The Moment of Truth

[ERD50]

By this logic, no law can ever stand if any part of it is found unconstitutional. ...

That's fine by me (though I obviously am not on the SC ). To my thinking, if Congress wants to bundle laws into one bill, then they should deal with the consequences. The President does not have line item veto either, and that's a good thing IMO. He can veto the bill and tell Congress what it would take for him to sign it, and they can decide if that works for them or not.

As far as your states comments, federal powers are different from state powers, so don't see the connection. If that was just to say what works or not, again, I don't think it is up to the SC to decide what works, just what is Constitutional - see my separation of powers comments.

If the health care law is tossed out, I think the people who don't want any type of national health care system will end up being very disappointed. ...

That may be. But that isn't an excuse to do an end-around of the Constitution.

-ERD50

 

[Chuckanut]

I'll note that the 'repeal and replace' folks have put some effort into the repeal effort, not so much on the replace part.

Agreed. I have talked with people who want the health care law repealed. I ask them what happens to some hard working person who does not have insurance through no fault of their own(I know of several people in this situation.) There response is usually "use the emergency room." So, they get basic care very late, at twice the cost. This is not my idea of good medical care or reasonably priced medical care.

 

[Texas Proud]

If the health care law is tossed out, I think the people who don't want any type of national health care system will end up being very disappointed. The alternative may be a single payer system, paid for by some type of universal tax (perhaps an extension of Medicare to everybody??) and even more Federal control over the medical system than we have now. This is just a gut feeling, I have no evidence for it. But, the current system is too faulty to continue. I personally know of several people who ended up in the emergency room this year (at double the expense of the non-emergency system) simply because they could not pay the medical fees and did not have insurance (they all work full time but are not offered insurance.) This is certainly not the way to get a handle on medical expenses.

If other countries can come up with something so can we. There are plenty of examples to study, compare and, perhaps, implement in some form.

You might be right, but I just don't see them getting the vote for a single payor system...

Congress has shown time and time again that thinking ahead is not a priority.... and that broken systems can stay in place for a long time...

 

[Texas Proud]

Agreed. I have talked with people who want the health care law repealed. I ask them what happens to some hard working person who does not have insurance through no fault of their own(I know of several people in this situation.) There response is usually "use the emergency room." So, they get basic care very late, at twice the cost. This is not my idea of good medical care or reasonably priced medical care.

Or the answer could be to use the free or reduced cost clinics or hospitals that are usually provided... but that means waiting in line...

We pay a tax in our county for this kind of person.... so it is provided...

 

[pb4uski]

......I agree with some of the Justices that it is not their job to be reading and picking out what is and is not connected as they really do not know... so I think throwing it all out or not should be based on what was in the law... if they did put in severability clauses, the rest should stand.... if they did not, well, it should all be thrown out if they decide the mandate should be...

My understanding is that the law does NOT include any severability clauses, so under that logic (with which I agree) if the mandate is unconstitutional the entire law would be thrown out.

 

[pb4uski]

My prediction is the SC will rule that the AHCA is constitutional and will stand as it is written.

and God bless the first amendment.

 

[easysurfer]

I couldn't disagree more. The purview of the SC is whether the law is constitutional or not. Whether it is "good" or "bad" should be irrelevant to whether or not it is constitutional.

Yeah...The SC's role is to act like an impartial umpire at a baseball game, regardless of what's popular or unpopular.

Of course, being that the outcome may very will be a squeaker, with historic implications, Imagine it's 2 outs, in the bottom of the ninth inning, bases loaded, 3-2 count, visiting team is up by one run and here comes the pitch...that batter takes it..

 

[pb4uski]

If the health care law is tossed out, I think the people who don't want any type of national health care system will end up being very disappointed. The alternative may be a single payer system, paid for by some type of universal tax (perhaps an extension of Medicare to everybody??) and even more Federal control over the medical system than we have now. This is just a gut feeling, I have no evidence for it. But, the current system is too faulty to continue. I personally know of several people who ended up in the emergency room this year (at double the expense of the non-emergency system) simply because they could not pay the medical fees and did not have insurance (they all work full time but are not offered insurance.) This is certainly not the way to get a handle on medical expenses.

If other countries can come up with something so can we. There are plenty of examples to study, compare and, perhaps, implement in some form.

I agree with a lot of what you say that if the law is thrown out that something needs to be done. I would see some solution utilizing HSAs and high deductible insurance, decoupling insurance from employment, some subsidization of insurance for the poor and somehow encouraging all to buy insurance as being features of any new solution.

However, my fear is that Washington will be so polarized by that time that nothing will get done and the end result will be worse than where we started. That would truly be a shame.

 

[pb4uski]

Yeah...The SC's role is to act like an impartial umpire at a baseball game, regardless of what's popular or unpopular.

Of course, being that the outcome may very will be a squeaker, with historic implications, Imagine it's 2 outs, in the bottom of the ninth inning, bases loaded, 3-2 count, visiting team is up by one run and here comes the pitch...that batter takes it..

Anyone for instant replay?

 

[easysurfer]

Anyone for instant replay?

No..called balls/strikes are not eligible for instant replay

 

[easysurfer]

Anyone for instant replay?

Taking this a little further, do you think umpires (the SC justices) get influenced by who's pitching at at bat? For example, if Albert Pujols is at bat facing some no-name, rookie closer, in this case, would the ump more likely call a ball? The ump shouldn't, but still.

 

[Gone4Good]

That may be. But that isn't an excuse to do an end-around of the Constitution.

The irony is that the way we're being asked to read the Constitution the government can buy insurance for you and force you to pay for it under threat of imprisonment but can't tell you to choose a policy for yourself or face a fine.

That is one strange configuration of liberty.

 

[samclem]

It seems to me the issue before the court is a fairly narrow one. It should answer that narrow question and leave drafting legislation to the legislature.

The very best indicator of Congress's intent is what they put in the actual bill. Severability clauses are a normal part of most large legislation, and it's for a reason. It tells the courts what Congress intends. Congress didn't include one in this law. There could be many reasons for that, but the Supreme Court needn't and shouldn't try to get into the reasons for that or try to re-write the legislation. Without the severability clause, there's no way to know if removal of the individual mandate still meets the intent of Congress.
If the individual mandate is struck down, Congress will be starting from a new set of known facts ("we can't make people buy private insurance, the Supreme Court told us that"). This apparently was not the understanding of legislators during the drafting of this law. They deserve to have the opportunity to craft the best legislation they can based on the new facts. If the Supreme Court strikes the mandate but leaves the rest of the law to totter forward they will have created a new law and new facts on the ground that Congress obviously did not intend. Aside from the Constitutional aspects, it could easily make the health insurance situation worse. If Congress wants to try to make this work without the individual mandate but with everything else just as it is, they should be able to vote on that expeditiously. Does anybody think that this legislative package is what they'd choose to vote on?
But, the Supreme Court has decided both ways in the case of laws without severability clauses, so we'll just have to wait to see.

 

[pb4uski]

The irony is that the way we're being asked to read the Constitution the government can buy insurance for you and force you to pay for it under threat of imprisonment ......

Where are you reading that? Not sure what you are thinking about.

 

[pb4uski]

No..called balls/strikes are not eligible for instant replay

I knew that, but was thinking that if I was the ump I would want it in that situation. Absent instant replay, call it like you see it (but don't forget that the talking heads will be showing where the ball was in relation to a hypothetical strike zone.

 

[Gone4Good]

It seems to me that the very best indicator of Congress's intent is what they put in the actual bill. Severability clauses are a normal part of most large legislation, and it's for a reason. It tells the courts what Congress intends.

And the court strikes down laws with severability clauses and severs laws without them. There is not much there, there because the court doesn't feel bound by them . . . nor could it be. You might also note there isn't specific language saying that all provisions should fall together. The law is silent on severability, which isn't the same thing as expressing a preference.

One thing that shouldn't be assumed though is the fantasy that Congress will enact some other reform if this one is struck down.

 

[Gone4Good]

Where are you reading that? Not sure what you are thinking about.

Don't have to read it. The first part is how Medicare works. The second part is how the ACA works.

 

[easysurfer]

If the health care law is tossed out, I think the people who don't want any type of national health care system will end up being very disappointed. The alternative may be a single payer system, paid for by some type of universal tax (perhaps an extension of Medicare to everybody??) and even more Federal control over the medical system than we have now. This is just a gut feeling, I have no evidence for it. But, the current system is too faulty to continue. I personally know of several people who ended up in the emergency room this year (at double the expense of the non-emergency system) simply because they could not pay the medical fees and did not have insurance (they all work full time but are not offered insurance.) This is certainly not the way to get a handle on medical expenses.

If other countries can come up with something so can we. There are plenty of examples to study, compare and, perhaps, implement in some form.

How about open enrollment of medicare for all without exclusion of pre-existing conditions? That way, those who want insurance, but currently can't get it because of pre-existing conditions can get it. Those who do not wish to purchase insurance aren't forced to. As to how to keep medicare for all afloat, that's for the number crunchers and lawmakers to figure out

 

[samclem]

One thing that shouldn't be assumed though is the fantasy that Congress will enact some other reform if this one is struck down.

So it's this law or we'll never have anything? I don't know why anyone would believe that. Health insurance/health care will properly join the packet of issues Congress is contending with. We all agree there's a lot of waste in our health care "system" now, in both the private side and the public side. As we have a fiscal crisis to deal with and Medicare/Medicaid is a big part of that, it might be best that we tie the issues together. Sometimes it's easier to reach an accomodation if the package is bigger, so everyone can see the the tradeoffs and there's more room for compromise/

 

[MichaelB]

How about open enrollment of medicare for all without exclusion of pre-existing conditions? That way, those who want insurance, but currently can't get it because of pre-existing conditions can get it. Those who do not wish to purchase insurance aren't forced to. As to how to keep medicare for all afloat, that's for the number crunchers and lawmakers to figure out

How about unsubsidized enrollment in FEHB without conditions or underwriting?

 

[samclem]

How about open enrollment of medicare for all without exclusion of pre-existing conditions?

We'd have the same problem as always due to adverse selection. Every person with a chronic medical condition would get on Medicare. And Medicare is already going broke even with all those people paying into it who aren't expected to start getting Medicare benefits for 30-40 years.

 

[Texas Proud]

The irony is that the way we're being asked to read the Constitution the government can buy insurance for you and force you to pay for it under threat of imprisonment but can't tell you to choose a policy for yourself or face a fine.

That is one strange configuration of liberty.

Don't have to read it. The first part is how Medicare works. The second part is how the ACA works.

You do not have to sign up for Medicare... besides that your stmt looks to be true...

 

[pb4uski]

Don't have to read it. The first part is how Medicare works. The second part is how the ACA works.

So you're saying that under Medicare the government can buy insurance for you and force you to pay for it under threat of imprisonment? I think you are misinformed.

So if someone like Warren Buffett or Mitt Romney refused to enroll in Medicare because they have the resources to pay for better health care the government would threaten to imprison them?

 

[samclem]

How about unsubsidized enrollment in FEHB without conditions or underwriting?

Of course there would be bumps.
1) How would current FEHB recipients feel about the flooding of their network with new patients? The present recipients are almost exclusively federal employees. I will leave the political aspects of that alone, but I think many in Congress and elsewhere would have problems supporting anything that adversely affected government employees.
2) The adverse selection problem driving up the price of policies for everyone. In addition, the FEHB doesn't take all comers now--the requirement to be employed by the government serves to screen out those with the most serious medical/psychiatric problems.
3) Affordability. If we want people of moderate income to buy this insurance, we'd still need the subsidies (or something like 'em)

But, maybe it (or something like it) could work.

 

[Texas Proud]

We'd have the same problem as always due to adverse selection. Every person with a chronic medical condition would get on Medicare. And Medicare is already going broke even with all those people paying into it who aren't expected to start getting Medicare benefits for 30-40 years.

I actually think that adverse selection is not as big a problem as some people make it out to be... when I was young, I bought the very cheap insurance because I did not need that much service... they got very little money out of me...

But if I had a problem that I could not get insurance (a pre-existing condition).... I could get a job at a mega firm and get on their insurance policy... none of the companies I worked with every had a pre-exisiting exclusion...

Now, if you needed emergency room care for whatever reason, you would not be able to sign up for a policy anyhow...