If the law is upheld, Republicans will take to the floor to tear out its most controversial pieces, such as the individual mandate and requirements that employers provide insurance or face fines
If the law is partially or fully overturned they’ll draw up bills to keep the popular, consumer-friendly portions in place — like allowing adult children to remain on parents’ health care plans until age 26, and forcing insurance companies to provide coverage for people with pre-existing conditions. Ripping these provisions from law is too politically risky, Republicans say.Apparently it's not politically risky to require insurance companies to go out of business, though, which is what this plan will in fact require. What you're going to get out of this plan is insurance companies that must provide coverage to anyone who asks, even if they wait until they get sick to ask; but without the funding that the individual mandate (however unconstitutionally) ensured.
Employers will drop their plans, and insurance companies will go out of business. Now what?
Courage is the most important political virtue, as Machiavelli reminds us. If you're going to fight for principled constitutionalism, have the courage to make an argument. It's not too hard to explain that the government ought not to demand that businesses are run in ways that make them go bankrupt. It's not too hard to explain that people are better off being able to obtain insurance than not.
If you haven't the guts to make that argument to the People, it's time to start drawing up single payer plans. That's where this plan gets us. If you want them at the state level, get going on it now. Otherwise, we'll have to amend the Constitution to permit it at the Federal level -- or just do what our left-leaning brothers and sisters do, and learn to ignore the Constitutional limits entirely.
You'd think that enumerated power in the U.S. Constitution, the one allowing Congress to regulate [honest to goodness] interstate commerce //hears a ghostly wail in the Ether, looks left, right, scans his 180°, then 360° overhead// would encourage the //coughs// legisla //coughs// to seek a regulatory solution such as allowing the peasantry to purchase any type of insurance suitable to their needs, from any insurance company*, based in any state in the Republic.
ReplyDeleteHistory lends support to the notion that competition improves the product and usually lowers the cost.**
*properly vetted by the State Insurance Commissioners offices which would all comply with a minimum Federal standards.
**At least until a special interest lobby invests enough cash and/or favor in our Best & Brightest™ to gain legislative favor.
One thing I will say... as monumentally stupid as it is to legislate in such a manner as to force insurance companies out of business, at least it's Constitutional. They DO have the authority to regulate federal standards for health care companies. Should they? No, of course not. But CAN they? On this point, yes they can.
ReplyDeleteThey DO have the authority to regulate federal standards for health care companies.
ReplyDeleteWhere is this in the Constitution, exactly? Not in the case law that flows from cynical Supreme Court constitutional amendments from the bench, but in the Constitution?
Eric Hines
It seems to me that the People may be continuing to take appropriate action vis-a-vis RINOs that are afraid of difficult choices.
ReplyDeletehttp://www.nytimes.com/2012/05/17/us/politics/gop-upset-puts-focus-on-would-be-kingmaker.html
and
http://thecaucus.blogs.nytimes.com/2012/05/08/indianas-lugar-loses-republican-senate-primary/
Eric Hines
I'm with you 100%, Grim. Any time the Republicans can't make the case for preserving the free market, and have to rely on freebies instead, they may as well pack it up and go home.
ReplyDeleteWhere is this in the Constitution, exactly? Not in the case law that flows from cynical Supreme Court constitutional amendments from the bench, but in the Constitution?
ReplyDeleteHealth insurance is an industry that crosses state lines. The individual plans may not, but the insurers surely do. To claim that this does not qualify them for regulations under interstate commerce is a bit odd. Now, mind you, I certainly do NOT hold that "failure to engage in commerce is a form of commerce" as the Administration tried to claim with the individual mandate. That's patently stupid. I don't participate in the drug trade. By their logic, I'm engaged in drug trafficking by not engaging in it. I expect the DEA any moment.
Health insurance is an industry that crosses state lines.
ReplyDeleteYour original remark concerned federal standards for health care companies. Health insurance is not health care, even though Progressives tacitly insist it is through their drumbeat conflation of the two, and too many others accept the conflation. If (health) insurance is a risk transfer industry and not the privately funded, federally mandated welfare program that Progressives also insist that it is, then the risk transfer is entirely intrastate, since the only things having to do with risk transfer are specific risk transfer contracts--the insurance policies--which are entirely intrastate. The fact that insurance companies have presences in multiple states in no way alters this.
But then, since EC Knight, which held that manufacturing was strictly an intrastate function, and more importantly, that as a manufacturing process, it was not part of commerce (and was the latest in 100 years of Commerce Clause precedent) was overturned by the FRD-packed Supreme Court (Wickard comes to mind), the distorted interpretation of the Commerce Clause to allow the Feds to reach inside individual states to regulate intrastate matters has opened the Pandora's box that produces the effort to regulate such intrastate--and individual--matters as the intrastate trafficking in health insurance policies and even the mental decisions of individuals (see, for instance Mead).
This distortion and appalling expansion of Federal power at the expense of federalism and of individual liberty (and duty--too often that part of the duality gets forgotten) makes all the more important the firing not just of the Progressives on the other side of the aisle in the Federal government, but the RINOs, as well.
Which is kind of what Grim was getting at in the OP.
Eric Hines
You are correct, I mistakenly states "health care companies" instead of "health insurance providers". But the point remains, these are nationwide companies who provide plans (on a State by State basis, it's true) and distribute the costs and risks across the nation. If you could show me a company that ONLY operated within the boundaries of a single State, employed only citizens from that State, and never transferred coverage to or from a citizen of another State, then I would be perfectly fine with having zero federal regulations upon that company. And mind you, I'm ALSO in favor of limiting the federal regulations to those companies to the elements of their business that cross State lines. So if out hypothetical "United Health Insurance of Georgia" only crosses State lines when transferring coverage for a South Carolina resident, the the federal regulations SHOULD be limited to those that deal with the transference of coverage and resolving issues between differing intra-State regulations arising from such.
ReplyDeleteBut, because these national companies defray their risks across State boundaries (i.e. coverage in regulation bound California is normally much cheaper than in say, South Carolina, so a company can keep the costs in California down by raising costs in South Carolina... not much, obviously, but it IS a factor), they can reasonably be expected to be regulated by the federal government, at LEAST in so far as the regulations deal with the interstate activity.
Now this is where ignorance of the health insurance industry basically makes most of the above just wrong.
ReplyDeleteFor example, the BCBSA (Blue Cross Blue Shield Association) has agreements amongst its member plans that any subscriber requiring some form of healthcare can basically use their insurance at the local health care provider, and that provider can submit a claim to the local BCBSA insurance plan, which then pays the provider and in turns gets reimbursed by the subscriber's actual plan.
All across the country. Some blues actually outsource their claim processing to other plans, again, across state lines.
In fact there are such things as 'national accounts' where some large national company with presences in many states, say, like Sears or Boeing insure through their local blue cross, but the actual claims processing goes through one plan, or sometimes several (everybody getting their piece of the pie, so to speak).
There is a whole system for the various blues to share or transfer data between the plans and nobody here has a clue on how complex that really is.
I have not even touched upon the Federal regulations for government programs (Nobody here actually thinks that the gov't actually processes medicare and medicaid claims, do they? Because they don't.)
...never transferred coverage to or from a citizen of another State...
ReplyDeleteMy understanding is that while (I think) life insurance coverage is transferable across state lines, health insurance coverage is not--the 50 states' legislatures and PUC facilities won't allow it. A new health insurance policy is required, even if it looks just like the one just lost. Now would be a good time for an actual lawyer to comment on this subject, as I freely admit my general ignorance, relying only on personal experience.
...these national companies defray their risks across State boundaries....
Money is fungible. Of course they're moving money, earned in the course of their business, not money that is their business, from here to there. If we're going to accept that as the definition of interstate commerce, because it might impact commerce, than we're simply validating the travesties that are Wickard and Mead.
these are nationwide companies
Steel mills and other manufacturers are nationwide, each with plants in a number of states. Until the FDR-packed court, though, the plants' activities were correctly understood to be purely local, and not involved in interstate activities. So it is with health insurance companies.
Eric Hines
I understand the frustration felt by officials who want to administer free health care to various folks caught in poverty or emergencies. So I get why they so badly want people to pay for insurance when they're young -- so there'll be a source later when we can't help ourselves from paying their medical bills. But it seems to me that the "interstate commerce" part is the public insisting on paying the medical bills of everybody in the country, not the patients' refusal to buy the insurance. It drives me crazy that we can't control our impulse to pay their medical bills, but we blame that on them. Some charity.
ReplyDeleteFor the past sever years I have purchased my health insurance, out of pocket, sans an employer plan. Having put in the time/effort to shop for appropriate coverage, at the best price, from a plan with a good rating and reviews, aka customer satisfaction, I can attest to the fact that if I were able to buy my coverage in Ala., it would be cheaper.
ReplyDeleteMy SIL and daughter live in Ala. The SIL was selling insurance for a while, and at my request, he did the research and compiled the numbers from several providers in both Ga. and Ala. for me. Using the same providers offering the same coverage, the premiums were cheaper in Alabama. This was approximately six years ago. Rates in the two states may have changed, relative to each other, but the point remains.
As far as my initial comment goes, I meant to include a link to this piece on giving people the option of purchasing health insurance coverage across state lines.
Steel mills and other manufacturers are nationwide, each with plants in a number of states. Until the FDR-packed court, though, the plants' activities were correctly understood to be purely local, and not involved in interstate activities. So it is with health insurance companies.
ReplyDeleteI guess we'll need to agree to disagree on this one. I think the lack of regulation on steel mills had more to do with laissez-faire economic policy than the fact that it was properly considered "intra-State commerce". An Ohio steel mill burning Pennsylvania coal to smelt Wisconsin iron ore to be sold in California represents the very definition of inter-State commerce to me. Every step of production, SAVE FOR the actual smelting, is a transaction between the industries of several states. So while I'd agree that the actual process should be immune to regulation at the Federal level, just about every other step should be reasonably regulated there.
I have a sense that what was meant by "interstate commerce" by the Founders was just, for example, the power to forbid tariffs between states.
ReplyDelete"I have a sense that what was meant by "interstate commerce" by the Founders was just, for example, the power to forbid tariffs between states."
ReplyDeleteOr as a fellow once remarked somewhere around about here, "I shall confine myself to a cursory review of the remaining powers comprehended under this third description, to wit: to regulate commerce among the several States and the Indian tribes; to coin money, regulate the value thereof, and of foreign coin; to provide for the punishment of counterfeiting the current coin and secureties of the United States; to fix the standard of weights and measures; to establish a uniform rule of naturalization, and uniform laws of bankruptcy, to prescribe the manner in which the public acts, records, and judicial proceedings of each State shall be proved, and the effect they shall have in other States; and to establish post offices and post roads."
Whoops! The farrier is here, gotta scoot.