Just Another Tax Loophole

I’ve written in these pages about what I consider the horror of ‘health care reform.’  We have a serious problem with health care in this country: it costs too much.  And nothing in the Patient Protection and Affordable Care Act will do anything useful to make care affordable.

I empathized with my conservative friends who considered it unconstitutional.  I wanted to believe myself that the requirement to purchase insurance went beyond the Federal government’s constitutional power to regulate commerce.  But I couldn’t quite believe that the Supreme Court could strike it down, although I couldn’t say way.

But the Supremes upheld Obamacare for the reason I couldn’t quite put my finger on.  The penalty for not having health insurance is a tax, Obama’s minions’ protests to the contrary notwithstanding.  Consider:

  • The penalty will be administered by the IRS;
  • You’ll pay it as part of your income taxes;
  • You won’t suffer any other consequences for failing to carry health insurance and paying the ‘penalty.’  You won’t get locked up, or lose your right to vote, or your professional licenses, or even get points on you driver’s license.  Hell, you won’t even lose your right to get medical care as an uninsured person.
  • If you don’t carry health insurance, and fail to pay the penalty, the government will come after you for… failing to pay your taxes.

If it looks like a tax, and quacks like a tax, well, it’s a tax.  It’s a selective tax, meant to encourage you to do something, and in that sense it’s hardly unique.  The tax code is filled with thousands of provisions to ‘adjust’ one’s tax liability in response to this or that.

It’s also telling that the Supreme Court didn’t touch any of the administrative apparatus of Obamacare.  They had no problem with the government defining what an acceptable health insurance plan consists of.  But then again, government has been regulating for over a century: what’s new about that?

Well, that settles one thing: I’m off the fence, and voting for Romney.  I don’t like either of the candidates, and for the most part I can’t see any meaningful difference between them.  But Romney acknowledges that health care reform is trouble, and at least pretends that he will do something about it.   (And yes, I know that as governor of Massachusetts, Romney pushed a similar health insurance plan to become law there.  But he’s allowed to acknowledge that it was better in concept than execution.)

Alas, I don’t expect the effort to repeal Obamacare to get much traction.  Not because of backlash from the other side, nor for the useful bits of the law that nobody wants to lose.   The big money will realize that Obamacare will marshal trillions of dollars to pay for health care, and they’ll want their share.  The result will be a big burst of investment in health care: new hospitals, pharmaceutical plants, and thousands and thousands of jobs.  (I can hear Senator Schumer now: ‘A vote to kill Obamacare is a vote to kill jobs.’)  It will pull the economy out of the doldrums–happy days are here again!–and last for two or three years, maybe four.

And then they’ll realize that nobody can afford to pay for health insurance, and the government is broke, and it will all implode.

2 thoughts on “Just Another Tax Loophole”

  1. I am glad other people see what this really is, a tax. I’m not opposed to universal health care and I feel we need it in this country but this is NOT it. What this horrendous thing will do is penalize people for not having insurance and will hurt those people who are poor yet don’t qualify for Medicaid. The reality is in many states Medicaid will not cover people like me, the childless. Instead I will be forced to pay for something I will not benefit from and in the event I am still broke I will be more broke. That is the reality. Plus, the Medicaid system, at least in Illinois is broken. The service is very poor, with doctors who are often the worst of the worst (many have gotten in trouble)and the equipment is outdated. The free and low cost clinics in Illinois are in ghetto areas.

    Let’s also mention the religious aspect, ie birth control. I am not opposed to birth control though I am Catholic. I am also not opposed to abortion either (though I have serious issues with it, including the women who use it instead of birth control). Part of the Obamacare involves Catholic organizations (which opposes birth control)required to pay for it. This to me is horrible and it would be like requiring a Jewish deli to give away free pork sandwiches. I realize we have a separation of state and church and I agree with that, but in effect this is telling Catholics to f* off.

    Having said that I do not think Romney will be better. He pushed something like this in Mass so I expect more of the same.

  2. There is case law that holds that the constitutionality of taxes cannot be adjudicated until after the tax is paid, so there will be yet another lawsuit in a few years to settle that matter. This is only the first round. Nothing is settled yet.

    I’m curious about how one proves that they are carrying health insurance. Do we send in a copy of our insurance card or will there be a W-2H issued by employers showing the amount of money that we paid (or was paid on our behalf) for health insurance during the year and number of months that the policy was in effect? There is Form W-2G issued for gambling winnings over $1199, so I just picked the next letter.

    A problem is that Obamacare does not end the cost-shifting that has been rampant for about 40 years. Different plans have different reimbursement rates, and hospitals are not required to be a member of every insurance network. As far as I know, EMTALA (Emergency Medical Treatment and Active Labor Act) is still in effect, so doctors and hospitals will still need to recoup the money that they lose on those cases on paying customers.

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