Sunday, November 28, 2010

Health care mandate removal could be bad, and employer deduction removal costly for Americans

For a while now I’ve wondered how losing the health care mandate will effect reform, and now I have the answer, in this NY Times article. It’s pretty profound, and will be abused most by conservative whiners who have objected to the mandate, because they will eventually buy insurance only when they need it. Their excuse for gaming the new system? It’s legal. Forget about the moral, ethical and humane reasons most people would find their response repugnant.

Obama officials are bracing for the possibility that federal judge Henry E. Hudson of Federal District Court in Richmond in Virginia will soon reject its central provision as unconstitutional and, in the worst case for the White House, halt its enforcement until higher courts can rule. So far, there has been only one ruling on the merits among nearly two dozen legal challenges to the health care act. Last month, a federal district judge in Michigan upheld the law. But another judge, Roger Vinson of Federal District Court in Pensacola, Fla., has joined Judge Hudson. Because the Supreme Court has said the commerce clause of the Constitution allows Congress to regulate “activities that substantially affect interstate commerce,” the judges must decide whether the failure to obtain insurance can be defined as an“activity.”

Any district court judge who rules against the law would have to decide whether to block enforcement of one or more of its provisions … the plaintiffs in the Florida case, have emphasized that Congressional bill writers did not include a “severability clause” that would explicitly protect other parts of the sprawling law if certain provisions were struck down … An earlier version passed the House last November (and) included severability language. But not the Senate version, which ultimately became law. Without such language, the Supreme Court, through its prior rulings, essentially requires judges to try to determine whether Congress would have enacted the rest of a law without the unconstitutional provisions.

The Justice Department acknowledges that several of the law’s central provisions, like the requirement that insurers cover those with pre-existing conditions, cannot work unless both the healthy and the unhealthy are mandated to have insurance. Otherwise, consumers could simply buy coverage when they needed treatment, causing the insurance market to “implode,” the federal government asserts. The administration argues that other key provisions do not depend on the insurance mandate … establishing health insurance exchanges, subsidizing premiums through tax credits and expanding Medicaid eligibility, nor would (it) undermine certain insurance regulations, like the requirement that insurers cover children younger than 26 on their parents’ policies.

Lawyers for Virginia note that the health law explicitly refers to the insurance requirement as “an essential part” of the act’s regulatory scheme, and that Justice Department lawyers —If it is so essential, Virginia’s lawyers have asked, why should a judge believe that Congress intended for the rest of the act to stand without it?

Another big move will effect consumers even more than reform itself, maybe even garner support for Obamacare:
AP: Job-based health care benefits could wind up on the chopping block … Budget proposals from leaders in
both parties have urged shrinking or eliminating tax breaks that help make employer health insurancethe leading source of coverage in the nation and a middle-class mainstay.
The key negative effect on consumers that will cause them to rise up screaming for single payer health care:

The idea isn't to just raise revenue, economists say, but finally to turn Americans into frugal health care consumers by having them face the full costs of their medical decisions. Tampering with health care tax breaks is "a terrible step in the wrong direction," said Mary Kay Henry, the new president of the Service Employees International Union, which represents many hospital workers. "

We want the middle class stabilized, not destabilized." Employer-provided health insurance is part of a worker's compensation. Unlike wages, it isn't subject to income and payroll taxes.

Having been in the private market for a decade and more, when Americans see how the system is gamed against them, advocates for total privatization will be hung in effigy. Maybe this will be the shock consumers needed to wake them up.
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1 comment:

  1. Yes, this will be huge. If the ruling goes against reform, we might see the process start all over.

    Maybe not a bad thing. Perhaps slower health care reform will result in a better alternative with bigger savings.