As legislation (like sausage) is being made...
it's not easily stomached because: The Devil is in the details.http://online.wsj.com/article/BT-CO-20090919-700883.htmlSEPTEMBER 19, 2009, 4:35 P.M. ET
Senate Democrats Take Aim At Health Insurance Excise Tax Plan By Martin Vaughan and Patrick Yoest
Of DOW JONES NEWSWIRES
WASHINGTON (Dow Jones)--Senate Finance Committee Democrats are taking aim at the excise tax on
high-dollar insurance premiums that is the central funding source for the health overhaul legislation proposed
by Finance panel chairman Max Baucus, D-Mont.
(BTW: Unions object to this)A majority of Democrats on the committee have proposed changes that would reduce the impact of the tax
or exempt some favored group, according to a list of amendments released ahead of a committee meeting
to consider the health bill slated for Tuesday.
To replace the revenues that would be lost from slimming down the insurance tax, some including
Sens. John Kerry, D-Mass., and Sen. Jay Rockefeller, D-W. Va., are seeking to revive a proposal first put forward
by President Barack Obama to reduce itemized tax deductions for the wealthiest.
Baucus has already signaled that changes to his proposal are likely even before the formal process
of offering amendments gets under way next week. The Finance session is important because it will test support
from Democrats and one vital Republican - Sen. Olympia Snowe of Maine - for a more centrist version of
health system overhaul.
Snowe also is seeking changes to the excise tax, and filed an amendment to lessen the tax's impact
on plans that cover people older than 55.
Rockefeller and others are proposing to exempt "high-risk professions," like coal-mining, from the tax
on gold-plated plans, while Sen. Debbie Stabenow, D-Mich., would exempt plans that cover retirees.
As expected, Rockefeller also plans to aim at the bill's omission of a public health insurance option.
Rockefeller plans to introduce an amendment that would include a public health insurance option that
would initial pay doctors and hospitals based on current Medicare payment rates.
An amendment offered by Snowe would establish a "fallback" insurance plan offered by a non-profit
government entity in states in which a specified proportion of residents do not have access to a low-priced
private insurance plan. Often referred to as a public option "trigger," the language would take effect only if
less than 95% of residents have access to a plan that costs 13% of their income or less.
Another Rockefeller amendment would strip out a part of the bill that would provide federal start-up funding
for non-profit health care co-operatives. Rockefeller argues that the co-ops are unproven on a large scale
and that co-ops currently in place operate much like private insurers.
Sen. Charles Schumer, D-N.Y., also offers an amendment that would scrap the bill's section co-ops and put
in place a public health insurance option. Schumer's version of the public plan would not base payments on
Medicare and would not require hospital and would require the plan to support itself financially after the
federal government paid initial start-up costs.
Another of Rockefeller's amendments would increase the requirements for "actuarial value" for insurance plans
in the exchange, in order for them to cover more of a patients' costs. Rockefeller seeks to fund this and other
amendments with a cap on itemized deductions, which was proposed earlier this year by President Obama
but saw little enthusiasm in Congress.
A number of senators filed amendments making health insurance more affordable to low-income people.
One such amendment, offered by Kerry and Sen. Robert Menendez, D-N.J., would increase federal subsidies
available to those from 100% to 400% of the federal poverty level.
The Kerry-Menendez amendment would be paid for by closing
unspecified "corporate tax loopholes."
Republicans seem likely to use their amendments to make the charge that the Baucus bill would break
President Obama's campaign promise not to raise taxes on the middle class. Sens. Mike Crapo, R-Idaho,
Pat Roberts, R-Kans., and John Ensign, R-Nev., filed an amendment that
no fee or penalty in the bill -
including penalties for failing to purchase insurance - would apply to an individual making less than $200,000
or a married couple with income of less than $250,000. Sens. Charles Grassley, R-Iowa, and Jon Kyl, R-Ariz., also filed amendments to
strike taxes on insurers,
drug-makers, medical device makers and clinical laboratories from the bill. But no Democrat has taken up
that cause, according to the amendment list.
Grassley, who on Monday issued broad criticisms of the Baucus bill, also has an amendment that would
remove
a requirement that individuals carry insurance. Another Grassley amendment would, during an economic recession, suspend a requirement that employers
provide insurance coverage or help pay federal costs of insuring their employees.
Two other Grassley amendments would aim to
blunt the effect of proposed cuts in the bill to privately-run Medicare
plans. The bill currently seeks to curb federal subsidies to the plan and establish a new bidding system that would likely
cut the federal government's payments to private insurers to run the plans[b](Medicare Advantage) .
One of the amendments would require the Department of Health and Human Services to certify that the Medicare Advantage
changes would
not affect access to the plans in rural areas, while another would require the department to certify that the bill
would not result in a loss of benefits to seniors enrolled in Medicare Advantage plans. Both requirements would have to be met
for the bill's changes to the program to take place.
--------------------------
Then there is scrutiny of the idea of the federal government can
force people to buy health insurance or be "fined"...or is that "taxed"?---------------------------
http://online.wsj.com/article/SB1000142405...emEditorialPageOPINION
SEPTEMBER 18, 2009
Mandatory Insurance Is Unconstitutional
Why an individual mandate could be struck down by the courts.By DAVID B. RIVKIN JR. AND LEE A. CASEY
Federal legislation requiring that every American have health insurance is part of all the major health-care reform plans
now being considered in Washington. Such a
mandate, however, would expand the federal government’s authority over
individual Americans to an unprecedented degree. It is also profoundly unconstitutional. An individual mandate has been a hardy perennial of health-care reform proposals since HillaryCare in the early 1990s.
President Barack Obama defended its merits before Congress last week, claiming that uninsured people still use medical services
and impose the costs on everyone else. But the reality is far different. Certainly some uninsured use emergency rooms in lieu of
primary care physicians, but
the majority are young people who forgo insurance precisely because they do not expect to need
much medical care. When they do, these uninsured pay full freight, often at premium rates, thereby actually subsidizing insured Americans. The mandate's real justifications are far more cynical and political.
Making healthy young adults pay billions of dollars in premiums
into the national health-care market is the only way to fund universal coverage without raising substantial new taxes. In effect, this mandate
would be one more giant, cross-generational subsidy—imposed on generations who are already stuck with the bill for the federal government's prior spending sprees.Politically, of course,
the mandate is essential to winning insurance industry support for the legislation and acceptance of heavy
federal regulations. Millions of new customers will be driven into insurance-company arms. Moreover, without the mandate, the entire thrust
of the new regulatory scheme—requiring insurance companies to cover pre-existing conditions and to accept standardized premiums—
would produce dysfunctional consequences. It would make little sense for anyone, young or old, to buy insurance before he actually got sick.
Such a socialization of costs also happens to be an essential step toward the single payer, national health system, still stridently supported
by large parts of the president's base. The elephant in the room is the Constitution. As every civics class once taught, the federal government is a government of limited,
enumerated powers, with the states retaining broad regulatory authority. As James Madison explained in the Federalist Papers:
"
n the first place it is to be remembered that the general government is not to be charged with the whole power of making and
administering laws. Its jurisdiction is limited to certain enumerated objects." Congress, in other words, cannot regulate simply because
it sees a problem to be fixed. Federal law must be grounded in one of the specific grants of authority found in the Constitution.
These are mostly found in Article I, Section 8, which among other things gives Congress the power to tax, borrow and spend money,
raise and support armies, declare war, establish post offices and regulate commerce. It is the authority to regulate foreign and interstate commerce
that—in one way or another—supports most of the elaborate federal regulatory system. If the federal government has any right to reform,
revise or remake the American health-care system, it must be found in this all-important provision. This is especially true of any mandate
that every American obtain health-care insurance or face a penalty.
The Supreme Court construes the commerce power broadly. In the most recent Commerce Clause case, Gonzales v. Raich (2005) ,
the court ruled that Congress can even regulate the cultivation of marijuana for personal use so long as there is a rational basis to believe
that such "activities, taken in the aggregate, substantially affect interstate commerce."
But there are important limits. In United States v. Lopez (1995), for example, the Court invalidated the Gun Free School Zones Act
because that law made it a crime simply to possess a gun near a school. It did not "regulate any economic activity and did not contain
any requirement that the possession of a gun have any connection to past interstate activity or a predictable impact on future
commercial activity." Of course, a health-care mandate would not regulate any "activity," such as employment or growing pot
in the bathroom, at all. Simply being an American would trigger it.
Health-care backers understand this and—like Lewis Carroll's Red Queen insisting that some hills are valleys—have framed the mandate as a "tax"
rather than a regulation. Under Sen. Max Baucus's (D., Mont.) most recent plan, people who do not maintain health insurance for themselves
and their families would be forced to pay an "excise tax" of up to $1,500 per year—roughly comparable to the cost of insurance coverage under the new plan.
But Congress cannot so simply avoid the constitutional limits on its power. Taxation can favor one industry or course of action over another,
but a "tax" that falls exclusively on anyone who is uninsured is a penalty beyond Congress's authority. If the rule were otherwise, Congress
could evade all constitutional limits by "taxing" anyone who doesn't follow an order of any kind—whether to obtain health-care insurance,
or to join a health club, or exercise regularly, or even eat your vegetables.
This type of congressional trickery is bad for our democracy and has implications far beyond the health-care debate. The Constitution's
Framers divided power between the federal government and states—just as they did among the three federal branches of government—
for a reason. They viewed these structural limitations on governmental power as the most reliable means of protecting individual liberty—
more important even than the Bill of Rights.
Yet if that imperative is insufficient to prompt reconsideration of the mandate (and the approach to reform it supports), then the inevitable
judicial challenges should. Since the 1930s, the Supreme Court has been reluctant to invalidate "regulatory" taxes. However, a tax that is so clearly
a penalty for failing to comply with requirements otherwise beyond Congress's constitutional power will present the question whether there are any limits
on Congress's power to regulate individual Americans. The Supreme Court has never accepted such a proposition, and it is unlikely to accept it now,
even in an area as important as health care.
[i]Messrs. Rivkin and Casey, Washington D.C.-based attorneys, served in the Department of Justice during the Ronald Reagan and George H.W. Bush administrations. ----------------------------
...and this is why artificial deadlines and vague slogans in speechs are not enough...
this stuff is extremely important, detailed, hard and encroaching into the lives of individuals.
BTW: this ain't racism...it's common sense, IMO.
