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Thursday, March 25

Mandated Health Care Coverage

Found this story at New Republic about mandated health care coverage. Virginia's attorney general is going to court to nullify the part of the bill that requires everyone to purchase health care insurance and claims it's unconstitutional. Here's the argument by E J Dionne Jr:

The Republican attorney general's move reveals how far into the past America's New Nullifiers want to push the nation. They don't just want to abandon a more than seven-decade-long understanding of the Constitution's interstate commerce clause that has allowed the federal government to regulate a modern, national economy. They also want to resurrect states' rights doctrines discredited by President Andrew Jackson during the nullification crisis of the 1830s and buried by the Civil War.

There are two issues here. One is whether the federal government can require individuals to buy health insurance. The other is the states' rights question. In a suit separate from Cuccinelli's, 13 state attorneys general -- 12 Republicans and a conservative Democrat from Louisiana -- also challenged the mandate. But their main argument is that the federal government cannot force states to pay for an expanded Medicaid program and take other steps the law requires.

It would take a rashly activist court to find the individual mandate unconstitutional because it is structured as a tax. No one will go to jail for not buying insurance. Starting in 2014, people who refuse will have to pay a penalty to the federal government, administered by the IRS. There are subsidies for those who cannot afford coverage on their own, as well as hardship exemptions.

The idea is simple: Most people without insurance currently receive at least some medical help, and the mandate is designed to get everyone paying into the system. One of the best defenses of a health insurance mandate came in a Wall Street Journal op-ed piece published in April 2006.

  • "By law, emergency care cannot be withheld," this commentator wrote. "Why pay for something you can get free? Of course, while it may be free for them, everyone else ends up paying the bill, either in higher insurance premiums or taxes."

I'd still like to know more about this so called mandate and I'm expecting that the president will go on national tv and explain it. I understand why they want everyone to pay into the system because we ultimately are paying for emergency room visits for the uninsured as it is. Obviously, the very poor will be covered. I'm curious as to how it will pan out for renters and homeowners who work but live paycheck to paycheck... how will they be able to muster up insurance premiums? Would they have to sell their homes in order to pay for the premiums? How would you have to prove that an extra $500/mo expense in your budget would bankrupt you? Who would set up the guidelines as to what constitutes hardship?

It remains to be seen.

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