Posts tagged ‘Individual Mandate’

11/04/2012

Undecided Voters: Social Issues

The better choice on each issue is in the left column, indicated by a (D) for Democrat, (R) for Republican, or (N) for neither.

(D) VOTING RIGHTS AND ELECTIONS: Which party is more likely to promote a constitution amendment to remove money from campaigns, or appoint Supreme Court justices willing to interpret large contributions as bribery? Romney goes in the wrong direction as he suggests getting rid of campaign finance laws. (1-16-12). Who is more likely to promote and protect the right to vote by removing unnecessary obstacles, and yet preserve the integrity of the system? Democrats clearly win this one.

(D) MEDICARE: Although the nation must get Medicare spending under control, Romney has no solution, for he would block grant it to the states, which would effectively kill it. (10-18-11) (11-12-11) (2-22-12). Not changing things for current retirees is just a way of screwing those who’ll retire later (1-8-12) Romney wants a premium voucher program, which inevitably will not cover increases in insurance company premiums (1-16-12).

(D) MEDICAID: Romney would also effectively end Medicaid by sending it to the states. (1-16-12). As he put it, he would get the government out of Medicaid. (1-19-12). The problem is a large segment of the population will prematurely die off.

(D) HEALTH CARE COSTS: Health care needs tough federal regulation to control doctor and hospital costs, as well as drug prices, but neither party openly proposes a solution. Since regulation is the only answer, and the modern Republican Party never advocates price controls, Romney cannot be the solution.

(D) OBAMACARE: Romney was wrong when he thought Obamacare would be declared unconstitutional. (12-10-11). He repeatedly promised to repeal it. (10-11-11) (10-18-11) (1-7-12) (1-16-12) (1-19-12) (2-22-12). He posed a good question when he asked what we would be replaced with. (10-11-11). He alleged Obamacare raises taxes 500 billion, cuts Medicare 500 billion, and is a government takeover. (10-11-11). He thinks eliminating it would save 95 billion annually (11-12-11) (1-7-12). Romney would give states health care waivers (9-22-11), which effectively would repeal it. Since the current health care system is dysfunctional, the greatest problem with the Republican position is their failure to suggest a rational intelligent alternative.

(D) INDIVIDUAL MANDATE: Romney argued people need to purchase health insurance to show their personal responsibility. (8-11-11) (11-9-11). He said uninsured persons are going to emergency rooms and taxpayers end up picking up the tab. (9-7-11). Romney insulted those who cannot afford health insurance by calling them “free riders.” (1-26-12). He later contradicted himself saying he opposed the individual mandate (1-23-12). The problem is even with a government voucher program, health care providers and health insurance companies will continue raising costs and premiums, and most will be priced out of coverage. Deductibles and co-pays will continue to rise. Prices need to be controlled and regulated. Since Republicans will never regulate, the vote has got to go to the Democrats.

(D) PRESCRIPTION DRUGS: Romney said he would not repeal the unfunded Prescription Drug Program started by Little Bush (9-12-11). The problem is we need drug price regulation, but the Republicans will never do it. Our only hope is with Democrats.

(D) SOCIAL SECURITY RETIREMENT: Social Security retirement should never be confused with Medicare, or other social welfare programs. The retirement plan, created in 1935, is the most successful and efficient program ever created by the federal government. It needs nothing, except to be left alone. While Romney called it an “essential program” (9-12-11), Republicans from Reagan to Little Bush have advocated phasing it out. So, even though Romney said we should save the retirement plan (9-7-11), he would be pressured by House Republicans to push a right-wing agenda, which is to privatize it. Although Romney said it would not change for current retirees (1-8-12), he would add a year or two to the retirement age (1-16-12).

(D) WELFARE: Romney would turn poverty programs back to the states (1-8-12), which would kill them. He thinks Obama is creating a welfare state (1-19-12), and the U.S. has become an entitlement society. (1-16-12). Romney would block grant Food Stamps (2-22-12), which would cripple the needs of the hungry.

(D) EDUCATION: Romney apparently thinks there is something wrong with teacher unions, as he said he would stand up them. (9-22-11) While he would test children in math and English (2-22-12), which is fine, too many Republicans push the idea of privatizing schools, a long range threat to our culture.

(D) EDUCATIONAL TV/PUBLIC BROADCASTING (PBS): In an shocking campaign promise, Romney said he would eliminate Public Broadcasting (11-12-11). At a time when more, not less, non-fictional programming on science is needed, why cut PBS? Personally, it’s the only benefit I ever received from the federal government. I can’t believe any candidate would eliminate it.

(D) ENVIRONMENTAL PROTECTION: In Presidential elections, we don’t just elect a man; we choose a party to manage the agencies of government. If Romney wins, House Republicans will name the head of the Environmental Protection Agency (EPA). Extremists like Republican Michelle Bachmann, who advocated abolishing it, will have influence. If Romney wins, we will have a weak EPA. We should prefer over-regulation, than the other way around. Although Romney said we can’t let pollution flow from one state to another (1-8-12), which implies a need for federal law, modern Republicans cannot be trusted to regulate.

(D) FEDERAL EMERGENCY MANAGEMENT AGENCY (FEMA) The storm that just hit the East Coast is a good reminder of how bad it would be if FEMA had been abolished, or privatized. We need to remember we all sink or swim together.

(D) SUPREME COURT: It is likely the next President will appoint one or more Justices. A Romney win would tip the court to the hard right. The Court currently has four right-wing Justices: Scalia, Thomas, Alito and Roberts (on most issues). Reagan’s appointee Kennedy completes the usual conservative majority, which has existed since 1972.

(D) ABORTION: The secular right to “liberty” found in the 5th and 14th Amendments allows women to have an abortion in the earlier stages of pregnancy, when the fetus is incapable of living outside the womb. As a practical matter, attempts to outlaw abortion have been a waste of time. Even if the anti-abortion crowd had another Justice, who would ignore precedent, and reverse Roe v Wade, subsequent attempts to convict women and doctors would fail. Prosecutors will never get 12 jurors to convict women or doctors, and there would be hung jury after hung jury. We live in a free country which has no official religious creed. People disagree as to whether life begins at birth, or some other point before the fetus can live outside the womb. Romney, a missionary for the very conservative Mormon Church, will almost certainly appoint right-wing Justices. He changed his position on abortion. Most recently, he said he is pro-life (12-15-11) (1-19-12). He said Roe v Wade was wrong, it should be overturned, and the issue should be left to the states. (1-7-12). His stand would only give religious fanatics the power to impose their religious views on a secular society, filled with many who want to be free.

(D) CONTRACEPTIVES: Romney did not think any state wanted to ban contraceptives (1-7-12), but he is part of a right-wing Republican Party willing to turn back the hands of time.

(D) GAYS: Romney, whose Mormon grandfather fled the U.S. and moved to Mexico, because he believed strongly in the right to have more than one wife, ironically wants to amend the Constitution to limit marriages to one man and one women. Why the Republicans want to control the life of gays, who are genetically predisposed, is a mystery. We live in free country. It’s time to leave gays alone. Although Romney opposes same-sex marriage (12-15-11) (1-8-12) (1-16-12), and would amend the constitution to stop gay marriage (1-7-12) (1-8-12), the Democrats have the better position, as they believe in personal freedom.

(D) GUNS: Neither party is doing much to control hand guns in cities. Romney signed an assault weapons ban when he was Gov. in Massachusetts, but now he says he is pro-gun (12-15-11). The Republicans offer little hope to control firearm violence.

(D) RELIGION: Romney served overseas in France as a missionary for the Mormon Church. (12-10-11). He said he would seek guidance and providence in making critical decisions (1-26-12). He thinks Obama is somehow attacking religious freedom. (2-22-12). I have no idea what Romney is talking about.

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06/04/2012

Regulating Commerce: What Can We Do?

The Supreme Court will soon be deciding if all or part of the 2010 federal health care act went too far under the Congressional power to regulate interstate commerce. The question is to what extent does the “commerce clause” give Congress the power to regulate?

Art. I, Sec 8 (3) of the Constitution provides: “Congress shall have power…to regulate commerce…among the several states.” The first significant “commerce clause” case involved a challenge to a state law in Gibbons v Ogden (1824), where Chief Justice Marshall held Congress has the power to regulate every aspect of commercial intercourse, including every transaction not wholly carried out within the boundaries of a single state.

During the nation’s first 100 years, despite a federal power to regulate commerce, Congress passed no significant law in that regard, and instead most legislation was at the state level. Congress first used the “commerce clause” in 1887 to create the Interstate Commerce Commission (ICC) to regulate the railroads. Three years later, they added the Sherman Antitrust Act (1890).

An activist conservative Supreme Court however went right to work limiting any federal expansion of the power to regulate commerce. They held in 1895, while Congress could control railroads and common carriers, manufacturing conducted wholly within the confines of a single state, was outside their reach. In Hammer v Dagenhart (1918), Congress tried to eliminate child labor by establishing a minimum work age, but a conservative Court held the act exceeded their constitutional powers, because manufacturing was outside the reach of the “commerce clause.”

The interpretation of the “commerce clause” changed significantly during the Great Depression, when a new Court held in NLRB v Jones & Laughlin Steel 301 U.S. (1937), Congress could regulate manufacturing, even if it is based within one state. The Court abandoned the old distinction that kept manufacturing beyond the reach of federal regulation. The new test was any activity “affecting” interstate commerce could be subjected to regulation. In a challenge to the 1938 Fair Labor Standards Act, which regulated wages and hours, a progressive court in U.S. v Darby (1941), finally overruled the old 1918 Hammer decision above.

In Wickard v Filburn 317 U.S. (1942), the Court upheld the power of the federal government to regulate local farmers, who never did any business outside their state, on the grounds their production nevertheless affected aggregate national supplies and prices. In Heart of Atlanta Motel v U.S. 379 U.S. (1964), a local motel in Georgia that discriminated against blacks was subjected to the federal Civil Rights Act of 1964, because they accepted guests from out-of-state, and therefore engaged in interstate commerce.

The question now is whether the Supreme Court will limit the national power to regulate health care providers, businesses that provide health insurance to workers, as well as the powerful health insurance industry. Will they exclude the “individual mandate” from the reach of the commerce clause? The answer is there are five conservative votes on a 9-member Supreme Court, and though we have no crystal ball, at least 4 or 5 of them will vote to overturn at least part of the new law.

12/27/2011

Health Care Law in Plain English

After reading a Health Care Law article by attorneys Skindrud and Cleary in the Wisconsin Lawyer (12-11), I translated it into a plain English version for ordinary Americans.

“Obamacare,” as Republicans put it, was not written by President Obama, it was drafted by lobbyists, enacted by Congress, and handed to the President on March 23, 2010, for his signature. It is actually two laws: the “Patient Protection and Affordable Care Act” and the “Health Care Education Reconciliation Act.”

The purpose the new legislation is to cover most Americans with private health care insurance, and to reduce taxpayer subsidization for ER services, provided to the growing number of uninsured.

The law contains an individual mandate, requiring the purchase of health insurance. The idea of forcing people to buy insurance is not new. For nearly 100 years in Wisconsin, businesses have been under a government mandate to acquire Workers Compensation Insurance, from private carriers, to cover employees in the event of accidents at work. Employers also contribute to the Federal Unemployment Tax Act (FUTA) to provide for laid off employees. They must further pay the Social Security-Medicare system, under the Federal Insurance Contributions Act (FICA).

What is different about the new health care law is the individual mandate to buy insurance, as opposed to one requiring businesses to do so. The new Act raises Constitutional issues as to whether it exceeds the Congressional power to regulate Commerce, a question that will be ruled upon by the Supreme Court. While states have long mandated the purchase of automobile liability insurance or at least proof of financial responsibility, the opponents of the health care law may be able to show legal distinctions between auto and health.

For the most part, the new law does not kick in until 2014, when individuals must have “minimal essential coverage.” If they do not, penalties may be imposed for each month they went without it. The punishment will be based on a percentage of income, as reflected in annual tax returns.

Although most Americans will see no tax increase as a result of the new law, those earning $200,000, or more, will contribute a certain percent of income to help finance the new Act.

The federal Medicaid program for the poor, administered by states, but paid largely by Washington, will extend coverage in 2014 to those under 65, who are not disabled, if they earn 133% of poverty or less.

Each state will open up Health Insurance Exchanges in 2014, as a place for individuals, and businesses of up to 100 employees, to find affordable insurance. Larger employers must wait until 2017. Individuals and businesses will pay a portion of the premiums, up to certain caps, and to insure affordability, the government will pick up the balance owed to the insurance industry. Those at the poverty level will pay 2% of income in premiums; those at 400% of poverty will pay 9.5%.

Private insurance companies will be required to provide coverage for “essential health benefits,” without lifetime caps. Co-payments and deductibles will disappear in 2014. Children will no longer be subjected to pre-existing condition exclusions, and are now able to stay on their parents plan through age 26. Adults have to wait until 2014 to be free of the pre-existing condition exclusion.

To control health care costs, the government is pushing health care providers through Medicare reimbursements to abandon the fee-for-service system, reduce ER visits, eliminate duplication, and end unnecessary procedures. Payments for excess readmissions for conditions like heart failure will be reduced. The plan is to cut Medicare re-imbursement rates by 30% in 2012.

Although the goal of coverage to all is a noble one, the current conservative majority on the Supreme Court may in a 5-4 vote find the individual mandate unconstitutional. If the law is upheld, some previously without coverage will benefit, but the biggest winner will be the health insurance industry, since the federal government will subsidize their unregulated premiums. The government will probably also lose the struggle with the health care industry to lower reimbursements. While a single-payer system would have been better, and more efficient, we can only wait and see what develops under this law.