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Archive for Friday, August 12, 2011

Federal government pledges more money to $31.5-million health insurance program Gov. Brownback rejected

August 12, 2011

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— The federal government on Friday announced the award of $185 million in grants to states to help set up health insurance exchanges — a process that was thrown into limbo in Kansas after Gov. Sam Brownback this week rejected a $31.5 million grant to work on establishing an exchange.

In a conference call from Washington, D.C., U.S. Department of Health and Human Services Secretary Kathleen Sebelius said the new round of grants would go to 13 states and the District of Columbia for the exchanges — one-stop shops where consumers can search for the best insurance policy for their needs. Kansas was not among the group. The exchanges are part of the federal health reform law and are scheduled to be in place in 2014.

In February, Kansas had been awarded a $31.5 million “early innovator” grant to start work on the health insurance exchange. But on Tuesday, Brownback, a Republican who had earlier signed off on the grant, rejected it, saying there were too many strings attached and too many unknowns about future federal funding.

Sebelius, a Democrat, did not address Brownback’s rejection in the teleconference, but maintained that states had been given leeway in implementing the exchanges to tailor them to their needs.

As a former governor, insurance commissioner and legislator in Kansas, Sebelius said, “I know the importance of letting states lead.”

But Lt. Gov. Jeff Colyer, Brownback’s point man on health issues, said one of the reasons Brownback rejected the federal grant was because of concerns about federal budget cuts.

“We have great concerns that in the long run there may not be the money there,” he said.

He said if there is an exchange in Kansas “the Legislature needs to pass a bill.”

Sebelius said the health insurance exchanges will increase competition between health insurance companies and that will result in better rates and policies for individuals and small businesses.

Sebelius and IRS Commissioner Doug Shulman also released proposed rules on tax credits to help people buy private insurance, and procedures to check income and eligibility.

Brownback has been praised by those opposed to the new health reform law for rejecting the grant, but others have questioned the wisdom in turning down the funding.

Kansas Insurance Commissioner Sandy Praeger, a Republican, said Brownback’s action represented a “missed opportunity.”

The ultimate fate of the Patient Protection and Affordable Care Act will probably rest with the U.S. Supreme Court.

On Friday, an Atlanta appeals court ruled that the requirement that nearly all Americans have health insurance or face a penalty is unconstitutional. But the panel upheld other parts of the law. And in June, an Ohio appeals court upheld the entire law.

Kansas was one of 26 states that joined the legal effort against the law in the Atlanta court.

Attorney General Derek Schmidt, a Republican, said, “For the first time, a federal appeals court has declared that this law requiring Americans to purchase a product or face a penalty exceeds the power granted by the Constitution to our federal government.

“The Constitution created a federal government of limited, enumerated powers and did not grant to the federal government an unlimited general police power to do whatever it wishes.”

He said the appeals court decision “makes Supreme Court review of the law almost certain.”

Comments

blindrabbit 3 years ago

The pied piper leads Kansans to Brownbackistan!

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chootspa 3 years ago

It's not almost dead, silly. It's only the mandate that's in question. The health exchange portion is still there.

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jafs 3 years ago

But without the mandate, the costs will likely skyrocket, since we're not increasing the risk pool to include young healthy folks who pay more in than they take out.

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chootspa 3 years ago

Indeed. But Brownie is still legally compelled by the rest of the law.

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Clinton Laing 3 years ago

Sorry, chootspa, this is just a bribe (with money the Feds don't even have to spend!!!) to get states to fall in line, or to undermine the support of states already suing the Feds.

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chootspa 3 years ago

Ah yes, a bribe of jobs in order to enact legislation that could lower our health care spending. I can see why our wise leader decided we'd rather have fewer skilled jobs and more expensive health care.

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fan4kufootball 3 years ago

Without the individual mandate then the whole plan is flawed. Since the plan does not allow insurance companies to deny pre-existing conditions then everyone will wait till their sick or have an accident to buy coverage. Therefore you only have people buying coverage that already have an illness or physical ailment buying insurance. See the problem? Insurance rates would be so high that NO ONE could afford them. If you take out the individual mandate then you also have to take out the provision that insurance companies must cover pre-existing conditions.

Look at if from the auto insurance world. If everyone was allowed to only buy insurance after they had an accident.....

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jafs 3 years ago

Well, there's be some incentive to get insurance before that, since the rates would be lower then.

But without the young healthy people in the pool, rates would be higher.

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chootspa 3 years ago

I'm not arguing that point. The true savings may be gone (if SCOTUS upholds the ruling), but the law is not, and Brownie still missed a chance to employ Kansans without raising taxes.

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wolfy 3 years ago

The individual mandate was a legislative compromise given to the health insurance industry. Without the mandate, the consumer protection provisions would be cost prohibitive. Everything will come down to the "severability" issue, i.e., whether the mandate can be struck without invalidating the entire act. Ironically, if the Surpeme Court severs the mandate, leaving everything else in place, that may only hasten the demise of private insurance.

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chootspa 3 years ago

The appeals court ruled that it was severable, and my understanding is the only point that would be heard by SCOTUS would be the mandate.

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mickeyrat 3 years ago

"This is a huge victory for business and should spark great optimism."

Great! And no new taxes? Now the "job creators" will start hiring like mad? Yeah, keep drinking that tea.

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raw 3 years ago

You are correct, defeating health care reform is a big win for business. But taking away health insurance is in no way a big win for those in need.

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Godot 3 years ago

I am waiting for the class action suit that alleges discrimination with regard to the waivers.

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skinny 3 years ago

Federal appeals court deals a blow to President Obama's health care law, ruling that the individual mandate is unconstitutional!! Told ya so!!!

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just_another_bozo_on_this_bus 3 years ago

And another appeals court has ruled the opposite way, meaning that it'll be up to the SCOTUS to decide this matter.

Interestingly, it's only the mandate that everyone must buy insurance that has been declared unconstitutional. That's the provision that got the insurance companies to sign off on Obamacare. So don't be surprised if the Supreme Court rules in favor of the mandate.

After all, it's Republican-dominated court, and Republicans generally do exactly what their corporate masters tell them.

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jafs 3 years ago

Unless there are regulations capping premium costs, insurance companies will just raise their rates significantly, if they can't include young health people in the risk pool.

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Jimo 3 years ago

It's always been perplexing the focus on the ACA mandate given that the mandate to buy insurance is not critical to the reforms.

Without any mandate, the ACA just covers less people, making it an even more conservative, incremental reform than it already is. (Despite unrelenting propaganda to portray it as 'socialized medicine' it is a market scheme to provide private sector solutions to public problems.)

What's more, there are plenty of ways to cut off free riders. Open enrollment periods with steep penalties for enrolling outside the "window." Requiring enrollment as a condition for a host of government services, every thing from food stamps to small business loans. Or you could just raise taxes and then offer tax credits back to those who document that they bought health insurance. Etc., etc., etc.

Like much of the loopy right these days, they confuse winning battles with winning the war. Even if the SC were to strike down this mandate (unlikely), it is of little practical consequence to the implementation of the ACA and constraint of unsustainable, inefficient, and out of control health care expenses in this country.

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jafs 3 years ago

I strongly disagree with that.

The most clear part of the ACA that reduces costs is the mandate, without which, given other requirements, like not rejecting people with pre-existing conditions, insurance premiums will go up, not down.

And, that is the part which is debatably unconstitutional.

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Jimo 3 years ago

You disagree with what?

My point is that there are plenty of ways of dealing with the free-rider program, the mandate being just one.

Nothing in your comment contradicts or addresses that. You seem to have avoided my comment and come back with free-rider solution = mandate, no mandate then free-rider kills affordability. Perhaps you only skimmed my comment and missed the point?

You correctly identify the free-rider problem as an issue. But you're overly focused on the one part of the larger solution at hand. And seem, still, unaware that there are a variety of alternatives available.

It's difficult to see the forest when you're standing an inch away from a single tree. Pick one of the several I mentioned (there are others) and focus on how that would work as a different way of controlling free-riders. Perhaps the enrollment window system.

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jafs 3 years ago

It's not about 'free riders" - it's just the math.

"the mandate to buy insurance is not critical to the reforms" is the part I disagree with.

Are there other ways to reduce costs? Sure, but they're not in there.

Keeping the costs down is being done by the mandate, and is thus critical to the reforms, given that the reforms involve increasing costs to insurance companies.

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jafs 3 years ago

And, again, the reason it's being focused on is the question of constitutionality.

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theoljhawk 3 years ago

Oh man here we go again with all the comments.......

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Mike Ford 3 years ago

article one section eight part three of the us contitution...the commerce clause... as a Choctaw Indian I know this clause by heart...congress shall regulate commerce between the foreign nations, the several states, and the indian tribes. buying and selling insurance is a commerce regulated by whom??? the federal government. aren't each of the fifty states dependant sovereigns of the federal government as stated by justice john marshall in the worcester v georgia supreme court case? stupid stupid country full of stupid people. this court was in georgia one of the bastions of the state's rights stupidity that stems from the us civil war and the battle over civil rights in the 1960's. if one wants to be one of these tea party dimwits declare your neighborhood a sovereign entity like peter griffin on family guy when he created peteopia. why don't the clowns try and secede and carry on their stupid temper tantrum??? I pay state farm for car insurance so that no one is left with unfixiable damage. everyone should pay for insurance so that hospitals don't have to charge us more because some people don't or can't pay for hospital services. what a bunch of disconnected and deceived dimwits in kansas and other rural areas.

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Betty Adema 3 years ago

Hmmm ... calling people stupid, clowns, and dimwit. Can we classify that as emotional damage? Maybe we should be required to purchase insurance so emotional damage is "fixiable."

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Lana Christie-Hayes 3 years ago

and so are you.. if you dislike the fact that differences of opinion are what this country is about, and you think this country is full of "stupid" people!

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this_guy 3 years ago

not stupid people ....but very selfish......and why not stepping on others is the way it works ..but if we can stop reproducing so much it would help health care is expensive and the doctors and nurses have families to feed also

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grammaddy 3 years ago

medicare/medicaid for all.

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Joe Hyde 3 years ago

$31.5 million in federal funds could have outfitted a fair number of currently jobless Kansans with decent-paying jobs relating to health care.

Even if they proved to be temporary, those jobs and the services delivered could have financially benefitted many Kansans for at least some small period of time -- even if the "Obamacare" critics realize their antisocial fantasy of killing public health care.

Hard times be hittin' Kansans. Where's the logic in refusing $31.5 million -- money that, once distributed, puts a hot dog next to the beans?

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Godot 3 years ago

riverat, you have exposed the fraud at the center of the Obamacare exploit. As Speaker Nancy Pelosi said, "We must pass the bill so we can know what is in it." Now that it has passed, and we have learned what is in this monstrosity, we must amputate and cauterize it before it rots us from within.

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jafs 3 years ago

That's an inaccurate, and incomplete quote.

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Mike Ford 3 years ago

cheeseburger, did you know the commerce clause verbatim???? do you study the law or are you like the rest of the dimwits who claim to vote for people who are strict constitutionalists who don't know diddly squat about the law other than what the Koch Brothers tell them to know...why do you champion stupidity???? this country is about championing angry and dumb and attacking smart people... keep attacking me like notleft_notright you actually think you can make up your own facts like any smart Michelle Bachmann wannabe ??? man you republicans champion dummies....

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Richard Heckler 3 years ago

Improved Medicare Single Payer Insurance for All is the solution.

  • Easy to Implement: Medicare has been in existence since 1966, it provides healthcare to those 65 and older, and satisfaction levels are high. The structure is already in place and can be easily expanded to cover everyone.

  • Simple: One entity – established by the government – would handle billing and payment at a cost significantly lower than private insurance companies. Private insurance companies spend about 31% of every healthcare dollar on administration. Medicare now spends about 3%.

  • Real Choice: An expanded and improved Medicare for All would provide personal choice of doctors and other healthcare providers. While financing would be public, providers would remain private. As with Medicare, you choose your doctor, your hospital, and other healthcare providers.

  • State and Local Tax Relief: Medicare for All would assume the costs of healthcare delivery, thus relieving the states and local governments of the cost of healthcare, including Medicaid, and as a result reduce State and local tax burdens.

  • Expanded coverage: Would cover all medically necessary healthcare services – no more rationing by private insurance companies. There would be no limits on coverage, no co-pays or deductibles, and services would include not only primary and specialized care but also prescription drugs, dental, vision, mental health services, and long-term care.

  • Everyone In, Nobody Out: Everyone would be eligible and covered. No longer would doctors ask what insurance you have before they treat you.

  • No More Overpriced Private Health Insurance: Medicare for All would eliminate the need for private health insurance companies who put profit before healthcare, unfairly limit choice, restrict who gets coverage, and force people into bankruptcy.

  • Lower Costs: Most people will pay significantly less for healthcare. Savings will be achieved in reduced administrative costs and in negotiated prices for prescription drugs.

http://www.healthcare-now.org/

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Richard Heckler 3 years ago

How much is the sick U.S. health care system costing you? http://www.dollarsandsense.org/archives/2008/0508harrison.html

IMPROVED Medicare Single Payer Insurance for ALL would cover every person for all necessary medical care 24/7 to include: * prescription drugs • hospital • surgical, • outpatient services • primary and preventive care • emergency services, • dental • mental health • home health
• physical therapy • rehabilitation (including for substance abuse), • vision care, • hearing services including hearing aids • chiropractic • durable medical equipment • palliative care • long term care

No deductibles No Co-pays

A family of four making the median income of $56,200 would pay approximately $2,700 a year in payroll tax for all health care costs.

Allow IMPROVED Medicare Single Payer Insurance for ALL be made available to all taxpaying consumers and business then let them make the choice. The mechanism is in place as we speak.

Health care in and of itself would remain a private industry however IMPROVED Medicare Single Payer Insurance for All leaves choice of doctors,clinics,hospital and services across the board to the consumer.

http://www.healthcare-now.org/

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skinny 3 years ago

It is not the role of the Government to provide you, the people with Health Insurance!

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jafs 3 years ago

I assume you will not be using any Medicare benefits when you retire then.

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Jimo 3 years ago

Yes, always amazing that the ideologues decry regulatory reform of private, market health care as "socialism" but are determined to suck at the teat of an actual public socialized medicine scheme (Medicare)!

But only in America does everyone (except the Unabomber and the occasional Neo-Nazi forest dwellers) participate in endless governmental assistance programs --- and yet turn around and whine that they personally don't benefit from any government programs.

Look at Marcus Bachmann for instance - bills (some say defrauds) Medicare and Medicaid, buys a house with government subsidies, wife benefits from student loans, wife "works" for IRS while taking advantage of gov't mandated maternity leave for 1/2 her career, wife collects paycheck directly from the U.S. Treasury, wife gets health care provided by taxpayer, wife gets pension plan provided by taxpayer, wife's family collect hundreds of thousands in ag welfare. And yet the Bachmann's--always in the context of talking about other people--talk about how we have to get people to stop relying on gov't!

It's not the Tea Party so much as the Chutzpah Party.

Preventing health care spending from bankrupting this country isn't just a proper role of government but a core responsibility.

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jafs 3 years ago

It's a strange contradiction.

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chootspa 3 years ago

That's pronounced "chootspah party." And yes, Michelle Bachman luuurves her some government teat sucking when she's not complaining about other people doing it.

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CountyResident 3 years ago

Then why is it the hospitals responsibility to care for everyone that shows up at it door seeking medical care. Lawrence Memorial Hospital charges off millions of dollars every year for treating patiences that cannot pay. Guess what, its not free. Everyone of us make up that loss. Either by paying more to the hospital directly or thru high health insurance premiums.

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coloradoan 3 years ago

If it wasn't Sam telling us that the government should not provide us with health care, at the same time he and his family are collecting ag subsidies, and while Sam is on the best health care plan taxpayers can provide, well then we might have a starting place for a discussion of the role of government. But as it is, the stated position of skinny and Sam, and others, is absurd.

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Richard Heckler 3 years ago

The Brownback and his soldiers are lying to Kansas.

Sandy Praeger got duped by Brownback during the campaign. Sam Brownback will be having a RINO run against Sandy Praeger at first opportunity. RINO's run against democrats and republicans on their platform of deception.

Sandy Praeger is an endangered species aka true republican.

STOP electing RINO’s ! My My father in law left the RINO party because he is a fiscal conservative socially responsible republican with at least 50 years under his belt. Evermore stunning he is working with the democrat party in Pennsylvania.

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Richard Heckler 3 years ago

Our government has been providing Iraq people with health care since Bush/Cheney why not americans?

The government would NOT be providing me or anyone else with health insurance. OUR TAX DOLLARS would be paying for OUR health insurance thus bringing OUR tax dollars back home to OUR local economy!

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Flap Doodle 3 years ago

"...And there is another type of Caps Lock user who doesn’t capitalize whole sentences but INSTEAD capitalizes a few SPECIFIC words for EMPHASIS. Now read a sentence like that aloud, shouting every time you come to a capitalized word, and tell me you do not sound like an absolute freakin’ lunatic. This method can turn even basic known facts into crazy-sounding gibberish (“The SQUARE of the HYPOTENUSE of a RIGHT triangle equals the SUM of the squares of the OTHER two sides”)..." http://pajamasmedia.com/blog/tips-for-not-appearing-crazy-on-the-internet/

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Jimo 3 years ago

You know, only a fascist would attempt to police the use of capital letters in other people's comments.

Does the writer have a point? Yes. Is the reader able to discern that point? Yes. Emily Post says: Approved.

Move on to yelling at those darn kids to get off your lawn.

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Mike Ford 3 years ago

turn down the volume of tea party and republican ignorance.... they have no platform except the stuff they make up debating each other in Iowa and lie, smear, and practice lots of coded racism. Look on Yahoo for all of the stupid racist comments attached to their stories on the internet. Time to call bs on this koch/gop/tea party idiocy.

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Cait McKnelly 3 years ago

Just to let ya know, I voted for Voldemort. He would have made a better governor.

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Lawrence Morgan 3 years ago

I think Merrill has some really good comments, and she has looked up much of this in great detail.

Skinny, just wait until you really get sick. What are you going to do? Go to the hospital and let someone else (the taxpayers) pay for it? Unless you are one of the few who have trust funds???, in which case you wouldn't care about anyone else but yourself.

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Joshua Montgomery 3 years ago

I am going to stick to my policy of buying insurance from whoever knocks on my door.

If they look honest, are wearing a tie and have a good haircut, that is enough for me.

Acme Insurance Co. of Delaware. Heard of them? I've never filed a claim, but I am certain they will stand by me. The salesman said so.

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KS 3 years ago

And just where do you folks all plan to get the money to pay for all of this? Don't look to the Federal Govt. They are BROKE! Someone earlier said there are a lot of stupid folks out there. Quite true. If is were against the law to be stupid, half of Lawrence would be behind bars by now. It is up to you to decide which half you are in.

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thebigspoon 3 years ago

Look, dufus, the money was already here, ready to create a workable plan of insuring all state citizens. Why do you not understand that? Because you refuse to look at facts,. just as do Brownback, Koch, and all like you and them. It's more important to you to put down the current president than to look past your petty, unthinking, unfounded lies, than to look at what can be done. Maybe there would not have been any more "seed" money, but the state could have done something useful with what was there. Get a grip and look at practical, "right now" matters and maybe you'll be able to see that Brownback has quashed another in a long line of programs that would have, at the very least, gone a ways toward making this a safe, sane state for its citizens.

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CountyResident 3 years ago

The Federal Govt. is not BROKE.

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Jimo 3 years ago

Ditto. The federal government not only isn't broke but can't be broke.

We can, however, refuse to collect taxes from the wealthy and then need to raise it from somewhere else.

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Richard Heckler 3 years ago

Moreover, Medicare tax dollars also pay for critical elements of the health care system apart from direct care.

Medicare funds much of the expensive equipment hospitals use, for instance, along with all medical residencies.

All told, then, tax dollars already pay for at least $1.2 trillion in annual U.S. health care expenses. Since federal, state, and local governments collected approximately $3.5 trillion in taxes of all kinds—income, sales, property, corporate—in 2006, that means that more than one third of the aggregate tax revenues collected in the United States that year went to pay for health care.

Recognizing these hidden costs that U.S. households pay for health care today makes it far easier to see how a universal single-payer system—with all of its obvious advantages—can cost most Americans less than the one we have today.

Medicare Insurance must exist in the fragmented world that is American health care—but no matter how creative the opponents of single-payer get, there is no way they can show convincingly how the administrative costs of a single-payer system could come close to the current level.

More on this matter: http://www.dollarsandsense.org/archives/2008/0508harrison.html

Bring On IMPROVED Medicare Single Payer Insurance for ALL http://www.healthcare-now.org/

Physicians for a Single Payer National Health Program http://www.pnhp.org/

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Mike1949 3 years ago

I don't see why the government can't provide an option to buy insurance. You think Medicare is free right now? If so, I should get all that money back that I pay per month!

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just_another_bozo_on_this_bus 3 years ago

The public option was torpedoed early on-- insurance companies don't want sensible, affordable alternatives to their overpriced rip offs.

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Flap Doodle 3 years ago

There's a blast from the past. merrill had taken his medicare for all post out of the heavy rotation for a while.

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fan4kufootball 3 years ago

Without the individual mandate then the whole plan is flawed. Since the plan does not allow insurance companies to deny pre-existing conditions then everyone will wait till their sick or have an accident to buy coverage. Therefore you only have people buying coverage that already have an illness or physical ailment buying insurance. See the problem? Insurance rates would be so high that NO ONE could afford them. If you take out the individual mandate then you also have to take out the provision that insurance companies must cover pre-existing conditions.

Look at if from the auto insurance world. If everyone was allowed to only buy insurance after they had an accident and yet expect to be covered for that accident.......

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Jimo 3 years ago

Errr...no. See post above noting multiple alternative approaches. Individual mandate is just the simplest and most direct means of achieving universal insurance.

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jafs 3 years ago

It's also the easiest way to keep premium costs down.

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Jimo 3 years ago

I don't know about easiest. Rather one easy means among several choices that was chosen for a variety of reasons.

An easier method it seems to me would be to require health insurers to provide an end of year tax document to each policy holder, that is then attached to your tax return to collect your refundable tax credit (say, $2,000). I would expect those who "refuse to participate" by not buying insurance to be 1-2% of the population and those refusing to collect the tax credit would be 0.01% - nearly universal coverage, which is the goal.

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jafs 3 years ago

That would require the government to manage the analysis, and refund of that credit, which is undoubtedly more complicated than just requiring people to buy health insurance.

And, my father in law, who is a big proponent of the ACA, routinely refers to the mandate as a cost reducing measure, not a "universal care" measure.

He readily grants that there are people, like young people from the ages of 20-35 or so who don't really need insurance and have low health care costs they can pay for themselves, but that the mandate enlarges the risk pool, and keeps premiums down.

As somebody who didn't have health insurance when I was younger, and didn't really need it, I completely agree with him. I had very low health care costs, all of which I paid for out of pocket.

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Jimo 3 years ago

"That would require the government to manage the analysis, and refund of that credit, which is undoubtedly more complicated than just requiring people to buy health insurance."

True, but: A. The gov't already has that infrastructure. It's called the IRS, a part of the gov't that has a significant positive multiplier to budget dollars invested (something Michele Bachmann should know). B. Regardless of cost, our experience with military health care and Medicare show that gov't can deliver any program for less that private industry, with its need for marketing and profit, can.

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Flap Doodle 3 years ago

Nice photo of Kathy doing the zombie-hand.

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weeslicket 3 years ago

asking for some information, please: A. when i look at various health insurance carriers, they are almost always: 1. corporations; 2. that sell products across the entire nation; 3. and sometimes sell products globally. how is this not interstate commerce?

B. while i understand the complaint that this legislation is "coercive"; how is this coercion different from, say: federal income taxes; or registering for the draft; or withholding federal highway funds unless the state drinking age is set to 21; or sending national guardsmen to escort schoolchildren; etc. ?

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jafs 3 years ago

As far as I know, most, if not all, insurance policies are bought intrastate.

The idea of regulating interstate commerce, as I understand it, is for the federal government to be able to provide some sort of equal ground for states that want to do business with each other.

That's quite a bit different from requiring us all to buy health insurance.

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Jimo 3 years ago

No.

A. There is not an "intrastate" economy. In anything. As multiple parties have learned the hard way in court over the years. (I think right now there are some gun nuts trying to evade all federal regulation by manufacturing firearms in Montana and only selling to Montana residents. They'll lose too.) Indeed, frankly, there are only a narrow number of areas in which there isn't a global economy at work - even the "buy local" ones. Buying a strawberry from a farmer in Eudora has an affect on a farmer in Chile; likewise, not buying a strawberry at all. B. Focusing on health insurance is too small a vision. The relevant market is health care, of which health insurance plays only a supporting if important role. Health care makes up 1/6th of the entire economy. If it isn't interstate commerce then nothing is. C. Interstate commerce has nothing (more accurately very little) to do with "states that want to do business with each other" but rather individuals who engage in commerce within a market. One engages in that market (as in any market) either positively, by buying and selling within it, or negatively, by not buying or selling within it. Either positive or negative choice affects the health care market - the demand for health care, the supply of health care, the prices and terms at which health care products and service are offered or even exist. In other words, everything that Congress might want to regulate in any market.

So, the market is health care, with a time period of a human life time. The only person who can truthfully say that they will never positively participate in that market is a dead person. Of the living people, 99.99% will positively participate in the health care market this year (let alone future years), even if they don't buy health insurance this year (let alone future years). Congress is free to regulate that market if it chooses. The only issue in the court case this week was the mechanism used to require self-provision for the all but unavoidable participation.

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jafs 3 years ago

That broad an interpretation of the ICC gives the federal government the power to regulate all individual purchases of just about anything.

I find it hard, if not impossible, to believe that was the intention of that clause.

If the government wants to regulate parts of health "care" that exist in interstate forms, that might be a little different. But forcing everybody to buy health "insurance", when we don't even buy health insurance across states, seems like quite an overreach to me.

It's the same broad interpretation that allows the federal government to prosecute people for growing marijuana for their own use in states which have legalized it - is that also ok with you?

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Jimo 3 years ago

"I find it hard, if not impossible, to believe that was the intention of that clause."

And yet the very first decision in 1824 of the U.S. Supreme Court on the Interstate Commerce cause found the Supremes disagreeing with you, saying:

"What is this power? It is the power to regulate, that is, to prescribe the rule by which commerce is to be governed. This power, like all others vested in Congress, is complete in itself, may be exercised to its utmost extent, and acknowledges no limitations other than are prescribed in the Constitution....If, as has always been understood, the sovereignty of Congress, though limited to specified objects, is plenary as to those objects, the power over commerce with foreign nations, and among the several States, is vested in Congress as absolutely as it would be in a single government, having in its Constitution the same restrictions on the exercise of the power as are found in the Constitution of the United States. The wisdom and the discretion of Congress, their identity with the people, and the influence which their constituents possess at elections are, in this, as in many other instances, as that, for example, of declaring war, the sole restraints on which they have relied, to secure them from its abuse."

SO --- "complete in itself" "may be exercised to its utmost extent" "acknowledges no limitations" "the wisdom and discretion of Congress [are] the sole restraints to secure from abuse"

Might I suggest that a "broad" interpretation is the only one available?

"gives the federal government the power to regulate all individual purchases of just about anything."

Bingo.

That's sort of the point of our Constitution replacing the previous Articles of Confederation, where Congress did not have broad power.

I think we all learned something today about the Interstate Commerce clause: (1) It is so broad that the difficulty is dreaming up scenarios where Congress can't regulate. (2) It has been so since at least 1824 (what Michelle Bachmann calls "Founding Father" territory). (3) In addition, that Congress has not up to now chosen to so regulate tells you nothing about whether Congress retains the latent power to regulate. Many a losing party to a federal lawsuit has made that error and regretted it. (4) Absent an specific prohibition, Congress has power to enact "all necessary and proper" means of carrying out any of its functions in virtually any manner it sees fit and without unelected judges second-guessing the weighing and balancing of competing interests that are the province of the legislative branch.

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jafs 3 years ago

If you were correct, there'd be no discussion and debate about the use of this clause. It would be self-evident that the "broad" interpretation is correct.

There must be more to the story than that.

So you like the marijuana example too? No problem there?

"to regulate, to prescribe the rule by which commerce is to be governed" is perhaps not synonymous with requiring that an individual buy a given product.

That sound much more like what I meant - the rules of commerce between different states.

I'll have to look up the ICC, and post it here.

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jafs 3 years ago

"The Congress shall have power to regulate commerce with foreign nations, and among the several states, and with the Indian tribes".

Dispute exists as to the range of powers granted to Congress by the ICC.

Clearly, "regulating commerce among the several states" is not immediately synonymous with forcing me to buy health insurance.

Since the Gibbons decision, the SC has held that "Congress may regulate only those activities within a state that ... substantially affect interstate commerce".

An individual growing marijuana for their own use in their backyard in a state in which it is legal doesn't seem to me like an activity that substantially affects interstate commerce.

And, my choice to buy or not buy health insurance in a given state doesn't seem like it does either - where's the "substantial" effect on interstate commerce there?

The first source I found was Wikipedia - I could look for others if you like.

The issue is clearly not as obvious and self-evident as you believe it is.

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Jimo 3 years ago

Really?

May I direct you to Wickard v. Filburn, a SC case from 1942.

Basic facts: Farmer Filburn grew wheat to be consumed on his own farm. The Feds however had in place a program limiting how much wheat any farmer could grow (to drive up prices during the Depression). Filburn was ordered to destroy part of his crop and pay a fine. He argued the obvious - no interstate trade.

The SC ruled against him: wheat was a nationally traded crop and his non-participation, along with others, had a cumulative and substantial effect in the interstate market and affected prices. There are multiple other cases saying the same thing.

The only controversy in the mandate case is the fact that Congress is pushing its regulatory power beyond the degree it has historically exercised it. That said, there is no case ever striking down any federal statute on a "non-participation" basis.

In fact, the SC has repeatedly ruled that Congress may regulate even local, noneconomic behavior when such regulation is “an essential part of a larger regulation of economic activity, in which the regulatory scheme could be undercut unless the intrastate activity were regulated.” That quote comes from one SC opinion (with even Scalia in the majority) quoting another SC opinion (with conserv. Rehnquist and conserv. O'Connor, joining Scalia and even Clarence Thomas!).

This issue isn't at all complicated. Step 1: Can Congress regulate interstate commerce. Yes. Step 2: Is health care interstate commerce. Yes. Step 3: Has Congress chosen a means of regulation rationally related to the ends of regulating interstate commerce? Yes.

Thus ends the analysis - anything more is tyranny by unelected judges, substituting their judgment for that of the elected branch(es). The only more searching analysis of Congressional act involves civil rights - right to religion, speech, assembly, to be free from discrimination, etc. Those are special and, in the big scheme of things, rare cases - not garden variety interstate commerce cases. While I'm sure the libertarian types will pound the table and demand their "civil right to economic liberty," there simply is no basis for such a claim anywhere in American constitutional history. You have the right to speak but you don't necessarily have a right to advertise.

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jafs 3 years ago

You're mixing up a few things there, I'd say.

And, I've already said it can regulate in states if the activity has a "substantial effect" on interstate commerce. Apparently the farmer's actions were found to have just such an effect.

Although, I'd say there's still a bit of a question there for me - how exactly does his growing wheat on his farm have such an effect?

And, again, there's a difference between health "care" and health "insurance", which you seem to want to blur. What's the "substantial" effect on interstate commerce if a 20 year old chooses not to buy health insurance?

Unelected judges like the SC, whose job it is to decide whether the government is enacting unconstitutional legislation?

Where's the line? If I choose not to go out to eat, it affects a restaurant - if that restaurant is a national one, does my decision substantially affect interstate commerce, and can the federal government require that I eat out a certain number of times/week?

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Jimo 3 years ago

I don't know anything about you so it's difficult to assess how you would fall under the "required to buy" part of the Act. 1. If you are employed or self-employed, your employment itself brings you under the Interstate Commerce clause. Employment is economic activity. 2. If you're underinsured (some but inadquate insurance), then you've "bought" insurance - entered into a commercial contract. Again, this is economic activity and you fall under the Interestate Commerce clause. 3. You've refused to buy insurance, thereby affecting the risk pools that are the basis for how insurance rates and coverage are set for everyone. This creates a substantial and cumulative effect on interstate commerce and therefore is regulable. What's more, as the above quote states, even if this were seen as noneconomic activity, because it is an essential part of a larger regulation of economic activity, in which the regulatory scheme could be undercut unless the intrastate activity were regulated (precisely what you started arguing this morning). As such, it is also regulable.

You've fallen into a common trap of assuming that just because self-interest persons wish to stir up a "controversy" that must mean that there is in fact an actual controversy. Looney tunes have long hated the entirety of the last century of constitutional law in this country and have an agenda of returning the nation to some misty-eyed vision of Little House on the Prairie where at least white people were never "told what to do" by their gov't. It's a simplistic and false view of history. It's not just this topic but the whole of the modern world that they can't deal with. Pretending that we've taken a "wrong path" at some recent point is belied by the facts I documented to you earlier that the Supreme Court has been on this path FROM THE VERY FIRST MOMENT of history. Yes, there were debates from Day One whether the gov't had broad powers (Hamilton) or narrow powers (Jefferson). Broad powers won. Won the Washington Administration. Won the Adams Administration. Lost the Jefferson Administration (sort of). And then from the Madison Administration (despite the fact Madison had been an early proponent of a narrow power view) broad power was in place and we've never looked back since.

Again, just because Congress has not historically chosen to exercise power in a certain area does not mean that Congress does not have the power to do so. Congress power to regulate interstate commerce is with any limit except one that can be found in the Constitution.

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jafs 3 years ago

Way too broad for my taste.

Employment within a state only falls under the ICC if it has a substantial effect on interstate commerce - not all employment in a given area should have that effect.

Same with insurance purchases.

You need to do more than just state these things, you have to demonstrate them.

Unless, of course, you're willing to grant unlimited power to the federal government to regulate every aspect of our individual lives that involves money - are you willing to do that?

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Jimo 3 years ago

I'm not certain what marijuana has to do with the topic.

That said, marijuana cultivation involves substantial economic interaction. I'm uncertain why you believe a farmer growing wheat on his own farm for his own use would differ from a pot-grower growing marijuana in his backyard for his own use. ?

The state of constitutional law on the question is open and shut. Any attorney who advised a client to "go ahead" and ignore contrary federal laws would be open to a malpractice claim.

In other terms, opponents of such laws sometimes ask: Can Congress pass a law telling you that you must eat broccoli? The answer is: yes, in fact Congress could do so. In fact, that's probably a good example of a question a law professor would put on a final exam to trip up the slow kids in the class who get stuck on their personal view of whether that's a good idea for a law. That, it never would do so, and that it would be absurd to do so seems to escape the critics attention.

Take away point: there's nothing in the Constitution that prevents Congress from passing absurd laws whether they involve broccoli or (to some people's minds) marijuana. The same gov't that would be unable to tell you to do stupid things would also be a gov't powerless to tell you to do necessary things required for people to co-exist in a civilized society. What you can an infringement on liberty is what someone else would call accountability for fraudulent activity. Your check on such absurd laws isn't the courts but rather the ballot box (as the 1842 case I quoted this morning said explicitly!).

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jafs 3 years ago

The case involves a person growing marijuana for their own use in a state which has legalized it.

According to a broad interpretation of the ICC, the federal government can prosecute people for doing that, and is in fact doing so.

An obvious difference between the two is that the wheat example involved legal commerce between states that the government was trying to regulate, whereas there is no such thing with marijuana use.

And, I still have a question about the wheat case - I'd need to see more substantive argument about how the individual farmer's action had such a substantial effect on interstate commerce to be convinced.

Really? You're comfortable with the idea that the federal government has the right to pass a law making us eat broccoli? I guess the laws about sexual behavior are ok with you too then? Are there any areas of human life that the federal government doesn't have the right to regulate?

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Jimo 3 years ago

I'm not trying to convince you. I'm just explaining to you what the law says. Also, in response to a private question from another and of potential interest to others: I am making no argument per se for or against policy. Any policy that achieves universal coverage for all Americans and costs less is a-okay with me. To paraphrase a well-known Chinese communist: I care not whether the cat is black or white, but only if the cat catches mice. My comments however focused on explaining why the particular approach at question is a perfectly valid exercise of Congress' powers.

Any areas of life the federal government can't regulate? Sure ... the ones the Constitution forbids. Last I checked though, that includes precious few instances of commercial activity.

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jafs 3 years ago

Well, we'll see what the SC says.

Their interpretation, not yours or mine, will be the deciding factor.

"substantial effect" is not synonymous with any/all effect.

So, you really think the federal government can mandate that we eat out a certain number of times/week?

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weeslicket 3 years ago

thank you jafs and jimo

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esteshawk 3 years ago

Hard work is rewarded? What all those people whose jobs skills max out at "you want fries with that?" Not to sound degrading, but the fact is that not everyone has the ability to gain employment that offers insurance, which more and more employers are not offering.

When the free market is broken, then the government has to step in. Thats why we have a government, to deal with economic issues, not to address Christian ideals (which in fact is specifically prohibited by the Constitution.)

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chootspa 3 years ago

Have you polled all 30% of the "good people of Kansas" that voted for Brownie to find out their specific standing on Brownback rejecting a grant that would have allowed hm to employ people in Kansas without raising taxes?

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ksjayhawk74 3 years ago

Yes hard work should be rewarded by access to health insurance. Anyone that can not get a good enough job to cover their insurance, should just die, because they're poor.

Also, it's a very fair assumption that anyone wanting health care reform and affordable health insurance are non-working, good for nothing Liberals and poor people. Of course Medicaid already does cover low income people and families. The health care reform is more for the crumbling middle class where people have been facing raising insurance rates, being dropped from the insurance plans and sometimes losing everything and going into bankruptcy because of huge medical expenses despite have insurance... That doesn't matter, let's still just say it for the stupid poors.

I'm glad you make sure to clarify that Kansas is for Christians because they are the only ones that matter. I'm pretty sure that Jesus had your same mindset. Jesus felt that poor people could just stay poor and hungry for all he cares. After all it's their own fault for being poor, so who cares, right? Jesus was well known for hating filthy poor people and loving rich people.

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Jimo 3 years ago

Strange how those "liberal panacea" places are filled with even harder working, more productive people who pay hefty taxes so that people in places like Kansas can collect more in gov't welfare than they pay in taxes.

Kansas collects something like $1.12 in benefits for every $1 paid in taxes. Missouri was like $1.32. Oklahoma was $1.36. Even brave independent Alaska - $1.78 in benefits for every $1 in taxes paid.

I'm uncertain what states you believe to be "liberal panaceas" but the ratio for some candidate states are: New York, collects back $0.79 for every $1 in taxes paid, New Jersey $0.61 for every $1, California $0.78 for every $1 in tax.

Someone from one of those "liberal panaceas" might say that "hard work" Kansans are really just a bunch of welfare moochers living off the productive efforts of liberals -- and, like many other parasites, have no gratitude to those footing the bill !!!!

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esteshawk 3 years ago

This just shows how stupid it was for Brownie to reject the money. It did NOTHING to reduce the debt, which apparently was his reason. It also did not "teach Washington as lesson." This action simply passed the money on to a more intelligent species.

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Don Whiteley 3 years ago

At least Sam had his heart in the right place. Until we remove the current politicians holding office, there will always be some pig somewhere who wants to take money our government doesn't have and bury us even deeper in debt.

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purplesage 3 years ago

And they said the Newsweek cover photo of Michelle Bachman was unflattering and scary?

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Don Whiteley 3 years ago

Absolutely! Just like any democrat! Pledge millions that you have to borrow!

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Jimo 3 years ago

Absolutely! Just like an republican! Spend billions that you have to borrow! (And then blame democrats for it.)

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Fred Whitehead Jr. 3 years ago

Brownbackwards was a rotten senator and now is wreaking his debauched and degraded theology on the citizens of Kansas. Other states are benefiting, but no, Kansas has to endure this idiot who attends prayer rallys with the equally obnoxious governer of the State of Texas. Just what were people thinking when they chose to hitch their wagon to this nit-wit who's onerous Rush Limbaugh style ethics were clearly visible. You get the government you deserve and in Kansas that has become the horror story of the decade.

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ThePilgrim 3 years ago

Obamacare is not dead. It will eventually go to the Supreme Court and get green lighted, especially if Obama gets to nominate another justice.

Kansas was leading the way with the insurance exchange. If they don't do it then they will be wait until the Feds do it for them, which equals less control and choice over the process. Kansas had the opportunity to lead, but the crazy grassroots folks wanted it killed. Now the state will have ultimately to pay for it.

Remember, the insurance exchange and mandatory coverage, with offset tax breaks, was a Republican party platform in 2008 in McCain's campaign!

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Godot 3 years ago

Re: the JW stirring the mud. There is no grown up in charge at the JW. There is no one with any perspective or respect for the magnitude of the problems we,us, our children, their children face as a result of the current breakdown in responsible governing. The perspective of the JW is just now. Just gotcha, hyper-partisan politics, because that is what they think will get them some government cheese, some democrat government advertising brownie points. Goodness knows, they cannot count on private sector advertising....they have long since burned that bridge.

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Don Whiteley 3 years ago

I'm an Independent who voted both for Sebelius when she was running for govenor and Obama for President, but decicions like this make me believe that this administration has no will or even the smallest inclination to control our massive debt load. On one hand, Obama talks about controlling spending, but his actions continue to show that he is as committed as ever to a program known for its run-away spending. I despise the tea party for the ultra-radical, right wing zealots they are, but decisions like these push me back into the Republican camp for the elections next year.

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WilburNether 3 years ago

The headline is misleading. It should read: "Federal Government Pledges to Borrow More Money from China for $31.5 gazillion....."

What Barack Hussein does not get is that we don't have the money to pay for this, and sooner or later the rest of the world will realize that they are fools for lending us the money for our government's profligate spending.

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Centerville 3 years ago

What is being purposefully ignored is that, to continue sucking in exchange money, the state has to have a plan that is at least as bad as the Sebelius one. Don't buy into the notion that a plan can put put together in Kansas with any flexibility.

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Centerville 3 years ago

Speaking of "zombie hand", did you see Kathy trying to tell Paul Ryan that rationing isn't rationing if she gets to do it? What is with her new, weird lips and makeup?

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jayhawxrok 3 years ago

We do have to control spending but spiraling healthcare costs are part of it...insurance companies, especially ones like United Healthcare, are beyond greed and BCBS is spoiled having little competition. We need reform across the nation.

Don't buy the Republican lies about healthcare, lying is their only strategy on every topic.

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