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Good Question: Can Health Insurance Be Required?

By Jason DeRusha, WCCO-TV

MINNEAPOLIS (WCCO)
— The U.S. Senate blocked an effort by Republicans to repeal President Obama’s health care bill Wednesday, but the future of the law is still in jeopardy. A federal judge on Monday ruled it unconstitutional, because of the mandate that individuals buy health insurance.

“If people are challenging the constitutionality of the government requiring us to buy health insurance, then should requiring us to buy car insurance be challenged as well?” asked Tom Wilmar from Plymouth.

So, what is the difference?

“In terms of differences, one is who’s requiring us to do it,” said Professor Amy Monahan, who’s been researching health care law at the University of Minnesota School of Law. “Characterizing it as messy is a good way to characterize it.”

States force us to buy car insurance. According to Monahan, they probably could force us to buy health insurance.

“They’re allowed to broadly regulate health, safety and welfare,” she said.

However, the federal government has more limited powers under the Constitution.

“We’ve never seen a structure like this in terms of what the federal government is trying to regulate,” according to Monahan.

The federal government does have the power to charge individuals taxes, and some have characterized the health care law as that. If people have affordable health care as an option and choose not to buy it, they pay a fine.

“The judge in Florida said you can’t treat this as a tax,” she explained. “It’s not raising revenue. This is really about making people buy health insurance.”

So, it comes down to the Commerce Clause of the Constitution. The federal government has the power to regulate interstate commerce.

“Preeminent constitutional scholars reconfirmed that the Affordable Care Act is firmly rooted in the Commerce Clause of the Constitution,” said Sen. Al Franken (D-MN). “We need to move past baseless challenges to the constitutionality of health care reform.”

But the question isn’t clear to Monahan.

“Is being uninsured an activity that can be regulated, or is it inactivity?” she asks.

Back to the car insurance analogy: driving a car is a choice, and getting insurance is a condition of being able to make that choice. But can the government require people to buy health insurance as a condition of living?

“That gets to the crux of the issue,” said Monahan.

She said that proponents of the health care law argue that by not buying health insurance, people are making an active choice to essentially self-insure. And that choice does affect interstate commerce, which makes it eligible to be regulated by the federal government.

“The Supreme Court will likely have to decide,” said Monahan.

More from Jason DeRusha
Comments

One Comment

  1. Matthew says:

    1) I am left-leaning
    2)Requiring people to purchase car insurance is not the same as requiring people to purchase. People have the right to not drive, avoiding the requirement to buy that insurance…..But the health insurance mandate is inexcapable. Just by living, you are required to have it.
    3)The judge in Florida is absolutely right that the entire law can be struck down if the insurance mandate is found unconstitutional. The Dems did not include a “severability” clause which, if included, would have allowed that provision to be struck down while leaving the rest of the law intact.
    4)Without the mandate, the rest of the law falls apart anyway since it was included to increase the amount of people paying into the “pool”, spreading the cost around, and making sure insurance companies profit even with the end of their previous discriminatory practices (denying coverage based on pre-existing conditions, etc, dropping patients when they get sick, etc).
    5)I believe the mandate is not the issue. Who can say that having health insurance is a bad thing? The fee associated with the mandate is the issue that I believe is getting people’s blood boiling. But then where are the “teeth” to the law? Wouldn’t people just wait until they get sick to buy insurance? Not so much unlike flood insurance, when people wait until the month before a flood happens to make their purchase, then cash in. Find another way to finance the law, and it would be much more popular.
    6)The constitutionality of the law is murky at best. The parts of the constitution used to justify the law do not explicitly allow for the law, but it is equally difficult to show how the law is unconstitutional.

    1. digger says:

      1) I am right leaning
      2) The people have the right to NOT have health care. were else can the gov. mandate you to buy. Gov owns part of GM all Americans must by GM car.
      the small amount of people in this country that do not have a drivers license is alot less than people without medical ins. there fore to have a drivers license ( you might borrow a car or rent one ) you must buy auto ins. for the good of us that DO by ins.
      3) agree
      4) agree
      5) I believe the mandate IS a big part of the issue. Having health ins is a good thing. But so is no smoking, no drinking, no sports that might cause injury, no driving without auto ins. the list is endless. countries all over the world that have “free ” healthcare are in horrible shape. it use to be health care was a bonus to getting good job . and that why I busted my butt to get do just that . its a human condition to take advantage of a system that gives you everything and expects nothing. tough love for tose that need it.
      6) the parts of the constitution that I have heard about to defend this madate all hade to do with business. not personel rights .

      just my view

      1. digger says:

        sorry about the fat finger reply

  2. Donna says:

    As of today, a majority of States in the US don’t think our Government has this right to regulate inactivity and argue this is unconstitutional. In my opinion, this is all because they (Democratic House, Senate & President) “didn’t want” to call this provision a TAX.

  3. Mr T says:

    Pretty soon the federal government will tell you that you can only have one child.

    How the heck are they going to enorce mandatory healthcare premiums? let’s say a person just got out of college and decides to take a year off and visit family , will this person go to jail if they don’t pay? Ridiculous. Stop the wars and the subsidies for illegal immigration and we’ll have plenty of money. Socialized medicine just leads to more people in jail……….

  4. Humbug says:

    Can anyone from the 6th US district explain to me why Tax payers are forced to pay for private enterprize earmarked stadiums.

    Yet the law forcing US to pay for health insurance is struck down by 2 judges.

    anyone?

  5. Well Now says:

    Can anyone from the 6th US district explain to me why Tax payers are forced to pay for private enterprize earmarked stadiums.

    Yet the law forcing US to pay for health insurance is struck down by 2 judges.

    anyone?

  6. Schemes says:

    One of his most telling statements, I thought, came about five minutes into he segment, when the MPR host asked why the Vikings owners shouldn’t just build a stadium themselves, given all the windfall profits they’d earn. Mondale’s response:

    “I don’t think it’s economically viable to think that the Vikings are going to pay for the entire new stadium. Because I don’t think it fits within the value of what they are going to get back.”
    Read that again: The Vikings wouldn’t build a new stadium with their own cash because they’d lose money on the deal. It’s confirmation, in other words, that most new stadiums don’t actually make money; they’re actually big money losers, which can only allow teams to turn a profit if there’s a public subsidy.

    http://www.fieldofschemes.com/

  7. Devoided says:

    Matthew…you said all you needed to say in bullet #1 (sorry point #1(pretty sure you are against bullets))

    Once Obama-care is in full effect no one will have to have car insurance anymore except to cover property damage (and that isn’t where the expense is). Right?

  8. Aristocrat says:

    I need some Stadium Care please. Can the gov. fund my Stadium Care?

  9. Joe says:

    The answer to the question is YES. If no one fights to change this you will need uncle sam’s permission to get any procedure done other than your temp taken but there will be a thermometer fee and a sitting fee if your not standing. Health care reform is needed but not like this.

  10. Jeff says:

    It’s funny Under this Obama care bill they have several hundred IRS agents Openings for hire.. Wonder why that is? It’s just another Tax People…

    1. scott says:

      That’s the only way that it will be able to be monitored. Your end of the year taxes. Check the box if you do have health care. Fill in the blank on with who and the policy #.

  11. Ron says:

    Glad we grabbed some words of wisdom from Al Franken since he is an expert in absolutely nothing. The Democrats have been attacking the Constitution since the liberal mental disease started. The law of the land is a critical part of our country but the liberals hate those laws. They do not like borders or using their brains either. Thus why this situation is such a problem. It probably is unconstitutional but they will spend as much of the deficit as possible to fight it in court.

    1. Mike says:

      Yes, health care coverage can be made manditory the same way Medicare, Medicaid and Social Security are, through taxation which is constitutional.

  12. MD says:

    I believe the main purpose of requring Car Insurance is to protect the other person you may hit. Not that I have ever had the minimum car insurance, but isn’t it where you can get it just to protect the other car?
    Health insurance only protects yourself. You should have the right as to whether you choose to protect your own self.

  13. AK says:

    Good point MD, but I think the problem with that is when something happens when you are in dire need of medical care. You are not going to steer clear of the hospital just because you don’t have insurance. And when you can’t pay your bills other people end up footing the bill for you

  14. sniffdog says:

    Interesting that Frankin used the words baseless challenge, since the crux of the issue is that some provisions in the HC package are baseless and approaching tyranny. Frankin is a clown. BTW, this story is another piece of drival from the ‘CCO staff. How do these guys keep their jobs?

  15. Judy says:

    The thing with healthcare is no one is getting it for free. The people who don’t carry health coverage get their’s paid by those of us that do pay for health coverage. If everyone had to purchase their own, you wouldn’t see people going to the emergency room to get a prescription for Tylenol. They don’t get charged for the emergency room visit, but those of us with insurance coverage are paying higher rates to cover those people. If we all had to have insurance coverage, those of us that are now paying for the cling-ons would end up paying less for our own coverage and it would benefit us in the long run. How come when there’s a discussion on healthcare, no one focuses on the real issue of who is actually paying for those people who don’t have coverage? It’s not free, it’s just a matter of who is paying for the healthcare that everyone is entitled to use. I’m all for everyone having access to healthcare, but I’d strongly prefer to just have to pay for my own family and let others pay for theirs.

  16. Peter Sovell says:

    Peter
    1. If universal health care, as accorded by many is so bad, can one of those in opposition please explain to me why the US is the only industrialized county in the world that doesn’t have some form of it. I don’t think putting the government in charge of delivery will change the cost of our health care. I believe we must also change the system to be more in line with what Teddy Roosevelt proposed the second time he ran for president. But then, certain special interests managed to defeat these ideas back then. Why should anyone believe different special interests won’t attempt to do the same today? This is after all our democratic process.
    2. I know many in opposition to universal health care will not follow the logic, but without universal heath care, US companies are put at a tremendous competitive disadvantage relative to companies who hire and operate off shore. In effect, those against universal healthcare are forcing US companies to hire abroad in order to stay competitive.
    3. Republicans are now advocating the single most effective way to ensure job loss for the US economy into the future by attempting to dismantle the insurance company written “universal plan” we now “enjoy.”
    4. I consider myself to be very conservative and somewhat nonpolitical. What has happened to the Republican Party I grew up with? For social justice reasons I, as well as many of my close friends, find it increasingly more difficult to blindly vote Republican. I am even beginning to find similarities among Social Democrat policies of the 1930’s and today’s conservative Republicans. To Michelle Bachman and other Tea Party conservatives, I must say,”I am afraid those who ignore history may doom all of us to repeat it.”
    5. I have lived in the Saint Cloud area long enough to understand your political beliefs. But, I know one life long Republican who will not vote Republican in upcoming elections.

  17. sniffdog says:

    Judy, I think you are confusing health care and health insurance. If we all paid for our own health care, there would be no need for insurance. Insurance helps spread out the risk and cost for everyone. I do agree with you though that we are paying for those who do not have it. I think the bigger problem is that we can not charge unhealthy people higher premiums (like auto insurance.) Almost 70% of diabetes could be avoided by personal deisions. Those who make unhealthy choices, smoking, fast food, no exercise, high risk behaviour, etc. should pay higher premiums. I’m sure someone will say that it’s too complicated to figure out…well its not. Another issue is where each dollar of health care goes: insurance companies should not be allowed to make a profit, pharma companies make too much money, doctors make too much money, Hospital admins make too much money. If health care is a human right, then we should not be making millionaires in the health care system. It should be a net-zero entity.

  18. JB says:

    comments are being deleted. Guess “Big Brother” only likes pro President Obama posts

  19. Kristen says:

    people drive all the time without auto insurance so…

  20. g says:

    You do not have the right to drive, it is a privilege. The roads are all created and maintained through direct taxation and are not privately owned and operated. Are we now saying that to exist as an American citizen is now a privilege and not a right? Come on, this is High School Civics here folks!
    Considering we just lost a bridge, do you really want the same folks in charge of our roads in charge of our health? We don’t have the budget to maintain our road infrastructure and its literally falling apart, what makes you think we can raise enough additional revenue through taxation to have a healthcare system that is any better than our roads?
    How is our plowing budget going here in MN this year, I know I cant park in front of my own house right now, again government run! I am more than happy to take care of what’s in front of my house. Are my neighbors going to do the same, doubtful.
    I know, lets tax the rich more to pay for it, too bad that hurts the incentive or drive to be innovative and prosperous in the first place.
    Truth is we will NEVER be able to give health care to everyone at an affordable price without removing the restraints like a billion dollars and 10 years to get a medical device or medication to market, or not allowing me to buy healthcare from Florida even though I am a Minnesota resident. Try looking up all the mandates In Minnesota alone that health care providers must provide at their own expense just to operate and honestly tell me that does not drive the cost of healthcare up. Also, remember that Health providers rank just below the Railroad industry in profitability, so much for them all being so evil and greedy!
    We need to lower the cost of healthcare by allowing innovation in a way that makes sense, not one that adds astronomical pricing and lag of technology through extreme oversight.
    We have the best healthcare in the world, hands down, yes Cuba might be on the cutting edge of some pharma and Israel might be on the cutting edge of caring for bomb/burn victims, but I certainly don’t want to live in either of those places.
    Government is not here to provide, it is here to give an equal playing field for all to enjoy a FREE existence so long as it does not infringe on others freedom.
    Forcing me to buy healthcare goes directly against my freedoms. If this goes forward the new saying will be “Death, taxes and healthcare” not just “Death and Taxes”.

  21. me says:

    Far as I am concerned..If they are going to mandate that everyone buy health insurance…then they need to get rid of privatization of these companies and find a way to level off costs. There are going to be quite a few people who cannot afford the premiums these companies charge. Even with insurnace through work I pay a little over 300.00 per month in insurance for 2 people. They need to find a way to make it affordable so people actually buy it.

  22. richard says:

    I thought the repubs were against ACTIVIST JUDGES???? HYPOCRITES!

  23. Andrew says:

    The state only requires liablity insurance on cars, to cover you crashing into someone else. Full coverage, which is like health insurance, is required by banks if you have a loan on your car to cover their interests.

  24. Orv says:

    Jason, you neglected to mention the fact the other night that there is a substantial number of Minnesotans who simply cannot afford insurance. What about that????????

  25. Larissa Miller says:

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  26. Roger Novotny says:

    How is the number of oeople at home that is going to watch the Super Bowl game estimated

  27. Willow says:

    Obamacare is a tax on merely existing. This is wrong, we have enough taxes. Raise the rest of our taxes if you want to generate more income. We’ll just spend less.

    1. Willow says:

      Also what are they going to do about the homeless who cannot afford health care and who do not have an address? Are they simply going to jail all the homeless for not buying health insurance? And where are they gong to put the real criminals…the murderers and rapists and drug dealers?

  28. Charlie says:

    So many of you on here seem to think they know all the answers, and if that’s the case, you should get into politics and run for public office so you can actually help fix the problems we have instead of just whining about them.

    Let’s face it: no solution to the health care issue is going to make sense to absolutely everyone. That said, other industrialized nations with universal health care have a longer life expectancy than we do. Granted, a lot of factors besides health care go into determining how long someone might live, but still, those numbers don’t lie.

    As we watch what used to be the middle class (which includes me) disappear in the US, I am afraid of the future. As you probably have guessed, I lean left, but a stray breeze can blow me to the right at times, too. In our household of three, we make what used to be a very decent middle class income. Now, we live paycheck-to-paycheck like many others. As a result, I’d personally rather have a totally universal system in which we pay for health care up front through taxes. This way, when I end up with kidney stones (has happened to me), I don’t have to worry about where the money is going to come from for the $200 ER copay. Yes, we’d be paying more in taxes thus lowering my income, but it’d be in small chunks instead of astronomical medical bills. You can call me a socialist if it makes you feel better–I don’t care.

    To those that say they don’t feel they should pay for others’ medical problems, I say this: let’s see if your tune changes when YOU are the one with $400,000 in medical bills.

    Since I am not a politician, I will not even pretend to tell you I have a way to make all of this happen. I simply am stating what I personally would prefer. And everyone is entitled to his or her own opinion.

    One last thought: we all pay for the public school system through our taxes (I’m not saying our public schools are wonderful or anything), yet not all of us have children. It seems like the same argument about health care, just in a different context, yet I never hear anyone complain about paying for someone else’s kids’ education.

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