Today in Washington, the Supreme Court begins the first of three epic days of hearings on the Affordable Care Act (or I guess if Obama is calling it Obamacare now, I might as well). The first day of hearings, which start at 10am ET, concerns whether or not the Court should be able to hear the case at all. At least at this time.
The Anti-Injunction Act, a law dating back to 1867, explicitly states that a tax cannot be challenged in litigation before someone is required to pay it. Since the exchanges don’t begin until 2014, and the monetary penalties for individuals not acquiring insurance don’t begin until 2015, this would allow the Court to sidestep a ruling on the merits for three years. One of the many lower court rulings in the case, from the Fourth Circuit Court of Appeals, stated that the Anti-Injunction Act applied.
This is an outcome that neither side actually wants. The justices had to appoint an outside counsel, a lawyer named Robert Long, to argue for the delay in the ruling under the Anti-Injunction Act. Both the plaintiffs and the defendant in the case will argue that the AIA doesn’t apply and that a ruling should be made immediately. In general, neither side wants the uncertainty hanging over the law for the next three years, during the crucial stages of implementation.
The government is in the strange position of arguing that the individual mandate penalty is not a tax, for the purposes of the Anti-Injunction Act, while arguing (or implying) it is a tax for the purposes of the merits of the argument. That’s not their only argument, but it is one that they have argued in other court proceedings. The other arguments for the mandate have to do with the ability for Congress to regulate interstate commerce, the idea that the “inactivity” of declining to buy insurance has economic impacts, and that the mandate is “necessary and proper” to the functioning of the health care insurance system they came up with. The health care system comprises 1/6 of the US economy and is well within the bounds of Congress to regulate.
Later hearings will tackle that individual mandate argument (tomorrow), as well as whether the mandate is severable (Wednesday) from the other provisions regulating insurers or even the entire law and whether the Medicaid expansion is allowable under the Constitution — also to be argued Wednesday – (a really deadly argument if the Court goes for it, because it would invalidate a number of public programs that operate under the same kind of state/federal structure).
You can read a great rundown of some of the legal arguments in the case from bmaz. He predicts that the Court will rule on the merits (though he thinks that’s more in play that some commentators recognize) and that they will find the individual mandate Constitutional by a 6-3 or 7-2 ruling. As he says, this is an important set of rulings regardless of what you think about Obamacare:
This is about far more than Obama’s questionably cobbled together ACA law; the law is inane in how it soaks Americans to benefit craven insurance companies. Either way, sooner or later, healthcare as constructed and/or mandated by the ACA will die a painful death, but will continue to decimate American families for years, irrespective of the ruling by the Supreme Court on its nominal constitutionality. At some point, single payer, such as “Medicare For All” is inevitable.
However, the pervasive effects of the Commerce/Necessary & Proper Clause determination on the individual mandate, caused by the nightmarishly cobbled together Obamacare, will shape the direction of the Supreme Court in relation to commerce, business interests and, indeed, potentially American life across the board, for decades, if not lifetimes, to come.
That is what is at stake this week. Yes, it is that big. No, it is not that easy or clear cut. I do not know how it all sorts out for sure, but I do think, unlike the vast majority of the political commentators opining in the ether, the Supreme Court understands the consequences for the long run and the gravity of what they are considering. That said, it is still a very political decision for the Supreme beings, and how they calculate that, vis a vis history, is anybody’s guess.
The Supreme Court still lives in the Dark Ages and does not permit television cameras in the courtroom, although in this wired age and with the packed courthouse we may see some unauthorized live-tweeting out of there. There will be an audio recording made available by C-SPAN.
…According to Eddie Vale of Protect Your Care, a pro-Obamacare group, the scene outside the Court is surprisingly one-sided, with 300 supporters of Obamacare and “only five tea party opponents. Literally only 5.” Rick Santorum will show up later today, however.




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Sitting around after the Sunday evening meal we guessed the S.C. decision would be 5-4. 7-2? Having lived in Oregon for 3 decades it seems the fight never ends on providing even a porous safety net for the uninsured, especially children. The people who’s healthcare is rationed by what they have in their pocketbook, while at WalMart, on any particular day. I trust the free market to deliver quality healthcare about as far as I can throw an elephant. I trust the ACA about twice that distance or about as far as I can throw a donkey. Should be interesting in the same way the Battle of Gettysburg is interesting to the re-enacters crowd.
The same people who gave us the TSA, Patriot Act, and the federal tax code are to be trusted with a healthcare program that will cover 300 million Americans and 40 million illegals?
No thanks. The private system is screwed up, no doubt, but replacing it with the disaster of “ObamaCare” isn’t the answer.
You do realize of course, that in fact, the private system is the group that will be running “ObamaCare” since the idea of “Medicare for all” was something the private insurers just could not deal with as it would take the profit motive out of healthcare.
Would it not be constructive to consider for a moment or two the unholy fucking mess we have created on so many fronts by our willingness to engage in or tolerate mindfuckery with regard to the use and meaning of various words and concepts? Your fourth paragraph provides one good example re “Is it a tax?” Unfortunately, there are thousands of others. How can anyone truly expect rationality and efficiency to emerge from such madness and dishonesty?
Lets not forget the pay off to big pharma. Birth control pills at $9 a month hardly seem like the kind of thing that requires a mandate for coverage with no copay, unless you want users to choose the most expensive versions available.
Ditto! (to all three comments)
Blue
“…it is still a very political decision for the Supreme beings, and how they calculate that, vis a vis history, is anybody’s guess.”
Let me take a guess. It will be a pro-corporate decision, not a Constitutional one, since the Constitution no longer matters to these people. They gave history the boot in 2000, and the other two twigs went along with them.
We need to Constitutionally impeach the lot of them. We the people.
ha,hah..mandate is NO CONSTITUCIONAL,i don’t see how an individual or a person can fit in
a commerce scam by imposition if the person does’t want to,but i can see Supreme Court approving the whole law,a lot of bla,bla and bogus oral arguments for nothing.
This show is happening because Obama and lawmakers did’t want a true Reform
with single payer.
If SCOTUS upholds the mandate NOTHING on Earth will prevent Congress from commanding by legislation, how YOU spend EVERY penny of your so-called disposable income. By allowing Congress to assume control over your NON TAXED income, the Court would be handing Congress a blank check… YOUR CHECK.
Wait and see.
I wish you the best of all luck in your fight with the IRS and your particular state’s tax collection board(if you have to pay state income taxes). And when tossing and turning on your lumpy mattress full of stashed bucks please consider it is Big Pharma which made it possible to sleep by manufacturing Ambien, etc. Fighting city hall and saving America is more than a full time job these days. Again good luck with that.
I’d bet they’ve made up their minds, all nine of them. The oral arguments are window dressing as usual.
Now ’till June we’ll be bombarded with neverending, redundant “facts” from the pro and con gadflies and TV talking heads, who know it all. Gotta support their sponsors, no?. Enjoy.
The Individual Mandate is is the biggest handout to private corporations in history. The law says we have to buy their product, AT ANY PRICE THEY ASK. WE have to pay. Wanna send your kid to college, forget it. Pay up. For this we get coverage for pre-existing conditions. Great. Does that law say they have to treat your cancer with more than aspirin? Does your kid get that kidney transplant? Or do the for profit insurance companies get to decide your level of care?
Republicans should LOVE this law. Hell, they made it up. Obama just copied them.
The Supreme court? They WORSHIP corporations. They will uphold the mandate. It is their law. That it arrived under Obama is theater.
Next up is a mandate for all citizens to purchase annuities, or at least thats on cass sunstein’s wish list, and the same argument mandating health insurance applies to mandating annuities. Very slippery slope here.
Republicans are so diabolical. Not one Republican voted for it. Every Republican is campaigning on it’s immediate over-turn if they’re elected. But Republicans LOVE this law.
Well written for background on the “legal” context, what about the moral & political context? NO ONE covered the passage of Obama’s health care package as well as FDL’s Jon Walker. In it’s beginning there was a clear majority of Americans, both parties, polling it was time to revamp our inept & corrupt health care system. WE gave Obama the opportunity – clear control of BOTH the House & Senate. So, we had the need & the Bully pulpit combining to use a once in 30 year opportunity to correct a TERRIBLE wrong in our society. So, what did Obama do? Obama chose to sell out those who voted for him, and the overwhelming majority of all Americans, down the river.
Obama is clearly the worst Democratic President ever, and one of the worst of all our Presidents – ever. I know of nothing he’s done in 4 years to warrant trusting him to lead our Country for another 4 years, NOTHING. For three plus years FDL was an incredibly strong independent Progressive voice. Now it’s silent on opposing Obama’s reelection, the most important political decision facing Progressives & almost all Americans, because?
Mandate to buy health insurance = Mandate to buy health insurance that covers birth control.
What I was meaning to say was, it isn’t a guess since it is a corporate win either way. Only a matter of which way you prefer to be shafted, since shafting is axiomatic, shafting is the template.
Eat your peas, America.
Not sure what you mean by ‘silent’, bailey. Otherwise I say ‘amen’ to all your points.
I agree with almost all of what you say. However, the pre-existing part of the bill has saved my best buddy and his wife about 150K because Oregon has an insurance pool for those who otherwise can’t buy insurance because of cancer, etc. Now, they’ve spent out-of-pocket about 75K in co-pays. But the difference is destitution vs. another decade of working in their own small business. Or until they’re about 73 yrs old, respectively. Resignation of either being obliterated or having to sacrifice dearly is an easy choice for them. It also helps that they love each other.
Please. YOU are referring to taxation, a power which is constitutionally bestowed on the House of Representatives. I would not be complaining if this were a tax.
Taxes must be used for public expenditures like, oh… I dunno, a public health system, for example?
The Obamacare mandate, however is NOT a tax. It is a tortured interpretation of the Commerce power that is being used for the first time Federally, to require citizens to spend their NON TAXED dollars (aka disposable income) on a private product. There isn’t even an alternative or a public option.
My quarrel with the mandate is that it uses Commerce to FORCE citizens into a commercial relationship and then purports to rule that relationship under commerce. Apart from the obvious cart/horse problem, there is the odious fact that Congress is overreaching.
Congressional authority over YOUR income is constitutionally limited to LEVYING TAXES. If Congress is now permitted to force you into a commercial purchase of a private product, then there is no power on Earth to stop it from requiring you to buy whatever crony Congress desires to service with any given mandate until YOU have no disposable (aka) non-taxable income left.
Your post refers to taxes, which are, as noted above, constitutionally authorized as one of the two means by which Congress can raise funding for government (the other by minting coins)
I do hope you understand the difference between a lawfully levied tax and an unprecedented grab into your non-taxed income. To date, nothing authorizes the Congress to do the latter… yet. If the Court permits Article I Section 10 to be abused in this way however, by upholding the mandate, you will see a flurry of pet legislative mandates coming down the pike .. all in the name, either of “fixing” our economy or “national security”. Oh and wait till Congress passes a national bank tithe…
That part of the law and a few others are clearly important and beneficial. If bmaz is right, and he is pretty smart on these things, then we need to move for changes in the law, whether we like Obama or not. There are upwards of 50 million people who need health care.
Except nothing is free. Medicare for all would also have to be paid for by something, in this case taxes.
Yes, however Medicare is a NON profit public agency run efficiently and has a well established record of costing well below private insurance. More importantly, rates and costs are federally controlled and Medicare is subject to federal oversight because it is a public agency, rather than a private corporation, like Aetna.
I would have no objection at all to Congress levying tax sufficient to cover the cost of expanding Medicare for ALL. I lobbied for it, totally support it. But Obamacare is nothing but an act of fealty to the private insurance industry and will do nothing whatsoever to curb the real killer of healthcare in this country — the cost of health insurance.
Obamacare will prevent insurance companies from turning down patients with pre-existing conditions BUT will NOT prevent the private insurance company from charging the effing Earth and back for premiums for said policy. READ THE LEGISLATION if you don’t believe me.
Medicare, however accepts all eligible (presently disabled and retirees) without pre-existing condition screening or any other damn thing. Expanding the program to everyone would only bring the USA in line with other CIVILIZED nations that use tax contributions to provide services for the benefit of the common good and the general welfare … you know, like nationalized health insurance.
If only…
oh and… Medicare is lawfully paid for by taxes which doesn’t place the Congress in the shaky position of torturing logic to make a mandate that private citizens spend their non taxable income fall under Commerce.
Sheesh.
Sounds about right. So that only says to me we need to change this law. I doubt repealing it will get us anything in the next 20 or so years. We need something.
That’s a good point and I think you’re right.
David, hope you are reading your blog. So I understand the money generated by the individual mandate represents a very tiny fraction of the overall cost of obamacare. Would the insurers still see a large profits as a result of the mandate? If so, is that why obama insist on having the mandate?
I’ve got it. But like so many things in life, and death, the tax code and its’ enforcement will be used as a hammer to smash dissent. I’ve fought for a lot of this bill for a long time and I still think it stinks. But my past experience in Oregon tells me the mandate beats the heck out of their legislative process. One year the poor and children have insurance and the next they don’t. But they get sick and die every day! If adults are forced to pay it should free up monies for the people who cannot defend themselves. As Bob Dole said, ” the poor don’t have lobbyists “. As to fears about opening this can of worms to what may happen down the road, legislatively, we’ll see. As someone who started door-to-door politickin’ in 1962 for Stan Gregg at the age of 10 I have no use for Obama and signed the FDL pledge not to vote for him. But, as someone who has need for factions within the Dem. party, I’ll take these table scraps and give them to the poor and their children. And work to get the adults in the room to grow some and stop dissembling about the individual mandate. Single payer has a mandate, also, and it is called higher taxes for all. Which I support wholeheartedly. And to understand that Obama won’t be around forever.
If the onerous mandate were to stand, does anyone think the people would be more motivated to go to the polls in the upcoming elections and vote for anyone who would either repeal it (they would be up against the insurance lobby) or force the obvious solution of Medicare for all? (Again- against the insurance lobby, but much more understandably desirable to the voters.)
How did this ever come to be about insurance instead of health care?
INDEED.
When the banks went under, it became about insurance instead of health care. Insurance products are nothing but arbitrage streams of cash to Wall Street. I was a health insurance executive for 10 years. Health insurance companies don’t make their money on the profit/loss ratio of paying out claims vs. taking in premiums. They make their money via financial arbitrage. The banks are essentially bankrupt, but we can’t see that becuase of the change in accounting rules. Insurance funnels money to banks. No one in power ever was concerned about actual health care. Getting health care is only a byproduct of health insurance.
Here’s a good place to start. Once the public option was dropped (which was the nearest we got to Medicare for All), the whole damned thing slid rather quickly into the for-profit insurance business.
I’ve had trouble keeping up with this and never read the bill. What exactly does “Obamacare” change? Don’t health insurance companies keep right on keeping on? I know it enables children to remain on plans longer and something to do with pre-existing conditions being allowed to keep on being covered, but I honestly don’t know what the mandate entails etc.
One of those “in a nutshell” things, but I hope it helps some:
“The individual mandate is intended to work in conjunction with two other new rules in the law: Insurers must offer everyone coverage regardless of health status, and insurers may not charge people with pre-existing conditions more than other policyholders in their geographic area who have the same plan.”
Insurance companies make out like bandits. Many of us wanted Medicare for all.
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