US health care law stands up

See the NY Times article for details

As a non-American, this is purely spectator sport for me, but it’s still interesting.

Some comments (below the fold):

  • It’s actually a little disappointing that the mandate held up. Because if it had been struck down, the only viable alternative would have been single-payer. Because the US voters would not let the insurance companies go back to the days of being able to reject (or massively charge) people with pre-existing conditions anymore than they are happy about the concept of cutting Medicare. (Remember all the Tea Party types waving signs like “Keep your government hands off my Medicare!”?) As the insurance companies need a large customer base of healthy people to subsidise the high risk types, they can’t do it without a mandate. So they won’t – and if forced to, they’ll fail – and the government will be forced to pick it up. The end result would be a single payer system andmuch less spending on health care.
  • I found it very odd that the Federal government’s conditions on Medicaid funding were cut down. Apparently they can put conditions on new funding but not pre-existing?? Simple answer: unconditionally cut anyway, then offer matching new funds with conditions – unless the court is saying that the government can never cut a funding program to the states for any reason. Like I said, weird. My gut feel is that Roberts wanted to block the law, but didn’t want to face the heat for doing so – so he settled for a symbolic slap.
  • The way that this has settled on the commerce clause is very intriguing. It does potentially expand the ability of the Fed to interfere in private markets. For example, it could compel all states to set uniform sales/use taxes for interstate purchases (which see Delaware’s corporate population reduce to almost nothing while not seeing a single job leave the state)
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