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A6 U.S. NEWS
Thursday 9 January 2020
'Obamacare' mandate: hot for lawyers, ho-hum to consumers

By RICARDO ALONSO- and constitutional sense.
ZALDIVAR U.S. District Court Judge
WASHINGTON (AP) — The Reed O'Connor in Texas
repeal of an unpopular fine ruled that by zeroing out
for people without health the tax penalty, Congress
insurance has had little rendered the insurance
impact on "Obamacare" mandate unconstitution-
sign-ups or premiums, a al, and without it the en-
gap between the real tire health law must fall.
world and legal arguments President Donald Trump
from conservatives again agreed.
challenging the Affordable Recently, a federal ap-
Care Act.The 10-year-old peals court in New Orleans
law has proved more resil- agreed with O'Connor that
ient than its creators or de- an unenforceable insur-
tractors imagined, even as ance mandate is uncon-
the Supreme Court consid- stitutional. But the appeals
ers whether to take up the court sent the case back
latest effort to roll it back. to him to see whether other
Opponents argue that the parts of the law can stand.
constitutionality of the en- Defending the law, a co-
tire 900-page law hinges on alition of Democratic-led
the now-toothless penalty states, along with the U.S.
for not having health insur- House, appealed to the
ance. Collected as a tax Supreme Court, seeking a
by the IRS, the penalty was fast-track decision amid
intended to enforce the this year's presidential elec-
law's "individual mandate" tion. The court has asked
that Americans be insured. lawyers for the conserva-
A previous Republican-led tive states to respond by Fri-
Congress set the fines to $0, day on the timing question.
effective last year. University of Michigan law
"We've gotten a lot of evi- This screen grab from the website HealthCare.gov shows the extended deadline for signing up for professor Nicholas Bagley
dence by now about what health care coverage for 2020. said the stability of the
the market looks like with- Associated Press health insurance markets
out a mandate penalty, exposes "the artificiality" of
and on the whole it looks ed. was constitutional. That al- with not-healthy people," the conservatives' argu-
pretty stable, which is sur- Partial sign-up numbers for lowed the law to survive Sebelius said. "What be- ment.
prising because that's not 2020 released Wednesday what's still seen as its most came clear when the law "It really goes to show how
what most people would by the government point to serious legal challenge. went into effect (in 2014) is ridiculous it is to claim that
have expected when the stability. Nearly 8.3 million Kathleen Sebelius, health that the subsidies in many Congress understood the
ACA was being written," people enrolled in the 38 secretary for President ways provided a greater mandate to be so essen-
said Cynthia Cox, who states served by the federal Barack Obama, said in incentive for people get tial that if it were to be red-
directs research on the HealthCare.gov website. 2012 that it was generally health insurance." lined out, the rest of the law
health law for the nonpar- That's down only about 2% accepted that the insur- Those subsides are de- would have to fall," said
tisan Kaiser Family Founda- from last year, when one ance mandate was part of signed so that low- and Bagley.
tion. additional state was using a three-legged stool key to moderate-income house- Not so fast, said Andrew
A Kaiser study released this HealthCare.gov. A final stable markets. The other holds only spend a fixed Schlafly, a lawyer repre-
week found that removal count including that state two legs were taxpayer- percentage of their in- senting groups siding with
of the penalty pushed pre- — Nevada — and others provided subsidies for pre- comes on premiums, shield- Texas and the other GOP-
miums up about 5% going that run their own sign-up miums and a guarantee ing consumers from high led states opposing the
into 2019, but the bottom efforts is expected by the that patients with preex- sticker prices. law.
line was a wash because spring. isting medical conditions Cox agreed that the law's "The question is not wheth-
of other factors. Insurers The insurance mandate could no longer be turned "carrots" seem to have er in reality (the ACA) can
appeared to be making was the central issue when down or charged more. made more of a difference work without the mandate,"
healthy profits. the Supreme Court first up- "It was thought that the than its "stick." said Schlafly. "The test is
The penalty was thought held the health care law in trade-off for changing the Fast-forward to 2018 and whether it was intended to
to be critical when the 2012, over a year before rules on preexisting condi- a coalition of conservative work without the mandate.
law was being written in HealthCare.gov opened tions would have to be ... states led by Texas won a "Theory does matter to
2009-2010. The idea was to for business. some penalty incentive lower court decision that these Supreme Court jus-
nudge healthy people to Chief Justice John Rob- so you would get healthy the insurance mandate tices," he added, "and they
sign up, helping keep pre- erts cast the key vote in people in the pool, along was still critical, in a legal do take theory seriously."q
miums in check. But Cox that 5-4 decision. He found
said there's no indication that Congress lacked con-
that healthy people have stitutional authority to re-
dropped out in droves. In quire that Americans have
one telling statistic, the Kai- health insurance. But be-
ser study found that aver- cause Congress has broad
age hospital days per 1,000 powers to levy taxes, Rob-
people enrolled dipped erts ruled that a tax on peo-
slightly in 2019, even after ple who did not purchase
the penalty was eliminat- coverage offered them