Today, U.S. District Judge Henry E. Hudson become the first judge to rule that the individual mandate in the new health care reform law is unconstitutional (PDF).
Hudson concluded that the individual mandate exceeded Congressional power because the federal government doesn’t have the constitutional authority to compel an individual to purchase a commodity on the private market.
Given that two other federal judges have ruled the individual mandate constitutional, the likely result is that the issue will soon end up before the Supreme Court.
This problem could have been avoided
This problem, of course, could have completely been avoided. You don’t need an individual mandate penalty forcing Americans to buy insurance from a private company to create a near universal health care system. There are dozens of ways to design a health care system without using the government to force people to give money to private companies.
An easy way around the constitutional issue would have been to include a public option and make the whole system more like Medicare. Instead of an individual mandate, you could “tax” individuals and provide them with insurance through the public option. You could then grant everyone who had private insurance a waiver from the tax. Even if the state doesn’t have the right to compel an individual to buy a private product, its constitutional right to tax individuals in exchange for government services is not in doubt.
It is important to note that there is still time to deal with this problem. Reconciliation can be used to add a public option to the health reform package if it is done before the end of this lame duck session.
Instead of an individual mandate, you could also just allow insurance companies to charge a back-premium penalty as a way of preventing people from signing up only when they were sick. This would give insurance companies the right to charge the previously uninsured a set amount of “back premiums” upon sign-up, reducing the financial incentive to remain uninsured until ill.
Completely eliminating the individual mandate shouldn’t have a huge effect on the insurance companies, despite what the administration and the defenders of the bill claim. Several states require guaranteed issue for individual coverage already. You don’t need the individual mandate in order to outlaw the denial of coverage based on pre-existing conditions.
Because the cost of insurance in the current law is so much greater than the cost of the mandate, making the decision to not buy insurance is still viable–the price of the penalty would still not make buying insurance a smart economic decision. Therefore, the mandate was unlikely to convince many additional people to buy insurance, and likely wouldn’t have that much impact on the number of people in the risk pools.
There is no reason the health care bill can’t stand as-is without the mandate. The fact that insurance companies have already been complying with things like guaranteed issue at the state level for years without a mandate means the law can stay in effect without one.




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Thank you for pointing that out again. I don’t see why every non-corporate democrat wouldn’t get behind this judge’s ruling. He was careful to not invalidate the entire law. He just pointed out how the individual manadate was intended to be a penalty and not a tax. Good for the judge. I sure hope that the original corporate whores who wrote this bill will be the ones that cause the individual mandate to be taken out, while at the same time keep the pre-existing conditions in the bill. Bravo
I love how he pointed out in court that the oringinal wording was penalty and not tax.
I think our first priority should be advocating/demanding that the gov bargain with drug companies for bulk discounts. If we could do that, and implement a few other measures, we could open medicare up for all without even raising taxes on participants.
ETA:
I definitely agree that the mandate needs to go, though. I meant we need to consider abandoning the Obamacare corporate narrative which appeared progressive but really is just a huge giveaway to the pharmaceutical companies, etc.
Because i despise the Obama health care bill so much, i’ve always wondered why there was realatively little (visible) outrage on the right. It must be that, since everything Obama says or does is eqaually abhorent to the right, they saw no especial outrage in the details of the HCR. Thats to be expected some because the right are generaly low information voters and im sure they just plan to ignore the new law.When the IRS starts collecting penalites and threatening and leaning on people im sure the interest level is going to go waaaaay up.
“Instead of an individual mandate, you could also just allow insurance companies to charge a back-premium penalty as a way of preventing people from signing up only when they were sick. This would give insurance companies the right to charge the previously uninsured a set amount of “back premiums” upon sign-up, reducing the financial incentive to remain uninsured until ill.”
which ignores the central part of the whole problem, with the uninsure and with the idiotic mandate. The vast majority of Uninisured arent hanging back, waiting till they get “sick enough” to “justify” paying for insurance, they flat out cant afford to buy it. They rely on emergency room care, and if they are lucky enough to have familly with an occasional 30 or 40 bucks to spare for presrcriptions, that too. The uninsured arent making some kind of rational business decision. They cant afford the fucking insurance, and they wont be able to afford the fucking insurance just because barrack and the IRS tell themn they have to.
Thank you!
QUICK, someone fax that over to the big zero and see if he wants to save his presidency, that would be the first step to accomplish just that
obamacare is not progressive nor does it look progressive, it looks entirely corporate
What happens if the mandate is struck, but the rest of the health reform goes into effect? Seems like that would devastate the for-profit health insurance companies, since they’ll still have to cover people without the requirement that they get paid for it.
Relatively little outrage on the right? Welcome back from Klendathu, I guess, you obviously don’t live on this planet.
Hell, it’s not as if Obama can depend on AHIP to keep its word to back him in 2012, should they make such a promise — he’s already seen them go back on their deal with him to help Democrats in 2010 in exchange for killing the public option. There’s no reason for him to be nice to them, ever again.
But of course he still will, because he’s been firmwared to do this.
Of course, the goal of the individual mandate was not to create a near universal health care system, but precisely to force people to give money to private companies in order to increase the latter’s profit margins. Creating a near universal health care system was secondary at best.
And the Supreme Court will most likely blow off the issue of its constitutionality in favor of securing the revenue stream of the private companies.
The summer of 2009 was the summer of dipwads crashing town meetings. Of course, if most Democrats weren’t craven appeasers afraid of mixing it up verbally with these clowns, they wouldn’t have been such a big deal.
No because there was no regulation on what they could charge for insurnace premiums. People can only sign up during a certain time period each year. The insurance companies can still charge them extremely high premium fees.
That the uninsured are a 50 million strong group, actively plotting to scam the insurance companies, is just absurd.
I don’t think the public option is progressive, either, if it doesn’t take on the pharmaceutical companies, medical device companies, etc. And I don’t think we should “have faith” that all of that will get addressed later.
you know, I said this downstairs, if obama really wants to save his presidency all he has to do is embrace this decision and go with a public option using this as his excuse
then re-write his insurance give away so that it eliminates wealthy welfare
if he does those two things he just might do a 180 in popularity
I agree with you, he has to lose the monopoly on drug buys, he has to be able to use the buying power of the government to lower prices
since pharma screwed him and his back door deals I would think he would jump at the chance removing their corporate protections
No, it won’t devastate the insurance industry. They’ll just raise the premiums and even more people will be uninsured.
not going to happen.
Obama is all about committing political suicide.
No one is this stupid! so Obama is intentionally destroying his presidency.
the question is how many DEMS follow Obama to the un-employment line in 2012.
remember POLLS about TAX BILL for RICH GOOD! :)
POLLS about PUBLIC OPTION BEING POPULAR NOT GOOD !
the WH and Dems in the senate are hilarious, you got to laugh, now the favorite word in DC is “POLLS”
they consider us all MORONS!
they don’t know we are laughing at them, not with them.
see you in 2012
remember don’t get mad when we play games DEMS
Kabuki goes both ways
Henry E. Hudson?
I would have expected this kind of a decision from a judge with a name of a slightly different regional flavor.
More like Robert “T.” Lee, for example.
Don’t forget Doctors and Hospitals, that’s over 50% of health care costs.
In the end, universal healthcare will mean universal Medicare. Back in 1991, Florida Congressman Sam Gibbons offered a 3 page bill that eliminated Medicare’s “65 and older” language and made every US resident eligible for coverage. Updated to account for changes in Medicare law since then, that bill is the fastest way out of the woods (the benefits package can and should be improved, but the first goal should be universal coverage)
Jon’s idea to provide a tax credit for private insurance premiums paid is a good one, but not really necessary since Medicare Advantage (“Part C”) already allows Medicare recipients to “opt in” to private health coverage. So put everyone into Medicare, if you miss hearing from Humana or Aetna, you can go sign up for their Medicare Advantage plan.
Dude. In 2012, just like in 2008, there’ll be no choice.
Very true. There are also private lab companies, diagnostic companies, etc. It’s a monster.
Bill started out as a reform package. Countless number of times we heard Single Payer, Public option, Anti-trust oversight exemption removal, drug reimportation were mentioned during the bill progress.
Anything which looked even remotely like a reform was dropped from the package at the last minute and the individual mandates was the only thing remaining. At that point if one had any scam ideas to suggest they might have made into the bill. Thats how scammy the bill was turning into. Now if the individual mandates had went through they do not even have to offer a semblance of medical system but still could make tons of money without anybody checking over the shoulder.
Anyway real bottom line is no child born in this country which wrote Declaration of Independence from a hereditary bunch and served as a inspiration world-wide for countries to overthrow their own hereditary bunch should not grow up thinking that he or she has to work life-long so that he can part a paycheck to some organization every week whether he wants to or not and he would not have any say in how that organization is run or composed of.
How about Pres. Thomas Jefferson.
He would have been the first one to reject this abomination of Individual Mandates.
The justification offered for the individual mandate was that it would make the risk pools larger, and thus make insurance less costly. This seems to have been offered without any actual proof – as in, as is often the case, economists just assumed that was true, because microeconomics says so.
Is anyone here aware of a study that tests that assumption?
Anyone with a scintilla of legal training would have seen this “mandate” was going to run into a slew of legal questions. More evidence of the Enabler’s dire need to appease his corporate overlords.
Meanwhile, our Stockholm Syndrome President is still shoveling billions down the ungrateful maws of AHIP:
http://theincidentaleconomist.com/wordpress/obama-ahip-gift/
In reality I am seeing rules of Economics does not apply to AHIP and Pharma, In bad economic times I see all the stores dropping their prices but only exception is AHIP & Pharma which raised rates even this year. Even within medical field LASIK surgery which faces competition has seen steady drop in the prices over the years.
Individual Mandates were all about control over people, making easy money over peoples hard work and less about treating people.
All of us on this board would have been fine with Single Payer which requires all of us to chip in or Public Option and not with continuation of existing system which sees the rates to go only way UP and UP just like ever increasing blind greed.
Jon et al;
Based on the current text of the law, is there any upside at all to having health insurance if (i) you are healthy and (ii) the mandate is struck down?
I’m not trolling, I’m unfamilliar with the technical details regarding guaranteed issue, and honestly curious if health insurance offers any benefit at all to a healthy person if the mandate is struck down.
Not saying I like them. It’s just that the constitutionality arguments rely on “10ther” logic. States rights and all that. It’s kind of a legal grab bag and arguments that depend on “the 10th” are not usually given a great deal of respect by legal scholars.
the problem there is, the percentage of profit has nothing to do with prices charged to customers
so long as there is no competition, (and insurers enjoy protections against competition), then corporations charge what people will pay regardless of costs incurred or profit margins realized
I’m reminded of Candidate Obama’s response to HillaryCare’s mandate:
“If a mandate was the answer, we could fix the homelessness problem by mandating home ownership.” (paraphrased.)
How things change, huh?
this argument doesn’t rely on “states rights” it uses the argument that the government cannot force you to buy from private industry
ya, very few people know when they will get sick or become “unhealthy” in time to grab insurance with a positive return on that savings
I wonder if Obama, being an “expert” on Constitutional law, actually thought it would be “interesting” to pass a law requiring a mandate, and see how broadly SCOTUS would define the Commerce Clause. Perhaps he will write a paper on the subject after he leaves office.
How is that for dissing Obama!
If you don’t have insurance and you, say, get in a car wreck and have a hospital bill, you can’t apply for insurance retrospectively to have it covered. Same if you get injured on the job, end up getting sick and needing to go to the ER, etc.
Bottom line is
No child born in this great country which wrote Declaration of Independence has to Grow Up thinking that he has to part a part of Paycheck to a private entity whether they like it or not. We have a word for that, servitude to a private entity.
On this issue Republicans and the judge were absolutely right because it deals with universal human aspirations and spirit of our consitution and need to be commended to be on the right side of the issue.
Thank you Judge Hudson; too bad you’re not on the Supreme Court instead of those other turkeys.
Obama knows he won’t get re-elected, but so what? The job he was bankrolled to do is to take out Social Security, and the mission is nearly accomplished.
Jon, regarding the text pasted below:
I question whether this would ever provide an incentive to obtain health insurance. Unless the “back premiums” are set at a level higher than the premiums that a consumer would have paid anyways, it seems to me that a back-premium penalty doesn’t impose any additional risk or cost on being uninsured.
Correct me if I am wrong, but I see two possible scenarios for a healthy person. Either (i) they stay healthy, in which case not obtaining insurance was a good financial decision, or (ii) they become sufficiently sick or injured to justify insurance, in which case they pay the exact same amount of money that they would have paid if they bought insurance.
I could be wrong on the details of what “back premium penalty” means, but it seems to me that it sets up a situation where foregoing insurance is sometimes better and never worse than buying insurance. Why would any healthy person buy insurance if that is the case?
As I noted in my post above, I am not trying to be antagonistic or trolling, I seriously do not understand some of the arguments being put forth that it makes financial sense to buy insurance even in the absence of the mandate, and I certainly don’t see how back-premium penalties (unless they are inflated over regular insurance premiums) change the result.
Ok, that’s a good point. And for any injury requiring same-day care that makes sense.
Generally, you can get insurance in 1-2 days, correct? If you are injured and forego care before getting insurance, the policy would cover the injury in that case, right?
All of us on this board would have been fine with Single Payer which requires all of us to chip in or Public Option
Actually agree with everything you wrote but I just wanted to point out that from a marketing standpoint, both “single payer” and “public option” are weak tea. Nobody knows what they mean, which means they can be defined by the Republicans to mean anything (“socialized medicine”, “govt option”, “death panels”). On the other hand, everybody had heard of Medicare and I believe most people (certainly most seniors with firsthand experience) have a favorable opinion of it.
This positive public opinion has an economic (or in this context, political) value as part of Medicare’s “good will” (“the value of intangible assets such as a strong brand name, good customer relations, good employee relations and any patents or proprietary technology.”).
Anyway, its just basic accounting that any healthcare reform that doesn’t utilize Medicare’s good will to build public support, but rather tries to create from scratch public support for a”single payer” or “public option” plan is a tremendous waste of political capital.
This argument is only true for illness or injury that requires immediate treatment, right? You could become ill, forego treatment for the day or two it takes to get insurance, and then seek treatment, right?
Obviously you are bearing the risk that you’ll suffer a catastrophic injury, like a car crash, in which you may need significant medical treament before you can obtain insurance (although I believe all treatment received after you get the insurance would be covered, right?).
But for the vast majority of serious illnesses, foregoing treatment for a day or two (or just paying the cost of 1-2 days of treatment) should not be that terrible.
It takes at least a couple of weeks to get insurance, IME. Lots of paperwork has to be mailed around, records checked, etc.
While I understand the appeal of a public option, if it happens under reconciliation during the lame duck session you may well see a political crisis unmatched in your lifetime. The Left is nowhere near strong enough to overcome the (admittedly worst-case scenario) ramifications.
Many of you feel the Republicans have been the “party of No” over the last two years and may even delude yourselves into thinking, “it can’t get any worse”. It can and it could. Big time. It’s one thing to say “no” because you have an honest difference in policy. It’s another to say “no” for purposes of political gain. But it’s yet another thing to say “no” because you feel you are righteously empowered – which is exactly how the Right would feel.
Many on the Right will see this as the most egregious political action imaginable. They will encourage (insist!) that HCR be stopped by a combination of non-funding, political investigations, and a message of “never, ever trust the Left”. The Right will also have built in funding for 2012. Climate change legislation? Card check? Guantanamo? Iraq/Afghanistan? Unemployment benefits after 2011? Immigration reform? Fuggetaboutit.
And that’s NOTHING compared to what happens should the Republicans hold both houses of congress and the presidency after 2012. Passing the public option now through reconciliation will feel good for about a month and after that there will be a LOT of tears for at least two years and possibly many more.
Great, thanks, that changes my analysis.
Democrats should be thanking their lucky stars that the courts appear willing to strike the worst part of the HCR act – the mandate.
It was always bad politics. And, unless the GOP gets some major quid pro quo, they are happy enough to let the Democrats try to defend it in the next election. Remember, with control of the house, the GOP is in great position to block any attempt by Obama to remove the worst parts of the HCR act.
Any guesses what the GOP may want from the Democrats to agree to remove the albatross?
No problem. You’re right that covering pre-existing conditions significantly reduced the incentive to carry insurance if you’re health. The effect is strongest for stuff like cancer and MS.
Regarding strategy – It appears that VA AG Cuchinelli wants to fast track this ruling. Why? Because, Justice Kagan agreed to recuse herself on this during Senate confirmation and if the Supreme court splits 4-4 on a case then the lower court ruling is upheld. Cuchinelli is trying to beat the other case, where the ACA was ruled constitutional, to the Supreme Court.
Medicare Drug Reimportation dropped. That should say it all for the purpose of this bill.
Defending Individual Mandates is like GWB defending Iraq war. One cannot defend the indefensible.
Best thing to do is accept the mistake and try to do the right thing in the future to salvage the reputation.
Mandated markets work that way. The no-fault car insurance that most states require is another example. When the insurance isn’t regulated in such a way as to make the market competitive, then inevitably it won’t work like an Adam Smith kind of market.
The other thing that makes current health insurance not like a truly free market is that it’s generally the employers who provide it. They don’t need to consider quality of the product as the first priority. Of course, that would tend to keep the price low, except that it’s not primary care that is paid for. You end up having this two degrees of separation thing between who pays for health care and who uses it.
Yet plenty of people will try to maintain the fiction that this is a free market, when it is nothing of the sort.
GOP got a new lease of life because of the individual mandates.
If courts remove it Democrats should consider themselves lucky. If Republicans remove it they will be regarded as saviors from servitude to a private entity by the mainstream.
It does when there’s not enough money coming in to pay the medical expenses, I think. The rest of the time, it’s a function how much of the medical cost ratio, and how well the insurance companies use the portion of the premiums that doesn’t go toward medical costs.
no, that’s not right, there are waiting periods unless those waiting periods are mandated away by alw
Anti-trust Oversight is exempted only for two industries. AHIP and Baseball
Free market rules do not apply to something which is rigged.
Only solution is to put in single payer or remove the exemption with breakup of all duopoly and monopoly companies to 10+ pieces or else they will destroy the free will in the people of this country and the other industries of this country with those mandates.
only when the income does not exceed expenses, those are really the only time
The Democratic/Republican party is not going to doing anything in reconciliation or otherwise which actually is in the best interests of citizens first. The tax cuts for the wealthy is just one of many examples.
As for “pre-existing conditions”, the insurance companies have already found a loophole around them as they apply to children and will do the same for adults in the future. Don’t forget, all the insurers need to do is say you didn’t indicate that you sought help for an “acne condition” in your past to yell “FRAUD”…then pre-existing conditions are out the door. No one SHOULD be surprised that a bill written by the insurance companies and the Heritage foundation would be full of useful loopholes for them.
Dedicated funding for community health centers and support for health care education WAS a benefit to our society. It should have been a health care bill which stood on its own. Whether “exchanges” are anything more than just another marketing ploy remains to be seen. Instead we have a bill which is basically corporate welfare (paid with individual mandates and additional taxpayer subsidies) for the health insurance and pharmaceutical companies. The long term negative consequences of the overall bill are just too large.
Thanks to Judge Henry E. Hudson for correctly speaking up for universal aspiration of freedom of free choice on which our constitution is based on.
Well good. I hope it holds up then. I trust it will render a host of similar “individual mandates to purchase services from a private entity” unconstitutional as well. Like my auto insurance, electrical service, homeowner’s insurance, waste collection, etc.
True, that’s another thing that makes health insurance not free. I think the end effect of making it mandatory would be to cancel out the effect of removing that anti-trust exemption, though, even had Congress had the will to do it.
Most (all?) auto-insurance mandates are from state governments. Since state governments have general legislative powers, as opposed to enumerated legislative powers (like the FedGov), there’s no reason why they can’t impose such mandates (or health care mandates, by the way).
And no, this isn’t “10ther” thinking, this is conlaw 101.
Actually, auto insurance and workman’s compensation insurance should cover both these events you mentioned.
To badgerexpat@31: Being without medical insurance is a crap shoot, and you choose how much you want to gamble. I’ve spent a small fortune on health insurance in the past few years, and you could say I’ve flushed it down the toilet since I have been very healthy. But I could easily have been diagnosed with something dire and been in deep sh*t. My elderly mother lives with me and has little income of her own, and I did not want to leave her homeless if I became seriously ill and lost everything to medical bills. Since I had some savings, I choose not to gamble, but I don’t know if I did the smart thing or not.
Well yeah, that’s under current law. As was clear to everyone else, my questions assumed that the portions of the ACA prohibiting insurers from denying coverage of preexisting conditions had taken effect. Under the ACA, you could have been diagnosed with something dire and been in deep shit, for 1-2 weeks (assuming the dire diagnosis required expensive treatment during those 1-2 weeks).
Auto insurance won’t cover med bills if you only have liability, will it? And with workman’s comp, you’re right in theory, but a lot of people get screwed.
The Reich wing doesn’t hate the mandate as such. They hate the idea that they might have to pay for millions who cannot afford the mandate. Mark my words they’ll find a way to keep the mandate and eliminate 99% of the funding for the poor. WTF do they care if the poor are turned into Health Ins. peons and or fined heavily for not bowing under the whip. They’ll bring back debtor prisons if necessary and think of all the new criminals that by coincidence now can’t vote.
It reminds me of a dystopian near future in Star Trek. Everyone was mandated to have a job, and if they couldn’t prove they had one, they were imprisoned within Sanctuary Districts. I wouldn’t be surprised if it’s Obama’s next ‘progressive’ bill/compromise.
Generally, you can’t go get insurance right after an injury and expect the insurer to cover it, unless the insurer is obliged to completely ignore all pre-existing conditions.
Health insurance applications require you to identify all conditions, illnesses, and injuries. You would have to identify the injury. If you failed to do so, and then tried to get coverage for your treatment, it would be denied under current laws, as a fraudulent claim.
Oh yes, Drug Reimportation… when freakin’ David Vitter comes out in favor of progressive amendment that the Administration twists arms to kill, there are definitely strange doings afoot at the Circle K.
Just another – amongst many – disastrous program from liberals. What will the government mandate next…everyone must buy a bible, or maybe a koran instead.
Yeah, the ACA changes that. How could you read this post and not get that?
Individual Mandate Struck Down in Court, But Plank Not Necessary for Successful Health Reform
———————————————
You are incorrect on this fact. This is the boilerplate of the legislation and the ONLY reason health care insurers went along with Obama in the back room deals he made, without this tenet, the insurers don’t have their “Garanteed” monies from the sheep. They will drop like flies…
Though the tax-everyone plan has some merit, it will still drive insurance costs upward. Individuals should still retain the option of not purchasing insurance at all. Even with a public option, a mandate that everyone has some type of insurance increases demand, and forces prices upward.
Forcing Americans to partake in an area of commerce, even when provided with a public option, pushes the envelope on Constitutionality–and of freedom itself.
I am a HUGE fan of the Public Option.
But it should remain as the name suggests– Optional.
In my state, I believe it’s mandated that you have PIP (Personal Injury Protection) which will pay medical bills, but maybe that’s not true in other states. I had a load of medical bills covered 12 years ago by auto insurance.
Without mandated universal coverage, I don’t think you’re going to see the pre-existing conditions covered. Not unless the premium is out of sight. If one goes, so will the other–it’s almost guaranteed.
Ok, that’s an interesting prediction. It would require a legislative change to ACA (assuming just the mandate, and not the entire bill are struck down), do you think that’s very likely?