GOP State AGs File Suit Against New Health Law

Here is the complaint (PDF). I took a cursory glance and have little respect for the constitutional arguments against the mandate, though they clearly have more political potency. More plausible is the argument regarding the imposition of duties upon State officials:

The Act requires states to expand massively their Medicaid programs and to create exchanges through which individuals can purchase healthcare insurance coverage. The federal government is to provide partial funding for the exchanges, but will cease doing so after 2015. [. . .] The federal government will not provide necessary funding or resources to the states to administer the Act. Nevertheless, states will be required to provide oversight of the newly-created insurance markets, including, inter alia, instituting regulations, consumer protections, rate reviews, solvency and reserve fund requirements, and premium taxes. States also must enroll all of the newly-eligible Medicaid beneficiaries (many of whom will be subject to a penalty if they fail to enroll), coordinate enrollment with the new exchanges, and implement other specified changes. The Act further requires states to establish an office of health insurance consumer assistance or an ombudsman program to advocate for people in the new programs.

The GOP State AGs will argue this runs afoul of Printz. The complaint states:

57. By effectively co-opting the Plaintiffs’ control over their budgetary processes and legislative agendas through compelling them to assume costs they cannot afford, and by requiring them to establish health insurance exchanges, the Act deprives them of their sovereignty and their right to a republican form of government, in violation of Article IV, section 4 of the Constitution of the United States.

58. The Act violates the Tenth Amendment of the Constitution of the United States, and runs afoul of the Constitution’s principle of federalism, by commandeering the Plaintiffs and their employees as agents of the federal government’s regulatory scheme at the states’ own cost.

Clearly this is designed to invoke Printz, where Justice Scalia wrote for the Court:

It is most implausible that the person who labored for that example of state executive officers' assisting the Federal Government believed, but neglected to mention, that they had a responsibility to execute federal laws. If it was indeed Hamilton's view that the Federal Government could direct the officers of the States, that view has no clear support in Madison's writings, or as far as we are aware, in text, history, or early commentary elsewhere.

To complete the historical record, we must note that there is not only an absence of executive commandeering statutes in the early Congresses, but there is an absence of them in our later history as well, at least until very recent years.

The Government points to a number of federal statutes enacted within the past few decades that require the participation of state or local officials in implementing federal regulatory schemes. Some of these are connected to federal funding measures, and can perhaps be more accurately described as conditions upon the grant of federal funding than as mandates to the States; others, which require only the provision of information to the Federal Government, do not involve the precise issue before us here, which is the forced participation of the States' executive in the actual administration of a federal program. We of course do not address these or other currently operative enactments that are not before us; it will be time enough to do so if and when their validity is challenged in a proper case. For deciding the issue before us here, they are of little relevance. Even assuming they represent assertion of the very same congressional power challenged here, they are of such recent vintage that they are no more probative than the statute before us of a constitutional tradition that lends meaning to the text. Their persuasive force is far outweighed by almost two centuries of apparent congressional avoidance of the practice.

Scalia goes on to rule such "commandeering" unconstitutional:

The dissent of course resorts to the last, best hope of those who defend ultra vires congressional action, the Necessary and Proper Clause. It reasons, post, at 3-5, that the power to regulate the sale of handguns under the Commerce Clause, coupled with the power to "make all Laws which shall be necessary and proper for carrying into Execution the foregoing Powers," Art. I, § 8, conclusively establishes the Brady Act's constitutional validity, because the Tenth Amendment imposes no limitations on the exercise of delegated powers but merely prohibits the exercise of powers "not delegated to the United States." What destroys the dissent's Necessary and Proper Clause argument, however, is not the Tenth Amendment but the Necessary and Proper Clause itself. [n13] When a "La[w] . . . for carrying into Execution" the Commerce Clause violates the principle of state sovereignty reflected in the various constitutional provisions we mentioned earlier, supra, at 19-20, it is not a "La[w] . . . proper for carrying into Execution the Commerce Clause," and is thus, in the words of The Federalist, "merely [an] ac[t] of usurpation" which "deserve[s] to be treated as such." The Federalist No. 33, at 204 (A. Hamilton). See Lawson & Granger, The "Proper" Scope of Federal Power: A Jurisdictional Interpretation of the Sweeping Clause, 43 Duke L. J. 267, 297-326, 330-333 (1993). We in fact answered the dissent's Necessary and Proper Clause argument in New York: "[E]ven where Congress has the authority under the Constitution to pass laws requiring or prohibiting certain acts, it lacks the power directly to compel the States to require or prohibit those acts. . . . [T]he Commerce Clause, for example, authorizes Congress to regulate interstate commerce directly; it does not authorize Congress to regulate state governments' regulation of interstate commerce." 505 U. S., at 166.

To call Printz an exercise in brazen conservative judicial activism far understates the case. Nonetheless, it provides a reed of an argument for the GOP State AG's challenge to the state exchanges in the health bill.

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    Interesting. Thanks. (5.00 / 1) (#11)
    by oculus on Tue Mar 23, 2010 at 02:31:05 PM EST
    Nice to see in Printz Justice Scalia confined himself to deciding the case before him.

    Why a Mandate? (5.00 / 1) (#17)
    by SOS on Tue Mar 23, 2010 at 03:32:50 PM EST
    Because I suspect in the near future, the big spenders in Washington will issue IOUs, as they begin to "permanently borrow" funds from this vast new pool of accumulated health care tax funds.

    Just like they did to the Public Trust Fund known as Social Security. Which of course is in trouble because it was quietly slipped into the general expense accounts of these hi-rolling politicians who quietly bled SS to death.

    Why a Mandate? (5.00 / 1) (#18)
    by MO Blue on Tue Mar 23, 2010 at 03:38:16 PM EST
    Because the insurance industry was pricing themselves out of the market and more people and employers were dropping coverage due to the expense.

    Insurance Company's don't need to worry (5.00 / 1) (#19)
    by SOS on Tue Mar 23, 2010 at 03:52:22 PM EST
    about that now do they?  Imagine what you could do with guaranteed future revenues as collateral. Yachts, exotic vacation homes, etc.

    To combat adverse selection (none / 0) (#29)
    by Manuel on Tue Mar 23, 2010 at 05:32:14 PM EST
    If you are going to keep a private insurance based system, it is an economic necessity.

    Government (5.00 / 1) (#54)
    by DancingOpossum on Wed Mar 24, 2010 at 08:57:56 AM EST
    Go to school.
    Pass a standardized test.
    Enlist in the army.
    Pay Taxes.
    Comply with regulation.
    Travel with a passport.

    None of these involve buying a specific product from a private corporation. None of these mandate that you spend your money on a product you may not want and may not be able to afford.

    That's the point. Most of us (if we are reasonable people) accept the necessity of taxes to have a functioning civil society where everyone shares in the benefits and the risks. That is NOT the same as accepting the necessity of further enriching a specially selected industry. When you pay your passport fee or for your emissions test, that money goes to the government. It does not go to a certain for-profit, private industry especially singled out for this special treatment (oh the lucky ducky).

    BTD, what would happen if the court rules in (none / 0) (#1)
    by Buckeye on Tue Mar 23, 2010 at 02:19:14 PM EST
    favor of the GOP?

    Not sure (none / 0) (#9)
    by Big Tent Democrat on Tue Mar 23, 2010 at 02:29:52 PM EST
    I do not know if there is a saving clause in the legislation or even if there is one, a court would deem the legislation able to function without the exchanges.

    By "savings clause" did you mean (none / 0) (#31)
    by Peter G on Tue Mar 23, 2010 at 06:31:22 PM EST
    "severance clause"?  If not, I'm not sure what you do mean here, BTD.  Clarify?

    Interchangeable? (none / 0) (#32)
    by oculus on Tue Mar 23, 2010 at 06:35:46 PM EST
    Precisely (none / 0) (#34)
    by Big Tent Democrat on Tue Mar 23, 2010 at 06:37:07 PM EST
    I know it as a savings clause (none / 0) (#33)
    by Big Tent Democrat on Tue Mar 23, 2010 at 06:36:37 PM EST
    You seem to know it as a severance clause.

    Same thing.


    Thanks (none / 0) (#38)
    by Peter G on Tue Mar 23, 2010 at 09:25:27 PM EST
    My mistake, I guess.  I thought a "savings clause" would be a provision that if the present law were struck down then any prior inconsistent law that it had repealed would be automatically revived.  Every day I learn something new is a good day.

    Even if Courts dismiss the complaint (none / 0) (#52)
    by BobTinKY on Wed Mar 24, 2010 at 08:52:19 AM EST
    that dismissal provides basis for appeal up to the Surpreme Court.  And that is where the radicals reign.

    In fact I would seek dismissal (none / 0) (#57)
    by BobTinKY on Wed Mar 24, 2010 at 09:17:27 AM EST
    If I were the AGs I'd file this complaint in the most liberal court I could find and have it dismissed, hopefully in the 9th Circuit where a dismissal might be more likely to be upheld.  Then onto the Supremes where you get the "right" judges to rule, judges that have demonstrated that they do not confine themselvs to the issue before them.

    The sooner it gets to SCOTUS the better the chance it will be struck down. The practical roadblocks get less surmountable as more time passes.


    They undercut their own argument IMO: (none / 0) (#2)
    by andgarden on Tue Mar 23, 2010 at 02:19:40 PM EST
    Should a state not wish to participate in the exchanges, it can opt out only if it provides coverage for uninsured individuals with incomes between 133 percent and 200 percent of the federal poverty level, a higher income level than that which would be applied for participating states under the Act. The only other way for a state to avoid the Act's requirements is to drop out of the Medicaid program, leaving millions of persons uninsured.
    Because the states have the option of opting out of Medicaid, this is not a Printz case, it's a Rumfseld vs. FAIR or South Dakota v. Dole case.

    The really, really stupid thing (5.00 / 1) (#13)
    by Socraticsilence on Tue Mar 23, 2010 at 02:42:55 PM EST
    is that Medicaid at least as currently constructed (not as modified by the bill) is a great deal for the poorer states- they get incredible match rates and when you add-in the funding they recieve for Community Hospitals (forgot exact taxonomy) some states can actually come out ahead in Medicaid funding (Miss. for instance has at times recieved more in federal funds than they laid out in total disburesments- essentially profiting from medicaid-- 90-10 or whatever match rate plus a hostpital allowance greater than the remaining 10% given directly to the state). So essentially they're arguing that they're willing to get less money from the federal government than have to help poor people.

    Sure (none / 0) (#3)
    by Big Tent Democrat on Tue Mar 23, 2010 at 02:22:48 PM EST
    But if you want to decide a certain way, this is the best argument to latch on to.

    The mandate argument is simply ridiculous.


    Yeah, I think so too (none / 0) (#4)
    by andgarden on Tue Mar 23, 2010 at 02:24:47 PM EST
    Realistically, I can't see the Court invalidating Obamacare. Even Roberts would hesitate to call Medicaid into question.

    The exchanges (5.00 / 1) (#5)
    by Big Tent Democrat on Tue Mar 23, 2010 at 02:26:08 PM EST
    are the easiest bit to get at it seems to me.

    I agree (5.00 / 1) (#6)
    by andgarden on Tue Mar 23, 2010 at 02:27:30 PM EST
    And it's because the "moderates" insisted that they be state based. The House bill made them national.

    Sure (none / 0) (#7)
    by Big Tent Democrat on Tue Mar 23, 2010 at 02:29:06 PM EST
    "Federalism" you know.

    I assume you relish in that reality, BTW (none / 0) (#8)
    by andgarden on Tue Mar 23, 2010 at 02:29:46 PM EST
    Considering that they're Ezra's prized possessions.

    I admit (5.00 / 4) (#10)
    by Big Tent Democrat on Tue Mar 23, 2010 at 02:30:32 PM EST
    that I would experience a little shadenfreude (sp?) if it happened.

    Schadenfreude (5.00 / 1) (#12)
    by gyrfalcon on Tue Mar 23, 2010 at 02:36:06 PM EST
    there's a "c" in there.  And if you wanted to be absolutely, perfectly correct, you'd capitalize it (nouns are all capitalized in German).

    Die Schadenfreude. (none / 0) (#24)
    by oculus on Tue Mar 23, 2010 at 05:07:00 PM EST
    And see:
    German To Spanish - Schadenfreude  
    n. alegría de mal ajeno (f), gustazo (m)

    Ridiculous perhaps, but (none / 0) (#51)
    by BobTinKY on Wed Mar 24, 2010 at 08:50:03 AM EST
    why would lack of any precedent stop the Roberts Court?

    The mandate argument is popular with the right wing.  TPM has a good analysis of the mandate argument and concludes, wisely, while there does not seem to much if any legal support for the AGs' position, SCOTUS overturning the mandate is not out of the realm of possibility.  I would go further and say, however ridiculous the arguments against the madate are in light of existing law, one should not be surpised if the court strikes down the mandate in a 5-4 decision.  

    The Roberts Court is as radical a Court as we have seen.


    GOP AG's . . . (none / 0) (#14)
    by Doc Rock on Tue Mar 23, 2010 at 03:19:33 PM EST
    There's no business, like show business . . .   !

    Please, (none / 0) (#16)
    by bocajeff on Tue Mar 23, 2010 at 03:30:56 PM EST
    Can someone tell me why, if I don't want to, have to buy health insurance for myself? Why can't I self insure if I elect to? Why is it anyone's business what I do for myself.

    Sort of like motorcycle helmets, seat belts, weed, etc...

    Because health insurance is based on the idea (5.00 / 1) (#20)
    by Spamlet on Tue Mar 23, 2010 at 03:54:42 PM EST
    of pooled risk.

    If some of the healthy people are not in the pool, then the cost of health care rises for everyone else who is in the pool, since treatment costs for sick people drive up the cost per capita.

    That's why insurance companies exclude people with "pre-existing conditions" and engage in other practices.

    No national health care system, however imperfect, can function without mandated universal health care insurance. In exchange for the mandate, insurance companies stop practices like excluding people for pre-existing conditions.

    One major objection I have to Obamacare is that there is no public option and no protection (that I can see) from regulatory capture.

    Can someone tell me why, if I don't want to, have to buy health insurance for myself?

    Nobody's talked about (5.00 / 1) (#26)
    by TeresaInSnow2 on Tue Mar 23, 2010 at 05:10:40 PM EST
    how much they can CHARGE people with pre-existing conditions in premiums.

    Some say (see Corrente) they can charge 4x the amt that "healthy" insurees pay.

    If you have  to insure under the mandate pray that you don't get sick before it's implemented.

    Otherwise you'll be "simply paying the tax" as some on this blog have flippantly called it, while "self-denying" yourself insurance because you can't afford to pay 4x the amount that "healthy" people pay.


    Yes, like helmets and seatbelts (5.00 / 2) (#22)
    by MKS on Tue Mar 23, 2010 at 04:26:22 PM EST
    That does answer the question....

    For the good of society.....


    Would you be willing (5.00 / 2) (#23)
    by Natal on Tue Mar 23, 2010 at 04:30:07 PM EST
    to provide evidence that you're capable of self-insuring if this were allowed?  Sign a waiver, declare assets, have a guarantor if need be etc. As a participant in the healthcare program I'd want some guarantee the self-insured were not going to impinge on my program costs.

    Becasue, you can't be trusted to do (none / 0) (#25)
    by Radix on Tue Mar 23, 2010 at 05:08:02 PM EST
    the right thing. Don't get me wrong, I don't blame you for not doing the right thing, but you wouldn't. You end up in an emergency room, after being struck by lightning, it turns out you simply don't have enough money/assets to cover your costs, rather than crawling out of there and quietly dying, doing the right thing, you insist on being treated under Medicaid. Thereby forcing society to cover your Medicaid costs.

    What if (none / 0) (#27)
    by TeresaInSnow2 on Tue Mar 23, 2010 at 05:13:57 PM EST
    you get an injury that your federally mandated junk insurance won't cover?  There is no regulation/stipulation on what insurance has to cover.  No, they can't deny you "coverage" for pre-existing conditions, but they can severely limit what they cover of your pre-existing condition.

    What if you "self-deny" and "simply pay the tax" because you can't afford insurance?

    What then?  Why, you'll still be visiting the ER.

    The problem isn't solved by making it illegal to not have insurance.


    Not sure I accept all your (none / 0) (#28)
    by Radix on Tue Mar 23, 2010 at 05:23:56 PM EST
    statements on the coverage aspect of things. Also not sure how these issues, assuming for the moment they are fact, address the issue of why we can't simply trust people to self insure.

    The fact is (none / 0) (#35)
    by TeresaInSnow2 on Tue Mar 23, 2010 at 08:19:58 PM EST
    People may have NO CHOICE but to self-insure under these laws.  I've been on the individual market for years.  I am CONFIDENT that my insurance will go up this year and the excuse this year will be the bill.

    With no cost controls, and with "mandates," by 2014, I've no doubt the affordability of insurance will be way less than it is now.

    What I'm saying is this bill will NOT change many people's need to use the ER as their only mechanism.  But now instead of Democrats feeling sorry for people who have to use the ER as their only mechanism for healthcare, these people will be deemed deadbeats, as you are all but doing.


    I think the tax is intended to offset the cost of (5.00 / 1) (#58)
    by BobTinKY on Wed Mar 24, 2010 at 09:45:15 AM EST
    emergency room visits etc by uninsured people.  Thus there is less reason to call the unisinured deadbeats or free riders as economists prefer.  

    I may be wrong but I don't share your pessimism on the cost impacts.  The wider pool of insured that will include many new & healthy premium payers, the oversight of plan costs a transparency etcc. these things will put downward pressure on premiums for the same coverage.  

    More importantly, I think the new dynamics of health care, with everyone now concerned about costs, will drive people to demand more cost effective health insurance, including government provided insurance.  I think it is important to recognize that HCR not only alters the health insurance market, it alters the political ground on which the continuing debate for an improved system takes place.

    Even if you are right that by 2014 costs will skyrocket, do you believe that would not be the case had the bill failed?  I hate to sound like I am pledging allegiance to this bill, I think we could have gotten a much better bill had Obama and the Dem acted like Dems, but it is hard for me to see how yesterday's status quo was in any way preferrable to today's HCR legislation.


    Petitions proliferate here in WA (none / 0) (#21)
    by RonK Seattle on Tue Mar 23, 2010 at 03:57:39 PM EST
    Not petitions to the court, but petitions asking our GOP AG (and Gov hopeful) Rob McKenna to cut the crap.

    Here's one by King County Democrats.

    Here a Facebook group, Washington Tax Payers OPT OUT of Rob McKenna's lawsuit.

    Here's one by blue/green alliance FUSE.

    There's probably more.  Sightings in other states? Any signs of national pressure group action?

    Clean Air Act (none / 0) (#30)
    by Manuel on Tue Mar 23, 2010 at 05:58:38 PM EST
    Wouldn't this kind of thinking ivalidate the Clean Air Act?  That act imposes all sorts of extra costs on individuals and governments including emission control equipment in your car.

    I'm not fined for not having (5.00 / 1) (#36)
    by coast on Tue Mar 23, 2010 at 08:48:12 PM EST
    a car.

    You are required to buy something (none / 0) (#37)
    by Manuel on Tue Mar 23, 2010 at 09:16:19 PM EST
    (emission control equipment) you might not want otherwise.  The question would be how one might  distinguish the two cases legally.  It seems clear the government has the power to require citizens to buy materials or services.

    So following your logic, (none / 0) (#39)
    by coast on Tue Mar 23, 2010 at 09:32:50 PM EST
    the government could go beyond simply requiring manufacturers to include emmissions equipment on cars, which I still have the choice to buy or not buy without facing a fine, and instead require us to purchase specific automobiles...possibly GM cars?

    IANL (none / 0) (#41)
    by Manuel on Tue Mar 23, 2010 at 10:08:48 PM EST
    but given that they can set tariffs it seems within their power to make you buy only American cars.  Moreover, standards already require way more than emissions.  You could save a lot of money by buying a non standard vehicle.

    Only if you choose to own a car (none / 0) (#53)
    by BobTinKY on Wed Mar 24, 2010 at 08:55:53 AM EST
    You could be fined (none / 0) (#40)
    by Manuel on Tue Mar 23, 2010 at 10:01:00 PM EST
    if you operate a car that didn't pass the emissions test.

    Again, (none / 0) (#42)
    by coast on Tue Mar 23, 2010 at 10:11:09 PM EST
    that's if I chose to own a car.  You don't have a choice under this bill.  Either you get insurance or pay a fine.  There is a simple concept called choice that is eliminated with a mandate to purchase insurance.

    You're simply being dishonest about this (5.00 / 1) (#43)
    by andgarden on Tue Mar 23, 2010 at 10:36:43 PM EST
    Your "out" is to pay a tax.

    I believe that is exactly what I said. (none / 0) (#44)
    by coast on Tue Mar 23, 2010 at 10:41:45 PM EST
    "Either you get insurance or pay a fine."

    Is there another instance where the federal government gives us this "choice"?


    I don't know where to draw the line (5.00 / 1) (#47)
    by Manuel on Tue Mar 23, 2010 at 11:13:24 PM EST
    for all the things government might require citizens to do.

    Go to school.
    Pass a standardized test.
    Enlist in the army.
    Pay Taxes.
    Comply with regulation.
    Travel with a passport.


    Not the same. (5.00 / 1) (#48)
    by Peter G on Wed Mar 24, 2010 at 12:18:03 AM EST
    As Andgarden said, the new law requires that you pay a federal tax if you do not carry health insurance.  Not that you pay a fine; it is not punishment.  Rather, you pay a tax, to help offset the public costs that results from people not having health insurance.  The power of taxation is hardly of doubtful constitutionality.  Of course, single payer supported by taxes on everyone would be better, and a public option would have been next best, but the very people now complaining that near-universal health coverage is to be achieved through private insurers are the ones who most strongly opposed the other, fairer, less expensive, more effective systems.    

    direct tax or income tax? (none / 0) (#49)
    by beowulf on Wed Mar 24, 2010 at 02:53:28 AM EST
    I think the HCR law muddies the water with how it sets the tax. If it was a simple 2.2%  income tax surcharge that would seem pretty straightforward application of the 16th Amendment.

    However the law makes it the greater of $695 or 2.2%.  So if your taxable income was $30,000, 2.2% is $660, and you'd pay the flat $695.  Since that sum isn't based on your income, its a direct tax.  As the AG's lawsuit notes, the Constitution requires direct taxes to apportioned equally among the states on a per capita basis.  A simple example would be if there only two states, say,  if Mass. and SC and they have equal population-- but SC if  twice as many uninsured people subject to a direct tax, then Mass. would have to collect twice as much from each resident.  That the HCR law neglects to apportion the direct tax , the argument goes, makes the levy unconstitutional.

    An obscure issue, but the sort of technicality Scalia loves.


    "Tax" or "Fine"...? (none / 0) (#50)
    by EL seattle on Wed Mar 24, 2010 at 03:01:05 AM EST
    I think that the communication on this issue has left something to be desired.



    Oh boy (none / 0) (#55)
    by DancingOpossum on Wed Mar 24, 2010 at 09:00:10 AM EST
    the new law requires that you pay a federal tax if you do not carry health insurance.  Not that you pay a fine; it is not punishment.  

    Good luck -- really -- explaining this fine distinction to the really p.o.'d unemployed Americans who are forced to make this choice. Really, good luck with that. And no, the GOP isn't going to make an issue out of this. Oh noooo.


    Pay your federal income tax obligation (none / 0) (#45)
    by oculus on Tue Mar 23, 2010 at 10:45:46 PM EST
    or go to jail and/or pay a fine and the taxes owed.

    I don't believe the governments right to (none / 0) (#46)
    by coast on Tue Mar 23, 2010 at 10:55:52 PM EST
    tax is based on the commerce clause.

    Also, I have the to earn income to be subject to the tax.  If I don't have earned income or choose not to earn any income, I'm not subject to the tax and don't owe anything.  


    I think you're being a bit naive (none / 0) (#56)
    by BobTinKY on Wed Mar 24, 2010 at 09:09:37 AM EST
    The law is whatever 5 justices on the Supreme Court say it is.

    There are at least 4 justices on this court who I believe will strongly sympathize with the Tea Bagging argument that the government has no right to coerce people to buy something they don't want.  It does not matter what cases you cite with these folks.  If they think they can strike out the mandate, which will gut the whole statute, without creating havoc with any number of unrelated issues then I believe they will.  And Kennedy might join them.

    I think the bill would have iron clad protection against this sort of activism had Congress simply raised income taxes and provided a tax credit for purchasers of health insurance.  Striking down the concept of tax credits would create massive problems through out society, striking down a tax penalty for not participating in a certain market would, as far as I appreciate today, create much less havoc.  The concept, if not entirely new, has been little used.

    Precedent means little to the Roberts Court and Scalia's originalism is merely a cheap intellectual license to ignore precedent whenever you like.


    Still not the same (none / 0) (#59)
    by DancingOpossum on Wed Mar 24, 2010 at 03:33:07 PM EST
    Pay your federal income tax obligation

    Still not the same. Paying taxes is not the same as being forced to buy a commercial product.

    Try this: Shop at Wal-Mart only or pay a fine to the IRS. Does the government have the right to tell us that?

    think of it this way (none / 0) (#60)
    by CST on Wed Mar 24, 2010 at 04:43:47 PM EST
    they are raising everyone's taxes by a certain amount, and you get a deduction or tax credit for the same amount if you have health insurance.  Just like you get credits/deductions for paying student loan interest, or donating to charity, or anything else.

    Because that's essentially what it is.