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Court's conservatives question insurance mandate
Richard Mondale yells at a Obama health care reform supporter during a protest in front of the U.S. Supreme Court building March 27, 2012, in Washington. / Getty Images
Updated at 4:28 p.m. ET
(AP) WASHINGTON - Sharp questioning by the Supreme Court's conservative justices cast serious doubt Tuesday on the survival of the individual insurance requirement at the heart of President Obama's historic health care overhaul.
Arguments at the high court focused on whether the mandate for virtually every American to have insurance "is a step beyond what our cases allow," in the words of Justice Anthony Kennedy.
But Kennedy, who is often the swing vote on cases that divide the justices along ideological lines, also said he recognized the magnitude of the nation's health care problem and seemed to suggest that it would require a comprehensive solution.
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He and Chief Justice John Roberts emerged as the seemingly pivotal votes in the court's decision, due in June in the midst of a presidential election campaign that has focused in part on the new law. Republican candidates are strongly opposed.
Justices Antonin Scalia and Samuel Alito appeared likely to join with Justice Clarence Thomas to vote to strike down the key provision of the overhaul. The four Democratic appointees seemed ready to vote to uphold it.
The congressional requirement to buy health care insurance is the linchpin of the law's aim to get medical insurance to an additional 30 million people, at a reasonable cost to private insurers and state governments. Virtually every American will be affected by the court's decision on the law's constitutionality.
Audio: Complete oral arguments from day 2
Audio: Complete oral arguments from day 1
Video: Bachmann, tea party rally at Supreme Court
The biggest issue, to which the justices returned repeatedly during two hours of arguments in a packed courtroom, was whether the government can force people to buy insurance. And if so, could other mandates — to buy broccoli, burial insurance and cellphones, for example — be far behind?
"Purchase insurance in this case, something else in the next case," Roberts said.
"If the government can do this, what else can it not do?" Scalia asked.
Kennedy at one point said that allowing the government mandate would "change the relationship" between the government and U.S. citizens.
"Do you not have a heavy burden of justification to show authorization under the Constitution" for the individual mandate? asked Kennedy.
At another point, however, he also acknowledged the complexity of resolving the issue of paying for America's health care needs.
"I think it is true that if most questions in life are matters of degree ... 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," Kennedy said.
Roberts also spoke about the uniqueness of health care, which almost everyone uses at some point. "Everybody is in this market, so that makes it very different than the market for cars or the other hypotheticals that you came up with, and all they're regulating is how you pay for it," Roberts said, paraphrasing the government's argument.
Solicitor General Donald Verrilli Jr. sought to assure the court that the insurance mandate in the Patient Protection and Affordable Care Act that Mr. Obama signed into law two years ago is a key part of the law's goal of reaching many of the more than 40 million people who don't have health insurance through their employers, don't qualify for government aid and cannot afford to buy coverage on their own.
Indeed, the law envisions that insurers will be able to accommodate older and sicker people without facing financial ruin because the insurance requirement will provide insurance companies with more premiums from healthy people to cover their increased costs of care
Paul Clement, a predecessor of Verrilli's who is representing Florida and 25 other states in challenging the law, called the mandate "an unprecedented effort by Congress."
He said the requirement would force people, especially those who are young and healthy, to buy a product they don't want.
Justice Ruth Bader Ginsburg said she found the debate over health care similar to an earlier age's debate about the Social Security retirement system. How could Congress be able to compel younger workers to contribute to Social Security, but be limited in its ability to address health care? she wondered.
Does it to have to be "a government takeover"? she asked.
Clement acknowledged that a system of national health insurance might well be constitutional.
Earlier, Scalia repeatedly pointed out that the federal government's powers are limited by the Constitution, with the rest left to the states and the people. "The argument there is that the people were left to decide whether to buy health insurance," Scalia said.
Scalia and Roberts noted that the health care overhaul law would make people get insurance for things they may not need, like heart transplants or pregnancy services. "You can't say that everybody is going to participate in substance abuse services," Roberts said.
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How is this individual mandate that we buy health insurance any different than the mandate to have car insurance if you drive a car?
So we have Democrats trying to make people BE RESPONSIBLE FOR THEMSELVES, and Republicans/Tea Party okay with the current system that fails Americans, and lets some FREE-LOAD off society.
And then we have the issue of Health care costs for businesses. Businesses are unable to afford insurance these days. They do business in a global economy against foreign companies with zero health care costs because their government takes care of it. Do you know how much time small business owners spend, and how much their costs have gone up in the last 20 years? Ask them! It's a mess.
So we have this group of Republicans who want to continue a failed system. They could not fix the problem when they had control of the WH and Congress. In fact, all they did was give tons of money to Rx's that did nothing to fix the problem. How's that for leadership?
Now they want to continue a system that lets some FREE LOAD off society to pay their health care needs. It doesn't stop there. This group of Republicans is keeping American businesses from being competitive because they are forcing health care on employers, or just allowing them to ignore the needs of their workforce.
Yeah, I'd say this generation of Republicans is much different than our grandparents. This generation of Republicans support an unhealthy workforce, free-loading off society, and an uncompetitive business sector.
But not necessarily insurance. People receive health care all the time with no insurance. Some pay for it outright, some have it paid for them. But as a matter of law the principle of forced activity being outside the bounds of government is an important one. Yes, you'll get your health insurance today but tomorrow someone may require you to buy something you don't want.
2. All states force employers to pay an unemployment tax based on their turn over rate. The exception to this, is that if one is self employment or a corporate officer.
3. The Federal housing Association (FHA) as of March 2011 will not back a loan to a homeowner now without carrying flood insurance if they are in flood zone.
4. If you own a car, you have to pay auto insurance to get your tags.
5. If you want to get a loan for a house, you have to pay house insurance.
6. If you are over 16 and you want to fish or hunt you have to get license that your pay for.
7. If you have a dog, in most places you need tags.
8. If you want to modify your house, you have to get a permit.
Point is that we are forced to pay for a lot of things.
So, now we have people complaining about requiring you have health insurance. So, no health insurance, and you are treated at the hospital. That is the most costly thing we can be doing as a country. Require health insurance, and spread the costs around. I'm tired of paying people taking their kids to emergency, because they can't afford the $80 bill at a regular doctor. So, instead we tax payers have to pay hundreds of dollars for a ER visit that can't even be treated with antibiotics. How about the lady that I saw in the hospital who was in the hospital for 5 days for pneumonia. I asked her why she didn't go to the doctor earlier - couldn't afford it. She explained to me, that the only way to get quick treatment was to go to the hospital ER. The welfare system takes too long she explained. By the way, she almost died there all from not having the financial ability to go to a family physician the week before.
There are around 50 million people out there that are uninsured. Everyone who is uninsured has twice the rate of going to the ER, and when they do go they are usually really sick by then. It is their last resort. Over half of all personal bankrupts are due to health costs due to medical issues.
I think some common sense is lacking in this country. We need to realize that most of us are one paycheck or one bad car wreck from disaster. We are paying hundreds of million of dollars in funding to hospital ERs to take care of the uninsured now. This is not cost efficient, and is a real burden on our society. If all have health care, then one can go to a doctor, and prevent these high cost ER visits, and stays in the hospital. You may ask how do I know this, because I had a cousin who was in charge of the hospital subsidies for the uninsured in the Federal government - top guy. The waste that is going on now is inexcusable. I tell you frankly, we can do better as a nation.
The Citizens United decision proves that this is the most activist court in American history. They care not for the Constitution or Democracy. Imo, this will be another decision to give the powerful insurance industry what they want, and show total disregard for the needs of Americans, American families and American businesses.
Please answer me, as to how, will they be able to pay for insurance?
Granted, it would be wonderful, if everyone could afford insurance, but in this real world, it doesn't happen. If it is allowed to force those to buy insurance, what's next? What else will be forced on each of us.?
Don't know about you, but that scare me!
That's fine then don't go to the hospital and not be able to pay for the services.