Supreme Court Ruling on Health Care

Spun from this thread:

Please remember to charitably discuss the issues, not each other.

Please do not argue with each other.

I disagree with the ruling. I think they were right to strike down the inability to opt out of medicaid without losing existing medicaid support for the reasons they gave, but disagree with the characterization of the penalty (so called in the legislation) for not buying health insurance as a tax and therefore being upheld.

The ruling says that the penalty can be interpreted as a tax on the uninsured. I find this to be a word game that changes nothing. The court ruled that an actual mandate making it illegal not to have insurance would be unconstitutional, in part because it would expand federal power - but allowing a tax on people who refuse to join in a specific activity seems to be nearly as bad. Part of the argument the justices made is that if the law could make refraining from buying insurance illegal, then it could also make it illegal to buy bread or somesuch.

But as things are, what’s to prevent a tax on people who don’t buy bread, to use the justices example? Or a tax on people who don’t join health clubs, or what have you. The idea that the government can lay taxes down on any group that isn’t behaving as it desires seems nearly as problematic to me as the idea that the courts rejected, and in fact nearly identical.

To be fair, the court did say that the reason the penalty (original language) could be construed as a tax is because it is fairly low. I don’t actually know what the number is, but I also don’t see how this makes sense. Why not just make a high tax on people who don’t do ___? So far as I am aware, there is nothing that says that taxes must be low in order not to be considered penalties.

In short, I dislike the idea of taxes targeted at people who aren’t doing something. I can understand a tax on an activity (sales tax, income tax, etc), but a tax on an absence of an activity is, in my view, too much.

Would you say that people are taxed for not having children? People get tax deductions for having them, we could rephrase it to say that people get an extra tax for not having them.

Indeed, I have always preferred to think about this as a tax deduction for people who chose to buy insurance.

Or what if we just let Bush’s tax cuts expire and then offer tax credits to all the insureds?

The math works out to be the same, just expressed differently.

Given that before obamacare, people who bought their health insurance did so with after-tax dollars, while the insurance provided by an employer was a business tax deduction for the business and not counted as income for the employee.

If what you are saying were the case, the government could have easily actually just given a tax break to those who bought their own health insurance. That would have saved all sorts of botheration.

But nooooooo, they had to pass a bill which gave them much more control over us and did *not *solve the problem, which is the high cost of health care.

This may be what they end up with if Romney manages to repeal and replace OC.

And then we’ll have to hope China can lend us the money. :rolleyes:

But it’s not like they haven’t done it before, so it’s not the worst of ideas.

I do not agree with it because people should not be forced to buy something they don’t want, in this case health insurance.

You could argue that numerically a deduction for having children and a tax on not having children is more or less the same, however to do so is to ignore why that deduction exists. I’m going to have to make up some phrases here, but I’m pretty sure the ideas are right even if the phrases aren’t common. Income tax (where that deduction lives) is supposed to take a certain fair portion of a person’s “excess income” income. (We see this because people who don’t make much money are considered not to have enough excess for the government to take any, and so aren’t taxed.) Deductions and the like, especially for having children, are supposed to determine how much of a person’s actual income is excess. The adjusted gross income is adjusted downward so that the percentage taken will be fair. This makes sense because children cost a lot of money.

This is qualitatively different from what is happening with the insurance mandate (though I suppose we should now call it the “insurance definitely-not-a-mandate-at-all-really, you-just-have-to-pay-tax-if-you-don’t” in light of the new ruling).

I just wrote about 5 paragraphs explaining how it was different before I realized that the difference is actually pretty obvious and I doubt that anyone would disagree with it, so I’ll just state it instead: the tax is meant to force people to buy insurance by making it the economically sound choice. Clearly the tax deduction for having children doesn’t do this. I’ll just quote some random website to support this then leave it at that unless someone wants to debate it:

The health care law sets out a formula to determine your penalty, which will be assessed and collected by the IRS as part of your federal income taxes.

The penalty will be the greater of a flat dollar amount per person, OR a percentage of your taxable income. For dependents under 18, the penalty is half the individual amount.

The annual penalty is capped at an amount roughly equal to the cost of the national average premium for a qualified health plan — in other words you cannot be forced to pay more than it would have cost to buy a plan in the first place.

Flat dollar amount for individuals: $95 in 2014; $325 in 2015; and $695 in 2016; increases indexed to inflation after that, subject to a cap.

Percentage of individual taxable income: fixed percentage of household income in excess of tax filing threshold – 1% in 2014; 2% in 2015; 2.5% in 2016.

There are plenty of exemptions from the penalty. You do not face it if your insurance premiums would be more than 8 percent of your gross income, if you’re a member of an American Indian tribe, or if you lacked insurance for less than three months during a year.

The fact that amount changes, the fact that it depends on the number of people dependent on you who are not covered - so that in the deduction view, there is now a tax on having children that goes away if you insure them - and the fact that it is capped near the cost of a health insurance plan, as well as the fact that people automatically get the deduction (in the deduction view) if health insurance would be costly for them and they don’t buy it, all indicate that it would be very difficult to interpret this as anything other than coercion.

I’m really curious as to who those people are who ‘don’t want health insurance’. Would they be willing to carry a medical bracelet saying what to do about their health care if they have an accident and can’t speak?

Don’t get me wrong, I think health insurance is a great idea, and I plan on always having it, and think everyone should if they at all possibly can.

I just don’t like the government coercing people into buying it.

What’s the alternative? Ask nicely and wait interminably while each individual mulls his/her decision? That’s no way to govern.

Is there a good source that explains most of the ramifications of what this healthcare does and how it will impact the lives of individuals.


I agree with mandating that everyone have insurance and that those who refused to have insurance get fined/taxed/penalized/whateveryouwanttocallit. The reason is that so many people (in many cases for reasons completely beyond their control) are drawing from the funds, but are not (for many varied reasons) not putting back into it. By mandating that everyone have insurance, everyone is contributing to the pot.

I am not convinced that this will put an undue burden on the middle or lower class because those who can’t afford to pay for insurance will be offered more affordable options, and even medicaid. Those who can afford it should buy it because they will eventually be drawing from the pot themselves, and it’s quite naive to think they won’t.

I am not convinced that this will lead to more people seeing medical intervention, because those who found it ‘useless to go to the doctor’ are not going to change their mind just because they have insurance.

I agree with the part that mandates all business who meet certain criteria (I think they have to have 50 employees or more?) have to buy insurance for their employees, and I don’t think anyone should be exempt from it. If it’s a mandate made across-the-board, then it’s across the board. But I don’t think this was part of yesterday’s ruling. That will probably be challenged and dealt with later.

Then the hospitals shouldn’t be forced to provide treatment either. Currently there’s an imbalance.

Personally, I think everyone should vote for conservative candidates, that voting for liberal candidates is a bad idea and only ever harmful to the individual and society. I am fairly certain of this. Should I then try to pass a law requiring people to do so, because instead trying to convince people with reason is just “asking nicely” and no way to govern?

The government does not exist to make every important decision for us.

The problem with poeple having the choice to buy into it (or not) is the huge number of those who aren’t buying into it, or who haven’t had a chance to yet, but who are drawing from it. The government is burdened by medicaid and more people simply need to contribute to it. If one is willing to accept it, one should be contributing to it.

If one doesn’t want to buy it, then they should carry some form of ID waiving their rights to medical treatment so they don’t rack up all sorts of bills when life happens and they need medical intervention.

You know, people belly aching about all this can do like the Amish and get together and form a self-sufficient community that neither pays into nor draws from the system. They could do that. I have no idea why they won’t. Life would certainly be a bit quieter…

But why is that? Hospitals shouldn’t be forced to save lives? I strongly disagree. They should be forced to provide treatment regardless of a person’s insurance status or ability to pay. I have been in a situation a few times in the past where I had to go to the hospital and did not have health insurance or a way to pay the bill. Thankfully this thing called claim aid helped me out and paid the bill in full for me.

If you were not able to pay then your state picked up the bill. That’s how it works. Now you will be able to have your own insurance, and if you have financial problems, then you may qualify for a subsidy to pay for your own policy.

Big Point 1: This is about insurance, not the free ride stuff. The insurance companies pay for the healthcare of the insured. The insured who don’t need as much health care cover the costs of those who do. Insurance charges based on the risk of needing healthcare. This works fine.

The problem is that congress has now radically redefined the insurance business. Insurance companies are being forced to ignore the risk of illness. Obviously, this will cause price of insurance to go up for most people because the insurance companies must get the money from somewhere - and if they can’t take less from healthy people and more from unhealthy people, then they’ll take a sort of average from everybody. Unhealthy people would pay less, healthy people more than normal. This would still balance out - it’d have to, prices would change until it would.

However, in the process of balancing out, because health insurance would go up for healthy people, fewer healthy people would find it to be a good plan economically, so they wouldn’t buy it. So the prices would rise. So fewer healthy people would buy it. So prices would rise again. Etc. It would stabilize eventually, but with higher prices.

To try to prevent this, congress has decided that everyone needs to buy it so prices will stay at the lowest of the necessary increases for healthy people. So they have made this necessary.

This has absolutely nothing to do with people not paying in and taking out. Mandated coverage is not meant to solve that problem. And it won’t, because there is an exemption for people for whom health insurance would be extremely costly - the same people who receive the “freebie care” will still receive freebie care without having insurance.

Big Point 2: Providing medical care to people who cannot afford it is charity. If it is necessary that this charity be carried out by the government, then the government should find ways of paying for it that do not infringe upon people’s rights. If it can’t, then it should scrap the program entirely.

You cannot do what is wrong so that good will come from it. Coercing people into buying something should not be done. The government needs more money? Cut costs and raise taxes as required.

I’m not familiar with claim aid. Who pays into that? Would they cover cancer treatments for an extended time? Just asking.

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