There seems to always be a new surprise as we find out what's in this law. Is it really manadatory?
The Michael Cannon quote referred to above:
Can you opt out of Obamacare? Two weeks ago, I pointed out Section 1555, one of the major chinks in PPACA's armor according to an attorney at the Goldwater Institute. Section 1555 is in the law under "Subtitle G - Miscellaneous Provisions." Since bringing this up, I've heard from some who believe that this section is limited solely to those who sell ("issue") health insurance.
Here again is Section 1555: "No individual, company, business, nonprofit entity, or health insurance issuer offering group or individual health insurance coverage shall be required to participate in any Federal health insurance program created under this Act (or any amendments made by this Act), or in any Federal health insurance program expanded by this Act (or any such amendment), and there shall be no penalty or fine imposed upon any such issuer for choosing not to participate in such programs."
I've contacted Goldwater Institute's attorney, Nick Dranius, and other attorneys for more information and opinions. I've also transcribed Mr. Dranius's webinar comments so you can read them for yourself. See "News to Know" below.
Here is a summary of what I've heard so far:
1) Because of the rush to passage, no Congressional history exists that would describe the meaning or explain the purpose of this section, thus no one is sure why it's in the law, who put it there, or what it means.
2) The language is ambiguous. There are two possible interpretations of the language:
Interpretation #1: The placement of the comma before the word "or" means that the words preceding it ("individual, company, business, nonprofit entity") are not modified by the words,"issuer offering group or individual health insurance coverage."
Interpretation #2: If you disregard the placement of the comma, or otherwise disagree with the above interpretation, the entire opt-out section applies only to entities "offering group or individual health insurance coverage" -- including individuals, companies, etc.
3) Final interpretation may be left to judges if Section 1555 is used in a legal challenge.
4) Given all the mandates in the rest of the law (the totality of the law), some judges may dismiss this section, but others may not.
5) For states with health care freedom acts that challenge Obamacare in court, Section 1555's ambiguity may have to be considered and a legal interpretation made.
But regardless of the interpretation of this section, the fact remains that states, employers and individuals can opt-out of compliance -- and in some cases may even be able to avoid the penalties for doing so (read Michael Cannon in Quotes below).
Individuals and employers still have power. As Justice Roberts ruled, no one can be forced to buy insurance. Likewise, no one has to sell insurance and no one is required to provide insurance. There are penalties for refusing to buy or provide insurance, but they are significantly less than the cost of buying or providing insurance. As the price of insurance skyrockets under Obamacare, expect more and more individuals and businesses to choose penalties rather than insurance.
States can refuse in two ways. States can refuse to expand Medicaid, as the U.S. Supreme Court ruled. And states can refuse to establish the federally-controlled state-based exchanges. The law doesn't require it.
Refusing to cooperate -- which starves Obamacare of the dollars, machinery, and manpower needed for implementation -- may be our best protection until the law is repealed.
"[D]efaulting to a federal exchange exempts a state's employers from the employer mandate - a tax of $2,000 per worker per year (the tax applies to companies with more than 50 employees, but for such companies that tax applies after the 30th employee, not the 50th). If all states did so, that would also exempt 18 million Americans from the individual mandate's tax of $2,085 per family of four. Avoiding those taxes improves a state's prospects for job creation, and protects the conscience rights of employers and individuals ... -- Michael Cannon (Cato Institute),
Just in case anyone debates that rationing will be part of the result of this law. They always knew it would be:
Nick Dranius, a constitutional attorney at the Goldwater Institute said the following during a webinar: "The bottom line is this. The federal health care law is very poorly drafted. Surprise. Surprise. And one of the things that remains a mysterious inkblot into which you can read anything you want is this curious provision that says, 'No individual, company, business, nonprofit entity, or health insurance issuer offering group or individual health insurance coverage shall be required to participate in any Federal health insurance program created under this Act.' It goes on to repeatedly emphasize essentially that nothing is mandatory in Obamacare, depending on how you understand what is meant by the term 'federal health insurance program.'
"And the reason why this is important is it's an obvious ambiguity. It, in one sense clearly cuts against most of the mandates that are in Obamacare, and it can be leveraged under current case law to vindicate state sovereignty under Health Care Freedom Acts such as Tennessee's and the 14 other states that have versions either at the constitutional or statute level....
"This provision, because it is so ambiguous, undercuts any claim that the -- a federally established exchange would preempt [Tennessee's] health care freedom act. Because this language clearly says that no one's required to participate in any federal health insurance program and as [Cato Institute's] Michael Cannon pointed out, a key aspect of any exchange is to do just that, to facilitate and effectuate various mandates to ensure that everybody's participating in a federal health insurance program, namely PPACA's.
...So do not lose faith just yet in the various challenges to PPACA..."
"We need death panels. Well, maybe not death panels, exactly, but unless we start allocating health care resources more prudently - rationing, by its proper name - the exploding cost of Medicare will swamp the federal budget. ...Many countries whose health care systems are regularly extolled - including Canada, Australia and New Zealand - have systems for rationing care...At the least, the Independent Payment Advisory Board should be allowed to offer changes in services and costs. We may shrink from such stomach-wrenching choices, but they are inescapable." - Steven Rattner (Obama's "Car Czar"), The New York Times, September 16, 2012.