Tag Archives: Affordable Care Act

Uninsured in Texas? Try the Federal Government, Says Greg Abbott

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Greg Abbott hosted a forum on his website a few days ago with some policy advisors, and according to Joe Deshotel at Burnt Orange Report, his answers regarding regarding healthcare for the millions of Texans who lack health insurance in the present moment were less than mind-blowing:

To sum it up, Abbott does not support expanding Medicaid or creating and operating our own health care exchange, yet wants more flexibility from the federal government. If you can not afford health insurance, or you don’t have enough to put away in a Health Savings Account, check out the federal government and see what they have to offer! In the meantime the number one campaign issue will continue to be “repealing Obamacare,” and it says so right on his website.

Is anyone surprised by this? You shouldn’t be.

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Corporations Don’t Go to Church

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Rick Santorum was defending the right of self-proclaimed Christian corporations to deny reproductive healthcare coverage because First Amendment:

“I mean, the idea that the First Amendment stops after you walk out of church, that it doesn’t have anything to do with how you live the rest of your life, I don’t know very many people of faith that believes that their religion ends with just worship.”

Someone needs to remind the ex-senator that this whole kerfuffle is about the supposed religious rights of corporations, not individuals. Unless people are attending church services specifically in the capacity of a representative of Hobby Lobby, corporations do not “walk out of church.” I’d say that Santorum doesn’t understand the distinction, but I suspect that he actually just doesn’t care.

He also had some odd words about the imposition of religious values:

“And President Obama is saying, ‘No, once you step outside that church, I get to impose my values on you, your religious values don’t matter anymore, it’s my values that I can impose on you,'” the Pennsylvania Republican continued. “I don’t think that’s what the First Amendment stands for. And I don’t think that’s what the court will say.”

See? It’s freedom of an employer’s religious beliefs, not freedom from an employer’s religious beliefs! I mean, that’s in The Federalist Papers, I think in the footnotes somewhere.

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Generation Opportunity Prepares College Kids for Future Emergency Room Visits

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"Backyard tailgate party" by tobo [CC BY-SA 2.0], on Flickr

Not pictured: The actual Generation Opportunity tailgate party

I have long suspected that much of the motivation behind opposition to the health insurance mandate aspect of the Affordable Care Act comes from an “It won’t happen to me!“ attitude. I never suspected, however that they would actually go and state it as bluntly as Generation Opportunity did last weekend.

The Koch brothers-funded Generation Opportunity — famous for its series of over-the-top advertisements trying to scare young Americans into not buying health coverage through Obamacare’s insurance marketplaces — took its opposition to health care reform to a whole new level on Saturday. The group threw a tailgate party during the University of Miami-Virginia Tech football that featured flashy cars, drinking games, models, a DJ, and plenty of “educational” material about why young people shouldn’t take advantage of Obamacare.

“We rolled in with a fleet of Hummers, F-150’s and Suburbans, each vehicle equipped with an 8’ high balloon bouquet floating overhead. We hired a popular student DJ from UMiami (DJ Joey), set up OptOut cornhole sets, *beer pong tables, bought 75 pizzas, and hired 8 ‘brand ambassadors’ aka models with bullhorns to help out,” wrote David Pasch, Generation Opportunity’s communication director, in en email to the Tampa Bay Times. “*Student activists independently brought (lots of) beer and liquor for consumption by those 21 and over. Oh yeah, and we educated students about their healthcare options outside the expensive and creepy Obamacare exchanges.”

The line of reasoning, as I understand it, is that college-age people tend to have fewer healthcare needs than older people, and therefore do not need the same level of coverage—therefore, they should not have to have health insurance coverage because Freedom. I suppose one could say my bias is showing, but if even one insurance-eschewing kid at that tailgate had drank too much and, say, gotten alcohol poisoning, fallen and sustained an injury, or crashed a car, our great Socialist state requires emergency rooms to provide them with treatment. Guess who pays for it if the student (or more likely the student’s parent[s]) doesn’t have the cash to cover the tab? I guess it’s our patriotic duty to subsidize liberty-loving college kids’ love of liberty. Or not.

Hell, even insurance-eschewing kids who avoid drinking and all other risky activities could still get hit by a car driven by a less-responsible individual, or even by an entirely-responsible individual who has a car accident for a near-infinite number of reasons. Of course, college-age kids never unexpectedly get sick, or for any other reason find themselves in sudden need of healthcare. Or not.

America: We have raised irresponsibility to an art form.

Photo credit: “Backyard tailgate party” by tobo [CC BY-SA 2.0], on Flickr.

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If You Push Hard Enough, Maybe They’ll Finally Send the Black Helicopters

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By Dmitry Pichugin [GFDL 1.2 (http://www.gnu.org/licenses/old-licenses/fdl-1.2.html) or GFDL 1.2 (http://www.gnu.org/licenses/old-licenses/fdl-1.2.html)], via Wikimedia Commons

What is this, Russia? In this picture, yes.

I came across an old complaint about the Affordable Care Act during my Googlings, which criticized a law professor’s attempts to alleviate concerns about the penalty aspect of the individual mandate. Walter Dellinger told the Senate Judiciary Committee back in 2011, according to Ann Althouse:

There’s a misimpression out there that… federal agents arrive in black helicopters dressed in fully equipped armed ninja costumes, kick down your bedroom door and drag you off at the point of bayonets to an insurance agency.

In fact, what — all that happens is that for those who are not otherwise exempted and — when they’re filling out their federal income tax return, if you’re not maintaining minimum coverage, you have to pay an additional 2.5 percent, much less than Social Security. That’s all that happened.

So in that sense, this great intrusion on liberty doesn’t approach any slippery slopes or exceed any understood limits in our legal culture.

The concern seems to be that the government will exercise its police power against people who refuse to cooperate with the insurance mandate, pay the fine, or respond in any way to what the law says. Believe me, I am very sympathetic to the argument that we must be vigilant against expansions of the government’s police power, but this is not one of those instances of government going too far. Besides that, I’ll be more sympathetic to concerns from the right over police overreach when they get more consistent about it. Continue reading →

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You Can’t Argue With Folks Who See a Different Reality Than You

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The following is an excerpt from a conversation between Washington Post reporter Jonathan Capehart and Belmont, NC resident David Jackson:

Capehart: [Y]ou — and correct me if I’m wrong, I’ve been listening to you these last few minutes — you don’t think President Obama loves this country?

Jackson: Not at all. Not one bit, not one breath that comes out of his body.

Capehart: So why would he run for president of a country that he doesn’t love?

Jackson: Because he wanted to change it.

Capehart: And change into what?

Continue reading →

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That Other Time the Heritage Foundation Advocated for Affordable Health Care

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Khan approaching and looking at me

The inventory of Creative Commons images in a search for “Heritage Foundation” is rather small, so this is a picture of a jaguar named Khan from the Wildlife Heritage Foundation. How do you not include a picture of a Jaguar named Khan?

The Heritage Foundation, the conservative think tank that has been on the front lines of recent opposition to the Affordable Care Act (a/k/a “Obamacare”). It has not always been so opposed to aspects of the law like the individual insurance mandate, as it rather strongly supported such an idea way back in 1989. As it turns out, its support for various parts of the ACA was in evidence much more recently.

The “universal health care” that many Republicans have recently touted is formally known as the Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986. In short, EMTALA states that hospitals accepting payment from federal programs, including Medicare and Medicaid, cannot deny treatment to a person due to inability to pay or insufficient insurance coverage, if that person is experiencing an acute medical emergency. The government does not directly cover the costs of care required by EMTALA, meaning that the costs either get unloaded as tax write-offs for bad debt, or they are covered by higher hospital costs charged to other patients and private insurers. EMTALA had the best of intentions, but it has had the effect of shifting the costs onto other private actors, not the public. Although the Tea Party has tried, no one has ever seriously argued in recent years that people should not have access to acute care because of a lack of ability to pay. It’s a fundamental human decency thing, at least in my opinion.

The Heritage Foundation generally agreed with these sentiments, i.e. that EMTALA had good intentions but caused many problems, as recently as 2007, and their analysis and recommendations included features now found in the Affordable Care—sorry, Obamacare that they so vehemently oppose all of a sudden. Back in July 2007, John S. O’Shea, M.D., a Health Policy Fellow at The Heritage Foundation’s Center for Health Policy Studies, wrote the following:

The Emergency Medical Treatment and Active Labor Act (EMTALA) is another example of federal legislation that hurts the very people that it was meant to protect: low-income patients in need of emergency medical services. Enacted in 1986, the law is a con­gressional response to well-publicized cases in which patients were refused immediate medical treatment based on their inability to pay. Continue reading →

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Health Insurance is Not Being “Forced on You,” but Your Health Care Might Be Forced on the Rest of Us

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By Thierry Geoffroy (Thierry Geoffroy) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia CommonsThe individual insurance mandate originated as a conservative, free-market alternative to the single-payer system, with the significant support of the Heritage Foundation, and it was one of the signature achievements of Romney’s term as MA governor. It acknowledges that health insurance should principally be an individual and family responsibility, not something employers should be required to provide en masse, and it takes into account the fact that a person who declines to obtain health insurance becomes a drain on society when they become sick or injured. Republicans, and conservatives in general, were mostly on board with it until the instant that President Obama supported it.

So please, spare us the “forced upon people” *%#@*!#. People who refuse to obtain health insurance because of liberty, if they are otherwise able to do so, ought to agree in advance to decline all health care that they do not pay for out-of-pocket. Otherwise, they are the drain on society, because many hospital emergency rooms cannot turn them away for inability to pay for services. This means that, if you are in a traumatic accident, have no health insurance, and don’t have enough cash on hand to pay for the emergency room, you agree in advance that you’re probably going to die and the taxpayers are not going to help you. You should probably wear a wristband or something so people will know that you do’t want to participate in the social contract.

Here’s the thing, though. If a person refuses to obtain insurance because they think that the individual mandate infringes upon their freedom to do…..whatever it is they think is being infringed, I would still support them receiving medical care in the emergency room regardless of their ability to pay. I would support this because I am not a monster. I just wish that those people would have the courage of their convictions and agree to risk dying rather than accept the government-mandated healthcare that is (to them) such obvious tyranny.

Photo credit: By Thierry Geoffroy (Thierry Geoffroy) [CC-BY-SA-3.0], via Wikimedia Commons.

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That Time the Heritage Foundation Promoted the Individual Mandate, Citing “an Implicit Contract Between Households and Society”

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Stuart Butler publicity shotIf you have the means to purchase insurance for yourself, but refuse to do so because freedom, the taxpayers of the U.S. will  foot the bill to treat you for catastrophic injuries, because we are fundamentally a decent people. Don’t take my word for it, though. The Heritage Foundation said so back in 1989, when its Director of Domestic Policy Studies, Stuart M. Butler, Ph.D., promoted the idea of an individual health insurance mandate:

Many states now require passengers in automobiles to wear seatbelts for their own protection. Many others require anybody driving a car to have liability insurance. But neither the federal government nor any state requires all households to protect themselves from the potentially catastrophic costs of a serious accident or illness. Under the Heritage plan, there would be such a requirement. This mandate is based on two important principles. First, that health care protection is a responsibility of individuals, not businesses. Thus to the extent that anybody should be required to provide coverage to a family, the household mandate assumes that it is the family that carries the first responsibility. Second, it assumes that there is an implicit contract between households and society, based on the notion that health insurance is not like other forms of insurance protection. If a young man wrecks his Porsche and has not had the foresight to obtain insurance, we may commiserate but society feels no obligation to repair his car. But health care is different. If a man is struck down by a heart attack in the street, Americans will care for him whether or not he has insurance. If we find that he has spent his money on other things rather than insurance, we may be angry but we will not deny him services – even if that means more prudent citizens end up paying the tab. A mandate on individuals recognizes this implicit contract. Society does feel a moral obligation to insure that its citizens do not suffer from the unavailability of health care. But on the other hand, each household has the obligation, to the extent it is able, to avoid placing demands on society by protecting itself.

(Emphasis added.)

Here’s a PDF copy of the lecture (source), in case the HTML page goes away.

Photo credit: By Stuart Butler [CC-BY-SA-2.0], via Wikimedia Commons.

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My First Thoughts on the Supreme Court’s Health Care Decision

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Last week, House Majority Leader John Boehner issued a plea to Republicans et al not to “spike the ball” should the Court strike down the law. It was a magnanimous, if futile gesture. Rush Limbaugh, never letting an opportunity to issue jowly gloats slide, admonished his followers to keep doing what they do best (i.e. commit mass asshattery). Here is what I imagine their ball-spiking party looks like today:

1241261617_football-fail(Source: GIF and video)

I’m surprised, first of all, at the way the vote split. The opinion just posted to the Supreme Court’s site, and I have not had a chance to read all 193 pages (go figure). I’m uploading a copy of the opinion below, if anyone wants to indulge.

Treating the individual mandate as a tax is an interesting outcome. I thought the Commerce Clause arguments were pretty solid, given precedent (stare decisis: look it up and explain it to Justice Scalia, please.)

At the moment, I doubt anyone outside the court itself has read the opinion, unless they have mad speed-reading skillz. It will be several days before there is any meaningful analysis or commentary. I will be ignoring the media drivel. If I can get around to it, I’ll delve into the topic some more.

Opinion of the Court, National Federation of Independent Business v. Sebelius, Supreme Court of the United States, June 28, 2012

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