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Obamacare Goes to Court Obamacare Goes to Court

03-28-2012 , 08:27 AM
mpethy owned this thread last night.
03-28-2012 , 08:29 AM
Quote:
Originally Posted by mpethybridge
You wouldn't have an expansion of the commerce clause power.

If this case gets upheld on commerce clause grounds, then you will have:

1. a Supreme Court opinion that says that the federal government is free to compel you to engage in market activity it thinks is a good idea. Or,

2. A Supreme Court case that says everybody is engaged in commerce automatically just by virtue of being alive. Or,

3. A supreme Court case that says, yeah, this is no different than Wickard, your personal choices have a cumulative effect on interstate commerce.

Either of the first two scenarios represents a very obvious expansion of the federal government's authority to regulate personal behavior that it cannot currently reach under the Commerce Clause and would have difficulty reaching in any other way. The third scenario is, in my mind, the worst, because it would be a continuation of the trend toward disingenuousness in Supreme Court opinions that purport to not be expanding the powers of the federal government but actually do.

The broccoli example actually illustrates the problem pretty well. Right now, there exists no Supreme Court precedent that could support forcing a consumer to buy groceries that amount to a healthy diet. The current state of the law is that you have a right to buy whatever groceries you like with your own money.

If this law passes, it opens the way for government to pass a law that mandates the purchase of particular groceries. In principle, there is no difference between forcing you to buy health insurance, and forcing you to buy groceries that are good for you. Right now, the government's power is limited to asserting its preference concerning your dietary habits by way of imposing sin taxes on groceries it considers bad for you.

Big difference, IMO.

By contrast, if the mandate passes as a tax, then it is just another example of the government exercising a power that has long been recognized to be broad in scope.

The primary argument against this slippery slope argument is "oh well, the government would never tell you what food you have to buy, lol, you're seeing monsters under the bed." But do you really think that James Madison and Alexander Hamilton envisioned a government that would dictate the type and content of the insurance policies you'd be forced to buy? I don't think they did. The historical fact is that if you give government a hypothetical power, it will eventually exercise it. There is no better historical example of this trend than the Commerce Clause itself. The Raich decision which 2+2 hates because it is a regulation over your ability to grow and smoke your own pot is an absolutely inevitable result of the Wickard decision that prohibits your ability to grow and eat your own wheat.
Do you think they envisioned nuclear weapons?

Do you think they envisioned the Patriot Act?

Do you think they envisioned airplanes? What about trains? What about ****ing cars?

Do you think they envisioned the Internet?

Do you think they envisioned the War on Drugs?

Do you think they envisioned Wal Mart?

Far too much is made of what these people thought or did, they died 200 years ago. Jefferson himself expressed a desire that the Constitution be rewritten every 19 years because the country should belong to the living.
03-28-2012 , 08:51 AM
Quote:
Originally Posted by awval999
I really think mpethybridge is crushing this thread; but this is a good argument, i'm interested to hear any retorts, because I don't have one.
The Commerce clause does not stand in isolation.

So there would be a number of other ways to contest Federal income tax of 99%.

I do not think that the XVI Amendment extends to the appropriation of all individual income.

Last edited by DiggertheDog; 03-28-2012 at 09:00 AM.
03-28-2012 , 08:56 AM
Also, +1 to a fear that the government could eventually ban cigarettes...we've seen what they've done with pot, and that was WITHOUT Obamacare!!!111!!

/snark

seriously tho, I don't love Obamacare. I think a single payer system would be far, far better. For that reason, I'm not sure what I want the Court to decide here. But I think the fears about it somehow leading to an enormous expansion of government powers down the old slippery slope are incredibly overdone. All the justices in this case are super aware of that very issue and I don't see it holding up without them recognizing health care as a unique market or something along those lines.
03-28-2012 , 09:06 AM
Quote:
Originally Posted by DiggertheDog
The Commerce clause does not stand in isolation.

So there would be a number of other ways to contest Federal income tax of 99%.

I do not think that the XVI Amendment extends to the appropriation of all individual income.
Not thinking so and pointing to a limiting principle are two different things.

Or maybe you've misunderstood me? I'm saying the power to tax doesn't appear to have a limiting principle, or, if it does, that limiting principle is very weak.

Last edited by 13ball; 03-28-2012 at 09:12 AM.
03-28-2012 , 09:24 AM
Quote:
Originally Posted by __w__
Yeah, but what about the conservative lawyers that actually have constitutional grounds to argue against it? Do they not count in your silly silly world?
Their arguments are ludicrous. Here is a straight-forward summary by a conservative attorney:

http://www.acslaw.org/acsblog/lookin...tionality-of-t
Quote:
The Following is an excerpt from Harvard Law Professor Charles Fried’s testimony during a Senate Judiciary Committee hearing on the constitutionality of the Affordable Care Act.* Prof. Fried was former solicitor general under President Ronald Reagan.
Quote:
If insurance is commerce, then of course the business of health insurance is commerce. It insures an activity that represents nearly 18% of the United States economy. (In this connection recall Perez v. United States, which held that a very local loan sharking operation was within Congress’s power to regulate commerce.) And if health insurance is commerce, then the health care mandate is a regulation of commerce, explicitly authorized by Article I, Section 8 of the Constitution. [...]

In a debate last November before the Federalist Society (of which I have been a member since its beginning), my good friend and former student Professor Randy Barnett, by way of peroration, said that it was not the America he knew if a person could be compelled to enter a market and purchase a product there he did not want. (As has been repeatedly asked, may Congress by way of regulating commerce force you to eat your veggies or visit the gym regularly? Surely not.) But the objection, while serious, is not at all about the scope of Congress’s power under the Commerce Clause. It is about an imposition on our personal liberty, at liberty guaranteed by the 5th and 14th Amendments, and guaranteed against invasion not only against federal but also against state power.

Is the health care mandate an invasion of constitutionally protected liberty? That question was answered in 1905 by a unanimous Court in Jacobson v. Commonwealth of Massachusetts, upholding against a liberty argument the imposition of a fine for refusing to submit to a state-mandated smallpox vaccination. By refusing vaccination, Jacobson was endangering not only himself but others whom he might infect. By refusing the much less intrusive and less intimate imposition of a requirement that one purchase health insurance if one can afford it, a person threatens to unravel — in the view of Congress and the health insurance industry, but Congress is enough — the whole scheme designed to protect by health insurance the largest part of the population. .

As for the veggies, I suppose such forced feeding would indeed be an invasion of personal liberty, but making you pay for them would not, just as making you pay for a gym membership which you can afford but do not use would not.

To sum up:

Insurance is commerce.

Health insurance is undoubtedly commerce.

Congress has the power to regulate commerce, and that means that Congress may prescribe, in Chief Justice Marshall’s words, a rule for commerce.
03-28-2012 , 09:31 AM
Quote:
Originally Posted by suzzer99
They aren't. If you don't pay taxes you go to jail. If you don't buy UHC under Obamacare, you have to pay a tax penalty. But if you don't pay that nothing happens to you. There is nothing remotely 'forced' about it.

I think this is another one of those key points people like you are literally incapable of remembering.
Something about this just like lit a lightbulb in my head.

Use obamacare cards for voter IDs! boom. Then we can deny the vote to people who don't have insurance, and we can instantly end the stupid voter ID debate.

Man I'm a ****ing genius.
03-28-2012 , 09:36 AM
Quote:
Originally Posted by Paul McSwizzle

Far too much is made of what these people thought or did, they died 200 years ago. Jefferson himself expressed a desire that the Constitution be rewritten every 19 years because the country should belong to the living.
There have many good arguments made that the Constitution is a living document, and there have been many good arguments made against that very position.
03-28-2012 , 09:51 AM
Quote:
Originally Posted by pvn
Something about this just like lit a lightbulb in my head.

Use obamacare cards for voter IDs! boom. Then we can deny the vote to people who don't have insurance, and we can instantly end the stupid voter ID debate.

Man I'm a ****ing genius.
Then the obamacare cards would need a picture. Currently there is no pic on medicare cards.
03-28-2012 , 09:53 AM
Quote:
Originally Posted by bringmehome
The government would never mandate the purchase of a product whose effectiveness depends on it being used/consumed.

A brocoli mandate would only work if it also required consumers to eat brocoli. Requiring consumers to actually ingest a certain type of food would be a huge intrusion on civil liberties. What if people are allergic? What if they don't like the taste? What if they have religious objections? The same goes for a gym membership - a membership itself does not make people healthier unless it's actually used. Requiring people to actually go to the gym is a lot different than requiring them to carry insurance.

So I think if you are looking for a limiting principle, or a way to distinguish health care insurance from other products, it's that it is an intangible product whose effectiveness does not depend on the consumer taking any additional action aside from simple ownership.

health care insurance doesn't depend on any other action aside from simple ownership? You mean as long as i have the piece of paper all is well? i won't get sick, or if i do it will fix me? You mean i don't have to decide to go to a Dr. for a check up (like going to a gym) or follow a dr's advise about my diet or lifestyle (like actually eating better foods rather than fast food)?
03-28-2012 , 09:56 AM
Quote:
Originally Posted by champstark
grunching

If the court votes to overturn the law, isn't that a case of super-aggressive legislation from the bench, which is the very thing those who would vote to overturn the law constantly rail against? Is anyone else a bit disgusted by how hypocritical that position is?
We've covered this in other threads but

"Judicial activism" = when a court strikes down a law that you like, while

"Garden variety exercise of the power of judicial review" = when a court strikes down a law that you don't like.

(ETA: Not saying mpthy necessarily does not like this law, just borrowing his terminology because it was succinct)

Last edited by Namath12; 03-28-2012 at 10:08 AM.
03-28-2012 , 09:59 AM
Quote:
Originally Posted by swinginglory
Spoken like someone who has never been chased around by the IRS before

Cliffs:

You might get by for 2 or 3 years, but old uncle schmule is gonna get you and attach your bank accounts/wages to get his end!

And he just loves interest and penalties....... trust me
Please read the statute before posting stuff like this. If you can't be bothered to do that, at least read the thread. This has already been covered.

And I am an accountant so I'm quite familiar with the IRS' collection methods.
03-28-2012 , 10:08 AM
Quote:
Originally Posted by mpethybridge
The method it selected was to assert the existence of a commerce clause power that has never before been recognized by the Supreme Court, and never before asserted to exist by the Congress. The power asserted by Obamacare is "unprecedented" in the literal meaning of the word--there is no precedent for it--I have been saying this for 2+ years on 2+2, and the Supremes acknowledged the correctness of this argument today.
True, as long as you acknowledge that the Supreme Court overturning the law and imposing this limit on Congress' commerce power would not find its reinforcement in precedent either. When you say that nobody has argued this before, nobody has argued that this limit exists under the Commerce clause either. It's an issue of first impression within a known power - not exactly the same as a Griswold type case where the court is being asked to recognize an entirely new right contrary to precedent, or legislation, or something else.

Really, I see the case as asking the court to recognize a new limit, since the constitutionality of laws passed by Congress is presumed.

Quote:
Originally Posted by mpethybridge
For some combination of political expediency and cowardice, Congress decided to claim that it has this new commerce clause power to regulate the purchasing decisions of individual Americans. This new power puts at potential risk the economic liberty that comprises one of the founding principles of our country. One of our founding political principles is being infringed in the name of providing political cover to a few craven politicians.
You're not making a Lochner economic liberty argument are you? In an age where the government tells us what we can put in our contracts, what we can buy, what we can sell, what we can rent, etc, the idea that the flag will fall if this law is upheld loses some of its gravity.
03-28-2012 , 10:13 AM
Quote:
Originally Posted by LawMess
health care insurance doesn't depend on any other action aside from simple ownership? You mean as long as i have the piece of paper all is well? i won't get sick, or if i do it will fix me? You mean i don't have to decide to go to a Dr. for a check up (like going to a gym) or follow a dr's advise about my diet or lifestyle (like actually eating better foods rather than fast food)?
As long as you have that card, you will be able to pay for the check-up you need when you wake up with a tumor, or wake up in the hospital after being blindsided by a Mack truck. Any of these things could happen to anybody at any time. A meteor could fall on you in the privacy of your own home. It is obvious that these services couldn't be paid for by mandating a transaction between only patients and health care providers, which is why the minimum insurance mandate becomes necessary and proper.
03-28-2012 , 10:16 AM
After a night's reflection, I've decided to go out on a limb and predict that the Court will be compelled to articulate a brand-new commerce clause principle, and in doing so, will deem the mandate constitutional. Here is my reasoning.

First, the court appears to want to reach the merits of the commerce clause argument, and did not seem very impressed the other day with the claim that it was not ripe. Nor does a majority appear enamored with the tax power claim.

Second, and more importantly, prior Commerce Clause cases do not directly address the issue that received most of the attention yesterday: i.e., the constitutionality of forcing an individual into commerce (which is another way of invoking the activity/inactivity distinction).

Now, supporters of the law have an extremely strong claim that the precedent contains no language indicating that this type of distinction is relevant. They can also point to other situations (though not necessarily commerce clause cases) where the government does force activity. Still, the court has never, to my knowledge, actually taken the step of saying that the activity/inactivity distinction is irrelevant, simply because the issue has not been framed that way before.

Accordingly, one way or another, this court is going to have to discuss the activity/inactivity issue head-on. Here is where it is worth examining Kennedy and Roberts particularly closely.

Both Kennedy and Roberts initially asked whether the government could create commerce, or force people into commerce. Kennedy suggested that the government's burden might be greater in such a situation, but did not suggest that the burden was necessarily insurmountable. Further, both made comments acknowledging the government's argument that the health care market is truly unique, and that unlike perhaps any other market, every individual is destined to participate (though Roberts wanted to parse whether distinctions could be made about particular types of medical service, and tried analogizing the situation to police and other emergency services). Read in totality, all of those remarks indicate to me that, even if not yet convinced, both Kennedy and Roberts recognize that health insurance may truly present a set of circumstances that could be distinguished from other situations.

I found these comments by Kennedy (made at different points) particularly telling:

Quote:
Is the government's argument this -- and maybe I won't state it accurately. It is true that the noninsured young adult is, in fact, an actuarial reality insofar as our allocation of health services, insofar as the way health insurance companies figure risk. That person who is sitting at home in his or her living room doing nothing is an actuarial reality that can and must be measured for health services purposes; is that their argument?]
Quote:
The government tells us that's because the insurance market is unique. And in the next case, it'll say that the next market is unique. But I think it is true that if most questions in life are matters of degree, in the insurance and health care world, both markets - stipulate two markets - the young person who is uninsured is uniquely proximately very close to affecting the rates of insurance and the costs of providing medical care in a way that is not true in other industries. That's my concern in the case.
Of course, this is speculation. But those comments don't sound to me like someone who is searching for a way to overturn the law. They sound to me like someone who is hoping he can find a principled way to avoid overturning the law.
03-28-2012 , 10:22 AM
Did all the pundits who freaked out yesterday just miss that second comment? Wow. I mean it's not a slam dunk or anything but I agree it sounds like he's looking for a way to uphold.
03-28-2012 , 10:22 AM
mpethybridge,

I appreciate the work you've done in bringing some legal analysis to this thread, but I have some criticisms of your argument.

You've focused substantially on the idea that, if the individual mandate is considered a constitutional exercise of the Commerce power, it is very difficult (if not impossible) to discern any principle limiting Congress' power to require a person to take market action. Indeed. But I don't see why this is problematic. Conceding, as I must, that the Commerce Clause is a limited grant of power, U.S. v. Morrison, I fail to see why that power doesn't encompass compulsory market activity. Your argument to the contrary is, essentially, a reductio ad absurdum. Surely Congress can't - you seem to be saying - use the Commerce power to require the purchase of a mundane consumer good, such as broccoli.

But why not? The Court has already held that Congress can properly use the Commerce power to limit personal production of wheat as part of a comprehensive scheme to control its price. Wickard v. Filburn. Why couldn't Congress compel you to purchase broccoli if Congress thought there was, for instance, a dearth of interstate trade in produce and considered lowering the price of broccoli by stimulating demand an essential component of encouraging such trade? Here, Congress' goal is to control the national market for healthcare, where it perceives there to be substantial problems of cost growth caused by people's failure to carry insurance.

Last edited by DrModern; 03-28-2012 at 10:29 AM.
03-28-2012 , 10:34 AM
Quote:
Originally Posted by drugsarebad
...

You're not making a Lochner economic liberty argument are you? In an age where the government tells us what we can put in our contracts, what we can buy, what we can sell, what we can rent, etc, the idea that the flag will fall if this law is upheld loses some of its gravity.
I'm a not a lawyer but first of all there are jurisdictional issues with all of these things you mention. To me you're implying that "government" is a ubiquitous entity and it's not in the USA (at least not yet). Second of all regarding all of these to me it's more about what govt says you can't do more than what you must do. Consumers have choices with all of these. Not so much with the way Obamacare is set up. Again I'm a layman but I would think the government would have a much stronger case if a minimum level of coverage was specified rather than you have to purchase this specific coverage more or less.
03-28-2012 , 10:51 AM
Quote:
Originally Posted by miajag
Did all the pundits who freaked out yesterday just miss that second comment? Wow. I mean it's not a slam dunk or anything but I agree it sounds like he's looking for a way to uphold.
I think that the freakout-ery can be explained a few ways.

First, some pundits were probably hoping, or unrealistically expecting, Scalia, Roberts and Kennedy to be outright dismissive of the law's challengers.

Second, because the government went first, the initial hour was spent with the government on the defensive. Scalia, who is ordinarily very active in oral argument, dominated.

Third, pundits overlook - or misunderstand - how some judges (and evidently, this is the style of both Kennedy and Roberts) like to pose questions of both sides, not to express doubt necessarily but to test propositions and sense reactions from their colleagues.
03-28-2012 , 11:27 AM
Quote:
Originally Posted by goofball
I love the slippery slope argument. Because totally, if we let the federal government people prevent people from freeriding the health care system then basically the next thing is they're going to tell you what kind of shoes you're allowed to buy, what kind of haircut you're allowed to get, who is allowed to get healthcare, and eventually Federal agents will just gun down people in the street and there'll be nothing anyone can do.
Yeah, next thing you know the AG will come out and say that 'due process' doesn't mean a hearing in front of a judge.

Oh wait!
03-28-2012 , 11:47 AM
Quote:
Originally Posted by mpethybridge
The primary argument against this slippery slope argument is "oh well, the government would never tell you what food you have to buy, lol, you're seeing monsters under the bed." But do you really think that James Madison and Alexander Hamilton envisioned a government that would dictate the type and content of the insurance policies you'd be forced to buy? I don't think they did. The historical fact is that if you give government a hypothetical power, it will eventually exercise it. There is no better historical example of this trend than the Commerce Clause itself. The Raich decision which 2+2 hates because it is a regulation over your ability to grow and smoke your own pot is an absolutely inevitable result of the Wickard decision that prohibits your ability to grow and eat your own wheat.
Alexander Hamilton literally supported a mandatory payroll tax on all merchant sailors that gave them access to marine hospitals as a response to them having poor healthcare so yes i could indeed see Alexander Hamilton envisioning a government making people buy health insurance.

It was also supported by Adams and Jefferson, fwiw.
03-28-2012 , 11:49 AM
Economist from the Brookings Institute criticizes the Justices' understanding of externalities

http://www.brookings.edu/opinions/20...tus_aaron.aspx

Quote:
Several of the justices, notably Scalia and Alito, responded to the externalities argument by saying that every economic transaction creates similar externalities. "If I don't buy a Volt, I raise the price of Volts," said Scalia. Alito said much the same thing. So did Paul Clement's brief for the plaintiffs.


This response was and is bad economics. It is true that every commodity is produced along what economists call a "cost curve"—raising output may lower average or marginal unit costs by spreading overhead or achieving economies of scale, but it may also raise costs by forcing up the cost of inputs or incurring diseconomies of scale. None of this occasions concerns about fairness or free-loading or, to use the economist's term, "externalities." But the cost shifting that occurs when uninsured patients fail to pay their bills does; it causes one group—the insured—to have to pay part of the cost of services others use.


Perhaps the most glaring instance of the failure to appreciate what an externality really is came from Justice Alito who at one point challenged the solicitor general by positing that the cost of all of the care currently used by those who are uninsured is less than would be the cost of the insurance they would be forced to carry. That being the case, Alito asked, how can one say that the uninsured are shifting costs to the insured? This query is painfully detached from an understanding of what an externality really is, how insurance works, or what the impact of insurance would be on service use.
03-28-2012 , 12:12 PM
NYT editorial today:

Quote:
In ruling on the constitutionality of requiring most Americans to obtain health insurance, the Supreme Court faces a central test: whether it will recognize limits on its own authority to overturn well-founded acts of Congress.

The skepticism in the questions from the conservative justices suggests that they have adopted the language and approach of the insurance mandate’s challengers. But the arguments against the mandate, the core of the health care reform law, willfully reject both the reality of the national health care market and established constitutional principles that have been upheld for generations.

The Obama administration persuasively argues that the mandate is central to solving the crisis in America’s health care system, which leaves 50 million people uninsured and accounts for 17.6 percent of the national economy. The challengers contend that the law is an unlimited — and, therefore, unconstitutional — use of federal authority to force individuals to buy insurance, or pay a penalty.

That view wrongly frames the mechanism created by this law. The insurance mandate is nothing like requiring people to buy broccoli — a comparison Justice Antonin Scalia suggested in his exasperated questioning of Solicitor General Donald Verrilli Jr. Congress has no interest in requiring broccoli purchases because the failure to buy broccoli does not push that cost onto others in the system.

Congress has indisputable authority to regulate national markets and provide for the general welfare through its broad power to tax. Nothing about the mandate falls outside those clearly delineated powers.

In fact, Justice Scalia has, in the recent past, declared Congress’s broad authority under the commerce clause to regulate activities with far less direct economic impact. In a 2005 case upholding a federal law prohibiting the growing of medical marijuana for personal use, he wrote that Congress may regulate even intrastate activities “that do not themselves substantially affect interstate commerce.”

The skepticism of Chief Justice John Roberts Jr. and Justices Scalia and Samuel Alito Jr. was also troubling because it seemed to accept an odd distinction of timing made by the opponents of the law.

Those critics concede that the mandate would be constitutional if it went into effect at the moment an individual actually needed health care. In other words, Congress could require the sick and dying to pay for insurance or for medical services when they show up in the emergency room, but it cannot require precoverage of medical costs through insurance.

The court has no authority under the Constitution to judge the merits or effectiveness of the health care law. That is Congress’s job.

Yet, as Justice Stephen Breyer remarked about the points made by a lawyer for the opponents: “All that sounds like you’re debating the merits of the bill.” To counter the challengers’ claims of alarm over a novel policy, he offered several examples in American history where the court has strongly backed new solutions to major problems, like the creation of a national bank in the early 19th century.

If the Supreme Court hews to established law, the only question it must answer in this case is modest: Did Congress have a rational basis for concluding that the economic effects of a broken health care system warranted a national solution? The answer is incontrovertibly yes.
03-28-2012 , 12:46 PM
There is so much to say on this issue. First, the uninsured only pass costs to the insured so long as doctors are required to treat them. Its also worth noting, the uninsured pay far more for healthcare because they can't negotiate rates (the ones with money at least... and the law only applies to people with money).
03-28-2012 , 12:49 PM
Quote:
In ruling on the constitutionality of requiring most Americans to obtain health insurance, the Supreme Court faces a central test: whether it will recognize limits on its own authority to overturn well-founded acts of Congress.
oh man the nyt is always good for a laugh. The support for the filibuster based on who is in charge is better though.

      
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