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No Mandate to Buy Insurance, But Mandate to Sell You Insurance Still Preserved - A Progressive Win?

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sasha031 Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-10 08:39 PM
Original message
No Mandate to Buy Insurance, But Mandate to Sell You Insurance Still Preserved - A Progressive Win?
Source: Twitter / By David Sirota

Over the past few hours, the mediasphere has been ablaze with talk that Republicans and their insurance industry backers supposedly won a huge victory with a Virginia court's ruling that the mandate to buy private insurance is unconstitutional. On the policy merits, this seems to make no sense. At all. In fact, the Republicans pushing this court case may have inadvertently helped America take a progressive step on health care, if progressives can actually take advantage of the situation. Hear me out.
The mandate to buy insurance was always a huge giveaway to the private insurers. It guarantees them a pool of customers that will pad their profits for eternity, thus solidifying private insurance as the profit-taking middleman in the American health care system. The Virginia court, however, struck down the mandate but did not strike down the other mandates forcing the insurers to sell you insurance. For instance, the court ruling did not eliminate the mandate for insurers to sell you insurance despite your preexisting condition; did not eliminate the mandate for insurers to use a certain percentage of their revenues to provide health care services (rather than padding profits); and did not eliminate the mandate that ends lifetime caps on health care benefits.

So, assuming this ruling stands (which, granted, is a big assumption), we have a situation whereby the insurance companies no longer have the state forcing you to buy a private product with no public alternative (ie. a public option), but the insurance companies do have the state forcing them to offer their product to you in a way that doesn't discriminate against you on the basis of pre-existing condition, and in a way that allows you to buy their product when you want to buy it.

Read more: http://www.openleft.com/diary/21120/a-progressive-win-no-mandate-to-buy-insurance-but-mandate-to-sell-you-insurance-still-preserved



Someone please tell me how this is a bad thing for the progressive cause of cracking down on the insurance industry and empowering health care consumers.

This is exactly why you have the insurance companies freaking out, threatening ever-higher premiums unless they get the mandate they originally rammed through Congress. And like loyal corporate lapdogs, this is why you have the Obama administration - which crafted the original health care bill with the insurers - telling the New York Times that "if (the mandate) eventually falls, related insurance reforms would necessarily collapse with it, most notably the ban on insurer exclusions of applicants with pre-existing health conditions." It's a scare campaign aimed at making sure the insurers get their ransom - aka the guaranteed profits and power that come with a customer mandate.
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Jackpine Radical Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-10 08:43 PM
Response to Original message
1. There is a poll somewhere in GD showing the great majority of us
are not unhappy with the court decision. Including me, for the reasons you mentioned.
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Zavulon Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 12:06 AM
Response to Reply #1
6. Including me as well.
We waited for years and years for a health bill and got the most festering piece of shit imaginable. I actually applauded out loud when I heard the decision.
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dkf Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-10 08:44 PM
Response to Original message
2. Are they mandated to sell to us? I'm not sure about that.
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eomer Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 06:04 AM
Response to Reply #2
14. They are mandated to sell to everyone if they sell to anyone.
If they want to be in the health insurance business in a particular geographical area then they are mandated to sell to everyone without discriminating based on health or pre-existing condition.

They are allowed to discriminate in their premium rates based on age but with a ratio limiting how much.

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MannyGoldstein Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-10 08:44 PM
Response to Original message
3. Health insurer stock prices largely unchanged today nt
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pnwmom Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-10 08:45 PM
Response to Original message
4. No, because in states that have tried this -- a mandate to sell insurance,
but no mandate to buy -- premiums have sky-rocketed.
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ProudDad Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 12:30 AM
Response to Reply #4
8. And in Mass...
a state with a mandate to BUY, costs have gone up, coverages down and many thousands have opted out -- preferred to pay the fine...

Health care should be a Public Utility...
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madrchsod Donating Member (1000+ posts) Send PM | Profile | Ignore Mon Dec-13-10 08:47 PM
Response to Original message
5. they are mandated but at what cost?
i`m un-insurable if i tried to buy a policy. if it was mandated i could`t afford to buy it. good thing my wife has my insurance and one more year i`ll have medicare.
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eomer Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 06:01 AM
Response to Reply #5
13. The mandate is that they sell to everyone without regard to pre-existing conditions or
other ways of filtering or rating based on health of the applicant. The only things they're allowed to vary premiums for are age and geographical area.

So if an insurer chooses to sell policies at all in a particular area then it has to sell to everyone at the same price with just the variation by age.

Regarding age, there is a limit on the ratio of what they charge the older group over what they charge the cheapest young group (or something like that, I would have to look it up to say it exactly).

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ProudDad Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 12:29 AM
Response to Original message
7. Mainly because allowing the profit takers to remain in charge of the USAmerican Sick Care System
We will never get Comprehensive or Universal Health Care...

We will never get "affordable" Health Care -- costs will continue to rise in order to satisfy the leeches on Wall St...

Striking down the mandate is only a good thing for Progressives if it hastens the final victory of Universal Comprehensive Single-Payer in USAmerica...

Just like the entire Civilized, Industrialize world has ALREADY DONE!!!
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movingviolation Donating Member (47 posts) Send PM | Profile | Ignore Tue Dec-14-10 01:23 AM
Response to Original message
9. Give us Single payer/ public option please!
Or STFU!
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No Elephants Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 10:20 AM
Response to Reply #9
17. +1 Nothing else is a "victory."
Edited on Tue Dec-14-10 10:21 AM by No Elephants
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movingviolation Donating Member (47 posts) Send PM | Profile | Ignore Tue Dec-14-10 11:57 PM
Response to Reply #17
19. Amen!
We got the shaft....again.:mad:
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truedelphi Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 02:49 AM
Response to Original message
10. Hope what you are saying is true, though I am still inclined to
Believe the philosophy of a young and vibrant candidate running for the Illinois Senate in 2004 - "That Single Payer Universal Health Care is the best and most logical means to repair the broken HC system in this nation."

I have no idea what happened to that young and enthused black man, as no one who compares to him occupies any elected office in our United States. Almost makes me a believer in theories about Alien Abduction.

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MedicalAdmin Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 07:43 AM
Response to Reply #10
16. What happened to him? Nothing. He's a politician. He lied.
And now that he's elected he can feather his own nest. Just like every other rich politician.

Why are you surprised?
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movingviolation Donating Member (47 posts) Send PM | Profile | Ignore Wed Dec-15-10 12:05 AM
Response to Reply #10
20. When Pres. Obama met with *, the evil that inhabited * transfered
Edited on Wed Dec-15-10 12:07 AM by movingviolation
itself into Pres. Obama ala "Grand Theft Me."

"Grand Theft Me is when one character forcibly and deliberately swaps bodies with another. There are two main versions of Grand Theft Me. In the first case, the goal is to "upgrade" one's body; an ailing character (elderly or disabled) swaps bodies with someone who is young and healthy, or a Muggle swaps bodies with a super-powered person, or both. In the second case, the goal is to deceive the rest of the world; a character who is imprisoned or wanted for heinous crimes swaps bodies with an upstanding member of the community."
http://tvtropes.org/pmwiki/pmwiki.php/Main/GrandTheftMe

:tinfoilhat:
:-)

(Well I thought it to be a funny thought that bounced in my head-noodle!)
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LandR Donating Member (102 posts) Send PM | Profile | Ignore Tue Dec-14-10 03:26 AM
Response to Original message
11. this ruling is not all the hype the media claims
It would not be good for progressives if this provision (Section 1501) were struck down because it would spike the cost of health care. Requiring qualified individuals who do not currently have health coverage to get health coverage is the mechanism to pay for the addition of new high-risk patients, who had previously been unable to receive health care due to pre-existing conditions, as well as insuring young adults until the age of 26 under their parents. Without this mechanism that would bring a wave of new customers into the health care market, the cost of health care would rise. Therefore, this provision is important to the Affordable Care Act because the goal of the law is to make health care cheaper, not more expensive.

Moreover, this Virginia case is not as significant as the media hype is making it out to be. Since the respected provision will not take effect until 2013, today's ruling has no practical implications. The only thing this ruling does is urge the Supreme Court to hear a case about Section 1501. There has already been three other District Court cases in the past 3 months where Section 1501 was found to be constitutional. Thus, there has been 3 cases ruling the provision as constitutional and 1 ruling it as unconstitutional.

The Supreme Court is very likely to hear a case on the constitutionality of Section 1501 of the Affordable Care Act. The following link has the other cases regarding Section 1501 and other information about this matter, such as the fine amount for not having health care. http://www.leftandrightnews.com/2010/12/13/key-health-care-provision-struck-down/

In the end, this provision is far from being done for and is likely here to stay, as most of the District Courts have already ruled.

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Skittles Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 03:35 AM
Response to Original message
12. because nothing addresses what they can CHARGE you
it was always a giant turd of a bill
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Recursion Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-15-10 10:07 AM
Response to Reply #12
21. That's just not true
It's capped at either 8.5% or 9% of your income.
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eomer Donating Member (1000+ posts) Send PM | Profile | Ignore Tue Dec-14-10 06:18 AM
Response to Original message
15. Healthy people would opt out, resulting in a "death spiral" of the entire system.
Edited on Tue Dec-14-10 06:19 AM by eomer
Healthy people, especially young ones, would opt out. This would make the premiums fairly expensive, which would make it make sense for people whose health is somewhat good to opt out. That would result in the premiums being even more expensive, which would make it make sense for people whose health is somewhat marginal to opt out. That would result in the premiums being even more expensive, which would make it make sense for people whose health is moderately bad to opt out. And so on. The system would spiral down and down until the only ones left are the seriously ill. Once you reach that point the system is not a benefit to anyone because the seriously ill would be trying to pay the full cost of their illnesses rather than spreading that cost over a broader group of people, many of whom are still healthy.

In other words, what would be left after this court ruling would be a system of insurance that is missing one of the essential requirements of insurance and so it must fail. It would be like letting people wait to buy fire insurance until their house is already on fire and then requiring insurance companies to sell it to them anyway. Why, under those conditions, would anyone buy fire insurance unless their house is on fire? And why, in the health case, would anyone buy health insurance until they already have a major illness that makes it cheaper to be insured than to be not insured?

I don't know and am not offering an opinion on whether it would be a good thing for the system to crash, only saying that it will crash. After it crashes I don't know what would happen next.

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Recursion Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-15-10 10:08 AM
Response to Reply #15
22. Didn't Crassus do that?
It would be like letting people wait to buy fire insurance until their house is already on fire and then requiring insurance companies to sell it to them anyway.

It worked in ancient Rome...
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Roy Rolling Donating Member (762 posts) Send PM | Profile | Ignore Tue Dec-14-10 11:09 AM
Response to Original message
18. very good pernt
Shhhh, don't let on. The trap is set :toast:
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pokercat999 Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-15-10 12:11 PM
Response to Original message
23. With luck this will hold and kill the health insurance industry
forever. But I'm sure the Pres and congress will come to their rescue. How else will they "earn" their bribes..er donations in the next cycle?
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NorthCarolina Donating Member (1000+ posts) Send PM | Profile | Ignore Wed Dec-15-10 02:05 PM
Response to Original message
24. Since health insurance is no longer financially an option for my partner and myself,
at least we will maintain a measure of dignity by not being considered criminals.
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