Most Popular Question at Healthcare.gov: How to Get Exemption From Lack-of-Coverage Penalty Fee?

    One day away from the launch of the Obamacare marketplaces, the question most on the minds people visiting the Healthcare.gov website is not about coverage, but rather about avoiding the penalty, or tax, for not having health insurance.  As of Monday morning, here is how the website listed its "Most Popular" items:

    As the website explains, the fee (tax) in 2014 is 1% of annual income or $95 per person, whichever is higher. The fee increases each year. By 2016 it increases to 2.5% of income or $695 per person, whichever is higher.


Note: A version of this article first appeared at The Weekly Standard.

The ACLU's Versatile First Amendment

    The ACLU has long been the target of critics who claim that, with a few exceptions, the organization is far more concerned with liberalism than liberties, its name notwithstanding. Two recent posts on the ACLU website will bolster the arguments of the critics, of whom I count myself one.   On April 3, 2013, the ACLU weighed in on a case currently before the Supreme Court:

Yesterday, we filed a friend-of-the-court brief in the Supreme Court in a case called United States Agency for International Development v. Alliance for Open Society International, opposing the so-called "Anti-Prostitution Pledge." The Pledge is a requirement that public health organizations who wish government funding for their work combatting AIDS and other diseases make a formal statement "opposing prostitution." 

The Pledge puts organizations in a quandary: On one hand, they can take the government's money and say something they might not really believe, have no opinion about, or see as a complex social issue irreducible to anything as simpleminded as "opposing prostitution." On the other hand, they can take a principled stand against the Pledge, forfeiting a share of billions of dollars in government aid that they could otherwise put to good use curbing disease and relieving human suffering. 

As we argued to the Supreme Court, the Constitution forbids the government from engaging in such moral compulsion. The First Amendment is, at its core, a shield against government intrusions into belief. When the government attempts to compel adherence to its view on any issue, it invades our very minds.... 

... the Supreme Court has made it clear that – whatever else the government may do – it may not dictate personal thoughts or beliefs. Any attempt to do so does violence to human dignity and distorts public debate.

    A conservative, especially a religious one, might be inclined to Amen the characterization of the First Amendment as "a shield against government intrusions into belief." The ACLU, however, finds that shield to have limited application on the judicial battlefield.  Contrast the stirring defense of "personal thoughts or beliefs" with the position the ACLU takes on the "contraceptive mandate" that is part of the Affordable Care Act:

[T]he ACLU and the ACLU of Illinois filed a friend-of-the-court brief in two additional appeals challenging the Affordable Care Act's ("ACA") contraceptive coverage rule... 

The contraceptive rule, which requires health plans to include coverage for contraceptive care without a co-pay or deductible, ensures that millions of women will have access to affordable birth control, and represents one of the greatest advancements for women's health in decades. Ignoring this fact and the fact that the contraceptive rule is constitutional, the companies and their owners argue that providing health insurance coverage for contraception to their collective 1,168 employees imposes a "substantial burden" on their religious exercise. We strongly disagree... 

As we noted in the brief, the contraceptive rule does not compel or coerce employers to use or purchase contraception themselves. The rule simply requires employers to provide their employees with a comprehensive health plan.

    The ACLU has taken a constitutional stance that allows no conditions to be imposed on an organization receiving taxpayer money, yet permits the government to coerce an organization to spend its own money in violation of its beliefs.  The values and priorities of the ACLU have created this ludicrous pairing of positions that would be comical if the stakes were not so high.  The First Amendment "shield" is not strictly a defensive weapon for the ACLU, but, depending on the objective, can be used as a bludgeon as well.

Passport to a Brave New World

    In a recent post, I wrote about how the Obama campaign has been touting the strides it has made on behalf of the "transgendered", the "T" in LGBT.  One such stride dates back to June 2010, and receives not one, but two mentions on the LGBT page of the campaign website under the heading "Trans Equality" [emphasis mine]:

• Ended the Social Security Administration’s gender “no-match” letters and allowed for true gender passports
• Ensured that transgender Americans can receive true gender passports without surgery

    It is unclear why this accomplishment is listed twice.  But even though the repetition would seem to indicate its level of significance, at the time the White House ignored this development.  There's no press release or statement about it on the White House website in June 2010 or since.  Even when President Obama addressed an LGBT Pride Month reception in the East Room at the White House on June 22, 2010, just 13 days after the State Department announced the rule change in a "Media Note," he made no mention of the new passport rule.  However, the change was reported more heavily in the media than the SSA's dropping of gender "no-match" letters that I noted in my previous post.  Time and CNN, for example, both covered this story.  So why the initial soft-sell from the administration?
    I believe it is part of an overall strategy (though not an organized conspiracy) to move the country leftward on social issues.  Conservatives and Christians must recognize that this slow but relentless push for amorality is not a slippery slope, but a carefully planned and staked out rainbow path to virtually complete sexual license.  Pioneers like Gore Vidal (as Albert Mohler wrote about the other day) are sometimes brash and confrontational, but the broader movement often follows a slow Obama-like"evolution", trudging down the path, dragging American culture and social mores behind them.  Unfortunately, the weak moral principles of much of American society and even American churches often do not even require dragging.  We simply lollygag back further on the path until fear of being completely left behind and labeled as intolerant haters goads us into reluctantly catching up.
    The increasing profile of transgendered issues follows President Obama's and Vice President Biden's switch on same-sex marriage.  Now that that bomb was dropped, it's time to deepen inroads in other areas.  The emphasis on the passport rule is a good example of the strategy.  The LGBTer have borrowed a page from the pro-choice handbook by couching transgender issues as "medical" matters best left to the individual and his/her doctor.  The State Department rule change says:

It is also possible to obtain a limited-validity passport if the physician’s statement shows the applicant is in the process of gender transition. No additional medical records are required. Sexual reassignment surgery is no longer a prerequisite for passport issuance.

Every type of abortion, from the earliest abortificents such as RU-486 to post-birth/partial-birth abortions, has been justified by a "health of the mother" exception.  "Health" has, of course, been expanded to cover mental, emotional, physical and any other type of "health" abortion advocates can squeeze in.  So labeling transgender as a medical/health issue says, "Hands off.  It's my body.  It's between me and my doctor."  As the faux religious compromise on the HHS insurance mandate shows, "medical" needs (birth control, abortifacients, sterilization) trump religious liberty in the Obama administration.  How long will it be before religiously affiliated institutions or even churches are barred from discriminating against the "medical" needs of the transgendered?
    While it was encouraging to see free speech and freedom of religion largely defended, even by some on the left, in the recent Chick-Fil-A dust-up, note this:  Chick-Fil-A and many of its defenders were quick to point out that Chick-Fil-A does not discriminate against customers on the basis of "sexual orientation," and regarding employment, Chick-Fil-A is "an equal opportunity employer and does not discriminate in employment decisions based on any factor protected by federal, state or local law."  But how far can those laws be pushed?  When will the North American Man-Boy Love Association break through and receive acceptance from the experts in the medical community?  Will we kick and scream for a few decades before falling into line?
    And does anyone think that "LGBT" is really the end of the line?  Try Googling "LGBTQIA".  That's right, 119,000 results as of today.  "Lesbian, Gay, Bisexual, Transgender, Questioning, Intersex, and Asexual."  And there are still 19 more letters in the alphabet.  Brave New World indeed.  But who will be the brave?

The Real Insurance Mandate Problem

    During the lead up to the Supreme Court's consideration of ObamaCare, we were told over and over again, "Of course the government can require people to buy insurance.  Look at auto insurance!  No one disputes that the government can require that." (I find the comparison silly - auto insurance is only needed if one drives, and it's primarily to cover other drivers, not the one who owns the policy.)  But where does the auto insurance comparison logically lead based on Thursday's decision?  From page 4 of the opinion:

[T]he mandate need not be read to declare that failing to [purchase ... health insurance] is unlawful. Neither the Affordable Care Act nor any other law attaches negative legal consequences to not buying health insurance, beyond requiring a payment to the IRS. And Congress’s choice of language—stating that individuals “shall” obtain insurance or pay a “penalty”—does not require reading §5000A as punishing unlawful conduct. It may also be read as imposing a tax on those who go without insurance. (see also)

Is this anything like the penalty (or "tax" as we now call it) for driving without auto insurance? Hardly, according to this Fox Business News article.  The laws vary from state to state, but those penalties can be quite severe.  Roberts's opinion actually comments on the relative leniency of the penalty as working in ObamaCare's favor in his decision to uphold.  Roberts also noted that the ACA restricted the IRS's power to even collect the penalty/tax:

The Act ... bars the IRS from using several of its nor­mal enforcement tools, such as criminal prosecutions and levies... And some individuals who are sub­ject to the mandate are nonetheless exempt from the penalty—for example, those with income below a certain threshold and members of Indian tribes. (page 8)

So is there really a meaningful individual mandate?  Or has it been more of a suggestion all along as I wrote earlier?  How is the IRS ever going to collect this penalty/tax without threat of "prosecutions and levies"?  As the Fox Business article I referenced above notes, even with more severe penalties for not having auto insurance (which is much cheaper than health insurance,) up to a quarter of drivers in some states do not carry it anyway.
    The real problem with mandates is not the individual mandate, but rather the mandates that the federal and state governments have placed on the insurance companies.  Insurance companies that lack the freedom to consider pre-existing conditions, health history, and determine what they will and will not cover are not "insurance" companies at all, but simply inefficient, unnecessary money conduits.  Frankly, they are irrelevant. The same outcome could be achieved by eliminating insurance companies altogether and requiring all healthcare providers to provide all services for a set monthly fee regardless of how little or how much care patients required.  But it has always been easier to paint insurance companies as greedy and evil than it has been to characterize doctors that way, and liberals need an enemy to push their policies.  That is why, barring repeal of ObamaCare and serious, comprehensive state-level insurance reform, it is the insurance company mandates that will eventually bring down the system and lead to the single-payer system that Barack Obama and many liberals have wanted all along.  

Is That a Mandate?

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