The Case Against the New Health Care Law (PPACA)

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    The lynchpin of the PPACA is the individual insurance mandate. Without the individual mandate, the entire health care reform legislation loses its base of support and ultimately collapses. To date, federal appellate courts have been split concerning the constitutionality of the individual mandate. Which way do you think the Supreme Court will ultimately decide?

    it certainly is unprecedented: twenty-six states and the national federation of independent business banding together in a legal challenge to the highest court in the land over the health care reform law that was president obama's signature legislative achievement. one hundred five members of congress have also signed an amicus brief urging the supreme court to declare this health care law unconstitutional. without dispute, the patient protection and affordable care act (ppaca) is one of the most hotly contested legislative acts of all time. the supreme court has agreed to begin hearing the case in march of next year and should make a final decision regarding its constitutionality by july, 2012.

    the landmark case before the supreme court centers on two key issues. the first area of dispute is the constitutionality of the individual mandate. the lawsuit claims that congress is exceeding its power by requiring every american to buy health insurance by 2014 or pay a penalty. the pivotal issue is whether congress has been granted the power to impose this mandate by the commerce clause in the u.s. constitution. the question presented in the petition is: "whether congress had the power under article i of the constitution [i.e., the commerce clause] to enact the minimum coverage provision [i.e., the individual mandate]."

    the second key issue is the "severability" of the insurance mandate. can the other provisions of the ppaca remain legally in force if the individual mandate is nullified? the question presented is: "whether the aca must be invalidated in its entirety because it is nonseverable from the individual mandate that exceeds congress' limited and enumerated powers under the constitution."

    the supreme court could conceivably:
    1. uphold the entire law,
    2. strike down the individual insurance mandate,
    3. strike down other provisions,
    4. declare the entire law unconstitutional, or
    5. simply put off making a decision concerning the mandate until 2014, when the law goes into effect.
    besides these complex issues, the highest court in the land will also hear arguments concerning the constitutionality of a sweeping expansion to medicaid under the ppaca, something of great concern to budget-strapped states. the states maintain that this expansion is unduly coercive and they simply cannot afford the costs and burdens of this dramatic expansion to medicaid enrollment.

    the lynchpin of the ppaca is the individual insurance mandate. without the individual mandate, the entire health care reform legislation loses its base of support and ultimately collapses. to date, federal appellate courts have been split concerning the constitutionality of the individual mandate. which way do you think the supreme court will ultimately decide?

    references

    1. department of health and human services, et al., v. florida, et al.
    2. florida, et al., v. department of health and human services, et al.
    3. florida scotus aclj amicus brief
    4. national federation of independent business v. sebelius, et. al.
    5. supreme court to hear constitutional challenge to ppaca
    6. supreme court to take on ppaca cases
    Last edit by VickyRN on Dec 2, '11
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    39 Comments

  3. by   VivaLasViejas
    I hope the SCOTUS goes for the jugular and kills this beast once and for all.

    Failing that, the individual mandate has got to go. I don't care what any of its proponents say, it is unconstitutional to force people to buy a commercial product (that tens of millions of us can't afford on our own) as a condition of merely drawing breath on U.S. soil. That has never been tolerated in America, and indeed shouldn't be tolerated....ever.

    'Nuff said.
  4. by   dudette10
    Quote from VivaLasViejas
    I hope the SCOTUS goes for the jugular and kills this beast once and for all.

    Failing that, the individual mandate has got to go. I don't care what any of its proponents say, it is unconstitutional to force people to buy a commercial product (that tens of millions of us can't afford on our own) as a condition of merely drawing breath on U.S. soil. That has never been tolerated in America, and indeed shouldn't be tolerated....ever.

    'Nuff said.
    In one context, it has been tolerated and freely accepted for a very long time. Drive a car? Every single state requires a driver to not only have auto insurance, but also a coverage called "uninsured/underinsured motorists coverage" that would pay for personal injury and property damage if an accident is caused by someone who decided to not follow the law. Not only does the state tell you that you must have this commercial product, they also dictate how much minimum coverage you must purchase.
  5. by   VivaLasViejas
    Quote from dudette10
    In one context, it has been tolerated and freely accepted for a very long time. Drive a car? Every single state requires a driver to not only have auto insurance, but also a coverage called "uninsured/underinsured motorists coverage" that would pay for personal injury and property damage if an accident is caused by someone who decided to not follow the law. Not only does the state tell you that you must have this commercial product, they also dictate how much minimum coverage you must purchase.
    That is an oft-mentioned argument, but it doesn't hold water because nobody HAS to own or drive an automobile, therefore, one who does not use private transportation does not have to purchase insurance. The health insurance mandate requires everyone to purchase a policy as a condition of LIVING.
  6. by   Spidey's mom
    Quote from dudette10
    In one context, it has been tolerated and freely accepted for a very long time. Drive a car? Every single state requires a driver to not only have auto insurance, but also a coverage called "uninsured/underinsured motorists coverage" that would pay for personal injury and property damage if an accident is caused by someone who decided to not follow the law. Not only does the state tell you that you must have this commercial product, they also dictate how much minimum coverage you must purchase.
    Nope - that's not the same at all. That argument has been debunked for a long time.

    The American Spectator : The Spectacle Blog : Health Insurance Isn't Car Insurance


    ....."But Catron adroitly points out that state automobile insurances laws "aren't universal mandates." He writes, "Rather than forcing people to buy insurance simply because they exist, as the Obamacare mandate will do, state auto insurance mandates only affect people who buy and drive automobiles."....."

    ...... 'Yet you would be amazed how many people who argue in favor of Obamacare use the automobile insurance argument. So on some level I guess we shouldn't be all that surprised that Obama would use the same argument. When I have been engaged in such arguments about Obamacare and the person with whom I am conversing brings up auto insurance, I ask them if they should be forced to buy auto insurance if they have neither a drivers' licence or car. It usually brings the discussion to a sudden stop..... "
  7. by   dudette10
    Don't we use healthcare services from the moment we are born?

    I guess I don't get all the uproar over this mandate. People scream about not having coverage and/or not qualifying for it and/or losing it, but when a plan is put forward to help everyone get it, people scream even louder.
  8. by   VivaLasViejas
    Dudette, I love ya, but have you tried to buy health insurance for yourself lately? I tried to put my husband on my employee health insurance plan last year, but they wanted almost $1,000 per month!! And he and I both are basically uninsureable because of pre-existing health conditions, so private insurance is out of the question. I can't afford that.......can you?

    I have yet to see any documentation that promises health insurance will be made affordable to consumers with medical problems under Obamacare---available, yes, but not within the reach of middle- and low-income families. Nor is there anything in Obamacare which attacks the actual cost of health care, or addresses the need to limit medical malpractice awards and put an end to frivolous lawsuits. So until they take this POS legislation back to the drawing board, I---along with millions of other Americans---will continue to resist the mandate and to protest it to the highest court in the land.
  9. by   VickyRN
    it's ironic that it's called the affordable care act, yet costs for health insurance premiums have skyrocketed since the ppaca's inception.

    in defense of the ppaca, this legislation does have a provision in place to finance a new type of nonprofit health insurance company that is entirely run by its customers. this prototype is termed a 'consumer operated and and oriented plan.' i do not know how affordable or available these insurance plans will ultimately prove to be, but it does look somewhat innovative and promising.

    to read more, please see health care for a changing work force and consumer operated and oriented plans (co-ops).

      • by january 1, 2014, you may be able to buy a co-op health plan through a new competitive health care marketplace in your state, called an affordable insurance exchange. you may also be able to buy a co-op health plan outside of an exchange.
      • co-ops are required to meet the same state and federal quality and financial standards as other health insurance plans.
      • the health care law encourages co-op plans to offer better coordination of consumers’ medical care.
    consumer operated and oriented plans (co-ops) | healthcare.gov
  10. by   VickyRN
    Quote from VivaLasViejas
    I hope the SCOTUS goes for the jugular and kills this beast once and for all.

    Failing that, the individual mandate has got to go. I don't care what any of its proponents say, it is unconstitutional to force people to buy a commercial product (that tens of millions of us can't afford on our own) as a condition of merely drawing breath on U.S. soil. That has never been tolerated in America, and indeed shouldn't be tolerated....ever.

    'Nuff said.
    If the SCOTUS does decide that the individual mandate provision is constitutional, then this will be a nightmare to enforce and a nightmare for those who simply can't afford to buy any health insurance. Then, these unfortunates will be forced to pay some sort of fine or penalty on top of all their other personal financial troubles. Big Brother, here we come!
  11. by   Jolie
    Ironically, the fine, or tax (whichever it is being called on any given day) for failure to purchase insurance is far cheaper than premiums. So those who truly can't afford coverage will be better off to pay the fine and then still show up in the ER uninsured for care.

    Big improvement!
  12. by   wooh
    Single payer. Everyone screams communist/socialist/fascist/whatever scary word they last heard, but it's what the other industrialized countries are doing. And most of them are strangely NOT communist/socialist/fascist. Except Cuba. But what does it say that an actual real communist country has better access to healthcare than our good ol USA?
  13. by   FranEMTnurse
    I too am against obamacare. I believe his plan is going to cripple us. When my daughter lived in Canada, I saw how their public healthcare works, and I didn't like it. After my grandson was born, we had to go to a hospital clinic and wait for a long period of time just like we used to here in the states. (I loathed going there and waiting so long.) That experience in Canada took me way back in time to unpleasantness. My daughter also told me that you only get the very basic care, and there is no universal dental or eye care other than checkups.
  14. by   nurseprnRN
    Quote from VivaLasViejas
    I hope the SCOTUS goes for the jugular and kills this beast once and for all.

    Failing that, the individual mandate has got to go. I don't care what any of its proponents say, it is unconstitutional to force people to buy a commercial product (that tens of millions of us can't afford on our own) as a condition of merely drawing breath on U.S. soil. That has never been tolerated in America, and indeed shouldn't be tolerated....ever.

    'Nuff said.
    Actually, you are compelled to buy insurance to be able to drive in many states. In our state, there's a pool to insure high-risk drivers that no regular insurance company wants to cover; the catch is that if you want to have an insurance company license in the state, you have to participate in the pool. Not all companies do, so they don't write auto liability here. This is exactly the same model for health insurance.

    Don't panic. MA has had this for years, it's a good thing, nobody suffers for it, our incidence of uninsured children is the lowest in the country, the ERs are getting less pressure to be primary care clinics so they aren't having to make up money on the insured, the city hospitals are using their tax support for staff and services instead on uninsured ER care ... it's all good. And we've been doing it for years and years, and the sky has not fallen, and the population is overwhelmingly satisfied with it.

    I'm not sure what part of that you wouldn't like to see replicated on a national scale, and why.

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