Supreme Court Upholds Affordable Care Act’s Individual Insurance Requirement

In today’s big news, the U.S. Supreme Court has upheld the individual insurance requirement that was the key part of President Barack Obama’s Affordable Care Act, by a vote of 5-4. The court rejected arguments that Congress went too far in requiring most Americans to either have health insurance by 2014 or pay a fine.

The decision, reported by the Associated Press, hinged on whether or not it’s constitutional to require Americans to have health insurance. According to reports the relevant part of the mandate, Section 5000a, doesn’t need to be read as doing anything more than imposing a tax.

So under the taxing power of the Constitution, a tax can be levied on people who refuse to buy health care, rather than a requirement to buy a product, like say, broccoli — just one example brought up during the arguments over the mandate.

The Washington Post says Chief Justice John G. Roberts Jr. wrote the ruling and sided with the majority in voting to uphold the law, which is Obama’s signature domestic initiative.

In addition, the judges also found that the law’s expansion of Medicaid can move forward, but not its provision that threatens states with the loss of their existing Medicaid funding if the states declined to comply with the expansion.

This may not be the end of the story for the Affordable Care Act. Republican Presidential candidate Mitt Romney has pledged to repeal the legislation if he wins the election and his party maintains control of Congress.

“This is a victory for consumers,” said Jim Guest, President of Consumer Reports. “Health reform is alive and well and will benefit all of us. But today we are especially thinking of the seriously ill children who will continue to be able to get critical care, the young adults who can stay on their parent’s insurance, and the seniors who can better afford the prescription drugs they need. For these people and the millions of Americans with pre-existing conditions, the uncertainty is over.”

 

Comments

Edit Your Comment

  1. jojo319 says:

    Didn’t Obama say this WASN’T a tax?

    • TuxthePenguin says:

      Oh, I didn’t think of that as a issue… can Romney now campaign saying Obama raised taxes on all Americans, not just the rich?

      • wackydan says:

        Indeed it is a tax on all Americans… Some of it direct and some of it a trickle down tax from pharma, health care providers, insurance companies, etc…

        http://www.atr.org/tax-hikes-obamacare-scotus-rule-a6996

        I personally love how my FSA is now capped at $2500 for no good reason at all other than a tax grab… That FSA was helping us with high out of pocket costs… Thanks Team Obama!

        • Darury says:

          Indeed, I also love that ACA removed all over the counter drugs from my FSA as an additional tax grab. We wouldn’t want people buying tax-free aspirin without a prescription.

          • wackydan says:

            Right… Who wants to go to the doctor – who is already hard to get to, and oh… you have to pay a co-pay for – to get a prescription for an over the counter allergy med? Nice way to raise the out of pocket health care costs on us DEMOCRATs.

            • Kate Blue says:

              Why are you using a prescription to get an over the counter med anyway?

              • selianth says:

                I can use my FSA to pay for the over-the-counter med if I have a note or prescription from my doctor saying it’s necessary.

        • dameon says:

          Except you only get hit with that tax if you don’t have insurance. So Obama didn’t raise taxes on ALL Americans.

          • humperdinck says:

            Get out of here with your reasonable facts!

          • eldergias says:

            Just like how the income tax is not a tax on all Americans, because not all Americans have income.

          • ptrmom says:

            Are you kidding? So wrong. There are over 20 new taxes in the bill.

            http://www.atr.org/tax-hikes-obamacare-scotus-rule-a6996

            This article gives a rundown of them (with page numbers from the bill itself). EVERY American will be paying new taxes. Some took effect in 2010 and some will not hit for several years but don’t kid yourself. YOU are going to pay more because of this.

          • wackydan says:

            There are 11 other taxes that are applied to all americans as part of ACA… but that is ok… because the progs got their way.

            • Monkeyphonics says:

              If we got our way the Supreme Court would have been ruling on a Single Payer System.

        • longfeltwant says:

          Uh, it’s not a “tax grab” to narrow a tax exemption. FSAs are already a tax break, meaning they’re giving you something for free, something the rest of us have to pay for. It’s pretty weak to complain about it getting a tax break. It makes you sound quite petty.

          • Nasty Dan was a Nasty Man says:

            as petty as those who receive entitlements complaining that they’ve been “cut”, when the definition of cut is for said entitlement to be any amount less than last year’s amount + the automatic increase already scheduled. cuts resulting in getting more, only in america!

          • wackydan says:

            True… But if they are all about making healthcare more affordable why did they cap the FSA’s which make health care more affordable? Hmmmm?

            Something the rest of you have to pay for? Really? Get a job with decent benefits and you too can have an FSA…

            • Kuri says:

              Yeah, people can just do that…..

              • wackydan says:

                So what is the problem here? Envy? Is it unfair that some people have better jobs and benefits?

                Spare me.

                • RandomHookup says:

                  Let’s leave the envy argument at home.

                  It’s easy to say “get a better job”, but it ain’t always easy. Changing jobs is a major life event and is risky … nothing stops your new employer from cutting benefits.

                  I see more envy from the folks who scream about poor people getting benefits.

          • JEDIDIAH says:

            Sure it’s a “tax grab”. Now I have less money to put in the HSA. Also people are generally less encouraged to plan for future expenses.

            This is the whole point of an HSA.

            Yeah. Let’s not encourage people to be self sufficient and able to fend for themselves and pay their own expenses. Let’s take all of those savings and give it to the government. Great idea.

            Discouraging savings for future medical expenses is poor public policy and contrary to the stated goals of Obamacare. Regardless of any other talking point or bit of ideology, it is simply contrary to the stated Obamacare.

    • FatLynn says:

      The SCOTUS said that the penalty for not getting the insurance is allowed under the taxing power, not that the mandate itself is a tax. In any case, the SCOTUS can read things in a way different from what Congress or the President intended. It happens all of the time.

      • George4478 says:

        SCOTUS didn’t read it in some unusual way or dream up some different interpretation; the administration lawyers have been arguing “it’s a tax” before the Court. There have been numerous articles on this strategy all month.

        The Court just agreed with the administration’s argument.

    • Loias supports harsher punishments against corporations says:

      “doesn’t need to be read as doing anything more than imposing a tax” is not “a tax”

      Saying something is “like” something else, doesn’t actually make it the other thing.

      • JEDIDIAH says:

        It’s not a tax. It’s a penalty and there are 4 very smart, well respected, and powerful guys that agreee with me on that.

        The whole argument boils down to “we need to do something” versus “but it’s against the law”.

    • MeowMaximus says:

      It IS a Tax, an illegal one – the American Public loses. The first act of the Romney administration will be to overturn this law.

      • macnbc says:

        How can a tax be illegal if the Supreme Court of the United States says that it is legal?

        Their role is to interpret the US Constitution, and they’re the ultimate and final authority on the matter. If they say it is legal, it is legal unless you change the constitution.

        • partofme says:

          To be fair, they kinda waved their hands at the “direct tax” analysis that is Constitutionally required. It’s understandable that they waved their hands here, because the gov’t hardly discussed the taxing power theory in their briefs (or oral arguments)… because no lower court had thought it reasonable. This may actually come back around for full briefing and argument on that issue.

        • scooby111 says:

          According to the constitution, tax bills must originate in the House. The ACA (Obamacare) originated in the Senate and was “deemed passed” by the House because a previous version had passed the House but the House no longer had the votes to pass the Senate version. This was considered legal at the time by many people because it was loudly stated that the bill was not a tax bill and the mandate was absolutely not a Tax.

          Now that the administration argued that it is a tax and the Supreme Court has ruled that it is a tax, the entire legality of the bill is again in question because of that clause in the Constitution.

      • MrEvil says:

        Ha ha ha, you’re funny.

        http://web.archive.org/web/20100414010048/http://www.freestrongamerica.com/oped/item/romney_healthcare_oped_mr_president_whats_the_rush

        tl;dr version: Romney recommended THIS EXACT PLAN 2 years ago. You’re delusional if you think that party stooge is going to repeal anything.

      • Jaynor says:

        Unfortunately the GOP didn’t field a candidate this year – so you’ll have 4 more years of Obama to look forward to.

        I suspect all the A-list candidates are biding their time for next cycle.

    • RvLeshrac says:

      If you were literate, you’d see that the Chief Justice of the Supreme Court, a life-long Republican appointed by the previous Republican administration, stated that the reason the lawsuit was even allowed to proceed *at all* is because Individual Mandate is *NOT* a tax.

      If it *was* a tax, the Supreme Court would have issued a judgement upholding the legislation in full.

      The *COLLECTION* of the Individual Mandate’s penalty, however, is legal, because the penalty is collected in the same way one would collect a tax, thus allowing it to fall under Congress’s powers of taxation.

      • partofme says:

        No. You did literacy wrong. He wrote that it’s not a tax for the purposes of the AIA, because Congress can define their own terms in the US Code. However, he’s a functionalist (the idea that how it operates is more important than what the words are), and proceeded to Constitutional taxing power analysis for the painstakingly developed purpose of doing everything he possibly could to interpret it in a way that would allow it to be Constitutional. It has nothing to do with a distinction between the mandate and the collection of the penalty.

      • partofme says:

        FTR, an attempt to distinguish between them like that was thrown around in the briefs and oral arguments…. but it simply wasn’t adopted by the court today.

      • partofme says:

        Upon further review, the government’s win would actually be undermined by an attempt to divide the mandate from the tax. Why? Because if they’re separate things, the mandate is unconstitutional under CC. The tax is not a tax on not having insurance… it’s a tax for failing to comply with the mandate! Thus, if the mandate is separate from the tax, then the mandate falls… and the tax would apply to nothing.

    • mcgyver210 says:

      Can we SAY LIAR LIAR!!

  2. George4478 says:

    It’s a tax.

    Tell the American people in speech after speech after speech that it’s not a tax…can in no way be construed to be a tax…and then argue before the Supreme Court that it’s a tax and therefore legal.

    Politics.

    • Loias supports harsher punishments against corporations says:

      So it’s politics because he said it wasn’t a tax, and then years later a completely different branch of the governemnt, who up to that point had no say in the matter, says it’s a tax.

      Because Obama could read the Supreme’s Court’s mind AND see into the future?!

      • George4478 says:

        Obama was not the only person who said it wasn’t a tax; it was a talking point for the entire administration and Congress. Many more people than Obama gave speeches on the topic.

        And the Supreme Court didn’t dream up the tax idea; it was a strategy of both the Congressional Democrat and administration legal teams. The people who walked around saying it was not a tax hired lawyers to argue that it was a tax.

        Or do you think Obama, upon hearing the strategy for the legal team, flew into a rage over the idea? Harry Reid tossed them out of his office upon learning the strategy? Nancy Pelosi banned them from House Chambers? Yeah, the politicians were totally blindsided by this strategy. /s

        • Loias supports harsher punishments against corporations says:

          If you read the article, you’d see that the U.S. argued that it was allowed in the commerce clause. You’d also see that SCOTUS rejected that argument, but accepted the law because it is the same as a tax.

          So really, your statement is a complete fabrication.

          • TuxthePenguin says:

            They had a separate section of oral arguments on whether it was a tax or not and whether it could be upheld on that basis.

            Sometimes an article doesn’t include everything – but yes, the administration did argue that this was a tax, but they took a strange way to get there. First they said it was Commerce Clause, but if that didn’t work Necessary and Proper, and if that didn’t work taxing power.

            • partofme says:

              Actually, the separate argument was concerning whether it was a tax for the purposes of the Anti-Tax-Injunction Act. The controlling Roberts opinion says that it is not, as Congress is allowed to define their own terms between their statutes.

              However, he goes on to say that they cannot Constitutionally redefine the concept of a tax… and proceeds to uphold the individual mandate under the Taxing Power. It’s all very nuanced.

              • dush says:

                At least it’s not a mandate and Congress can’t force us to buy stuff.
                Unfortunately they can just tax people who choose to not buy something.

          • aerodawg says:

            The hell it is. If you listened to the oral arguments, the tax argument was the 2nd the soliciter general made. The whole premise was that even if it was unconstitutional under the commerce clause, it would still stand as a tax.

          • George4478 says:

            For my post to be a “complete fabrication”, Obama did not deny that the individual mandate was a tax. Yet here he is on ABC news doing just that: http://www.youtube.com/watch?v=7UcxU8PtzRs

            For my post to be a “complete fabrication”, other Obama administration officials did not deny that the individual mandate was a tax. Yet here is the Obama’s budget director during House budget hearings doing just that: http://www.youtube.com/watch?v=7UcxU8PtzRs

            For my post to be a “complete fabrication”, the Obama administration did not support the “it’s a tax” strategy during legal arguments. Yet here are a couple sample articles about how they did just that: http://www.thestreet.com/story/11470878/1/supreme-court-skeptical-of-obamacare-is-a-tax-argument.html and http://www.outsidethebeltway.com/tobamacare-at-the-supreme-court-day-one/

            I sure have a lot of facts to back up a “complete fabrication”, don’t I? I stand by my assertion: The Obama administration denied it was a tax to sway the public, then changed it’s tune when the legal stuff started.

            • RvLeshrac says:

              The Administration still holds the opinion that the legislation, as written and passed, imposes no tax.

              The Supreme Court, a completely different branch of government, declared that the penalty is not a tax.

              The Supreme Court, a completely different branch of government, upheld the law because the penalty is *collected* as a tax.

              • partofme says:

                Again false. SCOTUS said that the only way it could conceivably pass Constitutional muster is if they consider it a tax. It has nothing to do with a distinction between the mandate and the collection of the tax.

      • u1itn0w2day4ever says:

        So politics as usual. Lie, twist, contort, sneak unread & debated legislation in lengthy bills in the middle of night when no is paying attention. Business as usual for your federal government representatives.

    • one swell foop says:

      Actually, law. The administration’s goal was to keep it legal. This game was for all the cookies. You win with whatever argument will win for you. You also make multiple arguments, some of which may conflict without invalidating each other. As long as there is a basis for upholding a law or ruling on the basis of one of your arguments, then it may be upheld.

      • Loias supports harsher punishments against corporations says:

        This. You think anyone, ANYONE cares why they are right, so long as they are right. In law, you do whatever the hell you gotta do to win, whatever argument it takes.

        • dangermike says:

          Among those who do not ascribe to a Machiavellian sense of personal ethics, yes, being right for the right reasons is every bit as important as being right. The ends do not necessarily justify the means.

      • George4478 says:

        That’s kinda my point. Say one thing to keep it legal (it’s a tax) and say another to keep it palatable to the constituents (it’s not a tax).

        • fredbiscotti says:

          Unlike those that have opposed this law. They’ve been consistent the entire time, and never have changed their opinions, talking points or arguments. Nope. Not one single time.

  3. TuxthePenguin says:

    I’m still trying to figure out if this has better implications for Obama or Romney… we’re now told that the federal government can make citizens do anything if they attach a tax as a penalty for not doing it. That’s not going to sit well with many Republicans who might have been lukewarm on Obama.

    On Obama’s side, having the validation means that he has his signature accomplishment doesn’t go away, but it also means that he will now face a growing call for repeal from Romney and Republicans. Moreover, though, I think it gives validation that “we fixed healthcare and the Supreme Court agreed”. That’s a powerful weapon to have.

    But if you expected anything to happen in Congress before, I think now it will essentially shut down until the election.

    • RandomHookup says:

      I don’t think there are that many Republicans lukewarm on Obama. Lukewarm on Romney…that’s another story.

    • AstroPig7 says:

      I wouldn’t say they fixed health care so much as put a bandage on it. There’s still a lot of work to be done to bring down costs.

      • TuxthePenguin says:

        And many would reply that health insurance as it current exists is making costs rise so much faster because there is no incentive to keep costs down by consumer of healthcare. For them, the actual costs are detached from consumption. Imagine if you could buy insurance that meant that no matter what steak you bought, you only paid $2 per pound (what the fattest chuck goes for here in my fair ‘burb). People would start buying the nicer cuts of meat… and then the “grocery insurance” premiums would have to rise to deal with that. Butchers could also raise the “prices” on their meats that they bill to the insurance company since the consumer doesn’t care.

        Now, I’m not saying we don’t need insurance, but I think the ultimately solution would be as follows.

        Set up a single-payer system run by the federal government that covers any and all medical expenses after the citizen has incurred over $3000 (or some other high number – but this is what most HSA’s do now) in medical expenses. All medical spending by a taxpayer is a refundable tax credit that can be claimed during the tax filing. And for those who cannot afford a $3k bill, that’s where a rename Medicaid steps in, offering the support for that.

        That plan does two things – first, it puts incentive in the hands of Americans to keep routine costs down: shop around for the lowest cost physical, try to get cheaper medications, consume other things more responsibly. But, in the end, its all funded by the federal government and if something really hits the fan, people are covered.

        • AstroPig7 says:

          I also support ditching the current system for something more streamlined, but the likelihood of that passing Congress is somewhere between 0 and nil. -_-

          • Warren - the Original Chocolate Cake with Eyes! says:

            Agreed. And then they should do the same with the tax system.

            • AstroPig7 says:

              How should they redesign the tax system?

              • longfeltwant says:

                They should start by eliminating deductions, and the one they should start with is the business expense deduction. Corporations should pay exactly the same taxes as a human would, the same brackets and the same way of calculating income.

                That would be a massive change. The effect would be a backdoor sales tax, as all those taxes were passed onto consumers; but it would also be a huge takeaway from the rich, who hide money and hide lifestyle expenses behind the business expense deduction.

                After that, I would be willing to give up some exemptions I myself enjoy, such as the mortgage interest deduction.

                • AstroPig7 says:

                  Without deductions, my family would be royally shafted. Deductions for tuition, mortgage interest, medical expenses, job expenses, etc., are necessary to keep us in the black every April.

                • Bsamm09 says:

                  This is probably the stupidest thing I have ever read, unless you want to cut the corporate income tax to 1%.

                  But you go on to say that you want them to have the individual brackets so it is the stupidest comment I have ever read.

                  If a company had to pay taxes on YOUR pay at 35% before they gave it to you, how much do you think wages would go down?

                  • frank64 says:

                    Well in his deference he called it a kind of sales tax, which would be what it would amount to. This would mean prices for everything would go WAY up. It would be a bad way to fund government.

                    • Bsamm09 says:

                      I think you’d see a fundamental shift in the way people are paid too. Increase their pay but charge them for expenses that the business usually pays for. Make them rent their work area, allocate them utilities, etc.

                      Then they are issued their W2 for $100k but had to pay the company $30k, which would be business expenses and not deductible.

        • Loias supports harsher punishments against corporations says:

          I don’t get what bug crawled into Republicans’ brains to convince them this is a bad model. It doesn’t even have to be the ONLY model. Let citizens opt out and take care of themselves if they want as long as they have an alternative. Time will demonstrate the better model.

          Sometimes I feel Republicans oppose this because they absolutely, positively, must disagree with Democrats. Agreement shows weakness! Ko’Plah!

        • frank64 says:

          I like that idea, the only problem is I think everyone in the medical industry feels entitled to huge, huge markups and salaries. The was enabled due to the insurance and employer paid system, but these companies will not go back. I used to think that normal competition would reduce costs, however if you look at the dental industry, you see the same huge markups. The industry needs a nuclear bomb to fix this, this is barely a M-80. .

          • Warren - the Original Chocolate Cake with Eyes! says:

            I don’t have a problem with a skilled surgeon making a lot of money. It’s all the administrators making seven figures a year that needs to stop.

            • frank64 says:

              They should make a lot of money, but they do, and maybe more. A lot of money should have some end point. What is the magic number? I don’t know, but there should be some reasonableness.

              But it is not just the doctors, it is the medical instrument manufacturers, it is the pharmaceutical industry, it is the non-profits where the CEO’s make more than the private sector. It is the medial schools that mean for high doctor debt. It is everybody

      • wackydan says:

        A big bandage that nails the middle class. This could have been done far more intelligently… Obamacare/this bill is going tohelp in some aspects but hurt in others… All it did was shift costs around… not actually contain them.

        • frank64 says:

          It shifted the cost to allow them to keep rising. We had actually hit the straw on the camels back with the costs reaching more than we could possible afford. Medical industry stocks have risen after the announcements, not a good sign for us.

        • Loias supports harsher punishments against corporations says:

          More was wanted, but compromise was made.

    • StarKillerX says:

      ‘now told that the federal government can make citizens do anything if they attach a tax as a penalty for not doing it. That’s not going to sit well with many Republicans who might have been lukewarm on Obama.”

      Actually that shouldn’t sit well with anyone.

      Holy crap, talk about a massive expansion of power.

      • Maz says:

        Obama tried to compromise with what Republicans wanted years ago.

        Kinda wish you had your single-payer system now…

      • highfructosepornsyrup says:

        Why? That it’s not unconstitutional to tax stuff is not an expansion of anything. It’s still up to the government to decide what to tax. If the government decides to tax non-broccoli consumption then it’s up to the voters to vote in a new government that will repeal the broccoli non-consumption tax.

        • StarKillerX says:

          Actually it is an expansion because before this they weren’t able to tax you to try and force you to buy something.

          This ruling would even allow the government to mandate union membership for all US residence, and a fine of $5k for anyone not belonging to a union.

          I probably shouldn’t have typed that because I’m sure some people will think that’s a good idea.

          • highfructosepornsyrup says:

            I disagree. The government does a lot of taxation that’s essentially the same, except that it’s layered in much more bureaucracy.

            If the penalty were applied to everyone, then nobody would say it was unconstitutional – it would just be a regular tax. Then the government says, well… here’s a “you-have-insurance rebate/subsidy/tax credit”. Again nothing at all unusual. The net effect is exactly the same.

            • StarKillerX says:

              The net effect might be the same but the implimentation is completely different.

              We reward many things within the tax code, and even punish certain actions via the so called sin taxes, but now they are starting to punish people who don’t buy a certain thing. Huge difference.

              Name one other product anyone is required by law to buy or they are forced to pay a punititive tax?

              • highfructosepornsyrup says:

                By the arguments people are making, I suspect there isn’t anything with this kind of individual mandate out there. I would even agree that the implementation looks heavy-handed as well. Still, the difference is in the implementation, not the effect. That the purpose of the “tax” is to enforce/punish behavior rather than generate substantial income is not new.

                IMO the only real bone of contention here is whether the default way to run your life is to have some kind health care or not. What Obamacare basically says is that having health care is the default state, but with compromises due to the opposite being historically true. Obviously there are many people who prefer that the default state to be one where you don’t have health care, hence the uproar.

                • StarKillerX says:

                  No, my issue is that the government shouldn’t be defining a default state.

                  Afterall, they could just as easily decide that union membership is now a default state and not belonging to one, and paying dues, will result in taxes/fines. Or owning a new US made vehicle is the default state so if you don’t buy a new US made car every 5 or 10 years you’ll be fined/taxed.

                  My point is this sets the precident and things will only get worse from here.

                  I’m not one for conspiracy theories but consider this, while many will say thinking requiring union membership, or US car purchases are simply crazy talk, wouldn’t that have been the same thing they said if in 1999 or 2000 you told them that in a few years we would have federal employees at all airports frisking air travelers and making them stand in scanners that could see through clothes?

                  • dangermike says:

                    I usually agree with your posts, and this is mostly not an exception. But as far as the TSA is concerned, it would not have been a big surprise to me at that time. With all the crime bills, Ruby Ridge and Waco nonsense, and the overall extending reach of the government at the time, it would not have surprised me to see them in many more places than just airports. And by then, they were not and unusual sight in nearby high schools.

                    But i do agree with the sentiment of what you’re saying. This a a very significant trespass on individual rights, and sets an absurdly dangerous precedent.

                    • StarKillerX says:

                      Thanks,

                      Don’t get me wrong, I wasn’t stunned to see the government extending it’s reach, but I’m amazed at how far that reach has extended in 12 years and I think that anyone talking about what the TSA does today in 2000 would have been looked as a total nutcase by most of the population.

              • SabreDC says:

                “Name one other product anyone is required by law to buy or they are forced to pay a punititive tax?”

                Participation in a health insurance plan is not “one product”. If the government said “You must by the XYZ Corporation’s SuperCare HMO plan with a $1,000 deductible”, then I’d agree with you. But they aren’t requiring you to purchase a single product. They are requiring you to participate in any plan of your choice if you can afford it and are not religiously opposed to it. Just like they require you to pay into Social Security and Medicare. Just like they require every male to participate in the Selective Service System or face a $250,000 fine. And just like they require everyone to apply for a social security number or taxpayer ID number. And just like in many states, it is a requirement of every resident to purchase utilities (either directly in the case of homeownership or indirectly in the case of renting).

      • Stickdude says:

        And what’s sad/funny is that 99% of the commenters here will be unable to connect the dots between increasing federal power and increasing money in politics.

        They cheer an ever-expanding government pie, but are perplexed and angry when corporations/unions/rich individuals spend more and more money to get a larger piece of that pie.

      • eeelaine says:

        If you look at the whole opinion, it actually and quite severely limits the power of Congress due to the rejection of the interstate commerce clause. All it says about the tax issue is that it is within the constitutional powers of congress to impose a tax.

        So basically, you can think of it like a tax credit. No health insurance? Pay tax. Health insurance? Tax credit. This is not a “massive expansion” of anything.

        • eeelaine says:

          I should say “May limit” <– its unclear what the long term effects of the commerce clause rejection will be.

        • rugman11 says:

          How so? The Supreme Court has basically said that Congress can do anything so long as the penalty for non-compliance is a tax.

          No health insurance? Pay tax. Heath insurance? Tax Credit.
          No bank account? Pay tax. Bank account? Tax Credit.
          No gym membership? Pay tax. Gym membership? Tax Credit.

          The only barrier to Congress’s power now is Congress’s willingness to pass a law. That’s very dangerous.

          • SabreDC says:

            Just like the Constitution says. Go figure.

            The only barrier to Congress’s power for anything in Article I, Section 8 is Congress’s willingness to pass a law. That includes changing the US monetary system, laying taxes, declaring war, calling forth the militia to suppress insurrections, changing the standard units for weights and measures, and so on.

            Yes, Congress CAN pass a law to collect taxes if you do not have a bank account or gym membership. And they can pass a law making the “cord” the default unit of volume, or declare war on Canada, or devaluing the US dollar to the equivalent of 1 yen. That’s their role in government.

            If you are unhappy with that power, then you have several options. You can vote for representation (or represent others) in Congress in such a manner that would be against taxing non-members of gyms and banks. You can vote for representation (or represent others) in Congress in such a manner to amend the Constitution to take away that power. You can renounce your citizenship. Or you can break the law and deal with the executive branch.

  4. frank64 says:

    I think both points of view on this would have been better served if the law was stuck down. The healthcare law is a political hodgepodge that doesn’t get at the route of the problems and enables much of the industry to keep raising prices. It would have been much better to start from scratch.

    • Kuri says:

      Just as one pickaxe strike doesn’t get the gold, it’ll take more than one thing to fix some of the problems in the system, and some problems might never be fixed.

  5. clarkis117 says:

    A Victory in Reforming the expensive boondogle called healthcare!

  6. theblackdog says:

    This isn’t much different than investors who invest in a company because they’re excited about an upcoming product that ultimately turns out to be vaporware. You take a risk anytime you send money out, and yeah it sucks to get burned, but you’re the one who made the choice to send the cash.

  7. HomerSimpson says:

    “Activist lefist Supreme Court will PAY for this travesty!!!!!!!”

    /foxnews

    • RandomHookup says:

      I’m ordered a case of “IMPEACH ROBERTS” bumper stickers for the next Tea Party rally.

    • FatLynn says:

      Fox News was actually reporting that it was struck down, and then corrected themselves a few minutes later.

      • Rebecca K-S says:

        CNN, too.

      • ronbo97 says:

        WHY would anyone go to Fox News or CNN to read about this decision ? Fox is just the mouthpiece of the Republican party. And CNN is just, plain stoopid.

        The New York Times is my primary source. Intellegent writing; intellegent comments.

  8. dicobalt says:

    What if you can’t buy health insurance because nobody will sell it to you because you have an existing condition and even if you could buy it the cost would be so high it would be impossible to afford?

    What then?

    • FatLynn says:

      They cannot screen for or consider pre-existing conditions. That’s part of the law, too.

      • Zelgadis says:

        And that is the absolute best part of the new law. I could not get insurance when I lived in the US because of my own pre-existing condition. Thing is, if I ever ended up in the emergency room, they would be required by law to treat me. Then I would promptly declare bankruptcy since I wouldn’t be able to pay the bill and then the taxpayers would be on the hook for my care anyway.

        • wackydan says:

          It does nothing to address the hundreds of thousands of illegal residents that essentially do the same… They never even consider paying as there is nothing compelling them too! They’ve have single payer here in the U.S. for years! *Payer being the American citizen.

        • StarKillerX says:

          So, you feel that a company should have been forced to cover you despite your pre-existing condition?

          Do you also feel you should be able to buy full insurance coverage on a car today despite it being totalled last week and then expect the insurance company to buy you a new car?

          • dameon says:

            Wait, I thought we weren’t comparing this to Auto Insurance because they weren’t the same thing?

            • StarKillerX says:

              No, insurance is insurance so they themselves can be compared, what can’t be compared is the mandate to have auto vs health insurance as your not required to have auto insurance. What needs insurance is any car being driving on a public road.

              Huge difference.

          • dameon says:

            Your comparison is incorrect. It would be like asking an Auto Insurance company to insure a car that has some mechanical issues that allow it to be driven on the road but your mechanic can’t totally fix.

            You example would be like asking a Health Insurance company to cover a dead person.

            • StarKillerX says:

              Well if we are going to ignore the point and instead argue the minutia your example doesn’t work either but the point is that expecting to be covered for a pre-existing condition is silly because in effect it’s no longer a risk, it’s a given.

              Insurance is a pool of risks, but now we are changing it to a pool of payments. For example CNN is highlighting a girl who is 4 years old is averaging a couple hospital admissions a year each totally $50k. They are using her to talk about the elimination of lifetime caps but consider this, if she didn’t have insurance should her parents expect a company to sell them a policy for a few grand a year knowing that the girl alone will cost them over $100k each year?

              • RandomHookup says:

                We all know that insurance companies would prefer to insure only the healthy. This legislation would (theoretically) give them more healthy people required to by health insurance while requiring them to insure “losing propositions” as well. Under HIPPA, they have to accept individuals with pre-existing conditions they would generally have turned down otherwise.

                Someone will have to pay the $100k per year … an insurance company, the government, the recipient, the health care institution. Better to have it built into the volume model than to simply expect the individual (who probably won’t be able to pay it) or the health care providers to foot the entire bill.

          • aerodawg says:

            F*CK YEAH! I HAVE THE RIGHT TO ENTER A CONTRACTUAL ASSIGNMENT OF RISK AT A CHEAP RATE FOR AN EVENT THAT HAS A 100% PROBABILITY OF OCCURING!

      • dameon says:

        Not just A part, but the part that made the individual mandate (which the SC just upheld) a neccessity in fact.

    • Rebecca K-S says:

      Someone hasn’t been paying attention.

    • RandomHookup says:

      I believe that it’s covered in the complicated rules. You can’t be turned down for pre-existing conditions (because insurance companies will have more healthy people in their plans with the individual mandate). There will also be ways for people who can’t get affordable coverage to receive help from the government.

      Not that all of that isn’t subject to all kinds of rules, regulations and misinterpretation on my part.

      • StarKillerX says:

        ‘There will also be ways for people who can’t get affordable coverage to receive help from the government.”

        Yep, via yet another Obama caused tax increase since of course the more the expand medicaid coverage the more of our tax dollars will be needed to pay for that coverage although this will also result in an Obama State and sometime local/county tax increases since 50% of the cost or covered by the states (although some states pass along some of those costs to the counties, such as NY which requires the county to pay half of the state’s portion – in my county 86% of our county property tax goes directly for medicaid.)

        • RandomHookup says:

          Always a good idea to bring partisan politics into the answer for a pretty simple factual question.

    • frank64 says:

      The law says you cannot be turned down for a preexisting condition. That is a reason they wanted to mandate healthcare, if anyone could just wait until they got sick insurance would be very expensive.

    • Loias supports harsher punishments against corporations says:

      Keeping voting in Republicans – they can fix anything.

    • Lyn Torden says:

      What if the buyer doesn’t want to agree to the abusive terms in the contracts, and lack of accountability by the provider, and ends up being unable to find a provider that has acceptable terms?

  9. jojo319 says:

    I guess what I’m wondering is, does this mean the Feds can tax us for ANY reason? “Everybody has to lose weight or pay a tax”. “everybody has to wear a red shirt or pay a tax”. These are crazy examples, but what is the difference?

    • TuxthePenguin says:

      That’s the point everyone against ACA has been making. I think some of it might be stuck down as not a valid concern of the Federal Government (but maybe not)? But certainly you could argue that anything relating to healthcare could be done this way. Gym memberships, “fat” taxes, heck, maybe even food.

      • u1itn0w2day4ever says:

        Bingo!, I think the way the court seems to have backed up and increased the federal governments taxing power is just as ominous as lack of ‘axis’ to health care.

    • RandomHookup says:

      Probably not much, but Congress (and state legislatures) do have some pretty sweeping powers. It’s up to the voters (and public sentiment) to keep them in line, assuming the courts don’t.

    • StarKillerX says:

      That is exactly what it means.

      For example, if Washington DC decided US automakers need a boost they could now require all US citizens to buy a new US manufactured vehicle every 10 years or be forced to pay a $2,500 a year tax for not obeying the new law.

      It seems outlandish and some will say nothing like that could ever happen, but 12 years ago if I had post that in a few years that people traveling by air would be required to be scanned my a device that could see through their clothes and that federal employees would be frisking travelers in airports I’d have been laughed off the internet but here we are.

    • rugman11 says:

      By my reading, and IANAL, it does. The Supreme Court said that, so long as the tax is not so high as to make the only reasonable alternative to comply, it is legal. So if the government wants to boost housing prices, they can charge a tax on anybody who doesn’t own a home. If it wants to boost the banking industry, they can charge a tax on anybody who doesn’t have a bank account.

      Honestly, the health care law would have been far more narrowly allowed if it had been passed under the Necessary and Proper Clause.

      • partofme says:

        I disagree. The gov’t has long been able to do most anything with the taxing power. This ruling maintains that those encouragements have to be reasonable in magnitude. Only now, they can’t assess criminal penalties for things like not having a bank account. If this had been passed under Commerce + N&P, they could have gone back in two years and said, “Guess what? We’re not charging a penalty anymore for not having health insurance. We’re giving you a felony and five years in jail. Oh, and you’re getting another five if you don’t have a bank account.”

        On the other hand, under the taxing power, they’re much more limited in what they can do… as noted by comparison to the child labor cases… they can’t “tax” you 20% of your income for not complying with one of their “encouragements”. And they can’t just put you directly in jail.

    • Loias supports harsher punishments against corporations says:

      These “taxes” also must be voted on. Congress isn’t a complete vacuum (though they appear to be sometimes). If the citizens don’t want it at all, it ain’t gonna happen.

      And despite GOP outburst, there was a good portion of America that wanted this Act.

      • rugman11 says:

        As of the beginning of June, 68% of Americans polled wanted the Supreme Court to overturn either the entire law or at least the individual mandate.

        http://thecaucus.blogs.nytimes.com/2012/06/07/new-poll-the-supreme-court-and-the-health-care-law/

        • frank64 says:

          More on here seem to like the law, shows that this site does not represent the country.

          • Kuri says:

            Neither do any of the polls taken, since that assumes everyone in the country participated in said poll

        • AtlantaCPA says:

          You’re leaving out the fact that it’s 51% who wanted the entire law repealed and 27% who wanted just the individual mandate repealed. That 27% likes the rest of the law and doesn’t understand that you need the mandate to make the rest of the law work. If you have to put them into the like it or hate it camp, they’d be in the like it camp.

          I’d say that qualifies as making Loias’ comment about “a good portion of America” true.

          Rant: I can’t understand why people feel the need to try to disprove a statement that is true with facts that just show the original statement was true. I think it’s a reading comprehension fail. I’m seeing it a lot these days on here.

          • rugman11 says:

            Newsflash: People often like good parts of a law while disliking bad parts. Just because 27% of people don’t realize that the individual mandate is a critical part of the ACA doesn’t mean that, if they were informed of that fact, that they’d suddenly support the law.

            Think of it this way. Imagine that Congress passed a law offering free health care to everybody and it was paid for with a National Sales Tax (questionably Constitutional). 41% didn’t want the law, 27% didn’t want the tax and the rest were in favor or undecided. Sure, those 27% like the idea of free health care, but they don’t want to pay for it with a possibly unconstitutional National Sales Tax.

            I could just as easily make the argument that those 27%, once informed that the individual mandate was not severable they would all oppose the bill because, if they think one part of it is unconstitutional, then the entire thing is unconstitutional.

            • AtlantaCPA says:

              FOR PETE’S SAKE – Friggin ignore the 27% for a minute then – there is still a freakin third of the US that loves the law. That STILL makes Loias’ statement true (“a good portion”).

              Thank you for proving my rant true in my last post as well. I’d also like to point out that I never use caps or curse in my posts until now, thanks for ending that streak for me.

              • rugman11 says:

                Apparently we have different definitions of “good portion”. No need to get upset about it.

                • AtlantaCPA says:

                  I apologize. I had some other people who failed to read what I actually said arguing against me recently (with arguments that supported what I actually said). Yours was not as severe but it set me off coming after them. I try to remain level-headed usually and will take a few deep breaths.

        • ARP3 says:

          Actually, when you break up the individual components (80/20, pre-existing conditions, kids on parents health care until 26, etc.), most people supported it. I think there’s a bit of ignorance at the mandate as that allows the rest of the law to work.

          • rugman11 says:

            I would never deny that. Most people like the benefits of most laws. It’s just the pesky paying for it parts that they don’t like.

            • RandomHookup says:

              Someone cited a poll in Mass. that said that local residents highly supported their current health care system, but that a majority opposed ACA. Polls can only tell you so much.

    • highfructosepornsyrup says:

      You still gotta vote these people into office no? Problem isn’t that the feds can tax stuff – it’s that politics are so partisan that voters don’t trust the “other guys” to be non-evil and the elected officials can’t be trusted to make compromises.

    • dangermike says:

      Enter text…

      • dangermike says:

        Strange… clicked reply, clicked the text box, then ctrl-v to paste a quote, and then the page refreshed with the comment box back at the top and the above comment posted…

    • dangermike says:

      George says that every American should have a vacuum cleaner in their basement!’ What do you think, gentlemen?

    • SabreDC says:

      Of course.

      “The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises”

      It’s right there in the Constitution. It doesn’t say “The Congress shall have Power to lay and collect Taxes, Duties, Imposts and Excises for the following reasons: …”

  10. partofme says:

    I haven’t finished reading the opinion yet (obviously)… but from the summary, whether it’s a tax or not changes inside the opinion. It’s a tax Constitutionally… but for the purposes of the Anti-Tax Injunction Act, it’s not a tax. I’m looking forward to seeing what the reasoning is. Also, there were five votes saying this doesn’t fit into the Commerce Clause. Even the fact that they bought the coercion theory for the Medicaid expansion is interesting. Every piece of this is going to be an interesting read (and a very unexpected split of votes, for those who think that SCOTUS is only politics).

    • partofme says:

      I’m done. It’s interesting. Roberts really split it in a novel way. Ginsburg’s dissent simply recited precedent, ignoring some major flaws in logic presented by both the Chief Justice and the conservative dissent. The conservative dissent (without a stated author, but pretty clearly heavily influenced by Scalia) was actually very compelling on several points. It makes it clear why Roberts went to such pains to emphasize that he was doing everything possible to rule it constitutional when he went with the taxing argument (to the point of ignoring the text of the law, they argued). Also, it wasn’t until you got most of the way through the conservative dissent that you learned that the coercion theory on the Medicaid issue was actually 7-2! Only Ginsburg and Sotomayor disagreed. That’s pretty shocking for what most legal commentators thought was a very novel theory (and thus, quite unlikely to succeed).

  11. yankinwaoz says:

    Thank god. We can do so much better in this country than the mess we have now.

  12. Will Print T-shirts For Food says:

    So what I should be doing is dropping my major from Business Administration and Marketing and move to the medical field so that I can further rob the insurance industry…. Right?

    • frank64 says:

      Or you can work for the insurance companies and get your cut.

      • Will Print T-shirts For Food says:

        Hmmm…. I can continue with business and marketing and go into marketing for the insurance industry!

        Only problem is I pride myself on my strongly ethical business-y viewpoints, so having a job in general makes me want to kill myself.

        • frank64 says:

          You can work for a non-profit insurance company to take care of your ethical issues. They actually get paid very, very well there so you can kill to birds.

        • wackydan says:

          Just start your own business and keep two sets of books… Like many small business owners do. Might as well hide as much of your income from the gov’t as you can… because they are coming for it.

    • RxDude says:

      Wrong. Medical providers have been squeezed for years, and the ACA does nothing to alleviate that (if anybody has evidence to the contrary, please correct me). Why do we have a shortage of primary care/family care physicians? Because after working their asses off in school for 8 years, graduating with six figures of student debt, and working 80+ hour weeks during internship and residency for peanuts, doctors would like to pay their bills, buy a house, raise a family, etc. Reimbursement for primary care pretty much sucks. It makes more sense to go into a higher-paying specialty. Then there’s malpractice insurance, which is squeezing even the higher-paying specialties. The Nevada obstetrician shortage is a textbook example.

      As much as we would like to believe that all physicians are Dr. Quinn, Medicinewoman, health care providers are real people, just like the rest of us. They are motivated by the same goals other people share. They have a lot of bills to pay, they’d like to spend time with the people they love, they’d like to have nice things they’ve worked for, and they’d like to relax every once in a while.

      • frank64 says:

        It might not be worth it, but doctors when they first start practicing are able to buy $700,000 dollar homes and have expensive cars. Not saying the didn’t work for it, I am just saying they don’t suffer.

        True, there are problems, medical school is probably too expensive, but the answer isn’t to pay doctors more, the answer is to not allow for the huge huge costs that have risen exponentially. Our systems of getting everyone else to pay has enabled these increases, it might be nearly impossible to fix. That is why I advocate for the nuclear bomb approch to the whole industry. This law isn’t it.

        • wackydan says:

          I’ll tell that to my nephew the doctor… I think his Town home is all of $140,000… and he is still paying on his Nissan.

          Wide brush much?

          • frank64 says:

            My observations in knowing a doctor and his colleagues, and it conflicted with RxDude’s wide brush. There are many doctors that do not fit his narrative. It was his wide brush I was referring to.

        • icerabbit says:

          “Doctors when they first start practicing are able to buy $700,000 dollar homes and have expensive cars … ”

          I just happen to have first hand knowledge in the matter. Generally speaking, your statement is complete bullocks.

          Except for maybe 1% of the cases where a doctor’s wealthy family paid for his/her education and that person can start a career debt-free. In such a case higher paid specialists can take on a huge mortgage based on income projection.

          However, most doctors gross income is below $150k and they never ever come anywhere near owning a 700k home in their lifetime. A $200-$400k home and a European car after a number of years, yes.

          • frank64 says:

            I am telling you the doctor I know and his colleagues. He did get his loans waived by working in a “needy” area, but the area is fairly well to do too. What I saw was not bullocks. I live in an area where a $400K home would be only slightly above average, so we are probably talking about different areas.

            Are you saying doctors can only afford average houses? My only point for this part of the thread is that many doctors don’t have it as bad as he said. We are getting besides the point on this.

            • icerabbit says:

              Your comment was that doctors fresh out of residency buy / qualify for a 700k house … which I called an exception. (and you confirmed that his loans were forgiven in lieu for several years of practice in an underserved area, loan forgiveness only happens for a tiny fraction of doctors in underserved areas … but is a huge financial burden removed)

              Anyhow, doctor’s salaries vary widely by specialty and housing prices differ widely from one area to another and from state to state. While I agree that typically a doctor lives in an above average house and drives an above average car; it doesn’t start out that way fresh out of residency. The average doctor salary across all specialties is around $150k with plenty of physicians making less than $100k. On that salary one does not buy a 700k house on top of paying student loans, malpractice insurance, health insurance, cars, family expenses, …

              On a national scale, your friend is the exception.

  13. Bsamm09 says:

    “So under the taxing power of the Constitution, a tax can be levied on people who refuse to buy health care, rather than a requirement to buy a product, like say, broccoli — just one example brought up during the arguments over the mandate.”

    So do you have to buy health insurance? Could you just buy health care throughout the year? I didn’t RTFA but health care is vastly different than health insurance.

    • frank64 says:

      I think you are forced to have insurance. I am not sure if a high deductible plan would count. I really would like the ability to have a high deductible plan so I could pay for my routine care out of pocket.

      • rugman11 says:

        It depends on whether high deductible plans meet the government’s definition of “minimally acceptable insurance.” My guess, right now, is that they won’t.

        • icerabbit says:

          I would hope that a HDHP would comply.

          And, what I mean by that is that we now already pay $1250/mo now for a private policy with 5K deductible per person!

          I can’t imagine having to pay more than that for a lower deductible or getting hit with the tax because that isn’t enough.

          We have no other alternatives in our state. Take it or leave it.

          That’s why we would like reform and options; so that there could be several national or state plans that because of the number of participants are better value than this overrated individual $1250/mo ball and chain around our ankles. You pay the super expensive premium and for all your healthcare costs unless you were to need surgery.

          • AtlantaCPA says:

            It would comply. But if I read the law right it actually caps deductibles at $2,000 for a single individual and $4,000 for any other plan (family) starting in 2014.

            • icerabbit says:

              Thanks for the heads up. Hadn’t heard that one yet.

              That probably means we need to pay at least an extra 50% more for health insurance, with our current provider. I don’t even want to look it up for fear it is going to be more. The cost already doubled in the last 6 years or so (without illness, knock on wood)

              :/

  14. jojo319 says:

    What are your guys’ feelings on people who wait to buy insurance when they get sick? The whole law just seems counter intuitive. I mean, the whole purpose of an insurance company is to assess risk. That is really their function. By taking that away, it just doesn’t seem like a sustainable business model. What am I missing? I know people love the per-existing conditions clause, etc… But it just feels like this is going to explode premiums. They’ve increasing more than ever since this was passed.

    • jojo319 says:

      Spell check has not helped in my case =)

    • AstroPig7 says:

      That’s the whole point of the individual mandate. If it were struck down, then people could simply wait until they were sick to buy health insurance and then drop it after. The mandate requires people to buy health insurance or suffer a penalty.

      • u1itn0w2day4ever says:

        They can only suffer additional taxes. They cannot be pennalized for not having health insurance for which probably cannot already afford. Then they’ll need more taxes for debtors prisons for those who can’t the additional taxes.

      • Bsamm09 says:

        The penalty is not that much. Should be WAY cheaper than health insurance. But if you get into an accident that requires immediate expensive health care before you can buy insurance, you are screwed.

        • Kuri says:

          Yup, just like before.

          • AtlantaCPA says:

            Except now people will have far less sympathy for you. If you say you couldn’t afford it there are now subsidies that make it so you should have been able to afford it and you don’t have any excuse.

      • Stickdude says:

        They can (and will) still do that.

        The tax (remember, it’s not a penalty – it’s a tax) is much less than the insurance premiums would be, so it still makes economic sense for healthy people to just pay the tax until they get sick – at which point they get insurance that has to be offered to them regardless of pre-existing conditions.

        • wackydan says:

          That penalty was purposely designed that way… Gov’t knew they’d be collecting a lot of $$$ on these fines.

          • Stickdude says:

            The cynical part of me still believes this entire act was a roundabout way to destroy private health insurance in this country.

            • frank64 says:

              Insurance companies stocks actually went up. I think it makes them stronger. I think their lobbyist did real well on this.

              • dangermike says:

                Well of course. Just consider how many new customers they’ll have. Parents can keep paying for their kids plans until age 26, those 40-60 million uninsured will be legally “encouraged” to go out and buy a policy, and they can probably cut back on their marketing staff.

            • ttw1 says:

              Let’s hope so.

            • MrEvil says:

              I find that hard to believe since it was the insurance companies that came up with this. This was their “compromise” to avoid the government offering a public option.

    • jojo319 says:

      When is this supposed to start controlling health care costs and rising premiums? That was a HUGE part of selling this to the public. So far it has had the exact opposite effect apparently. It would just seem to me that, if you are forced to buy something, what incentive to insurance companies have to keep prices low? especially if there is no competition across state lines?

  15. fsnuffer says:

    Welcome all of you to the VA. All the people at the VA do a great job but they are critically understaffed and underfunded.

    • Vox Republica says:

      But they’re also one of the most cost-efficient, if not the most cost-efficient, health care providers in the United States today. Their computerized record system has substantially cut down on wasteful duplicate procedures and mishandled prescriptions. They’re unlike any other U.S. health care provider in their focus on preventative care (e.g., their MOVE program), and have one of the best market penetration insofar as outpatient mental health services. I can say this much: if we were able to serve all Americans as we’re able to serve our veterans under the current VA, I think our health care costs and outlooks would be substantially improved.

      • AtlantaCPA says:

        Why that sounds almost like … Socialism! Hey, wait a minute, my tax-funded police force and fire department sound like socialism too! What is this country coming to? /s

    • RandomHookup says:

      No, the VA is a closed system with primarily government employees. It’s more like “welcome to Massachusetts.” We have had the mandate for years, thanks to Governor Romney.

      Most people have elected to be covered, but there are some issues around practitioner availability and a big influx of new patients into the system. It’s cheaper to pay the penalty than to pay for insurance by yourself, but most figure they would rather get some value for their money. We have also seen a number of very low end insurers and scammers come into the market, claiming to provide coverage that meets the standards of the law (but doesn’t).

      Health care costs are still high and the state does spend a lot of money on them. I don’t expect that to change anytime soon.

      And we still have that gay marriage thing up here too, and we haven’t seen any damage done to traditional marriage.

      • dangermike says:

        “We have had the mandate for years, thanks to Governor Romney.”

        This was one of the things that bothered me most as he became front runner in the Republican primaries. I think Michael Shedlock said it best in his Global Economic Analysis blog: “A vote for Romney is a vote for Obama.” While they do disagree on a number of ancillary issues, when it comes down to the core of what’s important (yes, Bubba was right: It’s the economy, stupid), neither seems particularly qualified for leadership in these troubled times. In fact, I have never had the opportunity to vote for a presidential candidate that I have truly had faith in.

    • Bsamm09 says:

      They are not. Read the first few pages of some of the health insurance companies’ 10-K reports. The ones I read said they expect to increase premiums a lot in the next few years as these new regulation and taxes hit them.

  16. u1itn0w2day4ever says:

    So you can be “taxed” instead of being fined for not having health insurance. But if you can’t afford health insurance how can a financially stressed individual afford to pay taxes?

    The scary part of this decision is that it seems to expand the government’s taxing powers as much as anything. AND even those with health insurance might be lose some privacy because now you need somekind of proof of insurance. This is just more information for your government file.

  17. tennesseemom says:

    I’m more than happy to pay a tax so *everyone* can get health care. Is dental included?

  18. mbd says:

    The Supreme Joke Of The United States has ruled.

    • AstroPig7 says:

      Thank you for that insightful, well-reasoned comment. Your words are like ambrosia to this article.

    • u1itn0w2day4ever says:

      As with most political favors because that’s what a supreme court appointee is a political favor debts must be paid. I think they played both ends of the stick on this keeping themselves elidgable for more favors.

  19. ScottCh says:

    Right after job loss, the 2nd biggest reason for home foreclosures in the USA is the crushing expense of health care. It doesn’t matter whether you have what goes for health insurance in this country or not: you get sick enough, the hospital takes your home away and throws you and your belongings to the curb. How does that make any sense? Is there an alternative, other than refusing health care and dying quietly? We’ve read about people who tried to do that, and were given financially crippling health services anyway.

    Saying “We need to throw away ‘Obama-Care’ and start over” doesn’t cut it! We’ve heard that sorry story for decades. If the very best we can do given our mostly broken political system is a hacked up compromise, so be it. We’ve had dozens of efforts that went nowhere, and the problem continues to grow. Put something out there, anything, no matter how crappy it looks (think “Charlie Brown’s Christmas tree”)! Who cares what it looks like at first? It’s a beginning! Then get to work fixing it!

    We have let the lobbyists and their paid help in Washington protect their ginourmous profits at the public’s expense up to the point of near-complete failure. We are not being served, we’re being ransacked. There’s no road left to kick this can.

    • SirWired says:

      Exactly. The GOP hasn’t been real forthcoming as to what their solution is if there is no individual mandate other than “Keep doing what we’ve been doing.” Which is not working; a fact obvious to everyone but GOP hacks.

    • frank64 says:

      You say this is the best we can do, but then you point out how the lobbyist have rigged the system. The lobbyist have rigged this law to keep the enormous profits coming.

      This is why I think we would have been better off starting over. I believe ideally we should be able to come up with a more market driven system that could have reduced costs. However given the cost structure that has developed, the entrenched medical industry and the lobbyist, we may be better off with a single payer system. At least start off that way, and allow for private competition.

      • ScottCh says:

        frank64: what makes you think that there’s any chance of that occurring under our current political system? It took every ounce of political capital Barack Obama had, along with a democratic majority in both houses to get this much health care reform to be written into law. Have you looked at Washington lately? Following the 2010 elections campaign finance reform was eviscerated, and every bill that does not serve extreme right wing interests has been stonewalled. You think you’re going to get something better than what we have? You and what government?

        • frank64 says:

          There would only be a big change if one party was able to dominate. I am much more of a Republican, but I think ANY real cohesive plan, even the Democrats would be better than this hodgepodge.

          And you have to give the Dems some credit. I don’t think the Republicans have any real answers on a serious issue, and Romney hasn’t come up with anything.

          Your right though, this mess of a law is reflective of what we get with the extreme partisan politics on BOTH sides.

  20. dullard says:

    I have not as yet read the opinion, but it would seem that, in finding the purchase mandate to be in the nature of a tax, the majority found a way to reach what they felt to be a socially desirable result without having to expand the reach of the Commerce Clause.

    • rugman11 says:

      Except that this has even more reach. The Supreme Court basically said that Congress can force us to do anything, so long as the penalty for non-compliance is a tax that is not so burdensome as to force compliance.

      The narrowest decision would have been to find the law Constitutional under the Necessary & Proper clause.

      • dullard says:

        I don’t think the Necessary and Proper clause applies as it would seem that health care is not among the enumerated powers nor is it set forth elsewhere in the Constitution.

        I do agree, however, that it does bring to light another basis for expanding the power(s) of the Federal Government under certain circumstances.

  21. Fubish says: I don't know anything about it, but it seems to me... says:

    “candidate Mitt Romney has pledged to repeal the legislation if he wins the election and his party maintains control of Congress”

    You know what? If they win they ain’t going to repeal ANYTHING. They will gas off, holler, scream, screech, and squeal but in the end they will do absolutely NOTHING major. Nothing.

    The big insurance companies have been licking their chops since the individual mandate was first proposed and they are NOT about to let that baby get thrown out with the bathwater, believe me.

    • ronbo97 says:

      Whenever a politican ‘pledges’ or ‘vows’ to do anything, you know nothing is gonna happen.

  22. PhillipSC says:

    I wonder what the minimum qualifications for “insurance” is?
    could i offer you a plan myself for 1$ but with a 100 trillion $ deductible ?

  23. Bladerunner says:

    I remember when the issue first went to the SCOTUS, and some were saying it would be obviously declared legal under the taxing powers…oh the condescension they were responded to with!

    • partofme says:

      To be fair, pretty much no lower court took the idea seriously, and this way of doing it really wasn’t discussed in oral arguments. There’s already been speculation that the conservative dissent may have originally been the controlling majority (there are hints where the text calls Ginsburg’s dissent “The” dissent) until Roberts bought into the taxing argument and the liberal wing jumped on board to save the law.

  24. ArchersCall says:

    It’s not a tax to force me to pay for a service I can’t afford. It’s a tax if it comes out of my paycheck and everyone is automatically enrolled in a “free healthcare plan” (which you can opt out of if you have better insurrance with your employer or you want something better somewhere else).

    I’d prefer them take it out of my paycheck or yearly taxes than force me to pay for something monthly I can’t afford. That way when I’m unemployed and my income is under a certain amount, I don’t pay taxes but , I still have health insurance. The other way, if I’m unemployed, I’m still suppose to magically come up with money to pay some money grabbing health insurance company.

  25. Fishnoise says:

    I think it should have been upheld under the Commerce Clause, but I’ll take what I can get from Roberts — a penalty but not a tax upheld under the “taxing power” of Congress. Ginsburg’s concurrence is pretty good — talks about why this doesn’t mean the government can force you to buy broccoli. Haven’t gotten to the dissent yet.

    • Stickdude says:

      “In this case, however, it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without broccoli. Such legislation is within Congress’s power to tax.”

    • Stickdude says:

      “In this case, however, it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to have a BMI greater than 25. Such legislation is within Congress’s power to tax.”

    • partofme says:

      Ginsburg’s dissent doesn’t say anything about how the taxing power argument doesn’t mean the gov’t can force you to buy broccoli. She’s still fighting the Commerce Clause argument when talking about broccoli. They can definitely assess a “not buying broccoli tax”. But they can’t make that tax onerously large… or just put you in jail.

      • Stickdude says:

        But what happens when you pay all your taxes – except the “not buying broccoli” tax?

        • partofme says:

          Same thing that happens when you pay all your taxes – except the “taxable interest” tax.

        • partofme says:

          ….actually, not necessarily quite the same thing. Congress did actually restrict some of the methods that the IRS can use for collection of this particular tax. I don’t know what exactly they would do, but it would be some subset of the things that may happen if you don’t pay the taxable interest tax.

  26. deathbecomesme says:

    Ok so when do I get to sit on a death panel? Is it going to be random drawings like jury duty?

    • RandomHookup says:

      Dude, you’re going to make to make a donation to someone’s campaign to get one of those cushy gigs.

  27. u1itn0w2day4ever says:

    Question to the legal pros. Can SPECIFIC parts of this law be reappealed later on different grounds on a strictly individual part of the law basis?

    Rather than an academic argument if an individual person or entity want’s to reappeal on different issues can they?

    And what was all the hay about the law shouldn’t even have been appealed until it directly and actually affected someone?

    • partofme says:

      I’m not quite a legal pro, but I feel comfortable answering your question.

      This challenge was what’s called a facial challenge. The argument is, “There is not any way this law could conceivably be applied Constitutionally.” There is always the chance that later, as-applied challenges could be brought to court. They’re unlikely to win much of a broad victory, as this ruling uses the very powerful taxing power.

      They can certainly make claims on different issues at that time.

      The hay was concerning the Anti-(tax)-Injunction Act. Basically, Congress has said that you can’t challenge a tax until you’ve paid it (basically, you can’t make a facial challenge). Then you can challenge for a refund. That was the first issue decided. The controlling Roberts opinion decided that since Congress can define their own terms, they can determine that this is not a tax for the purpose of the AIA.

    • RandomHookup says:

      Sure… new cases come up all the time. But there’s no appeal for those who brought the case, it’s been heard by the highest court in the land. For a while, most new challenges will be turned down at the lower court levels, but it’s possible the law could be back at the SCOTUS in a few years (especially if there’s any change in the makeup of the justices).

  28. eeelaine says:

    Ok. Now that we got this out of the way and ensured that millions more people will be continue to be eligible for health insurance, let’s get down to actually fixing the system so that everyone will be able to get healthcare, not just health insurance.

    Big step in the right direction, but a lot of work still to do.

    • Kuri says:

      What’s what needs to be acknowledged, that the problem isn’t magically “fixed” or “made worse” but that we need to take steps to do it, and this could be one of them.

  29. damicatz says:

    Osamacare is nothing more than a bunch of crony capitalism and back-patting for very wealthy individuals who managed to bribe democrat officials into adding provisions beneficial to them.

    How many of you liberals have actually read the law?

    1.It effectively shuts down physician-owned hospitals. New physician-owned hospitals cannot collect medicare and old ones loose medicare if they expand. As it turns out, the American Hospital Association, who represents corporate-owned hospitals, has been funneling a lot of money towards the people that authored the bill.

    2.It forces everyone, under the threat of violence, to become a customer of a health insurance company. Naturally, the health care companies love this law (and in fact lobbied for it) even if they don’t want to say so publicly (they have to put on a good show). I mean, what company wouldn’t like a law that forces everyone to be their customer?

    3.It hands out other people’s money (I.E stolen money) like candy funding various “programs” and government agencies (in fact, it creates over a hundred new government agencies). In reality, this is little more than a money laundering operation which funnels stolen money into the pockets of various large democrat contributors (such as a $5.9 million “grant” for Obama’s golfing buddy Eric Whitaker under the auspices of “creating a system to share medical records”).

    4.The Obama administration, democrat law makers, and big pharma engaged in a quid-pro-quo backroom deal. In exchange for making it harder to import cheaper drugs from overseas, big pharma spent billions running front 501(c)(4) organizations supporting Obamacare.

    5.The AARP bribed politicians so that Medicare Advantage would be reduced, thus forcing many lower income senior citizens to purchase “Medigap Insurance”. AARP, of course, is more than happy to sell such a service at a “reasonable price”. Not all states have the same amount of reduction either; congresspeople from some states managed to make backroom deals so that their residents would have a greater amount of coverage.

    6.Different states get taxed differently and have different funding requirements based on how much backroom dealing their politicians did.

    In fact, there are so many new departments and new bureaucracies that even the Obama administration can’t keep track of them all.

    I could go on and on but if I went through every single provision of this monstrosity, my post would be so long that it would break the database.

    • Misha says:

      Even if you have something useful to say, I tuned you out as soon as you said “Osamacare”, so that’s one rhetorical strategy you might want to re-think if you want people to pay attention to you.

    • Vox Republica says:

      Can I go point-by-point? I’m going to go point-by-point.

      1. If you’re saying that “corporate-owned” hospitals are in the clear, then there is no single mechanism in law that would prevent individual physicians from incorporating and thus managing a hospital. If you’re alleging that the ACA establishes new bars to the standards of incorporation, you’re going to need to show me where they’ve amended all of the extant statutes and regulations pertaining to incorporation.
      2. There is no threat of violence. There is threat of financial penalty. Calling a financial penalty “violence” requires a lot of explanation. I don’t like the notion of captive markets, but to call it enforced by threat of violence is a huge stretch.
      3. I hate to break it to you, but you’ve basically described how taxation works in practice: money is collected via taxation, and then redistributed to various governmental agencies. That’s been the mechanism of taxation in democracies since people first realized you can’t run a civil society for free.
      4. The pharmaceutical industry benefits, yes. They also benefit under any system wherein we have a private pharmaceutical industry. More to the point: non-generics are solely the intellectual property of their manufacturer; subsequently, there is no importation option for these drugs. As for generics, there is already a price-competitive market for such drugs, rendering the cost savings from importation of generics (and the commensurate risks of increased proliferation of counterfeit drugs) relatively negligible.
      5. Interstate markets allow any private insurer to compete dollar-for-dollar with AARP when it comes to the Medicare recipient insurance market. AARP’s involvement in legislation that may ultimately benefit them (but only if they’re the most cost-efficient insurer on the block) is essentially no different from any other economic entity supporting any other legislation.
      6. Different states have a lot of differences when it comes to taxation, federal contribution, etc., in myriad aspects of their budgeting and subsequent tax burdens on their constituents. And, again, the major cost for many individuals–that is, health insurance–will see downward market pressures due to interstate competition.

      Can you find me a quote about the new departments and bureaucracies that the Obama administration has avowed they can’t keep track of? Or is that conjecture for dramatic effect?

      If you’d like to go point by point, please do; I’m more than willing to keep lock step.

      • mcgyver210 says:

        Do you really think the IRS is a polite agency they will violently take your property if you don’t pay them?

      • damicatz says:

        1.Ok, you try running a hospital without being able to accept medicare or medicaid and come tell me how that works out for you.

        Many doctor owned hospitals specialize (because doctors themselves tend to specialize). For example, a lot of the cancer hospitals are doctor owned. Now, the majority of cancer cases are in people 60 years of age and up which means that you would have no way to get any sort of payment from the majority of your patients.

        2.If you refuse to pay the penalty, the IRS will either forcibly steal your property (through wage garnishment or the like) or send jack-booted thugs to lock you up. Both are violent acts and thus, this penalty is imposed under threat of violence.

        3.Ok, I was under the impression that taxes were supposed to be spent for the “common good”, not the good of a few good cronies pocketbooks. My statement wasn’t about the fact that they are taxing but that they are taxing for the purpose of enriching political allies.

        Also, one does not need taxation to fund the government. I’m not suggesting that the government operate for free, I’m suggesting a move to a usage based system that does not require committing acts of aggression against people.

        Just some examples :

        Roads : Pay to use. We already do this with vehicle registration and tollbooths. I would simply increase the registration fees, increase the amount of tollbooths and the amount of tolls and then eliminate taxpayer funding of roads altogether. Ideally, the rates would be scaled so that those that use the roads most (like a trucking company) pay the most.

        Courts : Courts would be funded through court fees. This is already how they fund the courts in my state.

        Police : Funded by the criminals with maximal oversight to prevent abuse. If you commit a crime, you pay a fine to the police. Instead of prison, you will be made to get a job and everything other than basic upkeep will go to paying your victims and the police. This is the foundation of a philosophy known as “Restorative Justice”

        Military : Voluntarily funded through donations. If the cause is just, you will have no trouble getting donations. On the other hand, if you insist on running the New Roman Empire, occupying every country with countless military bases and using soldiers as centurians patrolling the border provinces, you will find people less likely to fund you.

        4.I’m not complaining that big pharma benefits, I’m complaining about how they got that benefit. I do not like backroom deals and crony capitalism and the only thing transparent about the “most transparent administration ever” is their lies. Democrat politicians helped rewrite parts of Obamacare to favor big pharma in exchange for big pharma funneling billions into 501(c)(4) front organizations promoting Obamacare.

        I would also dispute the notion of “intellectual property” as being inherently incompatible with personal freedom and private property rights. There are two basic rights under natural law : the right to person and the right to property. Any other right must flow from those two rights.

        If I take a piece of unclaimed land and I work it, I can morally claim ownership of that land and everything on it by virtue of the fact that I was there first and that I put work into it. In essence, I have homesteaded that land. Legitimate property rights derive either from direct homesteading or through contractual transactions that trace back to the original homesteader.

        “Intellectual property” is a violation of those fundamental rights because you are claiming ownership over a Platonic Universal; namely, that you own any copy of your work. What “Intellectual Property” says in essence is that people really don’t own any property; if I arrange the bits on my hard drive, for example, in a certain way, then you have the “right” to come in and take my hard drive. I reject this notion and so should you. I reject the notion that “intellectual property” benefits society (and even if it does, the ends do not justify the means). The mobile phone patent wars, software patents, gene patents, and Monsanto are proof enough of that.

        5.That’s fine. I prefer private FREE markets. But what I don’t like is HOW it was done. Again, AARP bribed politicians to make this happen. That is dishonest. In addition, they also bribed politicians to exempt themselves from the rate-review requirements.

        6.It has nothing to do with tax burdens or costs. It has everything to do with which politicians made the best backroom deals.

        “Can you find me a quote about the new departments and bureaucracies that the Obama administration has avowed they can’t keep track of? Or is that conjecture for dramatic effect?”

        Did you listen to Donald Verrilli’s arguments before the Supreme Court? It was an unmitigated disaster as he stuttered and stammered his way through being unable to even cogently explain the *intent* of the authors of the ACA. Be under no illusion : Verrilli did not win the Obamacare case. His commerce-clause argument was completely rejected.

        The only reason Obamacare survived is because John Roberts decided to argue the case FOR THEM. It is completely unprecedented and it is inappropriate for a justice of the Supreme Court to be acting as an advocate for one side of the case. The Obamacare ruling itself (yes, I read it), is nothing but the usual rank sophistry that I have come to expect from the Supreme Court; simultaneously declaring that the Individual Mandate is both a tax and isn’t a tax (it isn’t a tax so therefore the Anti-Injunction Act doesn’t apply but suddenly it is a tax when the taxing clause of the Constitution applies.)

    • The Dord says:

      I stopped reading at Osamacare.

    • AstroPig7 says:

      You lost me when you childishly referred to the plan as “Osamacare”.

    • HomerSimpson says:

      “I could go on and on”

      Well thank god you didn’t!

      Now get right on those “Impeach John Roberts” petitions

    • ARP3 says:

      Actually many of the ugly provisions in the law were Republican requested, when Democrats thought that giving these compromises would actually cause the people who asked for them to vote for the law. Silly Democrats.

    • ARP3 says:

      “I could go on and on but if I went through every single provision of this monstrosity, my post would be so long that it would break the database.”

      I don’t think you can. Or did the the Red State article that you copied and pasted into this post have more?

  30. u1itn0w2day4ever says:

    So the individual mandate taxes are going to spent on tax debtor prisons, increased welfare rolls, increased use of other government programs, actual health care, increased use of bankruptcy courts or basket weaving research projects in the middle of nowhere USA.

    • RandomHookup says:

      Well, the good thing about more prisons is prisoners get government-provided health care.

  31. aerodawg says:

    When your grandchildren ask you when you stopped being a citizen and became a subject, you can tell them 28 June 2012.

    It took nearly 250 years but we finally gutted any semblance of limits to federal power. No more ugly complicated commerce clause arguments required. All that’s required is say “Do this or we’ll tax you into oblivion” and let the IRS collect the “tax fines”

  32. lovemypets00 - You'll need to forgive me, my social filter has cracked. says:

    I’m waiting to see if my employer will stop offering health insurance in lieu of paying a fine instead. From what I read, it would be cheaper for them to do so.

    The other thing I’m wondering is this: what if you can’t afford to buy a policy on your own? I’ve read posts by people on this site saying they pay $1000, $1500 or more per month, with a deductible, for health insurance. What if your take home pay is only $2000/month? What then?

    • RandomHookup says:

      It generally is cheaper to pay the fines, but the cost becomes one’s ability to retain employees. May not be an issue at the retail level, but you won’t be able to get away with it with skilled workers.

      I’m dealing with our new insurance program that doesn’t cover new employees until the 1st day of the next month of employment and I’m getting a lot of concerned, highly paid folks giving me pushback.

    • Stickdude says:

      Yes, that part of it will be interesting to watch.

      My gut feeling is that most employers will keep their insurance plans initially, because being among the first to drop insurance in lieu of the penalty would put them at a competitive disadvantage when retaining quality employees.

      However, firms that are in financial trouble (and there are always plenty of those) will feel they have no choice but to drop insurance as a cost-cutting measure.

      Eventually, enough firms will have dropped their insurance as a cost-cutting measure that most of the companies still offering insurance will drop it as well – because the money they save by just paying the penalty will more than offset the cost of having a few employees go elsewhere.

      End result: employer-provided health insurance becomes a distant memory.

      But don’t worry – Obama promised that if you like your current health insurance, you’ll get to keep it…

      • Kuri says:

        Well, what if the insurance companies take enough of a hit from that happening that they begin lowering their prices?

        • wackydan says:

          They won’t have to. They will supposedly have all those people who are being coerced into buying off the exchange handed to them. The big companies like mine actually negotiate cheaper rates… so a company dropping them is actually good for the insurer.

      • frank64 says:

        If we could go back to square one, I would like to see employers out of our healthcare. It makes it hard to switch jobs for some, lowers our choices, and it hid the cost from us, enabling the prices to rise above where they would have.

        Make it so that the employers would have to pay us what they used to pay in insurance costs and then have us buy our own insurance. In our current tax system personal health insurance would to be tax deductible. .

    • Misha says:

      There’s a cap involved based on income relative to the federal poverty level (based on size of household).

  33. Steevo says:

    Soon the government will demand you buy an assault rifle or they will tax you.

  34. Duffin (Ain't This Kitty Cute?) says:

    I didn’t originally have too much of an issue, but that was back before when we were supposed to have a public option for insurance. Now, it comes down to pay $100 a month for health insurance or pay a freaking fine if you can’t afford it. How the hell is that fair?!

    • Kuri says:

      I was of the same mind, but the “one term president” crowd just wouldn’t hear of it.

    • Misha says:

      There is a provision for affordability, based on federal poverty level.

      Also, on what planet are you paying $100/month for non-HDHP insurance?

    • Crank says:

      Indeed. This decision reeks of corporate control of our lives clothed in populist garments. No public option, but you must buy insurance from a private company.

  35. Crank says:

    Two serious questions. I thought taxes were for things you buy. Is there any other tax due for something you don’t buy, especially from a non-government entity?

    Second, the ruling states you can’t go to jail for not paying the tax. Although it is generally a last resort, I thought there were plenty of people in jail for not paying Federal tax. So how can the no imprisonment statement be accurate?

    Personal disclosure: I’m in favor of healthcare reform, and I think the Obama law didn’t go far enough. But I don’t like the buy insurance or else clause, I think it is Big Brother and totalitarian.

    • RandomHookup says:

      On question 1, I’m not sure what you mean by “things you buy”? A tax is a government levy on you … it can be on things you own (property tax), things you buy (sales tax), something you use (use tax), money you earn (income tax) and I’m sure a number of other ways.

  36. frank64 says:

    This is an idea have: When I go to fix my car, I don’t pay have to get a guy with a doctorate in engineering. I get someone who had been certified to fix my car. He doesn’t know the deep physics involved.

    Why not have less training for most doctors? Even specialist could focus more traing on their specialty. It seems most of what my primary does is routine stuff and refer me to a specialist. When I went to have a small injury fixed, a nurse practitioner did all the work, a doctor just came and checked it out. He billed me for it, but he did nothing.

    A good strong four year degree and 2 more years should teach most of what they need to do, at least for routine care They would still be very smart people. At the least allow for nurse practitioners to be more independent. The AMA looks out for this best interest, like any group.

    • Crank says:

      frank 64 said: “When I went to have a small injury fixed, a nurse practitioner did all the work, a doctor just came and checked it out. He billed me for it, but he did nothing.”

      Not true. The Doctor evaluated the injury. His decision was that it was in fact minor and appropriate for treatment by a nurse practitioner.

      • frank64 says:

        I know that is the theory, but my car gets fixed fine with a person far less trained. I didn’t need a physicist to agree with the mechanic. I know my finger is more important, but the NP can give me a shot on her own and has many years of training. I am quite sure the AMA has fought them from being more independent Often the nurses know what to do more than the doctor on many things, they are more hands on.

        I don’t see as most of what the doctors do as needing the amount of education they get, and again, many things even minor get referred to a specialist. Why couldn’t the NP refer me to a specialist?

        • Crank says:

          It’s not the theory. It’s what really happened.

          You keep talking about cars, they are a very poor analogy. You are orders of magnitude more complex than a car. If you don’t believe me, try paging through a Chilton’s, and then try the same thing with a biochemistry text.

          Also consider the outcome of error. Mechanic screws up, you can buy another car. Doctor screws up, you can’t buy another body.

          Moving from fact to opinion, I think doctors are one of the few participants in the health care machine that deserve more money, not less.

          The for profit hospitals, the drug companies, the insurance companies, the supply companies – and all of their CEOs are the ones who are financially raping us. They are the ones who need to be regulated.

          • frank64 says:

            Obviously there is a major difference between a person and a car, and there would always be a major difference in training. The analogy works for the general idea that you do not need a doctorate to handle a cut finger, or many other ailments. I am not advocating someone pick up a manual and start cutting away, but a very smart licensed professional with a masters degree.. Apparently what I am suggesting is already done in Australia, wouldn’t it be a good idea to at least look at some other ways we could address our medical care? Did you read the links on NPs? Many feel that NPs could do more, should we just take the AMA’s word? They are the only lobbyist group that should not be questioned at all?

            The reason doctors deserve more pay is the costs and process they go through, what if most of it is not needed for a lot of our needs? It COULD be a waste. Other countries seem to think so, and many NPs feel they should have more responsibility, I think it is worth a look.

      • frank64 says:
    • yankinwaoz says:

      When I was living in Oz, I noticed how young many of the doctors where. It turns out they have 4 year degrees. They handle the simple, routine stuff. They can go on to get advanced medical degrees to become a surgeon, or specialist. But I agree. I don’t need a doctor with 8 years of medical training to treat a cold, or set a broken bone.

      The problem in the US is the liability issues, and the lobbying efforts of the AMA. In the US, if a doctor treats your broken leg, and doesn’t notice that you also had colon cancer, he gets sued.

      • frank64 says:

        Looking at these types of things would be very beneficial. Probably not going to happen though AMA very powerful, and doctors seem untouchable.

        If anyone saw Frontline this week on Dentists, there is a similar issue.

  37. Miss Malevolent says:

    I think Larry Johnson said it best:

    “We have entered the political version of Alice in Wonderland. Washington,DC and the cable news networks are engaged in incest and take each other way too seriously. Case in point is the circus underway this morning surrounding the Supreme Court Decision on Obamacare. A long, complicated decision does not fit with the need for screaming headlines and BREAKING NEWS bullshit. It has to be portrayed as a “winner” or “loser.”

    So let’s just deal with the damn facts.

    Fact ONE–The Court said that Obama was wrong in his repeated insistence that his Health Care act was not a tax. Nope. It is a tax.

    Fact TWO–States cannot be required to expand Medicare rolls.

    I think Judge Roberts did what he was selected to do–judge the strict merits of the law. He reaffirmed the right of the Federal Government to tax your ass off. He rejected the notion that the Federal Government can demand that you buy health insurance. This by no means settles or erases the controversies surrounding this law. The problems remain.

    What does all of this mean? Bad news for Obama going into the election. If this was a popular law and embraced by a majority of Americans, then Obama would be running on it. He is not. He has not attached himself to it. Now he will have to. No matter what the Court says about Constitutionality, it does not alter the reality that businesses face in trying to deal with this turd of legislation. Romney just got a gift. Let the Obama folks celebrate all they can. It is a Pyrrhic victory at best.”

    And more to the point…I think that Roberts statement was more of a calling cry to those in the Republican party. He was saying that we’re at this place because we continue to put people in that aren’t interested in the public welfare but more interested in a power grab. And that’s all this is…more intrusion into your pocket…which makes you a slave to the government.

    • partofme says:

      Actually, Roberts said that the only way it could conceivably survive was as a tax. It’s not that Congress or the Pres actually intended for it to be a tax. It’s just that it could possibly be conceived as one, and thus it can pass Constitutional muster.

  38. ronbo97 says:

    While the Obama-haters over at the Republican camp are scrambling to put a spin on this historic decision, I have a couple of questions:

    Wasn’t Obamacare patterned after Romneycare, as implemented in Massachusetts ?

    Wasn’t the Individual Mandate originally a Republican concept ?

    • frank64 says:

      One thing is this plan needs to be looked by not who developed it, but by its own merits. Party politics has not been mentioned by most here, we are talking of the merits of the overall plan as passed.

    • ARP3 says:

      Yes, see Bob Dole’s healtcare plan and Romney’s plan while governor. Also look at Republican President Ford, Nixon, Reagan’s top tax rates (70%+ and 39.5). Look at Reagan’s amnesty plan for illegals. Obama wants to essentially put in place Republican plans from the past. And yet, Republicans convinced everyone that the Democrats are ultra liberals who keep moving left (ever notice how each president or democratic presidential candidate is the most liberal ever?). In reality, Republicans have moved right in an effort to change where the “middle” is. Fox News makes its living on that game.

    • Fubish says: I don't know anything about it, but it seems to me... says:

      QUIT BRINGING UP FACTS, DAMMIT!

  39. GrammatonCleric says:

    I am so mad. Can’t even muster the energy to post a crazy rant about authoritarian government expanding powers, so you are all spared for now :).

    Note: The smiley doesn’t mean i’m not mad anymore… still mad >:(

  40. jojo319 says:

    Will poor people have to pay these “fines”, or will that all be subsidized? I’m just wondering if we’re going to have scores of people getting in trouble because they can’t afford insurance OR the fines. Also, what about people who don’t WANT to work, therefore have no money?

  41. AngryK9 says:

    Sorry, Jim Guest, President of Consumer Reports: This is NOT a victory for consumers.

  42. mcgyver210 says:

    This is Obama’s stepping stone to becoming a Dictator. He will continue to undermine our Constitution along with an Incompetent Politically Motivated SCOTUS. Which has now opened the door for Unlimited Taxation because now you can be taxed for not buying the size house Congress tells you to.

    I was speaking with some fellow Business owners that as soon as the SCOTUS Upheld this as a rewritten TAX all their employees just lost their Medical & no hiring would happen due to cost.

    Obama has KILLED our Recovering Economy which IMO was his true agenda on his way to his ultimate goal.

    • RandomHookup says:

      So business owners will act against their own self-interest just to make a political point?

      And, yes, killing the economy is a *perfect* way to ensure re-election and establish a lasting legacy. And is world domination his ultimate goal or just “president for life”?

  43. Libertas1 says:

    This nation is lost.

  44. theycallmeGinger says:

    I don’t get the naysayers. They prefer to continue paying for others’ health costs through their current taxes and insurance? I mean, people DO understand that they’re paying for the uninsured now… don’t they?

    • muzzleme says:

      Many societies take care of the poor I have no problem with dollars going to the poor. BUT those who voluntarily chose to use INSURANCE as their primary form of payment really shouldn’t complain. Until this law was passed INSURANCE was an optional form of payment many patients opted to use and expect. Same for the medical industry. INSURANCE/corporate based medicine is a monster the public help create with a sense of entitlement.

      INSURANCE should be for A catastrophic event or condition and NOT routine maintenance. Many patients look at INSURANCE as a service plan. Far too long the patient public as come expect their INSURANCE to take care of preventative maintenance and routine problems. The INSURANCE industry says ok, raise prices and makes a profit.

      In the meantime what was ment to be side benefit in lieu of pay is considered a primary benefit that has become exploited by the medical industry to the max. Many assume they are entitled to health INSURANCE. If one voluntarily choses to use health INSURANCE as a primary form of payment they must assume the risk and cost will be spreadout. Also knowing how the medical industry has exploited the INSURANCE industry with price gouging hyper inflated billing an insuree must assume they will suffer the cost of exploitation.

  45. Fixxxer says:

    My fear is that employers may find out that paying the penalty, er… tax, is cheaper than providing their employees with health insurance.

    • mcgyver210 says:

      You are 100% correct with the fear I am a business owner & know many others that have already decided it will be cheaper to discontinue coverage & pay the “TAX” aka penalty.

      This is very bad for small businesses that already pay many Taxes along with insurance etc etc….

      Too many people think businesses just have unlimited funds to contribute to these agendas.

    • SabreDC says:

      Good. Every employer should discontinue coverage. Health insurance shouldn’t be tied to your employment in the first place.

    • RandomHookup says:

      In a way, that’s always been the case and lots of small businesses don’t provide health insurance and “pay the price” by their ability to recruit & retain employees. It may be more of an issue for those employees that will have to pay the penalty themselves.

      The Mass. law sets a much lower threshold than the Feds do (50 employees) and it doesn’t seem to have caused any major problems.