Entries Tagged as 'mandate'

A Decision That Will Set Libertarians’ Hair on Fire

November 8th, 2011 at 5:36 pm 27 Comments

Judge Silberman has issued another tour de force in the extremely interesting opinions generated by Obamacare. I have noted other opinions on Obamacare’s constitutionality but this one is full of interesting tidbits.

The first and most interesting tidbit is who wrote it. The Honorable Laurence H. Silberman is no hippie.

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Res Judicata: Anthony Kennedy, The Unprincipled Justice

August 22nd, 2011 at 1:52 am 55 Comments

The brewing controversy about President Obama’s healthcare law means that the case will end up in the Supreme Court. One appellate court has upheld the constitutionality of the law (by a 2-1 vote) and another has struck it down (by a 2-1 vote).

Splits on appellate panels are rare. Two split opinions on the same question are even rarer, maybe unprecedented. Within the next month a third appellate court will issue its opinion. Then the Supreme Court will be petitioned to take these cases and decide whether the federal government has the constitutional authority to mandate people to buy health insurance.

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Eleventh Hour for the Mandate

August 15th, 2011 at 12:33 am 45 Comments

Increasing the odds that the only fiscally responsible portion of Obamacare is also unconstitutional, on August 12th the 11th Circuit Court of Appeals struck down the law’s mandate to buy or fund health insurance. (The opinion can be found here.)

As I said when the 6th Circuit reached its decision: we are in it for the long haul and big government cases makes for interesting opinions.

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Romney’s Mediscare Defense

June 1st, 2011 at 12:23 pm 6 Comments

Democrats seem to have latched onto an electoral strategy for the 2012 campaign. With an economic slump that is the worst in many a decade, ballooning deficits, the Obamacare debacle, a foreign policy that has not exactly met campaign promises, and a restless populace, Obama and his allies have hit on a three-syllable campaign slogan: Medicare.

The congressional special election in NY-26, a rout for Republicans in a GOP-heavy district, has only fueled Democratic speculation that they can ride Mediscare tactics to victory in 2012. (Yes, a faux-Tea Partier in the race may have influenced the results, but Republican Jane Corwin was leading in polling before Democrat Kathy Hochul went full Mediscare.)

In a striking turn of events, Mitt Romney may find Romneycare more of an electoral advantage than a headache: this legislation could insulate him from Mediscare tactics. Many other Republican candidates (such as Michele Bachmann) voted in favor of Paul Ryan’s budget or have endorsed it; Tim Pawlenty has quibbled with the budget but has said he would sign it under certain conditions. While Romney has said that he is “on the same page” as Ryan, he has not endorsed Ryan’s budget and has said that he will propose his own plan for Medicare reform.

The fact that, under Romney’s watch, Massachusetts implemented a set of health-care policies that gives coverage to over 98% of state residents can protect him from the charge that he wants to finance more tax cuts by leaving seniors out in the cold. By not having endorsed Ryan’s plan, Romney can agree with it in the spirit of market reforms without having to defend its particulars.

This combination could blunt one of the Democrats’ biggest knives. Imagine the following exchange from a presidential debate in the fall of 2012:

Barack Obama: The Ryan budget, overwhelmingly backed by Congressional Republicans, would end Medicare as we know it for all those under 55, who would be left with vouchers to purchase insurance from private companies. These vouchers would only rise in value at the rate of inflation, and health-care costs have risen faster than inflation for decades. Governor Romney and the Republicans want to end our nation’s decades-long commitment to care for the elderly. They would hold our seniors hostage to the whims of private insurance companies.

Mitt Romney: Mr. President, while I have my differences with the Ryan budget, let’s face the facts. When I was governor of Massachusetts, I crafted legislation that ensured health-care coverage for over 98% of state residents. I worked across the aisle with Republicans and Democrats to forge a compromise to expand health-care to all citizens of the Commonwealth. While this compromise was not perfect and cannot be completely adapted to the federal level, it was a step in the right direction of accountability and fairness. Rather then putting health-care under central government control, it unleashed the power of the market to expand health-care access.

Under your health-care proposal, Mr. President, over $500 billion will be cut from Medicare over the next decade. Under your plan, Mr. President, a fifteen-member panel will set price controls for Medicare. Your plan forces a one-size-fits-all mandate model on all fifty states. You’re already cutting Medicare. My record shows that I have not and I will not expand health-care coverage by taking away from our seniors. I believe that market-oriented reforms can eliminate waste and cut soaring costs while also improving care.

Romneycare can give Romney cover to push for market-oriented reforms. If he is a crypto-socialist, as some of his detractors allege, he can’t also be an anarcho-capitalist ready to kill off grannie. Romney can attack Obamacare’s cuts to Medicare while also deflecting the charge that he is a heartless Medicare-cutter himself. Moreover, Romney can distinguish between Obamacare and his own health-care reforms: on Medicare cuts, the federal mandate, centralized government control, and other features.

As only Nixon could go to China, perhaps Romney is uniquely positioned to advance market reforms of Medicare.

(Disclaimer: the debate over entitlement reforms is quickly evolving, so the dynamic noted here might not be found even a few months from now.)

Originally posted at A Certain Enthusiasm.

Obama’s Mandate Waiver Trick

March 1st, 2011 at 12:23 pm 23 Comments

On Monday, ed President Obama announced to the National Governors Association that he would endorse a waiver for states to create their own health plans.  States would be eligible for the waiver to cover their residents as long as they can create “the quality healthcare their citizens deserve.” But the waiver plan won’t make things easier for the states.  In fact, Obama’s move is a political masterstroke and once again he’s shown his ability to outmaneuver his critics.

Obamacare is an insurance coverage plan, not a reform of American healthcare. As Paul Starr, the Stuart Professor of Communications and Public Affairs at Princeton and winner of the Pulitzer Prize for his classic work, The Social Transformation of American Medicine, states:  “Ultimately, the expansion of coverage will not survive unless the growth in costs is reduced.” The failure to have a plan that controls costs dooms any insurance plan to fail and the waiver the president offered to the states cannot succeed unless the ability to control costs and limit the rich benefits and open enrollment requirements is also granted.

President Obama’s offer to allow states to craft their own insurance plan will lead nowhere if the waivers require the states to maintain all of the benefits Obamacare currently requires. The reason for requiring an individual mandate is that Obamacare entails a very expensive form of insurance and requires insurers to accept patients whenever they apply for healthcare insurance even if the patients wait until they first need the coverage to make their applications.  The economics of Obamacare cannot possibly work without a mandate that includes virtually every American. But this mandate is abhorrent to many voters. States cannot possibly implement their own versions of Obamacare unless the waivers relieve them not only of the individual mandate but also of many of the required care provisions of the plan.

If the states accept Obama’s proposal to grant waivers of the individual mandate while maintaining the onerous requirements of Obamacare, the president will have outmaneuvered his opponents. He can then watch their efforts at implementing insurance reform crash and burn.  Obama will have forced the states into a Hobson’s choice: accept Obamacare and fail to control costs or go on your own and fail even sooner without federal support. Either way, the burden of healthcare costs will continue to overwhelm state and federal budgets.

Giving Moderation a Bad Name

David Frum September 17th, 2009 at 11:06 am 18 Comments

Liberal Democrats have an answer to the problem of rising health costs. They want government gradually to take over the health insurance market, and then use its monopsony power to force prices down.

Conservative Republicans have answers too. We want to intensify competition by putting individuals not employers in charge of health decision-making and allowing health policies to be sold across state lines.

The so-called moderate Baucus plan announced yesterday offers no such answers. It imposes an individual mandate, extends federal subsidies, and imposes a tax on employers to generate some expansion of coverage. But as to cost control, it proposes virtually nothing.

Baucus takes pride in his plan’s deficit neutrality: It raises revenues in tandem with its higher costs. While minimizing costs to the Treasury is a valid concern, there ought to be at least equal attention to the costs to the economy – to employers and to workers. This issue, of so vital concern to both liberals and conservatives, was entirely dropped by the Baucus moderates.