Monday, May 21, 2018
Opinion

'Tax' fear puts reform at risk

In 2009, President Barack Obama was asked whether the individual mandate in his health care plan was really just a tax in disguise. "I absolutely reject that notion," he responded.

But if the president had been brave enough back then to call a tax a tax, his health care law might not be in such a mess today.

At the Supreme Court last week, both sides basically agreed that the Constitution allows the federal government to enact a national health insurance plan — even a government-run single-payer plan. (That, after all, is pretty much what Medicare is.) And both sides agreed that the Constitution allows the government to levy taxes to help pay for that health insurance. (We all pay a Medicare tax.)

But that's not how Obama and the Democrats wrote their health care law. Instead, to avoid the stigma of the word "tax," they included a requirement that everyone obtain health insurance or pay a penalty.

It turns out that was a big mistake. As we now know, there's one thing Americans hate even more than taxes, and that's being ordered around by their government.

Early in the debate on the health care law, polls found that most Americans were willing to pay higher taxes in exchange for universal health insurance. But Obama had promised during his presidential campaign that he wouldn't raise taxes on the middle class, and a health care tax would have broken that vow.

The administration's solution — the individual mandate — is now its biggest problem in the courts, judging by the questioning from the Supreme Court justices over the last few days. As Justice Antonin Scalia asked in Tuesday's hearing, if the law is upheld, does that mean the government "can make you buy broccoli"?

To answer such questions, government lawyers have emphasized that health care is a special case — and it is. Already, the government requires hospitals to care for the sick even if they can't pay, something it doesn't do for other goods or services. (You can't get free broccoli at a grocery store no matter how hungry you are.)

Given that health care is different, the government has argued, an individual mandate is a practical necessity. An insurance pool can't work if only the sick sign up because it would be unaffordable. So there has to be some kind of incentive for healthy people to participate.

Are there alternatives to Obama's version of a mandate? Sure. In Tuesday's Supreme Court argument, Justice Sonia Sotomayor suggested a nice, clean way to solve the problem: charge everyone a "health care responsibility tax" and offer an exemption or rebate to anyone who buys his own health insurance.

Insurance companies have proposed the idea of a limited "open enrollment" period each year, coupled with harrowing warnings about how much your health care will cost if you suffer an accident without coverage. That would make it impossible for sick people to game the system by buying insurance on their way to the emergency room.

Jonathan Gruber of MIT, one of the designers of the Obama law, has suggested another measure that might help: "auto enrollment," meaning everyone would be put into the insurance pool automatically and would have to take action to opt out. That kind of measure has significantly increased participation rates in employer-sponsored 401(k) retirement plans.

But these ideas aren't what the court is being asked to rule on. The president's lawyer even argued that while the mandate's penalty isn't a tax, the court should consider it a tax — or, at least, an exercise of the government's "taxing power," if that would help.

If the administration wins, it will be a case of legal double-talk being richly rewarded. If the administration loses, its biggest domestic achievement could be in ruins. It would have been simpler to fess up and call the mandate a tax from the start.

© 2012 Los Angeles Times

Comments
Editorial: Tampa Bay House members fail to stand up to Big Sugar

Editorial: Tampa Bay House members fail to stand up to Big Sugar

Big Sugar remains king in Florida. Just three of the state’s 27 House members voted for an amendment to the farm bill late Thursday that would have started unwinding the needless government supports for sugar that gouge taxpayers. Predictably, the am...
Published: 05/18/18
Editorial: Bondi holds drug industry accountable for Florida opioid crisis

Editorial: Bondi holds drug industry accountable for Florida opioid crisis

Florida Attorney General Pam Bondi’s lawsuit against the nation’s largest drug makers and distributors marks a moment of awakening in the state’s battle to recover from the opioid crisis. In blunt, forceful language, Bondi accuses these companies of ...
Published: 05/18/18
Editorial: A sweet note for the Florida Orchestra’s violin program for at-risk kids

Editorial: A sweet note for the Florida Orchestra’s violin program for at-risk kids

This is music to the ears. Members of the Florida Orchestra will introduce at-risk students to the violin this summer at some Hillsborough recreation centers. For free.An $80,000 grant to the University Area Community Development Corp. will pay for s...
Published: 05/17/18
Updated: 05/18/18
Trump backs off China tariff threat as China pumps money into a Trump family project

Trump backs off China tariff threat as China pumps money into a Trump family project

In barely six weeks, President Donald Trump has gone from threatening to impose $150 billion in tariffs on Chinese goods to extending a lifeline to ZTE, a Chinese cell phone company that violated U.S. sanctions by doing business with Iran and North K...
Published: 05/17/18
Editorial: Activism as seniors helps put Hillsborough graduates on the right path

Editorial: Activism as seniors helps put Hillsborough graduates on the right path

Lots of teenagers are walking together this week in Hillsborough County, a practice they’ve grown accustomed to during this remarkable school year.We can only hope they keep walking for the rest of their lives.Tens of thousands of them this week are ...
Published: 05/17/18
Editorial: Bondi holds drug industry accountable for Florida opioid crisis

Editorial: Bondi holds drug industry accountable for Florida opioid crisis

Florida Attorney General Pam Bondi’s lawsuit against the nation’s largest drug makers and distributors marks a moment of awakening in the state’s battle to recover from the opioid crisis. In blunt, forceful language, Bondi accuses these companies of ...
Published: 05/16/18
Updated: 05/18/18
Editorial: Johns Hopkins All Children’s should be more open about mistakes

Editorial: Johns Hopkins All Children’s should be more open about mistakes

A state investigation raises even more concern about medical errors at Johns Hopkins All Children’s Hospital and the venerable St. Petersburg institution’s lack of candor to the community. Regulators have determined the hospital broke Florida law by ...
Published: 05/16/18
Updated: 05/17/18
Editorial: St. Petersburg recycling worth the effort despite cost issues

Editorial: St. Petersburg recycling worth the effort despite cost issues

St. Petersburg’s 3-year-old recycling program has reached an undesirable tipping point, with operating costs exceeding the income from selling the recyclable materials. The shift is driven by falling commodity prices and new policies in China that cu...
Published: 05/15/18
Updated: 05/18/18
Editorial: HUD’s flawed plan to raise rents on poor people

Editorial: HUD’s flawed plan to raise rents on poor people

Housing Secretary Ben Carson has a surefire way to reduce the waiting lists for public housing: Charge more to people who already live there. Hitting a family living in poverty with rent increases of $100 or more a month would force more people onto ...
Published: 05/15/18
Updated: 05/18/18
Editorial: Voters should decide whether legal sports betting comes to Florida

Editorial: Voters should decide whether legal sports betting comes to Florida

It’s a safe bet Florida will get caught up in the frenzy to legalize wagering on sports following the U.S. Supreme Court opinion this week that lifted a federal ban. Struggling horse and dog tracks would love a new line of business, and state l...
Published: 05/15/18
Updated: 05/16/18