Thursday, March 25, 2010

Constitutionality of Healthcare

Big Fred and others on The Conservative Wahoo Live! radio program last night made spirited defenses of the ongoing effort by several state Attorneys General to have the insurance mandate portion of the healthcare reform bill overturned by the Supreme Court. I understand their points, but for some reason I had a feeling that the Supreme Court would likely not mess with something this big and "political"--showing deference to the political branches in the process. I'm not so sure anymore.

When the editorial pages of the Washington Post treat the effort with the respect that this piece did, it seems to me that idea may have quite a bit more merit than I thought. I'll try and educate myself further on the matter.

That said--were the Supreme Court to find the mandates CONSTITUTIONAL--I would support a mandate IF AND ONLY IF extension of "coverage" to pre-existing conditions was forced upon the insurance industry. If you--like me--wish to see insurance coverage provided by private companies, rather than the government; and if you--like me--believe that denying coverage to people with pre-existing conditions is coming to be seen as an important policy problem to be overcome; and if you--like me--see forcing insurance companies to take on people with existing conditions not as "insurance" but as an "entitlement"--than we are left without a good policy option to "deepen the risk pool"--except the mandate. If the mandate is found unconstitutional--but the requirement to cover pre-existing conditions remains--the insurance industry will be faced with a HUGE COST driver which will be passed along to those with insurance. Premium hikes are guaranteed by the bill as it is--without the mandate, the hikes will be substantial.

Bottom line--if the Supremes find the mandate unconstitutional, then the requirement to cover pre-existing conditions becomes problematic--both from a cost standpoint, and a political one. Republicans would have to be careful how they contest it, as they will assuredly be criticized for "taking away my healthcare" if they overturn (politically) the pre-existing conditions coverage requirement.

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