millions of people who cant ing afford it?

Are the rest of us supposed to support them in this , too?

Tell me, does the cost decrease per policy get offset by the number of people who cant afford it?

So, the Federal government has basically kept the profit and cost of health insurance private, but socialized the expense on the rest of us?

I hope this administration crashes and ing burns on this. I hope it is Obama's Epic Fail moment.

Not that I dont want healthcare reform, I just dont want THIS healthcare reform. Because this is a ing abortion, direct evidence that our government is bought and sold by corporatists who twist the system. The insurance companies are probably jealous of the bankers who have/had private profit and socialized risk. They want in on that deal.

If this (yes, horse , bull , fly , your , my ) passes, thats what it is. Another win for big business and another means for big business to get all the more wealthy and create dependance from a populace.

WTF!!!!!! Who cant see this?!!?!

Nice post.

The thing that struck me about the requirement of a mandate is that Obama campaigned against a mandate during the primaries, making the argument that the problem with health care is not that people didn't want it, it was just that they couldn't afford it. Therefore, if you bring cost down low enough, a mandate is unnecessary.

The other problem that I have with the mandate is how do we enforce it? Are people paying fines? So, again, we have situation where someone, according to Obama's logic, can't afford insurance and yet, we hit them with a fine. It's ridiculous.

[mogrovejo]

I knew I had read somewhere about the cons utionality of the a federal health insurance mandate. Here it is:

The Individual Mandate: An Uncons utional Exercise of Congressional Power
by Sheldon H. Laskin,
December 21, 2009 - 2:44pm

It is generally agreed, by both proponents and opponents of the Administration’s health reform bill, that the lynchpin of the legislation is the individual mandate requiring uninsured Americans to obtain health insurance, or pay a tax penalty for failing to do so. Without the mandate, even the Administration’s wildly exaggerated cost savings estimates simply cannot work. The whole plan is predicated on enlarging the risk pool by bringing in younger, healthier people who currently lack the means or the incentive – or both – to purchase health insurance.

Given the centrality of the mandate, it is somewhat surprising that little attention has been paid to the critical legal question of whether Congress has the cons utional authority to require Americans to purchase a commodity from a private, for-profit corporation. Other than some limited commentary on the Right -- George Will and Orrin Hatch both had columns on this topic in the Washington Post and the Heritage Foundation recently published a detailed legal analysis of the question – there has been almost no critical discussion of the issue. The silence on this issue is even more amazing in view of the fact that the Congressional Budget Office raised a red flag on the question during the Clinton Administration’s abortive effort at health care reform:

A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States.

CONGRESSIONAL BUDGET OFFICE, THE BUDGETARY TREATMENT OF AN INDIVIDUAL MANDATE TO BUY HEALTH INSURANCE, (1994) available at http://www.cbo.gov/ftpdocs/48xx/doc4816/doc38.pdf

Unlike the states, Congress cannot enact any law even if doing so would foster public safety and health. Under our federal system of government, Congress can only enact laws that are of a type authorized by a provision of Article I of the Cons ution, which sets forth the powers of Congress. Proponents of the individual mandate typically cite the Commerce Clause of the Cons ution as granting Congress the authority to require individual Americans to purchase health insurance.

Article I, Section 8 of the Cons ution grants Congress the power “[t]o regulate Commerce with foreign Nations, and among the several States, and with the Indian tribes.” Therefore, in order for Congress to have the authority to require Americans to purchase health insurance, the purchase of health insurance must cons ute “commerce” within the meaning of the Commerce Clause. It does not.

In 1982, the Supreme Court declared that, in order for a commodity to be considered an article in commerce, it must be capable of being sold. Sporhase v. Nebraska, 458 U.S. 941 at 949 -- 950 (1982). While there is no doubt that the sale of health insurance by an insurer cons utes commerce, it does not follow that the purchase – or more precisely, the failure to purchase – health insurance by a consumer also cons utes commerce. Health insurance, once purchased by a consumer, is not capable of being further sold in commerce because there is no market for it; who would purchase a health insurance policy naming someone else as the insured?

In order to understand the point better, it might be helpful to contrast health insurance with life insurance. Because paid-up life insurance has a cash value, an industry has developed in purchasing life insurance benefits from terminally ill patients. Known as viatical settlement companies, they will pay a percentage of the value of an insurance policy to a terminally ill patient if the corporation is named as the beneficiary of the policy. The patient gets the cash up front, to pay medical bills or to support his family, and the corporation makes a profit on its investment when the insured dies. Because there is a market for life insurance benefits, the purchase of those benefits may be regulated under the Commerce Clause to make sure that the patient is not coerced by the Tony Soprano Benevolent Society to name it as beneficiary.

But there is no market for health insurance benefits once the policy is issued. No one would buy my health insurance, because no one other than I can derive any benefit from it. Since there is no market, health insurance is not an article of commerce once issued. If it is not an article of commerce, Congress lacks authority under the Commerce Clause to require me to purchase it.

There are two Supreme Court cases that proponents of the individual mandate often cite in support of their position that Congress may require individuals to purchase health insurance. The first case involved government regulation of the amount of acreage used by farmers to grow wheat. A farmer who was fined for exceeding his acreage allotment challenged the fine, asserting that since he was using the excess acreage for personal consumption (he used it either to feed his chickens or to make bread for his family), Congress lacked authority under the Commerce Clause to regulate that excess acreage. The Court rejected this argument, pointing out that even wheat grown for personal consumption is marketable and that therefore the farmer’s excess acreage affected the supply and demand for wheat in interstate commerce. Wickard v. Filburn, 317 U.S. 111 at 137 (1942). Using similar reasoning, the Supreme Court recently affirmed congressional authority under the Commerce Clause to regulate the production and use of marijuana as applied to individuals who personally use marijuana for medicinal purposes under state laws that legalize such use. Gonzales v. Raich, 545 U.S. 1 (2005). Again, Congress had commerce clause authority to regulate personal consumption in this context because marijuana for home consumption is “a fungible commodity for which there is an established, albeit illegal, interstate market.” 545 U.S. at 18.

Unlike wheat or marijuana, health insurance is not a fungible commodity and is therefore not marketable. Again, no one would purchase my health insurance – it is personal to me and cannot be sold for any price.

Finally, proponents of the mandate often cite the fact that states require drivers to purchase auto insurance as justifying a federal individual mandate for health insurance. This is a facile comparison that ignores the cons utional differences between federal and state authority to regulate. As noted above, Congress can only legislate when there is a specific provision of Article I of the Cons ution that authorizes it to enact that type of law. Conversely, the states have virtually unlimited legislative authority to pass laws that foster the public welfare, health and safety. Driving is a privilege, and the states are free to impose any reasonable condition on the exercise of that privilege that they choose. In any event, the states have limited the auto insurance requirement to the purchase of liability insurance to cover injuries sustained by third parties. No state requires drivers to purchase insurance to cover their own injuries.

For single-payer advocates, a very powerful argument is that, while the individual mandate to purchase private health insurance is uncons utional, Congress can lawfully tax to support a government financed health insurance program. Article I empowers Congress to use its taxing powers in support of government programs that foster the public welfare; this is the cons utional authority for Social Security and Medicare. But to extend that authority to requiring Americans to purchase a private commodity raises profound civil liberties issues. 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. The auto industry is collapsing? Forget Cash for Clunkers, just order Americans to buy cars or tax them if they don't. Obesity crisis? Order Americans to join health clubs, or tax them if they don't. If Congress gets away with this, there is no stopping point and Big Business will have succeeded in making Americans into involuntary consumers whenever it so chooses.

..............................

Sheldon H. Laskin is an attorney who has appeared in the United States Supreme Court. He is an Adjunct Professor in the Graduate Tax Program at the University of Baltimore Law School. Mr. Laskin specializes in state tax cases under the Commerce Clause of the US Cons ution.

..............................

[mogrovejo]

Nice post.

The thing that struck me about the requirement of a mandate is that Obama campaigned against a mandate during the primaries, making the argument that the problem with health care is not that people didn't want it, it was just that they couldn't afford it. Therefore, if you bring cost down low enough, a mandate is unnecessary.

The other problem that I have with the mandate is how do we enforce it? Are people paying fines? So, again, we have situation where someone, according to Obama's logic, can't afford insurance and yet, we hit them with a fine. It's ridiculous.

Obama promised everything to everybody during the campaign.

In this case, he promised universal coverage (no pre-existing condition restrictions) + no mandate + budgetary neutrality.

Well, that's just impossible... he could have promised that he'd end with the existence of hurricanes or something.

[Winehole23]

No state requires drivers to purchase insurance to cover their own injuries.

If health care reform as currently construed passes, this comes in the door too and along with it, a raft of wanna-be "public welfare" mandates.

A personal insurance mandate enforced with fines for non-compliance is such a ty idea that it's amazing -- dumbfounding, to me -- that it was ever taken seriously to begin with.

I wonder what accounts for that?

[Wild Cobra]

Well, that's just impossible... he could have promised that he'd end with the existence of hurricanes or something.

Well, at least he knew his flock of lib s weren't that stupid.

Or am I wrong? Sometimes I think they are that stupid!

[Crookshanks]

Well, at least he knew his flock of lib s weren't that stupid.

Or am I wrong? Sometimes I think they are that stupid!

Supergirl is. I don't think I've read one comment of hers in this forum that has made sense.

[Supergirl]

Do I have to spell everything out for you s who insist on being obtuse? Or maybe you just ARE obtuse, and it's not something you can have control over.

Health care is a fundamental right. The fact that millions of people in this (still very wealthy) country don't have it because they can't afford it is a moral outrage. Not to mention, that fact is bankrupting our country and health care industry because of the reliance on ERs, so it doesn't even make good economic sense.

The only way to enforce compliance is to mandate people buy it, just like we do with auto insurance & home owners insurance. You would THINK people would always do what is in their best interest, but time and time that has been proven to not be the case, and sometimes you have to make decisions that are best for the country as a whole, because if you don't, what's the point of living as a country?

[SouthernFried]

Health care is a fundamental right.

This is why people might not have the highest opinion of you supergirl.

Where in the Cons ution does it specifically state that "health care" is a fundamental right?

[Supergirl]

This is why people might not have the highest opinion of you supergirl.

Where in the Cons ution does it specifically state that "health care" is a fundamental right?

Well, in the declaration of independence it says life, liberty and the pursuit of happiness, and access to basic medical needs is pretty essential to happiness in most people's eyes.

But I never said it was in the Cons ution. I even argued earlier that the VA decision was setting themselves up to try and challenge the cons utionality of the ruling, and that I didn't know whether that had a chance in of winning.

What I said was, I find this at ude and use of our legal system to be morally repugnant. I said I didn't think it was ethical. That isn't the same thing as not being Cons utional.

However, the whole purpose of government and of laws is to protect people and make their lives a little easier. Otherwise, governments have no reason to exist.

[Winehole23]

They exist for themselves too, Supergirl.

[Winehole23]

Well, at least he knew his flock of lib s weren't that stupid.

Or am I wrong? Sometimes I think they are that stupid!

Sometimes, you are that stupid.

[Marcus Bryant]

So it's akin to supporting slavery to oppose a law which would force individuals to hand over a significant portion of their income and wealth to large insurers on an annual basis?

Not to mention what such a precedent could mean for politicians to use on the gullible next time. This uplifter desire to micromanage national life is tiresome.

[mogrovejo]

If health care reform as currently construed passes, this comes in the door too and along with it, a raft of wanna-be "public welfare" mandates.

A personal insurance mandate enforced with fines for non-compliance is such a ty idea that it's amazing -- dumbfounding, to me -- that it was ever taken seriously to begin with.

I wonder what accounts for that?

From the moment you assume you want almost everybody to have health-care coverage, ergo that you want to prohibit or severely limit pre-existing conditions exclusions, then it's extremely difficult to escape mandates.

Supergirl is. I don't think I've read one comment of hers in this forum that has made sense.

I concur.

[Mr. Peabody]

The only way to enforce compliance is to mandate people buy it, just like we do with auto insurance & home owners insurance. You would THINK people would always do what is in their best interest, but time and time that has been proven to not be the case, and sometimes you have to make decisions that are best for the country as a whole, because if you don't, what's the point of living as a country?

The thing about auto and home insurance is that I choose to purchase a car or home and factor those costs into my budget at purchase. Also, as far as I know, my homeowner's insurance is a requirement of my financing company (which makes sense), but I could be wrong.

I don't know that mandating that everyone buys insurance is in every individual's best interest. What if you can't afford it? What if you can, but it's at the expense of a car or paying for daycare for your kids? Medical insurance is not cheap and requiring people to purchase it is a large added expense. Again, I don't think people are failing to buy insurance because they just don't want it. I think in many cases, it's just too expensive.

Until we control costs, essentially all we're doing is forcing people to participate in a system that gets more and more expensive every year.

[Aggie Hoopsfan]

If the individual mandate falls within Congress' powers under the Commerce Clause and the Necessary and Proper Clause, then the 10th Amendment cannot be an independent grounds for challenge.

That's still a huge reach, mandating that you take your money and buy a service. It is different than taxation.

This basically sets it up so if Obama/Pelosi/Reid try to jam through Obamacare, it is destined for a date with the U.S. Supreme Court.

[Aggie Hoopsfan]

Well, in the declaration of independence it says life, liberty and the pursuit of happiness, and access to basic medical needs is pretty essential to happiness in most people's eyes.

If I have to pay for your health care, it's infringing on my pursuit of happiness.

you.

Health care is a fundamental right. The fact that millions of people in this (still very wealthy) country don't have it because they can't afford it is a moral outrage.

Again, no one in this country is denied health care.

And acting like Obamacare will solve the problem of health care costs is comical. You are one stupid .

[Crookshanks]

Health insurance is not like Auto or Homeowners insurance. You are only required to have liability coverage, unless your car is still being financed. Mortgage companies require homeowner's insurance - but you really are only required to cover the cost of the house, not your belongings. And once your house is paid off, you don't have to have it (although it would be pretty stupid not to).

In both cases, insurance is required to cover losses incurred by the loan holders - not the individual. What Obamacare is requiring is far different - and it's wrong to force a person to buy something they don't want or can't afford.

[Winehole23]

Again, no one in this country is denied health care.

At the ER, no.

[Mr. Peabody]

Again, no one in this country is denied health care.

So, the studies showing that the uninsured are don't have regular doctors, have limited access to prescription medications, are more likely to forgo needed care, receive fewer preventive services, put off immunizations and routine checkups, and obtain inadequate care to manage chronic diseases, are all mistaken?

Then there's this from the New York Times -

Uninsured children who wind up in the hospital are much more likely to die than children covered by either private or government insurance plans, according to one of the first studies to assess the impact of insurance coverage on hospitalized children.

Researchers at Johns Hopkins Children’s Center analyzed data from more than 23 million children’s hospitalizations in 37 states from 1988 to 2005. Compared with insured children, uninsured children faced a 60 percent increased risk of dying, the researchers found.

The authors estimated that at least 1,000 hospitalized children died each year simply because they lacked insurance, accounting for 16,787 of some 38,649 children’s deaths nationwide during the period analyzed.

“If you take two kids from the same demographic background — the same race, same gender, same neighborhood income level and same number of co-morbidities or other illnesses — the kid without insurance is 60 percent more likely to die in the hospital than the kid in the bed right next to him or her who is insured,” said David C. Chang, co-director of the pediatric surgery outcomes group at the children’s center and an author of the study, which appeared today in The Journal of Public Health.

Although the research was not set up to identify why uninsured children were more likely to die, it found that they were more likely to gain access to care through the emergency room, suggesting they might have more advanced disease by the time they were hospitalized.

In addition, uninsured children were in the hospital, on average, for less than a day when they died, compared with a full day for insured children. Children without insurance incurred lower hospital charges — $8,058 on average, compared with $20,951 for insured children.

I don't know that basic emergency care (as you allude to) equates to "health care" as we think of it in this county.

[coyotes_geek]

Well, in the declaration of independence it says life, liberty and the pursuit ofhappiness, and access to basic medical needs is pretty essential to happiness in most people's eyes.

Your point is severely flawed. It doesn't matter if healthcare is essential to happiness. Happiness is not a fundamental right. Only the pursuit is.

[coyotes_geek]

Therein lies part of the problem.

10th Amendment to the Cons ution.... States Rights.



The sad part in all this is that Virginia is having to author a bill specifically to assert its sovereign rights in light of Obamacare.

You will be seeing more bills like this directed at Obamacare, Crap & Trade, and some of the other craptastic hyper-liberal ideas of Obama and his crew, as long as they are in power.

I'm all for states rights, so if that tact works then I'm all for it. But I still have my doubts that the supreme court would rule that a state law can trump a federal law when the two are in direct conflict with each other.

[EmptyMan]

What fascinates me is how disgusting this is from an ethical standpoint. We object to citizens having health care so strongly that we're going to resist the government's efforts to try and protect citizens' right to it. From a moral standpoint, the comparison to slavery is quite apt.

LOLOLOLOL, you fail at step one.

Start over. You will never understand the game if you blindly accept or assume the government's agenda matches your own.

[DarkReign]

Do I have to spell everything out for you s who insist on being obtuse? Or maybe you just ARE obtuse, and it's not something you can have control over.

Health care is a fundamental right. The fact that millions of people in this (still very wealthy) country don't have it because they can't afford it is a moral outrage. Not to mention, that fact is bankrupting our country and health care industry because of the reliance on ERs, so it doesn't even make good economic sense.

The only way to enforce compliance is to mandate people buy it, just like we do with auto insurance & home owners insurance. You would THINK people would always do what is in their best interest, but time and time that has been proven to not be the case, and sometimes you have to make decisions that are best for the country as a whole, because if you don't, what's the point of living as a country?

You literally embody everything that is wrong with the Democratic party.

You demonstrated about every cliche attached to said party in three paragraphs. Bravo, I say.

Elitist? Check
Knows whats best for everyone? Check
Even if they dont like it? Check
Will create law to enforce their views on everyone? Check
Has no ing clue how to pay for it? Check
..yet still finds a way to pander to big business? Absolutely Check.

Health care is a fundamental right.

No, it isnt. If it were, it'd be in the Cons ution. It doesnt appear there, so apparently, the forefathers didnt think much about people's right to lifetime healthcare.

But you obviously know better than all of us as evidenced by your "talking down" podium meeting you just had.

Let me set you straight on some , right quick...

You dont -all about whats best for every, single American. Nor do I. Nor does government. The inalienable rights dictated in the Bill of Rights are about as close to universal truisms the entire world of developed nations can agree on...sort of.

Outside of those obvious rights, everything else is a debate. Debates have two or more sides. Just because you think healthcare is some God given right doesnt make it so. Move to a state that has universal healthcare, is my suggestion.

As for the rest of us, we worry about things like...ooooh, I dont know....how people like ing you are going to pay for this? Beyond that, I know more than a few people wonder about, sheesh...lemme think....why health insurance providers will be private ins utions with socialized risk. That seems a tad unbecoming of a free and open society, methinks?

What do you think?

What the do you think about health insurance companies having an installed, mandated by law customer base of 400 million people? That their inevitable and exhorbitant profits will be divied up amongst themselves and their shareholders, but you (and us), the mandated-by-law consumer will never see a price break?

What the do you think about that? Are the millions of unemployed not enough for you? You want more?!

Are the hundreds of thousands of bankruptcies shy of your overall goal of complete meltdown? What the ing do you think will happen when every single mom with 3 kids and 18 year old high school grad with no career has a brand new monthly bill for ~$500?!

What do you think will happen?!

Because, to me, where I stand, the people I know, the unemployed, government-reliant people I know, this would crush them into poverty. Poverty by law and corporate profit.

To me, with your stated position and backing of this...craptastic bill, I know one or three things about you.

a) Youre an idiot that never put any real thought into the logistics surrounding an endeavor like universal healthcare.

b) Youre a blind loyalist. True Blue Through and Through, no questions asked, none required, a lemming on the edge of a cliff and brimming with confidence in mein Fuhrer.

c) You are smarter than you let on. You know this will create dependance and depression on a widescale. A government-reliant society is a controllable government society and that is your true aim.

Honestly, Ive wasted too much time on you as it is. Just stop talking. There will never be a rational mind in this country who will agree with your arguments on their own merits. Your husband agrees with you because you sit on something he wants, your children agree with you because youve brainwashed them and your friends might agree with you only because they know youre harmless.

No one else will, only those close to you. Because if/when you get on a podium in front of a diverse group and read the quoted three paragraphs aloud, I doubt you get through the first paragraph before youre drowned out by "boo's" and calls of "elitist". Rightfully so.

Let this post be my first and last rude interaction with you.

You need and require a much broader and more open mind desperately.

[DarkReign]

FWIW, I see a world with universal healthcare of some sort only because the current setup is far too expensive.

Not because its a right, but because the cost to most American families is dire and that medical expenses literally bankrupt people everyday.

Now, one can be crass and say "Those people probably shouldnt have received medical attention, then". With this at ude, I could never agree. Everyone who doesnt suffer from extreme depression, when faced with their own mortality, will opt for the care they require, consequences be damned.

I dont think we as Americans should condone a system like this by way of inaction.

But IF we are going to do it, then do it ing right. This ObamaCare bull is the exact wrong way to do this. This will kill us as a country (or at least until the day we erase it from the books). Not every American can pay their own insurance on their net income. So any law that says "You will be mandated to pay from your own pocket" is asinine.

How to enforce that? what about the millions who cant afford it? Is their drain on society just going to be subsidized by the rest of us? How will that affect costs to those of us who pay? What about the lowering of cost per premium? What about older people on fixed incomes and the highest medical bills on average?

No.

What Obama and Congress propose is an abortion. You either do it right the first time (which requires ing over a lot of billion-dollar businesses) or you dont do it at all. It would seem the spineless wonders on Capitol Hill have found their nice, sleezy middle ground that accomplishes nothing but appeasing the poor, the rich and the clueless.

Once again, government dances to the lowest common denominator.