Category Archive - Reform & Regulation

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Healthcare Reform Lawsuit Arguments Continue

Tuesday, August 31st, 2010
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Image: steakpinball under CC 3.0

When it comes to healthcare reform, controversy is never far behind. The federal government has continued to argue that the law is constitutional. In a district court, their lawyers claim that the burden of proof should be on the coalition of states suing.

Specifically, the states claim harm from the provision that mandates the purchase of health insurance plans. If a person or business does not comply, they are subject to annual fines of $695. However, the plaintiffs have allegedly failed to demonstrate imminent or actual financial injury, since that aspect of the legislation does not take effect until 2014.

Moreover, the federal government claims that even if the penalty (which would be collected by the IRS) is technically considered a tax, the Anti-Injunction Act prevents states from challenging it, since the individual mandate is considered integral to the structure of the bill.

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Colorado To Vote On Health Insurance Plan Mandate

Saturday, August 28th, 2010
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Like several other states, Colorado will have a healthcare reform-related question on the November ballot. Voters will be able to decide whether or not they want to legally challenge provisions of the law.

Similar to other states’ ballot measures, it would pass a law that prevents the federal government from enacting a health insurance plan mandate–one of the main provisions of the bill, intended to reduce the cost of health insurance by spreading the cost among more (typically healthy) people.

It remains to be seen if Amendment 63 is successful. Even if it passes, the federal law may still dominate state law. However, conservative groups are happy that the Colorado health insurance measure received enough signatures to reach the ballot.

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Will States Be Able To Implement Health Insurance Plan Reform?

Monday, August 16th, 2010

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Image: tomcensani under CC 3.0

Although healthcare reform will result in more federal involvement in regulations, the majority of the responsibility for regulating health coverage will still rest with the states.

However, it seems that many state insurance commissioners don’t have the power to do some of the things the Obama administration wants them to. Almost half of the states claim that they don’t have the legal authority to review health insurance plan rate increases, for example.

What are they doing to make sure that they can effectively enforce some of the consumer protection provisions that begin next month? States such as Florida and Texas have little recourse, except for gently encouraging health insurers to modify their contracts in order to comply with federal law. Regulators are planning on new state laws being passed in the next year, or using general laws against deceptive trade practices. It remains to be seen if these tactics will be successful. If they are unable to take the lead, the national government will step in–an unpalatable alternative to many.

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Yet Another Affordable Health Insurance Reform Lawsuit

Saturday, August 14th, 2010
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Image: Wikipedia

This time, a conservative group from Arizona is suing the Obama administration over healthcare reform. The Goldwater Institute, which filed the lawsuit, believes that while the issue of increasing access to affordable health insurance is important, the federal law is too heavy-handed.

They are representing a variety of interests, including Republican politicians on both state and local levels, as well as a small business owner. In addition to the belief that they will be forced to purchase a health insurance plan they don’t want (when, in their view, the Constitution delegates health care policy decisions to the states), the plaintiffs also fear that the legislation violates privacy rights.

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Massachusetts Man Doesn’t Buy Health Insurance Plan, Sues Govt.

Thursday, August 12th, 2010
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This may be a sign of things to come: a man who defied Massachusetts’ individual mandate by not buying a health insurance plan is contesting his $2,000 fine in court. He already tried the formal appeals process to get the fine reversed, but to no avail.

Michael Merlina claims that the $800 monthly premium for him and his wife under the Massachusetts Health Insurance Connector’s most affordable option was too expensive. Meanwhile, the couple’s combined income wasn’t low enough to qualify for heavily discounted state health care for the poor.

National healthcare reform will phase in a similar requirement in 2014. It includes elements of–but differs from–the Massachusetts model. It remains to be seen if it will have a similar impact for those caught between the cracks.

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Is There Precedent To Uphold Healthcare Reform?

Monday, July 12th, 2010

Image: BAR Photography under CC 3.0

One of the main arguments against the legality of healthcare reform is the contention that it is unconstitutional. Many opponents believe that the individual health insurance mandate, in particular, violates the 10th Amendment. That amendment says that all rights not specifically given to the federal government in the Constitution or its amendments are left to each state.

However, a competing interpretation–accepted by some conservative justices, no less–states that at times, the national government can exercise powers not expressly mentioned in the document. A recent Supreme Court decision (approved by seven out of the nine members) upheld the federal government’s right to indefinitely detain sex offenders after serving their sentences. Surely, the specifics of ankle monitoring or house arrest for child molesters and others were not on the founding fathers’ minds.

Granted, U.S. vs. Comstock is relatively less controversial an issue than affordable health insurance reform. Still, it’s a sign that the highest court is willing to consider the application of the “elastic clause”, which states that the federal government is allowed to pass laws to help it execute the powers it was expressly given.

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In The Meantime: Sebelius Tries To Get Health Insurance Companies’ Cooperation

Friday, July 9th, 2010

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The intention of the healthcare reform law is to increase access to insurance. It largely attempts to do so via stringent regulations. However, most of those regulations will not become effective until 2014.

The gap is a serious issue. Between now and then, health insurers will still be able to deny coverage to people with pre-existing conditions. Secretary of Health and Human Services Kathleen Sebelius is asking for their cooperation to help remedy this dilemma.

Doing so will probably be quite difficult, since the Obama administration has taken a largely adversarial role against providers of health insurance plans in the past. According to Sebelius, their goal is to stabilize the private sector by promoting the elements that could increase their sales (e.g. tax credits for small businesses).

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Healthcare Reform Complicates Tax Reporting

Thursday, July 8th, 2010

As most know, the healthcare reform law includes an affordable individual health insurance mandate, intended to bring more people into the pool and make health care less expensive for all.

According to the provision, the IRS is responsible for enforcement of the medical insurance mandate. Non-exempt individuals or employers who violate it will charged penalties on their tax returns. However, there are doubts that the Internal Revenue Service is up to the task.

The requirement also creates more complications for business and nonprofit accountants when filing tax returns. In an attempt to reduce underreporting of income (which would reduce federal funding for medical insurance reform), they will now be responsible with keeping records of the 1099 forms they will have to have for all transactions over $6,000, as of 2012.

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Will Health Insurance Plans Be Required To Cover Contraception?

Monday, July 5th, 2010


Many believe that healthcare reform will result in health insurers providing full coverage of contraception. This is because the law requires plans to cover “essential preventative care services” at no cost to the patient. That means no co-payments or co-insurance percentages!

For several reasons, the idea of full coverage for birth control is controversial. Social conservatives are leery of appearing to endorse premarital sexual activity (although married couples use contraception as well). For their part, many employer-based health insurance plans are dreading yet another mandate that increases their costs. However, that cost is far less than what they will otherwise have to pay in maternity cost.

The Health Resources and Services Administration will make the decision.

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Support For Healthcare Reform Continues to Rise

Friday, July 2nd, 2010

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Although healthcare reform is still extremely controversial, a recent poll showed that Americans’ outlook on the law became more positive in June.

The Kaiser Family Foundation’s polling showed that 48% of respondents were now in favor of the bill, an increase of 7% from the month before. Opposition decreased by three percentage points, to 41%.

Why the change of heart? There are several contributing factors. For one thing, the political heat has somewhat died down–other issues have taken the spotlight. Meanwhile, the Obama administration had launched a public relations campaign, which drew attention to the beneficial affordable health insurance-related provisions taking effect this year.

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