The Supreme Court has largely upheld the Patient Protection and Affordable Care Act (PPACA).
My limited understanding from media coverage is that the ruling on the “mandate” is narrow. The crux of the argument: The U.S. government can tax. Period. Since the mandate is a tax incentive, it’s not outside the constitutional scope for congress to enact such a tax incentive for people to purchase insurance.
Two quick points. First, we see once again, that Democrats lost the battle of words by the fact that the tax incentive provision became known as a “mandate.”
The fact is, it isn’t a mandate. It is an incentive. You are not mandated to purchase insurance. Rather, you pay a tax if you can afford but don’t purchase insurance. Or, put another way, you avoid paying a tax if you have insurance.
The word “mandate” is one of those wingnut terms of art (like “death tax”) that is factually inaccurate, but is fantastic for stoking emotions. It makes for good hate-stoking.
The second point. Of the thousand and thousands of words I’ve read on the constitutionality/unconstitutionality of the PPACA after the lawsuits were announced, one of the best was written by none other than Goldy:
See, the recently passed health care reform legislation does not require that all U.S. citizens purchase insurance, it merely provides a tax incentive to those of us who do. If you are not covered by an employer, and if you have not purchased your own individual policy, and if your income is above certain levels, and if you don’t hail from a state that has opted out of this mandate by implementing its own qualified health insurance system, you will be required to pay an additional federal tax, starting at the greater of $95 or 1% of income in 2014, and rising to $695 or 2.5% of income in 2016, up to a cap of the national average premium on a bronze plan. Both the minimum tax and the cap will increase by the annual cost of living adjustment.
Now, some might argue that this is still a mandate to engage in some sort of economic activity because it targets a tax at those who refuse, but one could easily flip this perception around. What it really is, is a flat, 2.5% federal income tax — much along the lines of what is already imposed to fund Social Security and Medicare — but for which the law provides a substantial exemption to those who choose to purchase private health insurance.
And don’t attempt to bog down this discussion in jibberish over whether this is a “tax” or a “fee” or a “penalty” or a “mandate” or whatever. The courts have long been consistent that lawmakers need not jump through such semantic hoops; if a law is constitutional worded one way, it is constitutional worded another, as long as the practical application is the same. And clearly, our tax laws are filled with provisions intend to encourage some economic activities and discourage others.
Along these lines, a better analogy than Troll’s theoretical handgun mandate would be our current home mortgage interest deduction. The federal government does not actually mandate that we all take out big mortgages to buy homes and condos, but it grants huge tax advantages to those who do, essentially penalizing renters. Think about it: with the extra tax revenue from eliminating the home mortgage interest deduction, the federal government could lower the base tax rate on all of us.
So, if the health insurance mandate-cum-exemption is unconstitutional based on the contention that it compels individuals to engage in an economic activity, then so too would be the home mortgage interest deduction, and any number of other federal tax incentives. And I sincerely doubt that McKenna would choose to join a lawsuit seeking to deny Washington homeowners this very popular deduction.
If the “mandate” is unconstitutional, so is the mortgage interest deduction. After all, it “mandates” that you take out a mortgage loan, or pay a tax penalty.
Finally…winners and losers: First, this secures Obama’s legacy. Even though the PPACA was only one of many solid accomplishments of Obama’s first two years, this one is more defining and will positively, directly touch the lives of more Americans. (Ironically, candidate Obama opposed a “mandate” while he was campaigning against Clinton in 2008.) Second, this takes away Romney’s arguments that “Obama didn’t do anything” when he had a Democratic House and Senate.
Likewise, Democrats win by getting through another great social program. This is, after all, the real reason why Republicans oppose this largely Republican-designed program.
On the other hand, this is a win for conservatives, in that they will certainly be motivated by hatred, anger, fear of “socialism” largely out of the misconception that the government is now “forcing them to do something.”
The other big winner is Rob McKenna, who by losing the lawsuit he claims to have co-founded, dodges a huge bullet. Who wants the vote for the prick that kicked you off your parent’s insurance, or the asshole that quadrupled your insurance costs because of a pre-existing condition?
The final big winner is America—we have now joined most of the rest of the civilized world by making health care available to the poorest of our citizens. A reversal would have been a tragedy for untold millions of Americans. The PPACA is far from perfect, but it’s almost certainly better than what we had.
