The Personal Mandate is Unconstitutional

Cross-posted from State House Call.

By John LaPlante

Politicians have long intervened to say what sorts of health insurance you must buy. (Nationwide, there are over 2,000 such requirements.)

Those benefit mandates are put in place by state-level politicians. Now Congress wants to up their legislative counterparts by moving beyond saying what kind of insurance you can buy to saying that you must buy it, period. And of course they’re going to also say what kind of insurance it can be–which may not be the kind that you want or need.

The Heritage Foundation has a new report on Why the Personal Mandate to Buy Health Insurance Is Unprecedented and Unconstitutional. Check it out.

More People Pay the “I’m Breathing” Tax

Cross-posted from State House Call.

By John LaPlante

Massachusetts officials and others celebrate the fact that in the last year for which data are available, fewer people paid a tax for not having health insurance.

COBRA Subsidies to Expire

Cross-posted from State House Call.

By John LaPlante

The federal stimulus bill included subsidies for insurance plans purchased under COBRA, a law that lets people hang onto their employer-sponsored health insurance for a period of time after leaving the employer. But at that point, the true cost of insurance becomes explicit for most people, who must pay both the premiums they used to pay as a worker and the “employer’s share.”

The subsidies became, in wonk-speak, premium subsidies, which will soon expire. They’re arguably better than simply putting people who lose their jobs in Medicaid, but they also lock people into one insurance plan–the one they had on the job. And of course policies purchased under the COBRA law, whether subsidized or not, are temporary. That brings home the point that our lawmakers ought to work to make insurance policies personal and portable. Unfortunately, they’re heading in the wrong direction, taking steps that will eventually herd us into a government program.

Not Enough Money to DiSH Out

Cross-posted from State House Call.

By John LaPlante

One problem with ambitious public plans to provide insurance for everyone is that eventually you run out of money–and then somebody squeals.

Seven hospitals in Massachusetts have sued the state for failing to give them enough money. The seven community hospitals receive “DSH” payments, meant to reimburse hospitals that treat a disproportionate share of patients in government programs.

The hospitals receive somewhere from 50% to 71% of their costs for treating Medicaid patients.

Nancy Pelosi: Our Powers Are Unlimited

Cross-posted from State House Call.

By John LaPlante

Speaker Nancy Pelosi says “Since virtually every aspect of the heath care system has an effect on interstate commerce, the power of Congress to regulate health care is essentially unlimited.”

Gene Healy of the Cato Institute argues otherwise, “Pelosi is wrong, but that doesn’t mean the court can be counted on to strike down Obamacare. Legislators have an independent obligation to consider the constitutionality of the laws they’re debating — and the individual mandate is flagrantly unconstitutional.”

And if Congress has an unlimited power over health care–and potentially everything you do, buy, or even say can have an effect on your health, in Speaker Pelosi’s world, the only limit on the power of government is the will of the politicians.

Using State Constitutions to Protect Health Freedom

Cross-posted from State House Call.

By John LaPlante

If a right to privacy is large enough to create a right to abortion, why doesn’t it also establish a right to keep government out of all of your health-related decisions?

George F. Will asks these and a few other questions relating to the constitutionality of the health “reforms” being pushed by the congressional leadership.

For example, speaking of efforts to establish health freedom in state constitutions, Will asks,

“But does not federal law trump state laws? Not necessarily. Clint Bolick, a Goldwater Institute attorney, says, “It is a bedrock principle of constitutional law that the federal Constitution established a floor for the protection of individual liberties; state constitutions may provide additional protections.””

One Program Expansion Deserves Another

Cross-posted from State House Call.

By John LaPlante

Both the House and Senate bills put more people on Medicaid, and (at least for a while) have the federal government underwrite most of the costs incurred by that move.

The states that would add more people are concerned that they’ll be left holding the bag, eventually, for higher costs. But other states, such as Minnesota and Vermont, expanded their Medicaid rolls a long time ago, so they’re not happy about underwriting Medicaid expansion elsewhere. There will be new money flowing off the federal printing press, and they’re not going to get any of it.

One health policy official in Vermont, for example, said “All the federal money for this Medicaid expansion, the majority would be going to states that have not taken the steps that Vermont has (taken).”

It’s a great example of how government programs have a self-perpetuating logic. I sympathize with officials and taxpayers in Vermont, who, having already expanded their own obligations with minimal help from elsewhere, are now faced with underwriting more spending elsewhere.

The easiest political way to address the objection may be to throw more federal money at Vermont, which it can then use to expand Medicaid well into the middle class.

Support for Health “Reform” Hits All-Time Low

Cross-posted from State House Call.

By John LaPlante

While a government takeover of health care proceeded in the Senate over the weekend, public sentiment isn’t necessarily in favor. In fact, by one recent measure, support for health “reform” is at a new low.

Just 38% of voters now favor the health care plan proposed by President Obama and congressional Democrats. That’s the lowest level of support measured for the plan in nearly two dozen tracking polls conducted since June.

 

The latest Rasmussen Reports national telephone survey finds that 56% now oppose the plan.

One encouraging sign from the survey, conducted over the weekend: Americans aren’t buying the claim that the plans moving their way through Congress will reduce health care costs, and a majority think the “reforms” will lower the quality of care.

A Review of Alternative Reform Ideas

Cross-posted from State House Call.

By John LaPlante

While there have been three different bills passed by Senate committees, and two other bills passed by the House, they share a fundamental feature: Increase the role of government bureaucracies and reduce the role of the individual in health care.

How about an alternative?

For several reasons ranging from election laws to political dynamics, we’re stuck with the Democratic and Republican parties as the two teams in national politics. All that is to say that Republicans aren’t necessarily the best option, but in this case, congressional Republicans are, among the political class, the ones offering the better options.

Their ideas have not gotten a serious consideration this political season, but let’s review them before we plunge over the cliff into the land of GovernmentCare.

Peter Ferrara offers up a list of some alternative methods of health reform: expand consumer choice in insurance; tighten up rules on lawsuits that drive up medical spending; use HSAs to let people know just how much they’re spending on health care, which could bring financial and medical benefits; expand high-risk pools for people who can’t get insurance otherwise; and allow small companies to pool employees together for insurance purposes.

Ferrara omits (I read this quickly; if it’s in there, point it out) any mention of equalizing tax treatment between employer-sponsored insurance and insurance you buy on your own. That’s puzzling, since what amounts to a tax on buying your own insurance keeps people in jobs they don’t like (”I need the benefits”) and is the single biggest cause of troubles afflicting health care.

These ideas are not the Sacred Writ of alternative health care proposals, but they’re a good place to start the discussion. Unfortunately, they’ve been dismissed, and we’re being sold the lie that you’re either for reform or you’re for people dying in the streets.

Reid Lets Loose an $849 Billion Monster

Cross-posted from State House Call.

By John LaPlante

Senate Majority Leader Harry Reid (D-Nev.) has cobbled together his own Frankenstein’s Monster, a health “reform” bill of $849 billion. Somehow it actually cuts the federal deficit (fat chance, that).

Sen. Tom Harkin (D-Iowa) asked “What’s not to like about this bill?” Is that a rhetorical question, senator, or are you really so clueless as to be unaware of the various objections to compulsory insurance, introducing moral hazard into the insurance market, and additional taxes?

The legislation contains three provisions that in the end will be more meaningless than meaningful: states can opt out of a “public plan” (though not, presumably, paying for it); the public plan itself (the bad is bad enough as it is); and a ban on use of tax moneys to pay for abortion (which can be jettisoned in conference committee).