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To say Obamacare has become a textbook Rube Goldberg contraption would be quite the insult to the estimable Mr. Goldberg, the late cartoonist who became famous for depicting highly complicated machines that perform simple tasks.
Now, I can already hear the screams from the left: insuring the uninsured is not a simple task. Wrong. If assuring universal health coverage at all costs is the goal, there were any number of straightforward ways to get there for those who did not choose to be uninsured (as opposed to the many, mostly young people who actively made decisions, most often financial ones, not to purchase health insurance).
We could have levied a surcharge on the overwhelming majority of Americans with health insurance. Or we could have raised enough new revenue to simply add the unwillingly uninsured to the Medicaid rolls – without concocting a contraption that created upheaval among the vast majority of the insured. We could have created assigned risk pools, as with auto insurance, that required insurance carriers to carry the sick and poor by increasing the premiums of their existing customers.
This is not to suggest that these are good solutions, but they would at least have the benefit of being in accord with the principle of Occam’s Razor, which states that the hypothesis based on the fewest assumptions, i.e. the simplest solution, is invariably the superior one.
But none of the simple solutions would increase the power of the state enough to satisfy the central planners of the left who see more government control as the answer to virtually every problem in the universe.
Instead, we got a law which gave the most power to the government that was politically possible – a law which from its inception has been unsatisfactory to everyone, from free market types who promote private solutions to the issue of universal coverage, to leftists who dream of a European-style single-payer system in which the government not only manages but provides all health care. Not to mention the vast majority who have no ideological skin in the game, but just want the right to choose a decent product at a decent price and decide for themselves where on the spectrum between a gold plated plan and catastrophic coverage they choose to land.
It should be rather simple: if a law is wildly unpopular among almost everyone except the small minority who directly benefit from it at the expense of everyone else, requires extraordinary political gymnastics just to keep it from exploding altogether, forces its proponents to keep moving the goalposts years after it was passed into law, violates with impunity the basic premises upon which it was passed (that you can keep your plan if you like it and that premiums will be reduced), discourages added employment and forces people to violate their beliefs (and there’s a lot more, but I haven’t got time for the pain) it is just plain a bad law.
My original plan was to devote this column entirely to the two Obamacare-related cases pending before the Supreme Court, but those plans were interrupted by the bombshell dropped on Monday by the administration, which announced that a major component of Obamacare will be delayed. Again.
For those of you naive enough to think Congress, the branch of government charged with actually passing laws, decided to amend the Affordable Care Act, think again. Such a turn of events would signify a healthy functioning of our constitutional republic. What happened instead is that President Obama decided it would be politically inconvenient to have lots more people lose their health insurance or their jobs in the run-up to the midterm elections. So, he simply decided to change the law by himself. Just like he did the last time it was politically convenient.
Just so we are all on the same page, this is the new [2] current status of the implementation delays*:
Self/Non employed: None. Individuals must buy a qualified health insurance policy by March 14 of this year or face a fine.
Corporations with 49 or fewer employees: None. No mandate under Obamacare.
Corporations with 50-99 employees: 1 Year additional delay. Instead of being required to offer or provide employees with health insurance or be fined (taxed) by the federal government as Obamacare required in 2014, or as required by the last “extension” in 2015, they will have until 2016 (or until Obama changes his mind again).
Corporations with 100 or more employees: 1 Year delay. Instead of being required in 2014 to offer coverage to 95 percent of full-time workers, as Obamacare required, these bigger employers can avoid the fines by offering insurance to 70 percent of them in 2015 (or until Obama changes his mind again).
The naked political calculation behind these latests changes to this Rube Goldberg contraption laid the motives for this move so bare that no less an administration apologist than the Washington Post editorial board [3] could not ignore it. “The law is also explicit that the government should be enforcing penalties already; that’s the plainest interpretation of Congress’s intent. The administration shouldn’t dismiss that without exceptionally good reason. Fear of a midterm shellacking doesn’t qualify as good reason.” Well stated.
This President sees no need to follow laws he considers inconvenient, even those he did everything in his power to pass. Even more unfortunate is that the courts will likely not bother to force him to do so. A challenge to the new implementation time frame, if brought at all, seems unlikely [4] to succeed. But there is another provision of Obamacare that is already scheduled for judicial review and it goes to the Supreme Court next month. The “contraceptive mandate” is the first challenge to the implementation of Obamacare other than the law itself, to reach the high court.
The challenge comes from two cases [5] where business owners claim a religious objection to certain contraceptives and assert that making them pay for it violates their rights. Under Obamacare, contraception is a service/product that employers who offer health insurance must provide without a copay or any additional charge to the employee. This puts them in the position of paying for the contraception of their employees in direct contravention of their religious beliefs, which forbid the use of certain contraceptives.
There is an exemption in the Obamacare regulations under which religious organizations may be exempt from the requirements. Another [6] court case will hash out the particulars of that provision, but it looks like the government may be on the losing side of that one. But the issue to be decided next month is different because it doesn’t involve traditional religious entities, but for-profit corporations.
The government would have us believe that people must leave their religious beliefs at the company door. While many people’s religious lives do not permeate their professional ones, for many, faith envelopes the entirety of their lives and beings. Whether that involves making a buck, or doing volunteer work, people animated by their faith do so not apart from their faith, but as one with it.
The excellent Cato Institute brief [7] in support of the companies challenging the mandate puts it plainly “[t]he government contends, however, that individuals cannot exercise religion in their professional lives while acting on behalf of a corporation. Central to the government’s position is the notion that human adherence to religious principles either does not occur or must be ignored in the context of corporate activity. Whichever way the idea is stated, it has no basis in law or reality.”
As George Washington said, “[g]overnment is not reason; it is not eloquent; it is force. Like fire, it is a dangerous servant and a fearful master.” Bypassing Congress by unilaterally enforcing nakedly political solutions to avoid the political ramifications of this disastrous contraption, and playing 52 card pickup with something as central and personal as people’s healthcare, is not only a fundamental violation of Occam’s Razor, but a concoction that would make even Rube Goldberg blanch.