Day One of a three-day marathon of SCOTUS hearings on this landmark case.
Before the court today was a jurisdictional question, as the court brought in one Robert Long to argue that an 1867 law, the "Anti-Injunction Act," bars the court from entertaining any suit to restrain a tax before said tax has been collected. If the AIA argument prevails, the court would have to defer hearings on the Affordable Care Act until 2015 at the earliest. Which raises the question, what is it? Tax, fine, penalty, well-meaning suggestion?
Basically, today's question is "should we punt"? As it happens, none of the justices seem persuaded that the penalty or fine Obamacare attaches to the tax code is in fact a tax, and some fun was had today at the expense of US Solicitor General Donald Verrelli, who in arguments today kept calling the mandate's backstop a "tax penalty" (the government's position seems to be that it's a bit of both).
“Today you are arguing that the penalty is not a tax,” Alito said. “Tomorrow, you are going to be back, and you will be arguing that the penalty is a tax.”
Justice Breyer got so carried away with the day's antisemanticism that at one point he wondered whether the mandate itself should even in fact be considered a mandate. With an explicitly unenforceable and uncollectable penalty as its only backstop, Breyer seemed to get a bit hung up on the mandate's lack of... mandatoriality.
In any case, it looks like the debate will really get rolling tomorrow, and we'll begin to get a sense of whether or not the Randy Barnetts of the world will be crying in their beer by this time Wednesday.
As always, scotusblog remains the best way to get the latest info on the case as reports come out, and the long-running debate between Randy Barnett, Ilya Somin, Orin Kerr and others over at the Volokh Conspiracy is a great place to get extremely well-informed (though noticeably more slanted) discussion of the day's rulings.


OT: Cameras and Line Standers
(#277016)I've learned this week that Line Standing is a business in Washington, DC. As in, there are firms that will take your money to hire people to stand in line outside important hearing rooms ahead of important hearings to hold a spot for you.
There are cameras covering Congress and the Senate, and many of the important committee hearings*, which is right and proper. The public's business should be conducted in public and in a nation of 300 millions, which territory spans a continent from ocean to ocean, cameras allow more of the public to witness the public's business.
So why aren't there cameras covering the SCOTUS?
------------------
*And is this age of the Internet and ubiquitous HD cameras, shouldn't ALL committee hearings be so shot, recorded, and archived?
A different question
(#277018)Why does the Supreme Court have oral arguments anyway? The parties involved file hundreds of pages of briefs, and it seems ridiculous for questions this important to be decided based on the off-the-cuff answers of nervous attorneys responding to justices who are more often than not just thinking out loud. If the Supremes have a serious question to ask they should put it in writing and ask the parties to respond in writing.
I don't think the cameras would hurt or help much. The rationale behind having public proceedings is accountability, but the judiciary is interionally structured to insulate them from short-term accountability, and there are some reasons for that. The oral arguments are mostly what-ifs and thinking out loud, rather than the motion-second-pass stuff you get in a committee or a legislature, so there aren't concrete actions the public could react to anyway. Are we going to impeach an SC justice just for asking a question?
The real decisions and deal-making (to the extent they engage in deal making) are made back in the chambers, and if you put cameras back there, they'd do it in coffee room or down the street at a bar.
Hell, they should get a blog!
(#277023)But seriously, and in defense of federal procedure...presenting oral arguments and taking questions in such a formalized setting is very different from exchanging memos or letters, or even having private meetings. In-person public dialogues involve an extreme level of concentration & scrutiny that can't be reproduced in writing...just ask Plato. It's one thing to read someone's argument, however well crafted. It's very different to hear it from them directly, and be able to challenge their thinking, ask for clarification, and ask them to respond to your own views on the issue. That said, I don't think the hearings are likely to sway any of the justices, but they are instead an opportunity for each of them to hone their thinking and (indirectly) challenge their colleagues.
M Aurelius was probably right.
Not To Mention. . .
(#277031). . .that every lefty legal pundit in the country would lose a reason to look down their nose at Clarence Thomas if oral argument was done away with, which is among the reasons why you will rarely hear one call for doing away with it (oddly enough, Des and I had a rare moment of agreement a few years back when I commented on the limited usefulness of oral argument and he agreed without prompting--he'll never make it if he tries to become a lefty legal pundit).
The universe may well have been created without a point--that doesn't imply that we can't give it one.
When I read tobins book on the court
(#277089)I seem to recall that the questions asked in fact do not always conform to how the justices rule... I think this will come down different than most people think......
Charles Laughton monocle trick
(#277151)The Charles Laughton monocle trick (Witness for the Prosecution) only works for oral arguments.
And I think the judges would feel silly wearing goat hair wigs while reading documents.
You will kill 10 of our men, and we will kill 1 of yours, and in the end it will be you who tire of it. - Ho Chi Minh
Don't know, but I agree.
(#277022)Archive this s#!t for posterity. We have googolbytes of video recording every aspect of our lives from first steps to picking our nose at the gas pump, and we can't tape the highest court in the land debating the most momentous legal decision of our generation?
M Aurelius was probably right.
Revenge Is A Dish Best Served Cold
(#277039)I sincerely hope that Justice Alito enjoyed making Mr. Obama's representative squirm by simply pointing out the obvious--the Obama Administration is trying to have it both ways.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
I wonder if maybe they aren't right.
(#277043)Congress had its reasons for writing the mandate as if it were giving an order, but structuring the thing exactly like a(n unenforceable) tax penalty in the Internal Revenue Code. The court is left with a choice: it can either accept Congress's terminology uncritically, or it can examine the actual functioning of the law. Seems like they're leaning toward the latter.
M Aurelius was probably right.
Did you read the response from the SG?
(#277052)because it sounds like Alito didn't understand the diference between the two cases:
That doesn't look like squirming to me.
I blame it all on the Internet
It's squirming.
(#277060)The SG has the first part right, using a different name doesn't change it from a tax to something else. But that last sentence is just grabbing at straws. There isn't any reason to believe that the three letters "t a x" have to appear for the statute to apply. Text here. From it's placement in the federal code it's clear it applies to challenges to the collection of any tax.
Do you seriously think that if the IRS called something an "assessment" or "collection" instead of "tax" in a letter to a taxpayer, the taxpayer would suddenly be exempt from the Anti-Injunction Act? Hard to believe the IRS would agree.
EDIT: BTW, that "narrow" case from a few days ago r.e. appealing an EPA ruling could very well be relevant here. The SC ruled that the EPA couldn't game the meaning of the word "final" so that it means one thing if it would benefit the agency and another if it would benefit the landowner. It had to have one meaning for everyone. The SC is likely to say you can't game the word "tax" either - the govt has to say whether the ACA penaltaxfeefine is a tax or not and accept all the consequences of that decision.
Don't Be Silly
(#277062)Sackett was a narrow, meaningless decision that will be forgotten to history when a court rules that the Sacketts are lying poopyheads when they have their day in court. It will have absolutely no relevance going forward.*
*closed-captioned for the sarcasm-impaired.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
I don't think so
(#277091)there are plenty of examples in tax law where items are accounted for different ways depending on context. That's why most companies bigger than a one or two man operation keep at least two separate sets of books, at least one for accounting purposes and one for tax purposes. Congress does this all the time, claiming that in some circumstances an item will be a tax and in others not. This also interacts with state tax laws in, um, interesting ways. So I don't think his answer is sophistry, just a recognition of reality. If you want a headache, and an understanding about why I never, ever would be involved in tax law, just read up on the definition of tax expenditures sometime.
I blame it all on the Internet
Mandatoriality or Mandatority?
(#277055)If coin we must, let us do it well.
I am not a pessimist. I am an incompetent optimist.
Mandatrition? -nt-
(#277056).
M Aurelius was probably right.
Regardless, the whole
(#277061)ACA could be described as mandacious.
Mandalitious
(#277073)mandatritious.
Manditative.
This is a problem for a toddler to solve. They have a unique grasp of language.
Obamacare question for legal minds...
(#277058)Challengers to the individual mandate yesterday painted a dire picture of a Congress overstepping constitutional bounds and inventing brand new powers for itself. The argument has become familiar:
In a nutshell, the government in this case is claiming that it is regulating commerce that already exists, i.e. the health insurance market which currently by default covers all Americans, insured and uninsured alike, subsidizing those without insurance to the tune of $40 billion annually.
But challengers say no, Congress isn't regulating commerce, it's forcing individuals to enter into commerce against their will, in a novel assertion of police power. Thus, the Court's decision, assuming it mediates between just these two narratives, is going to turn on whether the justices agree that this is regulating existing commerce, or creating brand new markets.
But first, a question for the anti-mandatians out there. Congress would be well within its rights to simply expand Medicare coverage to cover all Americans. They'd simply increase payroll deductions (and perhaps tack on some capital gains deductions), and we'd all be covered under the Medicare program. How would that be any different in kind from the individual mandate as it is structured? We would still all be forced to pay premiums, whether we need care or not, and those premiums would be used to pay private vendors, and we as private citizens would have if anything less involvement in the choice of vendors or the structure of payments to be made. Oh, and increased payroll taxes would be actually mandatory, as opposed to "mandatory, but nothing will happen if you don't pay" under Obamacare.
How could expanded Medicare be perfectly legitimate, while Obamacare with its individual mandate is a constitutional apocalypse? Medicare is quite obviously an example of federal police power: the government takes tax money and gives it directly to health providers & insurers. Obamacare instead represents an effort to remove the middleman (the government), and leave private citizens a greater degree of choice in how to spend the same money.
Put even more simply, if Obamacare's mandate is unconstitutional, how can Medicare - today's unmodified Medicare - be legal? I hope the court gets around to sorting out this difference.
M Aurelius was probably right.
Everyone agrees that Congress can tax
(#277059)and offer public insurance with the proceeds of the tax.
A mandate - with accompanying fine - to purchase the product of a private business is unprecedented, however.
Personally I'd like SCOTUS to sever and strike down the mandate, but the conservative justices rarely do me any favors ...
First off
(#277066)We're not anti-mandatians, we're anti-mandites.
Second, I object (yet again) to the use of the phrase "federal police power". Police power has a specific meaning, it's not what you say it is, and even the most liberal members of the court have stated that there is no such power, and they go so far as to explicitly deny that they are trying to create one when their rulings expand federal power.
But on your main point - you're making the same mistake people made on Citizens United: viewing this as matter of what rights/choices people have, rather than a question on the limits on Congressional power.
In the Citizens United case, people kept acting as if the 1st Amendment says "Each person has the right of free speech" when what it really says is "Congress shall make no law.." - and Congress had made a law.
Likewise here - regardless of what the motivation or ideology of the anti-mandites is with regards to markets, choices, or the net financial effect on individual citizens, that is not what is being litigated. What is being litigated is whether the ACA mandate is a valid part of the commerce power.
What got the government in trouble in the Lopez case (Gun Free School Zone Act, struck down) was this - the govt claimed banning guns from school zones was part of the commerce clause. The court then asked if there was anything that wasn't commerce, and the govt lawyers got tongue tied. They lost the case.
The government would justify Medicare, whether in today's form or in some expanded form, using (a) their constitutional authority to tax, and to tax as much as they want, and (b) their constitutional authority to spend for the "general welfare". I doubt they'd try to claim it was regulation of commerce. However, that IS what they are claiming on the insurance mandate.
But I don't think you addressed the issue,
(#277072)which is that, whatever you call them or however you rationalize the laws, Medicare and Obamacare are functionally identical. Government is taking money from citizens using tax power, in order to give that money to private vendors in the health industry. It matters not one bit - functionally speaking - whether the government first takes the money from you before handing it over, or simply asks you to hand it over yourself.
"You can't do that using the commerce power! You have to use the tax and spend power!" is a purely semantic argument. If the government does in fact have the power to take money from citizens and give that money to health providers, then why should the court get involved to make sure Congress is using the correct terminology?
Take that thought a step further. If the government can already exert this power to tax and spend for the general welfare, regardless of what they call it, then why all the cries of an "unprecedented" "novel" expansion of federal power? Tomorrow Congress could decide to expand Medicare to cover all citizens, raise FICA taxes, hand the extra money to health care providers, and call it a day. That would be a far more imposing use of federal power than what Obamacare proposes...so how can Obamacare be either unique or expansionary? How can a less imposing form of federal power be a greater abuse than a more imposing form?
Yet a third way to look at the issue: if Obamacare is unconstitutional, how can Medicare be okiedoke?
M Aurelius was probably right.
Update: Justice Kennedy
(#277077)the likely swing vote, seemed to indicate in today's questioning that a major concern of his is whether Obamacare's mandate "fundamentally changes the relationship between the government and individuals." I haven't yet found the gov't's responses to his concerns, but I'd hope someone will ask the court to consider how extraordinary it could be for the government to promote a watered-down version of already-established law...and to consider whether striking down Congress's rationale for a law makes sense when laws with identical (or even more coercive) effects are already fully accepted.
M Aurelius was probably right.
eeyn524, Has Me Convinced, Which is Why I was Always a Tax
(#277084)...and single payer system advocate.
I like finessing difficult questions as well as the next person, but sometimes the tried and true plain simple is best.
All of this is a result of the political argument I, among others, lost here in requesting single payer and...Obama, conniver that he is, decided to go in the Mandate direction.
The better argument was not presented, honorably, as an up or down...take your picks and force the issue.
I still think that single payer would have carried the day if presented well.
Best Wishes, Traveller (btw, now that I'm not paying $1,400/month for private insurance, I love my medicare....it is about $133 a month).
Yep
(#277095)I'm not a fan of single payer, and as Jordan says it would be at least as invasive/pervasive than what is being proposed - but it would be on more solid constitutional ground.
The advantage of private health care is invidual choice, the down side is nasty profiteering and swindling by insurance companies. The ACA manages to keep all the profiteering while killing off individual choice - because the regulations on qualifying insurance policies are going to be so narrow that there aren't meaningful differences between policies.
Not true, ACA defines a minimum level of coverage,
(#277097)but you can still elect for better coverage, choose from dozens of payment structures...and of course you'll be able to choose which doctors and hospitals you go to for treatment. If you or anyone you know's been treated in one of the local hospital butcher shops you can find in any city in this country, then you'll know that choice of doctor is the one thing that really counts.
M Aurelius was probably right.
I don't believe that.
(#277100)I believe once you create an office with 50-100 conscientious hardworking bureaucrats, they will produce more regulations to micromanage the options. And your side has already admitted that your big issue is inequality. As long as you define inequality as a problem there will be constant pressure to reduce the difference between the minimum and the cadillac plans. First by penaltaxing lavish plans - an idea that is already out there - and then eventually by restricting them.
Wait, you say, there isn't any section of ACA creating an office issuing regulations. Where the "regulations" will come in is when companies submit their offered plans to be certified/approved. That certification/approval has to come from someone, and that someone has to issue "interpretations" of the law defining what counts and what doesn't.
Private insurers have bureaucrats too.
(#277102)In fact, that is essentially the problem with private health insurance (their main job being to deny claims rather than provide health care).
M Aurelius was probably right.
Very true.
(#277103)Currently I can decide whether or not I want to deal with those evil private bureaucrats. You've passed a law taking away that choice.
Nope: Medicare. Already been done. -nt-
(#277105).
M Aurelius was probably right.
Haven''t reached fogeyhood
(#277107)yet so I'm kind of ignorant. Is there really a part of Medicare where I'll be required by law have to pick a private insurer and send them money?
Keep in mind that my definition of required is narrow. "Won't fully take advantage of some government benefit unless you do something" isn't the same as "will be in violation of the law you don't do it".
You have to file paperwork, you have to register
(#277109)with Medicare's agency, so really, pretty similar to being compelled to sign an insurance policy.
For that matter you have to register with the Social Security Administration before you're able to work. If you're self-employed, you're required to calculate & make quarterly payments on your Medicare "premiums." If you're employed by someone else, *they* are required to do the same on your behalf.
M Aurelius was probably right.
For Medicare to be "just the same"
(#277114)as ACA the following must be true: the payment is direct to a private party, and is mandatory. Mandatory means required by law, not required to obtain an optional benefit that one could elect to let go.
The "premiums" are to the government and are therefore a tax. As everyone explicitly acknowledges when then they use the phrase "payroll taxes".
It doesn't matter much to me who finally profits. What matters to me is whether the govt is spending its own money, or telling me how to spend my money.
BTW, this constant use of previous encroachments to serve as precedents justifying unexpected new ones is precisely why every single new thing the govt does has to be fought tooth and nail regardless of the merits.
The government's money is your money.
(#277116)The government is spending your money. Or rather, is telling you to give it your money so that the government can spend your money.
I'm not sure I understand your first point. Medicare premiums are mandatory, because the taxes are mandatory. Payments go to private parties. Payments are also mandatory -- Congress requires that the government spend Medicare dollars each year. So with Medicare, you're required to pay for it, and you're required to register for it, and the government is required to pay Medicare providers. But you're not required to use it. Just like ACA!
M Aurelius was probably right.
???
(#277122)We seem to disagree over simple words like "your". Possession of money is not eternal. When I go to the grocery, cash changes hand. Before it was "mine" and after it is "theirs". Likewise with the IRS.
I think you misunderstand my objection here. It is isn't about net cost so arguments based on net cost aren't going to sway me. It's about a deliberate attempt to blur the distinction between public and private property, money, and funds.
You say, basically, that the government could have taken the money as taxes. Actually, as a practical matter, no, because people were not going to go for a heavy, regressive flat head tax. But regardless of that, I think your argument proves too much. You're claiming that the government can dictate the spending of any money that they could, in principle, have taken anyway, and in principle they can take 100%. You are saying there is no money or property not at the absolute discretion of Congress.
Your side is going to have to come up with a "limiting principle" as the Supremes call it, and you haven't so far.
The government is your government;
(#277132)the government's money is your money. Either you believe in representative government, or you think this is Plantagenet Britain.
Yes, the government can dictate the spending of any money that they could take anyway...and only that money. That there's a limiting factor is obvious even in the way you put it. In this case, the limiting factor is a particular interstate commerce in risk-pool health insurance.
M Aurelius was probably right.
You don't literally believe that
(#277138)and neither does the govt since their own rules, laws, and taxes are chock full of text that distinguishes between stuff that belongs to one person vs another person vs them. Civil law would be really easy - all verdicts are that all the money belongs to the govt.
Your suggested limiting factor is indeed a limit but do you really think the lawyers for Obama are going to say that the commerce clause allows for mandates but only for risk-pool health insurance, and that any other future mandates not realted to risk-pool health insurance will be unconstitutional? Or are you advocating that they toss up a limit they openly plan to deny the next time this comes up?
Today they were asked to articulate a limit, and the standard was a very low one: name something, anything at all, that lies beyond the commerce clause. Without a limit, it turns into a general police power, something even Breyer wouldn't sign off on.
There's not a justice in that room who dreams*
(#277139)of claiming Congress is overstepping its rights in regulating interstate health insurance itself. That's as cut-and-dried a Commerce Clause market as it gets.
Instead, from what I've seen in the transcript, attorneys were asked to articulate a limit to a presumed "positive obligation" to participate in the insurance market by forcing individuals to buy insurance coverage. The government's response is that it's a BS question. They aren't playing ball with Randy Barnett: the insurance market is a current, ongoing form of interstate commerce that involves all US citizens, period. There is no novel power being asserted. They aren't asking you to buy something you don't want to buy; they're compelling you to pay for something you already enjoy.
*Well ok, Scalia can dream, but I doubt he'd say it publicly.
M Aurelius was probably right.
You forgot Thomas
(#277143)I'm guessing that's all he dreams of.
I blame it all on the Internet
Well, I'm Paying Someone Every Month....
(#277111)...I also have and pay directly for supplemental through Anthem/Blue Cross....I presume that the...well, I'll look it up...
Centers for Medicare Services
This is a Federal Government Agency, I think, that oversees and administers Medicare. This is who I pay.
http://www.cms.gov/
Best Wishes, Traveller
????
(#277120)the ACA requires coverage for pre-existing conditions, eliminates recission and offers other codified benefits to insureds while limiting the amount insurance companies can spend on items other than healthcare benefits. How is that "managing to keep all the profiteering"?
I blame it all on the Internet
Yup...
(#277135)I agree completely. I am not at all convinced that an arrangement where the government can compell citizens to buy a product or service is a positive development. On the contrary, it seems like another step towards crony capiltalism. Health insurers won't need to be good, they will only need to have the ability to lobby bureaucrats or politicians so they continue to be officially sanctioned.
There should have been a public option, end of story.
I am not a pessimist. I am an incompetent optimist.
Purely semantic issue?
(#277099)I think the two cases are not as identical as you think they are. The government could, if they chose, use the taxing power to levy a flat $17,000 annual tax on each person. $17,000 is roughly a year at minimum wage. They could then take that money and send it to private plantation owners in the swamps of Alabama, who would hire cotton pickers. On the other hand, the government cannot force people to be slaves on private plantations even though you might think the two cases are effectively the same.
I fully agree that a single payer system would in some respects give me less freedom with respect to medical care than the ACA mandate, and that the money ends up in the same place. However, under single payer paid from general revenue, I do have the freedom to do nothing at all except passively let the govt take tax out of my paycheck, something I've already accepted. Under ACA I have to get up off the couch and buy something I didn't want to. Clearly that's not an important difference to you, but it is to me.
It's important because I want to retain the definition of what it means for money to be "mine". What the pro-ACA folks want is to be able to keep saying that taxes are low, but make up for that by simply mandating how I spend an ever increasing percentage of what they call "my" money. It's a dishonest game and I see no end to it once you get started.
There's plenty of other examples of this game:
(1) If you want everyone to have plentiful contraceptives, why not buy them out of tax revenue and hand 'em out for free? Instead, you make people who don't need or want them buy insurance plans that cover them,.
(2) If you want to have a nice place for people to walk to the beach, use eminent domain to buy the land and make a greenbelt. Instead, you make property owners let people walk on their land, while still having to pay taxes and be liable.
------------
Having said all that, why not ask yourself why the govt decided to try a pass this off as regulation of commerce rather than tax-and-spend. I'll take a shot at it: if they called the mandate a general revenue tax, it's a flat $800 head tax, something that most progressives would (correctly) say is incredibly regressive and reactionary. They want the effect of a tax without the political costs. They want the effect of big government without having to say they once again raised the budget by a huge amount.
No, you don't.
(#277101)You could elect to simply pay the "penalty tax." Or, given the way the law is written, you could elect *not* to pay the penalty tax, and suffer no consequences. The Medicare Act does in fact take your money away from you and spend it without your consent. The ACA merely encourages you to contribute.
When you hit 65, you will have to get up off your couch and select Medicare providers for yourself, respond to correspondence, etc. It is exactly no different than being asked to sign an insurance policy. The more you compare the effect of the two laws, the less difference there appears to be between them.
It would seem your main problem with the ACA is that Congress is trying to have the benefit of a tax without calling it a tax. Politically venal, certainly. But I fail to see how this move is either illegal or unprecedented: as you point out, Congress does this all the time in other areas.
M Aurelius was probably right.
Whoa
(#277110)I honestly didn't know that. If seniors fail to sign up for a Medicare provider they are fined or jailed? Damn that sucks. What if they just forgot?
Or do you just mean that they don't get the handouts unless they go through the process?
Hm, I left out a transition.
(#277112)I meant that you could be jailed for not paying FICA taxes (first paragraph), then in the 2nd paragraph I switched to your point about what a hardship acquiring a policy can be.
M Aurelius was probably right.
No, Not Fined or Jailed...I Had to Research this Yesterday....
(#277113)Dear XX: (a person received medical care overseas...for which medicare should be happy since this is not reimbursable)
Quite a fascinating conversation with the Medicare people and Social
Security today.
In essence, this is a question of enrollment in Medicare...are you
still paying your premiums out of your Social Security or by other
means? If yes, no problem, if no, still no real problem, you cannot
lose your Social Security (do you get Social Security?) or Medicare,
but if out of the country for an extended period of time, and if not
paying your premiums every month, and some people over seas do opt out
when they retire, then upon return to the United States, you would
have to await your enrollment period to re-enroll in Medicare, start
paying your premiums, pay a 10% penalty for every year you opted
out....none of this seems like too great a problem to me.
In any case, this is the answer.
~~~
My follow up today:
The essential point is that you can not ever lose your Medicare
rights....even if you opt out, (stop paying the premiums from Social
Security, as you and I am doing....direct withdraw).
Some people that retire and are dual citizens and are covered by their
new country's medical plan and never intend to come back to the
US...opt out of Medicare.
But even then, after 10 years or however long you are gone, a person
can always re-enroll.
My recommendation, just so we are clear, is that you continue making
your Medicare premium payments as you are now....until you decided
that you are never coming back to the United States.
That's the good advice Medicare gave me, and I am giving you.
Best Wishes, Traveller
Kennedy addresses this single-payer question head on.
(#277115)The justices of the Supreme Court don't appear to have a ready answer to this question: if Congress can accomplish its end through one set of powers, how can it be unconstitutional to accomplish the exact same ends through a different set of powers? If Congress can tell citizens to give it money and then spend that money in a certain way, how can it not tell citizens to spend the same money in the same way?
M Aurelius was probably right.
Jordan is Correct....It is Apparently Mandatory
(#277117)In her March 16, 2011, ruling, Judge Rosemary Collyer of the U.S. District for the District of Columbia acknowledged that the three retirees had a legitimate point that the law does not specifically say that avoiding Medicare Part A means losing Social Security benefits. But in examining the law that Congress enacted in 1965 creating the Medicare program, Judge Collyer found that "[r]equiring a mechanism for Plaintiffs and others in their situation to 'dis-enroll' would be contrary to congressional intent, which was to provide 'mandatory' benefits under Medicare Part A for those receiving Social Security Retirement benefits." [emphasis in original]
This is not what I was told yesterday....though this involved a dual citizen afraid of losing their Medicare due to receiving treatment over seas. So at some level, a different question, and yet...
Hummmmm
Traveller
Two thoughts on the mandate
(#277067)1. I see a lot of people around complaining about "free riders" who don't have health insurance, who can't pay and go bankrupt when they need healthcare, and then society has to pick up the tab. In fact, the vast majority of people who go bankrupt b/c of medical costs in the US *have* private health insurance. It's just that the insurance doesn't cover a lot of serious illnesses. The ACA is supposed to fix a lot of these problems, but it would be nice if the ACA's regulatory framework were proven prior to mandating millions to buy what often turns out to be junk insurance. The focus on the bad, bad free riders instead of on the perverse private health insurance market is silly.
2. The mandate is clearly severable from the rest of the ACA. Congress can provide additional funding to cover increased premiums anytime they want. Given that the wealthy and corporations are currently paying a lower % of taxes as a % of GDP than at anytime since WWII, there are a multitude of options. Politically difficult =! unseverable. In addition, the effect of the mandate on premiums might not be all that significant - a recent RAND study suggested the increase if the mandate is struck down would be somewhere around 2%. http://www.rand.org/news/press/2012/02/16.html
I wouldn't be sorry to see the thing get tossed in the slightest.
People go bankrupt because of medical costs?
(#277075)[url=http://www.businessweek.com/bwdaily/dnflash/content/jun2009/db2009064_666715.htm]Is that different to any other bankruptcy?[/url] Should it be?
literally anything can become right or wrong if the dominant class of the moment so wills it
Yeppers
(#277133)As I see it, the administration agreed to the mandate (which as you say is not actually all that critical one way or the other) to placate the insurance companies (more $$ from young healthy enrollees) and conservatives + Blue Dogs (don't need to increase top rate on most wealthy to cover cost gap). Recall Obama didn't himself support a mandate as a candidate. Politically it was always a clear loser. In the grand tradition of Greek tragedies it was perhaps inevitable that the effort to overturn the ACA would leverage the one piece of it that foes of the overall legislation logically should (and in the past did) support.
That said, the mandate is pretty clearly constitutional, based on precedent (e.g., Wickard, Raich); it addresses a unique market in which everyone involuntarily participates while respecting established limits (e.g., Lopez). A decision against it would be nakedly political, could potentially threaten large established programs (up to and including Medicare, Social Security, EPA, etc, depending on scope), and would throw efforts at health care reform back into complete chaos. Betting from across the political spectrum before today was anywhere from 5-4 to 7-2 allowing the mandate, but the conservative wing of the Roberts Court is extremely results-oriented (Citizens, anyone?) and the questioning certainly looked to be antagonistic to the government's case. If we didn't have such a worthless media and such a large number of "everything Obama wants to do is necessarily horrible" voters I'd be more optimistic that a ruling finding the mandate unconstitutional would end up moving toward single payer, but... frankly I'm a bit worried at the moment. The ACA is decidedly imperfect but it's a big improvement over what we had.
Come, my friends. 'Tis not too late to seek a newer world -- Tennyson
Scalia's Broccoli Moment
(#277090)I suppose someone had to bring it up. Verrilli wasn't very convincing in answering this question, but it...well it kind of answers itself. Let's take a look (pdf).
Well no, Verrilli responds, for two key reasons. Yes the "food market" is universal, and a necessary expense. But the key difference is that the food market is predictable in terms of both timing and cost. Health care expenses, by quite dramatic contrast, are by definition unpredictable in terms of timing (nobody knows when they may need expensive health care) and cost (nobody can predict how much they may need to spend on reconstructive surgery or heart transplants in a given year). That is why the "broccoli argument" is built on a false analogy. Scalia isn't convinced.
Let's see. One is universal, necessary, and predictable (everyone must eat - a minimum of 1200 or so calories a day). The other is universal, necessary and unpredictable (nobody can be certain when they might need health services or how much those services might cost). Yes indeed, that would sound like a principal basis for distinguishing the second market.
Further, it's the unpredictable nature of health care that has led to the entire industry to be financed through risk-pool insurance...clearly a form of interstate commerce which is provably and demonstrably impacted by people who a) don't pay into risk-pools but b) nonetheless consume health care, cost-shifting the risk onto individuals who do pay premiums.
Justice Scalia: when it becomes common for people to carry Broccoli Insurance in this country, then your analogy will make a lot more sense.
M Aurelius was probably right.
I think the argument is pretty funny
(#277092)because by the federalist reasoning, it would be totally constitutional for your state to mandate eating broccoli. But since that fails the laugh test, their entire argument is specious.
I blame it all on the Internet
If you can find another market that is
(#277093)universal, necessary, and unpredictable, I'd say the federal government stands a good chance of being able to regulate it (or already does).
Let's run through some examples. The energy market!
Are energy needs universal? Yes. Necessary? No. Predictable? Yes. Bzzt.
Let's do education. Universal? Yes. Necessary? Yes. Predictable? Yes. Bzzt.
Flood insurance. Universal? Bzzt.
Funeral expenses! Universal, yes. Necessary, yes. Predictable, yes (at least in terms of cost). Bzzt.
Highways! Universal, yes. Necessary, yes. Predictable, yes. Bzzt.
Mortgage insurance. Universal, nearly. Necessary, yes. Predictable, no. Congress could regulate this under the same rationale (and does through FHA)!
M Aurelius was probably right.
Actually, I don't think this holds.
(#277094)It's trivial to come up with examples of markets that are not universal, not necessary and pretty predicatable that still end up regulated in one way or another. i.e. autos, investments, baby furniture, credit, firearms, etc.
Beyond that, some of your calls above are questionable (i.e. Mortgage insurance is neither universal nor particularly necessary, there are multiple ways around it even today)
All this is to say, I don't see how your test above binds in any way. Government regulates markets, but not based on what you're putting forward as the reasoning.
"Unfortunately the universe doesn't agree with me. We'll see which one of us is still standing when this is over." -- Eliezer Yudkowsky
The question Scalia asked was whether
(#277098)health insurance is a "unique" market. You don't have to buy my test, and the SG went in quite different direction in his responses (the SG points out, for example, that broccoli is not a currency for buying another product on an interstate market, while health insurance is).
But I think it's trivially easy to find things that make health insurance unique compared to broccoli, and even compared to other types of insurance, or other health/emergency expenses.
On mortgage insurance, I was assuming that most single & multi-occupancy dwellings (and most commercial properties for that matter) are mortgaged at one time or another, and that most homeowners & renters live in mortgaged properties for a significant part of their lives. But I don't know that much about that market, and could well be wrong.
M Aurelius was probably right.
Unpredictable
(#277123)Contraceptives - predictable, unpredictable? If predictable, therefore unconstitutional to make it part of mandated coverage?
Carrying a planned pregnancy to term - predictable, unpredictable?
Education - predictable, unpredictable?
You know, it might be worth letting you get away with this argument if that turns out to be the new limit. Flat ban federal programs for anything predictable. I see a glimmer of merit here....
On the brocolli laws - if ACA is upheld, and we see more Bloombergy type personal behavior mandates, I predict that some of the very same people scoffing will be using ACA to justify the laws. We need to fight you here and now so we don't have to fight you then.
Can a state force you to eat broccoli? nt
(#277124).
I blame it all on the Internet
Depends on the state constitution
(#277125)but in general yes. Massachusetts could and did have an individual mandate. However, just because some other state could in principle go totalitarian doesn't mean I need to accept the national govt doing the same. Look up "federal" and "enumerated powers".
But, I think you misunderestimate Randy Barnett and other parties to the anti-ACA team. They are going for much bigger game than an $800+/- mandate. They're trying to nail down the limits on the commerce clause once and for all. They're trying to bait the govt into saying what the limit is, and the govt has made it clear they don't want any limit.
That's ridiculous
(#277137)after Griswold such a law would be struck down on privacy and personal liberty grounds.
This mandate is different, it's part of a regulatory scheme for medical insurance that is well within the limits of the commerce clause. Barnett et. al. will fail, the SC isn't going to reverse 70+ years of precedent on this case no matter how much Thomas would like to do so. The government's response is, and should be, that they will stay within what they believe their constitutional limits are in order to provide for the general welfare and it is the court's responsibility to tell them if they overstep their limits and explain why.
The conservatives (including those on the court) will wish that they had ducked this issue by throwing it out on jurisdictional grounds.
I'll wager that the mandate, and the ACA, is upheld. My guess is 6 - 3 to uphold, with Roberts writing the opinion to keep it as narrow as possible. What do you say?
I blame it all on the Internet
Oops...
(#277141)Sorry, I misread it and thought you wrote buy brocolli. You're right.
On the probabilities you are probably right that the SC isn't going to overturn 70+ years of precedent - they'll likely find some way to uphold it and make vague references to there being a limit out there someplace but who knows exactly where to appease whoever is the one crossover vote. However, such cases do happen four or five times a century and that's what Barnett is hoping for.
BTW, we were debating "narrow" cases yesterday. "Your" side really messed up by overreaching in the Lopez case, which technically was just about a guy caught carrying a firearm too close to a school. At the govt position was that the 2nd amendment was not an individual right. If prior to getting to the SC they'd quietly hinted that they would let the Gun Free School Zone Act fall on 2nd amendment grounds, there were plenty of people, including the guy facing prison, who would have accepted the offer. But instead, they tried to get it all, Lopez brought up the commerce clause, and for the first time since the 1930's the SC said there's a limit out there someplace, and that mere possession of gun was outside that limit.
You're in danger of overreaching this time also.
I don't think so
(#277144)the governmment argument is that the market for health care and insurance is unique in several ways, as are the laws designed to regulate them. I think that's the definition of a narrow argument, they're not claiming that the feds can do this in any old market. The opponents are the ones who are overreaching and claiming that THIS WILL CAUSE TYRANNY UNTIL THE END OF TIME.
I blame it all on the Internet
The opponents are taking a risk
(#277147)which is that the SC will flat overrule Lopez and state that all human activity and inactivity are interstate commerce. That was pretty much the law prior to Lopez.
Other than that, what have they got to lose? Like any other lawsuit, the plaintiffs have a big advantage, they aren't risking anything except legal costs.
They'll never get Kennedy to go for that
(#277150)I think the narrow opinion will accept that the health care and health insurance markets are unique enough that this won't apply to other markets. After Bush v Gore, conservatives seem to prefer that kind of formulation.
The biggest danger for the opponents is that after 5 years or so, everyone will realize that their arguments were awful and the sky didn't fall - again. You can only cry wolf so many times before people ignore you. Conservative credibility is wearing thin in all kinds of areas, this is just another one.
I blame it all on the Internet
Universal, necessary, and unpredictable.
(#277136)Those three things together make the health insurance market pretty unique from a Commerce Clause perspective. You won't find many similar examples. But in any case, this is just my thinking; I wouldn't get too excited if you see holes in it.
The SG today made another interesting point about the broccoli argument. He pointed out that unlike insurance premiums, broccoli is not a currency for buying services on an interstate market. You buy broccoli to consume broccoli, not to participate in some other (Commerce Clause-liable) market.
The government's position is that they are regulating an extant market, and they utterly reject the notion that they are "creating commerce in order to regulate it." According to the government's position you, me, and every US resident on this blog is already a participant in the health insurance market. The reasoning goes like this: we're all virtually guaranteed to need health services at some point now or in the future. But we can't know when, and we can't know in advance how much. The most rational way to pay for an unpredictable necessity like health care is through risk-pool insurance. And by logical extension, we're all already in the risk pool together. Pool party! That is, we all, whether we pay now, later or never, a potential future cost that has to be covered now. You are a current risk, and therefore a current cost to the interstate health system, and the government is within its rights to set regulations on how you contribute to cover that risk.
M Aurelius was probably right.
The things that surprised me
(#277142)First, that the arguments seem to shift back and forth between medical care and medical insurance without distinguishing the two clearly. Second, a lot of the hypotheticals of the conservative justices indicate that they don't seem to understand how insurance works, especially health insurance over the lifetime of an individual.
I blame it all on the Internet
Congratulations
(#277146)AFAICT you're doing a better job than the SG in articulating a generally applicable principle limiting the commerce clause. Who elected those clowns?
The weakest spot, and I think you know it, is drawing a line between predictable and unpredictable. First, it's arbitrary - how did you derive that from the text of the constitution, or even from prior precedent? Second, as your argument in the last paragraph shows, unpredictability is really just a step toward proving necessity, which you've already stated.
Regardless, your proposal is more restrictive than what govt lawyers are going to accept. They're hoping for a ruling that there is no limit, or that the SC will somehow sidestep the whole issue.
Again, the gov't thinks we're all "active" in this market.
(#277163)They seem to believe that the active/passive distinction is essentially a fiction bought into by the plaintiffs. We are all members of the health insurance risk pool (which is not a notional economy but a real, actual interstate financial system), whether we pay premiums or not. From the gov't's point of view, this whole thing is well within Commerce Clause jurisprudence (well within Raich, for example), and the whole question of lines & limits is based on a misunderstanding of this market.
M Aurelius was probably right.
Bus drivers....
(#277106)....[url=http://motherjones.com/mojo/2012/03/obamacare-supreme-court-disaster]start your engines?[/url]
"Unfortunately the universe doesn't agree with me. We'll see which one of us is still standing when this is over." -- Eliezer Yudkowsky
Wait, I thought oral arguments don't matter. -nt-
(#277108).
M Aurelius was probably right.
You're Talking To The Wrong Guy
(#277155)Apparently, the moonbat colony over at Mother Jones has decided that they do--if they don't call out the inept on their side they'll have their "Make Fun of Clarence Thomas in intellectually dishonest ways" cards revoked.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
The tactics may be dishonest
(#277265)but he is no less deserving of mockery.
He sounds like Ann Coulter, albeit with less aggression and more whining. He's a pathetic excuse for a human being, let alone a SCOTUS justice. Attacking the same policy (affirmative action) he most certainly benefited from shows tribal fealty to dogma and a complete inability for self-reflection.
He may not be as dumb as he appears. OK, fine. Some of the smartest people I know don't say much. But his dissent in Hamdan was terrible. I have seen nothing in my admittedly far from complete reading of his writings that he belongs on any bench, let alone the highest one.
Damned if I know.
(#277467)I just thought it was funny that they started tossing dirt on the guy within 5 minutes of his leaving the building. Victory has a thousand fathers, potential defeat must belong to that guy over there.
"Unfortunately the universe doesn't agree with me. We'll see which one of us is still standing when this is over." -- Eliezer Yudkowsky
Even forgetting that health coverage ain't like a veggie
(#277153)Would Scalia be thinking that;
raising taxes and supplying deductions for some tax filiers, if they take part in an commerce related "activity" = ok (even if those that are "inactive" pay higher rates)
adding in a higher tax for "inactivity" =/= ok? (even though those that are "active" will again pay lower taxes)
"I’m to believe that North Korea is so dangerously unhinged that they would attack without warning – yet so meek and easily cowed that they will sit quietly and not retaliate when we start bombing them."
Major Kong
The government case: insurance isn't "passive"
(#277165)Where's Bernard when you need someone to explain how insurance works? Several justices on the Supreme Court, at least judging from oral arguments, don't seem to get it.
The Solicitor General's case boils down to this: every single US resident is already an active participant in the interstate health insurance market by virtue of the fact that we are all members of the risk pool (or, more accurately, the multiple interlinked risk pools). This is not a fancy notional concept: real money circulates in that market today, covering the real risk that one or more of us will need catastrophically expensive medical treatment. We ARE all insured one way or another, today; it just happens that we're insured haphazardly, expensively and not very effectively.
Insurance works by offsetting cash flows (i.e. premiums) against calculated risks. First, actuaries calculate, for example, the number of heart attacks, strokes, and gunshot wounds you might expect in central Colorado in a given year. Then they add up the medical costs of treating all of those maladies. Then, they distribute those costs out to the entire population in the form of monthly premiums, effectively distributing the risks facing each individual across the entire population. This is grossly simplifying, of course. Private insurers don't cover entire regional populations, but rather a small universe of private policyholders; they also try to build juicy profits for themselves into the premiums, while seeking to minimize actual payment of claims.
Be that as it may, in the US today, by law, we are all covered for catastrophic medical costs. We're in the risk pool. We currently benefit from reserves of cash, doctors, medicines & health resources that are kept on hand to cover our personal risk, whether we actually pay premiums of any kind or not. Therefore imagining that we only "enter commerce" when we purchase an insurance policy is factually incorrect, and exactly backwards. We enter that market when we're born, or when we set foot in the country. Congress is saying, in effect, if you're going to benefit from an interstate market, you should pay for those benefits.
Scalia's broccoli question and his health club membership question miss this point entirely. If there were a small but measurable risk that you might suddenly need 15 tons of broccoli, and if there were a Broccoli Reserve that warehouses broccoli in case you or anyone else in the country gets a Broccoli Attack, then the analogy would make sense (and, additionally, there would be no logical Commerce Clause challenge if Congress asked you to chip in and buy Broccoli Bonds). The health club question is even more removed: yes, your physical fitness relates to your actuarial risk of stroke, heart attack, etc. But there is no financial connection from health club membership > your fitness level > your measurable risk > appropriate premiums to cover your risk. To make that connection requires exactly the kind of extended "chain of inference" that the court rejected in Lopez (membership in a club doesn't guarantee improved fitness, etc.).
M Aurelius was probably right.
Plaintiffs, incidentally, accept that "everyone participates."
(#277170)That is, the plaintiffs have already accepted the argument that a) health insurance is an interstate market affecting interstate commerce, and b) every US resident is already part of that market.
The only question before the court is the question of payment. Plaintiffs have conceded that Congress can compel individuals to buy health insurance at the moment they seek medical care.
So the only question before the court is the question of timing. Since payment-on-claims-rendered is exactly the opposite of how insurance customarily works, all that remains is to convince the court to let Congress regulate insurance as it is, not as plaintiffs want to pretend it is.
M Aurelius was probably right.
Did they?
(#277205)If so, a major error. I confess to not having read all the briefs. What they should have accepted is that (a) health insurance is an interstate market affecting interstate commerce, and (b) most (but not all) US residents participate in the market for heath care.
It would be very disappointing if the anti-ACA people engaged in conflation of one business (taking in money as premiums and paying less out as providers) with a completely different one (accepting cash to stitch up wounds).
I really fail to see how my paying (or not paying) $130 in cash to someone to stitch up my thumb has any more affect on some person in Ohio than me paying (or not paying) $130 in cash to the grocery for a big-ass pile of broccolli.
Well, it's more like $500-750 if you pay cash in the ER.
(#277208)So your impact on the health care system is at least a couple orders of magnitude larger than your impact on the broccoli market. Also, you are extremely unlikely to find yourself in a situation where you need $150,000 worth of emergency broccoli. Or any other food, for that matter. Your analogy holds up pretty well otherwise: shoplifters in the produce section are like people who don't pay their hospital bills in that they make broccoli (or sutures) more expensive for the rest of us.
Of course, there are laws against stealing broccoli. Even federal laws. Stealing health care, not so much.
As for your point about conflation of two different businesses, health care & health insurance: the health care market already conflates those two businesses at every level. Is Congress supposed to ignore actual market practices because you prefer categorical distinctness?
M Aurelius was probably right.
Shoplifters
(#277267)You admit shoplifting is a problem, so we have two possible solutions:
(a) require every citizen to purchase in advance a govt approved annual food plan from a supermarket chain.
(b) punish shoplifters
I pay cash for a lot of medical services, in fact I did so last month. Why? Because (a) the doctor was cash only and (b) a family member needed specialized help immediately and I didn't want the insurance company delaying things by asking for various referral letters etc. Why do y'all insist on blaming me for this, calling it "stealing" and calling me a "free rider", and wanting to punish me by taking away choices from me?
Shoplifting is against the law.
(#277286)Shoplifting across state lines is against federal law. The courts don't even question this, so shoplifting is a bad analogy for health care.
IF you were to suddenly need $150,000 worth of emergency care, and you didn't happen to have the cash on hand, you would still get the care. So...you're covered, but you're not paying for that coverage. That's what makes you a free rider.
Insurance makes cash available NOW to doctors, nurses, hospitals, pharmacies, etc., in order to cover accidents/illnesses that cost money right now. You are not chipping into that system. As a result, the premiums of everyone who does chip into that system are higher.
M Aurelius was probably right.
Feh
(#277330)So, Congressman wants to benefit his friends in the airlines. We pass a law that if someone has a life and death emergency, airlines must provide transport and worry about payment later. OMG FREE RIDERS!!!!!! To prevent this, everyone, including people on the no fly list, must sign a $200/month contract with an airline to prevent the OMG FREE RIDER problem we've created.
Leaving aside the fact that the Free Rider problem was created by Congress, why isn't the plan narrowly tailored to large unexpected expenses only? When you are pushing up against the Bill of Rights (in this case 10th Amendment) the govt is required to carefully design their system to achieve their goals with minimum possible intrusion. There are illegal acts of speech, you can't use those to comprehensively regulate all speech.
You never answered the contraceptives/pregnancies/vaccinations/checkups/chronic pain question. Why are things that are (a) utterly predictable and (b) have a negligible free rider problem, lumped in with something like $150,000 of emergency care? Wait, lumped in is the wrong word. Expenses outside the emergency room completely dominate the market. You are using an extremely tiny percentage of cases as your constitutional justification pretext to regulate things that you could have very easily separated out. Why should the Supremes force the govt to narrow the ACA only to specific services that meet your criteria of universal, necessary, and unpredictable?
Basically your question boils down to: why insurance?
(#277356)And I've got to be honest and admit I can't see why you're still balking at the concept. But your examples are a mess. Don't feel bad: three or four Supreme Court justices seem to have caught the same bug, but still. :) I'll leave aside your emergency air travel example, because I don't think I understand it, but...
Pregnancy? Seriously? You don't see how pregnancy is universal, necessary & unpredictable? I mean, I take it we all of us have to be born at some time or another (universal) and that being born is a pretty much unavoidable requirement to being alive (necessary). Also, people don't always get pregnant on purpose (unpredictable)! Even women who intentionally get themselves pregnant face a number of different possible complications (ectopic pregnancies, birth defects, hell just labor itself can vary from 2-72 hours, etc.) that can drastically raise the cost of live birth. Insurance is the cheapest and by far the most logical way to pay for something that is both necessary and unpredictable, because it transforms unpredictable risk into predictable, manageable monthly payments...insurance is like gambling in reverse.
Ok, fine. So why contraceptives? Well, contraceptives prevent unplanned pregnancies, reduce risk, and so reduce the overall *cost* to the system by a small but significant amount. This is the concept behind....preventive care. And all the other examples you give are examples of preventive care: vaccinations reduce the risk of serious illnesses, checkups catch illnesses like cancer in early stages when they are far easier (hence cheaper) to treat. Preventive care is a big deal in the insurance world, because it measurably saves money. If we're all paying into a big health system (and we are, even today, even without Obamacare, all paying into the same horrendously wasteful health system), why would we not want the cost to ourselves to be cheaper?
One last thing. You say
The vast majority of truly expensive medical treatments - the huge Medicare budgets, major hospital procedures like transplants, CT surgery, brain surgery, etc. - are unpredictable in nature. Where do you get the idea that only a tiny portion of medical spending is unpredictable? We all know we're going to get old and die, but how many of us know we're going to need kidney dialysis, a titanium hip replacement, oxygen rebreathers for emphysema? How many of us know in advance that we're going to need a triple heart bipass, or that we'll have Alzheimer's, or melanoma? We know it's a dangerous world, but how many of us know in advance that a sprained ankle is going to get infected and put us out of work for 6 months, or that we'll detach a retina moving office equipment? How many people plan to become alcoholics or anorexics? Most medical needs, and certainly the most expensive ones, are unpredictable.
And that's why insurance. You've got this entirely backwards.
M Aurelius was probably right.
I'll just focus on your third paragraph:
(#277367)Yes, I know about preventive care. Your proposal was unpredictable = constitutional to mandate, predictable = unconstitutional. But apparently you are also willing to mandate purchase of insurance to cover predictable expenses if they have some bearing on the unpredictable ones. So, a question: Question: does a proper, balanced diet save on unpredictable medical costs? If yes, how do you separate diet from other aspects of preventive medicine?
I didn't make myself clear on "tiny fraction". Sorry. The "tiny fraction" is unpredictable expenses that lead to free rider situations.
Should Democrats Take Full Control Again. . .
(#277371). . .I'm thinking that Nanny Bloomberg will have a nice government job to carry him into his golden years: Dietary Czar.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
SCOTUS has banned "inference chains"
(#277399)from Commerce Clause legislation, and you're making inference chains.
Revenue from premiums goes directly into covering medical services today. It doesn't require any inference at all to say that people who get medical care without paying premiums are affecting the commerce in medical care. Again, even the plaintiffs in this case have acknowledged this basic fact of the market, and have said that Congress can compel people to buy policies at the moment when they seek medical care. The only dispute is over whether, since insurance works by balancing risk against cash flows over time, Congress can compel people to pay before the point of sale...when it makes most economic sense.
So, a balanced diet. I'm not sure exactly what you're asking, but how would Congress compel people to have a balanced diet? Do you make them buy balanced foods? But then how do you guarantee they aren't cooking it all in Crisco? How do you even guarantee they're eating it? Does Congress have the power to monitor every bite of food you take? And even if they did, would that necessarily improve your health outcomes? You have to pile up two or three inferences in order to connect "balanced diet" with "cheaper health care," and SCOTUS won't buy it. Congress does police minimum health standards in food (the FDA, USDA), and since they're responsible for minimizing the ratio of sawdust to wheat in the bread we eat, and cut down the number of human fingers and E. Coli bacilli we ingest, I'm cool with that.
Nearly all major medical expenses are "unpredictable." About $40 billion a year of those expenses goes to cover free riders (i.e. the uninsured)...is that a tiny fraction? I suppose it is. Is it an issue Congress can & should address? Why not?
M Aurelius was probably right.
That seems dirt cheap
(#277209)But regardless, how does Gonzales vs Raich have any impact on interstate trade? And somehow there is not a free rider when it comes to unpaid broccoli?
"I’m to believe that North Korea is so dangerously unhinged that they would attack without warning – yet so meek and easily cowed that they will sit quietly and not retaliate when we start bombing them."
Major Kong
You want to know why it's dirt cheap?
(#277264)Because (a) the doctor doesn't have to pay a billing agency, (b) the doctor gets the money now instead of months later, (c) there is real competition on cash, since the patient has incentive to seek the cheapest provider; with insurance, the incentive is to seek the most lavish provider they can get the insurance company to support. As has been pointed out many times, any third party payment system has perverse incentives and it doesn't matter whether the third party is private or public.
Actually, I don't remember how much the thumb stitching cost, but I do remember the blood work: $40 for cash patients and $400 for insurance patients, at the same office. They had separate cash and insurance blood drawing stations on opposite sides of the hall so they could truthfully say it wasn't exactly the same service. The nurse specifically mentioned item (c) above: "if you have insurance, why do you care how much we charge?".
----
Raich was an awful decision, and it showed that Thomas was the only member of the court that sincerely believes in enforcing the limits set in the constitution. I hope that the ACA case will make some of the others see the light, and either overturn or draw a narrow circle around Raich.
----
There are plenty of people, or free riders if you prefer, receiving food stamps (or the current day equivalent). Some of these people made foolish decisions earlier in life to spend all their money on frivolous things, rather than signing a life long food delivery contract from Schwan's. If we had stepped in and forced them to allocate part of the money to such a contract, or more realistically, forced them to spend their money on training for a job, they would not be free riding.
Therefore, it is NECESSARY and PROPER that EVERYONE should buy a govt approved food delivery contract from a private vendor, if they can possibly afford one, or more realistically, demonstrate to the IRS that they are spending a sufficient percentage of their income on job training.
See the problem here? You are taking the irresponsibility of a small percentage of the population, and using it to justify taking away choices that are of serious importance to me, as punishment for something I haven't done. Collective punishment of potential crimes.
The correct solution in the case of the free rider problem is to find a solution narrowly tailored to punish (or deter, if you prefer) only free riders, or to just suck it up like we do with people that didn't plan how to get food on their table.
I think I see the flaw in your cunning plan.
(#277313)What if Schwan's goes bankrupt? Does the government step in and make you whole again? And what happens to the money distributed to Schwan's shareholders and managers, does the government go after them to get it back?
I blame it all on the Internet
As for the fact finding/dissent
(#277435)1(a) is the billing agency a fixed cost, or variable cost?
1(b) is there that big of an allowance for doubtful accounts?
1(c) "the" patient has an incentive to seek cheap stitches? To a degree yes....but for starters, how often do you think people get quotes form car insurance providers to find the cheapest one? Now imagine all of those people require about 3 stitches. for 3rd parties, I haven't kept abreast of fraud/waste in most of the 1st world when it comes to their single payer system, is the fraud/waste cost prohibitive over there?
----
I would be more ok if "they" actually did see the light, but it's not looking that way.
But then again, I'm doubting Scalia would want to end the practice of not receiving tax credits for "inactivity" (yes I'm still perplexed by the "mandate"/"credit/deduction" angle).
----
What if people aren't saying that the amp goes up to "11" but are saying this amp is actually more powerful?
"I’m to believe that North Korea is so dangerously unhinged that they would attack without warning – yet so meek and easily cowed that they will sit quietly and not retaliate when we start bombing them."
Major Kong
This is all accurate and well expressed, but
(#277172)it sidesteps the issue that the mandate is effectively and deliberately shifting costs from high-risk subpools onto low-risk subpools. A subpool of 25-30 year olds could spread out their individual risk for a fraction of what they will have to pay to help offset costs (to the insurance companies!) of the pre-existing conditions and elderly subpools. Clement makes this argument around p74, and Breyer, correctly IMHO, suggests that this is getting into "telling Congress how to do its job" territory, so this probably isn't the legal issue that will settle the case, but I think it is one of the genuine and logical (as opposed to the many manufactured and wildly illogical) objections to the mandate. Kagan had already pointed out, p35, that individuals move from low-risk to high-risk pools so it balances out over a lifetime (which Scalia seemed to completely misunderstand) so maybe that suffices, I dunno. In a vacuum I (like most here) would prefer to cover the disproportionate cost of the high-risk pools through progressive taxation, but politically maybe the mandate was the only workable compromise to get something passed, which makes it depressing/infuriating to watch it used as the lever to pry at the underlying legislation.
Come, my friends. 'Tis not too late to seek a newer world -- Tennyson
Also. . .
(#277173). . .the fact that Congress banned high deductible plans as a means of complying with the insurance purchase requirement further screws the low risk persons.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
Or, high deductible plans screw the system
(#277178)by limiting the distribution of premiums and so failing to cover those individuals' own (lifelong) liability for the system. But it's really a matter of degree - all plans have some deductible, and the maximum deductible should ultimately be a function of total health costs vs. total GDP.
(Total Annual Health Expenses / Total US Income Earning Individuals) = the fairest (though somewhat regressive) possible distribution of risk, with no offsets for actuarial subgroups. An aging population, and sudden population increases (babies everywhere!) would strain that basic system, so you'd want to account for demographic shifts to smooth out relative risk across generations.
M Aurelius was probably right.
I don't think there are any "subpools" of risk,
(#277175)when it comes to the interstate insurance market, since all of the various insurance groups in the country are economically linked...losses in relatively sick subpopulations are offset by payments from the relatively healthy subpopulation. Health providers get funding from all sources, so at the actual point of sale, healthy individuals who pay premiums already wind up subsidizing unhealthy individuals who don't pay premiums. (Private insurers try to create "subpools", but that is another matter.)
In any case, this seems to me kind of a non-issue, since Congress would be within its rights to regulate the distribution of risk among current payers as it sees fit. But I'll have to look at the exchange in question.
M Aurelius was probably right.
That's true, hospitals
(#277180)offset some of their costs by "overcharging" elsewhere. And of course insurance companies already do spread income to balance payouts across demographics.
The main changes to the current structure of insurance (not so much care?), as I see it, that would be introduced by the contested legislation are (i) the ban on excluding pre-existing conditions skews the existing overall income/payout balance and (ii) offsetting that, the mandate captures healthy individuals who otherwise wouldn't pay premiums or use services*. In other words the "current insurance enrollees" changes even if, as you convincingly note, the "current players" don't. I agree that Congress can screw over** one group to help another but I think this is usually done via taxes although for the mandate my opinion is that the CC suffices.
* more precisely, it grabs a larger net income from low-risk groups who are infrequent consumers of care and overall don't cost much to treat.
** not that overpaying for insurance -- when you have a relatively decent income and thus don't qualify for subsidies -- is so terrible, in the big picture, but whatever.
Edit: actually, I don't know why I implied care wasn't significantly affected. Some of the pre-existing conditions might not qualify as emergency care so at least initial treatment could be denied without insurance. I guess I should say that the cost structure for hospitals doesn't change much because they shift from denying care to providing care but with compensation in those cases.
Come, my friends. 'Tis not too late to seek a newer world -- Tennyson
Just to add to that, people with pre-existing conditions
(#277184)impose costs on the system now...someone pays for them. More accurately, people who pay insurance premiums pay for them indirectly, in the form of both taxes and in increased health care costs (treatment prices are raised to cover those who can't pay).
I think the biggest change is your (ii) capturing healthy individuals who don't pay premiums and don't (generally) use services. My argument has been that your (ii) group does in fact enjoy the benefit of being covered from an actuarial point of view. They're covered today, in that they'll be treated in case of a catastrophic accident or illness, and they're covered over time, in that they'll eventually become old and/or ill and require coverage from a system they've never paid into.
Just because they are low risk doesn't mean they are no-risk...so people who don't pay premiums are in fact freeriding on coverage. Their actuarial risk is much smaller, and if we wanted to gear premiums to an individual's specific actuarial risk, we could do that. As I understand it, there are a lot of good reasons not to do things that way though - one reason being that "high-risk" individuals as a class (children, the elderly, the chronically ill) are less able to pay premiums than healthy adults in their prime earning years.
M Aurelius was probably right.
But sub-pooling is a major part of the problem
(#277193)that's what's leading to recission and people who can't afford insurance. As pools grow in size, the overall costs become much more predictable. That's what the ACA is trying to do, and in the process fix a lot of the cost shifting and uncovered people that the current system is creating.
I blame it all on the Internet
The only reason participation isn't passive...
(#277167)...is because the government forces hospitals to treat people, whether they can pay for it or not.
So, the government has the power to force people into a market. Then it has the power to do whatever it wants to people in that market.
Sounds like unlimited power to me.
It is better to get what you want than it is to be right. -me
Nope. Private insurance has free rider problems too.
(#277171)Hospitals have free rider problems (i.e. people who fraudulently claim insurance, John Does (which is pretty much everyone injured in an emergency who isn't carrying ID), charity cases, people whose insurance runs out, among other examples) with or without ERISA. The SG's argument in this case would apply whether or not the Feds were already regulating the market.
That said, the existence of ERISA proves that the feds can force people (hospitals, doctors) into this particular market, which leads you to wonder what might be unique about health care.
So...do legions of people with untreated diseases and injuries sound like a public health problem affecting the "general welfare" to you? It would seem they do to the courts up until now.
M Aurelius was probably right.
Not an expert, but from early questioning today
(#277183)it sounds to me like Kennedy and Roberts could join Alito, Scalia, and Thomas in throwing out the whole thing if the mandate goes. The administration is arguing that the ban on consideration of pre-existing conditions (wildly popular) certainly doesn't work without the mandate (not so much).
Come, my friends. 'Tis not too late to seek a newer world -- Tennyson
Memo To Democrats
(#277201)It's not so fun when an issue important to you guys is left at the mercy of Anthony Kennedy's mood swings, is it?
The universe may well have been created without a point--that doesn't imply that we can't give it one.
Is he considered erratic as a jurist?
(#277203)I realize he's often the swing vote on issues that decide the court, but is there anything inconsistent about his principles and/or application of the law? Despite being the main diarist on the Obamacare legal challenges here, I'm not a big SCOTUS watcher.
M Aurelius was probably right.
Principles?
(#277268)What principles?
The distinctions he draws often come across as pretty arbitrary
(#277295)to both sides.
I'll take it over the naked hackery from Scalia in this case, however.
I waffle on having respect for the guy, but the oral transcript for day 3 was unquestionably a travesty.
Hmmm...
(#277219)Did you really have your heart wrapped around anti-buggery laws?
"I don't want us to descend into a nation of bloggers." - Steve Jobs
Posting Rules
(#277223)And a correct result doesn't excuse crappy reasoning in arriving at it--one would think that Roe v. Wade would have driven that lesson home by now.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
I guess I'm relieved
(#277224)That you consider the implication that you support such laws to be a personal slight.
"I don't want us to descend into a nation of bloggers." - Steve Jobs
Scalia - nakedly political
(#277291)The oral transcript re: severing the mandate shows the most brazen line of political thinking by Scalia imaginable. I've read a fair few transcripts and never seen anything like it.
He's not even pretending to have anything in mind other than a political calculation for killing the entire healthcare bill and having Republicans craft anything or nothing instead.
Judicial restraint my a$$.
Thems The Rules
(#277319)Liberals have no complaint coming when conservative justices play by the same rules that liberals have continuously since at least the early 1960s.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
Cites on nakedly political decisions by liberals, please nt
(#277329).
I blame it all on the Internet
Have You Been Following The Arguments This Week?
(#277331)The liberal justices have been making nakedly political arguments for preserving the healthcare law.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
Examples, please
(#277335)because what I've seen is the liberals discussing the actual, you know, constitutional legal issues and the conservatives discussing the political issues and quoting tea party arguments. The conservatives are the judicial activists here.
I blame it all on the Internet
The Conservatives (Apparently) Have Five Votes
(#277337)Which by liberal rules, is all they need. You reap what you sow.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
Way to avoid discussing judicial activism
(#277343)and I'm sure you'll avoid talking about it in the future. Apparently conservatives don't actually dislike judicial activism.
BTW, simply having five votes isn't the definition of judicial activism.
I blame it all on the Internet
Frum is right
(#277275)The two prongs have been court challenges and repeal, neither of which are realistic, at the expense of pursuing a Plan B. It makes for good campaign fodder, but if Romney gets elected, Obamacare isn't going anywhere.
Government is merely a servant – merely a temporary servant; it cannot be its prerogative to determine what is right and what is wrong, and decide who is a patriot and who isn’t. Its function is to obey orders, not originate them.
A Lot Of Liberals Seem To Disagree. . .
(#277281). . .with the idea that court delivered oblivion is unrealistic, at least in the sense of being unthinkable given the events in the SC this week. And if Romney is elected and declines to participate in the dismantling/defunding of Obamacare after all but swearing a blood oath to do so, he'll be a lame duck before the 2014 election.
As for Frum:
I'm not a Court-watcher, and have no expertise to offer, but just going with my gut: I doubt it. Even though the Solicitor General reportedly choked today, that doesn't change the fact that the conservatives on the Court have spent most of their intellectual lives railing against judicial activism.
Rule of Five is the coin of the realm, Mr. King RINO--as long as liberals unapologetically use it, it will be legitimate for conservatives to push back. And your self-acknowledged ignorance on the law is noted (as if we needed you to confirm it).
The universe may well have been created without a point--that doesn't imply that we can't give it one.
The more interesting point
(#277290)Frum made is that this decision would make a Chilean-style privatization of Social Security unconstitutional. It really destroys the middle ground of regulated private market solutions for social welfare, and forces the body politic to choose between nothing or an all-government approach. It could be that conservatives will one day regret a win like this.
"I don't want us to descend into a nation of bloggers." - Steve Jobs
Destroying the middle ground....
(#277298)....in this case might not necessarily be a bad thing. Businesses are there to make money. Hand them a regulator/partner/enforcer and you've really managed to get the worst of both worlds. My preference is for a regulatory borderland to be set up, within which everything goes and outside of which nothing goes.
"Unfortunately the universe doesn't agree with me. We'll see which one of us is still standing when this is over." -- Eliezer Yudkowsky
Scalia claims even the bill's expansion of medicaid
(#277301)should be tossed and Congress should just start over 'from scratch'.
Apparently his political preferences supercede his judicial responsibility to only strike down the unconstitutional parts of a piece of legislation.
That's not just the absence of finding an unholy/uncomfortable middle ground, that's just straight up legislating for team Republican from the bench.
... What is a regulatory borderland?
Just a hard line.
(#277307)You could call it a box, if you like. Up to this point, along whatever dimension we're talking about, you allow business to compete laissez faire (best way to get value out of it). Beyond this point, the regulator steps on you. Having the regulator operate with the intent of steering people to the business, deciding how much the business can charge, how profitable it can be, what level of competition is allowed, etc, strikes me as a bad idea.
"Unfortunately the universe doesn't agree with me. We'll see which one of us is still standing when this is over." -- Eliezer Yudkowsky
Isn't the problem that business itself
(#277310)can't be confined to a box, isolating all consequences & externalities?
M Aurelius was probably right.
No more or less than anything else.
(#277333)Zimmerman-Martin case in point. Conceptually it's really easy: if you're not the aggressor, you may defend yourself with deadly force. In practice, there are obviously any number of case-by-case complications. Regarding externalities, I'd suggest that it's a fool's errand to try to remove them from human interaction. But if they're big enough to worry about, there are various ways of dealing with them, not least property rights: http://faculty.wcas.northwestern.edu/~mwitte/pf/handouts/coase.html
"Unfortunately the universe doesn't agree with me. We'll see which one of us is still standing when this is over." -- Eliezer Yudkowsky
Cool theorem, although
(#277357)it fairly well cuts people who have nothing and are worth nothing right out of the effin picture, doesn't it? And you say this is from a Chicago school economist?
Kelo vs. New London, anyone?
M Aurelius was probably right.
Aye, well, it's....
(#277466)....not like you're going to get much sympathy for Kelo from either end of the political spectrum, right? Redoing property rights on the fly strikes me as one of those "no go" areas.
"Unfortunately the universe doesn't agree with me. We'll see which one of us is still standing when this is over." -- Eliezer Yudkowsky
Because There Is No Such Responsibility
(#277320)Trying to keep a law going after part of it is rendered unconstitutional is a crapshoot (unless Congress specifically provides for severability, which it didn't in this case). If the law is well-written and relatively uncomplicated, leaving the rest of the law intact might be practical. Thanks to the choices of Pelosi and Company, it is neither.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
Of course there's such a responsibility
(#277348)It's inherent in the very concept of judicial restraint that the judiciary should only strike down that which is unconstitutional.
Scalia's whine about a long bill and 'practicality' was absurd. Anyone can tell that e.g. a medicaid expansion has no relationship to the individual mandate. It's not a borderline case and it's not complicated. Striking down the entire bill is extreme political activism.
Practicality is supposed to be Congress' job
(#277363)whatever happened to "judicial restariant" and only judging based on the constitutional issues involved? Obviously Scalia is nothing but a political hack.
I blame it all on the Internet
Yes Scalia is a hack
(#277369)but unlike a lot of liberals I'm not angry or surprised by it. The conservative majority on the Supreme Court demostrated what they were with Bush vs. Gore and confirmed it in spades with Citizens United. I mean any group that could write an opinion stating that unlimited campaign money does not lead to corruption is the definition of hacks.
He's a disgrace. Or, just
(#277373)He's a disgrace. Or, just reiterating what I've always suspected - judges are full of it. They have a predetermined outcome in mind, either subconciously or not, and figure out a way to get there. He's just spectacularly transparent.
Yeah
(#277377)I'm pretty sure Bush v Gore will be considered the Dred Scott case of the 21st century. Pure political partisanship.
I blame it all on the Internet
Hack counting
(#277384)Five Republicans voted for the Republican because he was a Republican. Four Democrats voted for the Democrat because he was a Democrat. I count nine hacks total.
Nope
(#277388)five hacks, five Republican hacks, because the constitution already had a remedy for the situation. The Florida legislature could have voted the electors however they wanted. Which is what the minority wanted, even though the Florida legislature was republican controlled and almost certainly would have given Bush the electors.
Didn't the "this ruling only applies to this election" part tip you off to who was arguing in bad faith?
I blame it all on the Internet
My reading
(#277405)of the opinion (starts on p.98) is that the dissenters wanted to send it back to the Florida Supreme Court, not have the legislature pick the electors. It is only coincidence, of course, that the Florida Supreme Court had ruled for Gore.
The way they handled it
(#277412)violates every tenet of federalism ever stated.
Yes, the dissenters wanted it sent back to the Florida SC because that's the only place they could have sent it. They can't send it back to the Florida legislature, but the constitution is clear on who gets to determine the electors.
Weren't you the one complaining that congress caused a problem and then went overboard trying to fix it? That's exactly what the conservatives on the SC did.
I blame it all on the Internet
Did I defend
(#277419)what the conservatives did? My writing must be getting very sloppy, I certainly didn't intend to when I called them 5 hacks.
No, There Really Isn't
(#277364)A competent Congress, in crafting a monumental health care bill that was obviously going to be challenged on constitutional grounds, would have:
--put a severability clause into the language of the law to make it clear that if a major provision of the law was removed on constitutional grounds, the rest could stand, or:
--written the law clearly enough to make it clear that the provision was severable in the absence of explicit language saying so.
Nancy "we need to pass the bill so we can see what is in it" Pelosi did neither--demanding that the Supreme Court save Democrats from their own incompetence is the extreme political activism here. It's not Scalia's problem that a Democratic Congress passed a law that was not politically sustainable, meaning that it could not be re-passed if something went wrong. If Obama doesn't like that the law has been nullified, he can always resubmit it to Congress. Good luck with that.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
In your zeal to poke Dems in the eye
(#277366)do you realize that this bill would benefit you far more than me, for example? You're a layoff or accident or medical issue away from not being able to get coverage.
I blame it all on the Internet
Priorities Hank!
(#277368)Does it piss off liberals and hurt Dems? Thats what matters.
Lots Of Laws. . .
(#277370). . .would benefit me more than (generic upper middle class person). That doesn't necessarily make them good laws.
Also, I noticed you didn't disagree with me that it really isn't the Supreme Court's job to rescue Congress from its own incompetence.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
No, I disagree on severability
(#277375)the conservatives are trying to second guess congress on what's "workable", which is the very definition of judicial activism. So let's not hear any more complaints about legislating from the bench.
and BTW, the reason this law is such a godawful mess is that Obama tried to compromnise with conservatives by using the methods they had been advocating for health care reform for the past two decades. So the lesson learned is that conservatives always lie and can't be trusted to negotiate with. Just like they broke the budget deal with the budget they just passed.
Scott, I really hope you don't get sick. Because if you do, you're f*&ked.
I blame it all on the Internet
Actually, They're Not
(#277376)The logic is the same as when the Supreme Court killed the line item veto law: a law is passed as a package, with compromises among those who voted for it. Barring language in the law that makes it clear that one part being removed wouldn't have been objectionable to some of those who voted for it--or a severability clause--the whole law must fall.
Oh, and Hank? Comment, not the commenter.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
I can't express sympathy?
(#277378)next you'll be saying that asking someone how they're doing is "addressing the commenter".
I blame it all on the Internet
There's A Unanimous Precedent. . .
(#277380). . .on the Forvm record that expressing concern for a (by then suspended for what ended up being permanently) commenter's mental health is a PRV and therefore warnable, notwithstanding the violating commenter's repeated and insistent assertion that it was sincerely meant. I would suggest to you that your "sympathy" falls under that precedent.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
That would apply
(#277385)if I was talking about your personal charcteristics. But I wasn't, I was talking about a situation you might find yourself in. Like this comment, which no one in their right mind would consider a PRV. Or this one, for that matter. So it doesn't apply.
I blame it all on the Internet
Context Matters
(#277387)And your personalization of the idea "someone who gets sick without medical insurance has a big problem" can readily be expressed without it being directed at a specific person. So I will note for the record that I object to such comments, and will continue objecting to them until the comments cease or the moderators are forced to address them.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
"the whole law must fall"
(#277413)That's not an accurate characterization of jurisprudence in general or even history of the ACA in the federal court system in particular.
It's a 2700 page law that affects nearly
(#277464)every aspect of life in the country, every federal department, every state budget, that took years for Congress to draft and months of compromises to pass. You're telling me if there's one constitutional violation anywhere in the document, no matter how small, the whole edifice has to be torn down simply because Congress didn't include instructions for how to carve each tiny part out of the whole?
You know what that is? It's a crazy uncle argument, is what it is.
M Aurelius was probably right.
Congress thinks the mandate is essential to ACA,
(#277400)and that in fact the law doesn't work without it. Why would they make it severable? Either it's indispensable, or it's severable. That's not incompetent, it's logical.
M Aurelius was probably right.
Tell It To The People. . .
(#277404). . .claiming that if the USSC rules that it is not severable, it will be an act of political hackery. The Obama Administration is claiming that the provision is severable. I sense a disconnect here, fueled by panic and desperation.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
Necessary, yet severable
(#277406)That's their claim. More than a little disconnect.
That's not an inconsistency
(#277411)The part of the bill specifying the mandate is a necessary and proper means toward legitimately regulating commerce. Or so the arument runs.
That doesn't mean the mandate is inextricably intertwined with other parts of the bill.
So you're saying
(#277420)(or rather they are) that the mandate isn't necessary for any of the other parts of the ACA, but it is necessary for some other purpose totally unrelated to the ACA?
Here's the distinction
(#277437)The ACA affects interstate commerce related to health care in multiple ways.
For at least one of those ways, the mandate is a necessary and proper means of doing so (the DoJ claims). But that doesn't mean it's a necessary and proper means for all the ways.
For example, the mandate has zero to do with changes to medicare and medicaid. The latter makes up 1/2 the estimated expansion of health insurance in the ACA and is surely its best component.
If the conservatives toss it b/c they don't like the individual mandate the left ought to advocate impeachment. An expansion of medicaid is not unconstitutional and we can't have hacks on the high court saying otherwise.
Fair enough
(#277471)The pro-ACA lawyers ought to be trying to salvage the parts that don't depend on the mandate as a necessary component. Or more accurately, salvage the parts they weren't claiming the day before depended on the mandate.
Congress lacks competence
(#277408)is not a reason to abandon judicial restraint.
Neither is the possibility that a law can be resubmitted.
It's open and shut that the mandate has nothing to do with an expansion of medicaid, a restructuring of medicare, etc.
These are not tough calls or borderline connections. The mandate was severed when it was struck down by more competent judges. Only that idiot hack in Florida struck the whole thing down. His ruling read like an all caps post on the internet and so did Scalia's contribution to oral argument on the topic.
Memo To Jordan
(#277409)Quod erat demonstrandum.
The universe may well have been created without a point--that doesn't imply that we can't give it one.
The Obama DoJ
(#277414)obviously thought the best tactic was to defend the mandate as unseverable. Probably they figured this was the best way to keep the whole law intact. Certainly it's plausible that the mandate is inextricably tied to e.g., regulations on pre-existing conditions.
But there are many parts of the ACA where this type of inextricability is simply not even prima facie plausible.
It's the judicial branch's job not to accept bad arguments before the court.
I was talking about Congress, you were talking
(#277463)about Congress. Remember?
M Aurelius was probably right.
LOL!
(#277465)"Congress lacks competence is not a reason to abandon judicial restraint."
I'll have to think about this one, catch.
"Unfortunately the universe doesn't agree with me. We'll see which one of us is still standing when this is over." -- Eliezer Yudkowsky
That is interesting
(#277311)he's not the first to have pointed out that the right only very, very recently discovered that mandated private health insurance, privatized social security, etc. are unconstitutional.
We can only hope that if SCOTUS strikes down the ACA it might solidify Democrats resolve to ram through a much more significant expansion of public insurance.
"Who lost health care?"
(#277314)I can see the campaign strategy for the next 20 years.
I blame it all on the Internet