Beginning on Monday, the Obama administration will argue for the constitutionality of the Patient Protection and Affordable Care Act before the Supreme Court. If the Obama administration is completely convinced of the constitutionality of both the mandate and the fine that will be assessed on individuals choosing to defy the law and not purchase coverage, then why not simply make the fine large enough to cover the premium and buy coverage for them in the private health insurance market? If the success of the plan is contingent upon everyone having health insurance and that in turn bringing down costs, then the ability of a certain percentage of the population to pay a small fine and avoid coverage will undermine the rationale for the entire program. Government purchase of coverage on behalf of those who refuse voluntary participation would certainly place no greater burden on individual freedom than the mandate itself. So why not a larger “fine”?
Would the size of the fine determine its constitutionality? Of course not. The Obama administration is in fact counting on a certain segment of the population declining coverage and paying the fine because generally speaking, that segment (mostly the young and healthy) will not access the healthcare system in large measure anyway. The fine is merely a revenue generator that the government keeps rather than being surrendered to an insurance company as would be necessary if the fine were actually purchasing coverage. It provides a convenient revenue stream with no related costs (other than enforcement.)
This policy maneuver is similar to the dynamic at work with cigarette taxes. The government refuses to actually make cigarettes illegal, and yet heavily taxes them in order to ostensibly reduce their usage and thereby reduce the associated health risks and costs. But the government benefits from the taxes paid by those cigarette users to such a degree that it would be fiscally damaging to wipe out smoking altogether. The government has done a cynical cost-benefit analysis to keep the money flowing.
Cigarette taxes and ObamaCare are both examples of money and power grabs disguised as compassion. While the public has diminishing sympathy for a “right” to smoke (and understandably so,) the right to make decisions about health insurance still enjoys widespread support with 56% in favor of repealing the ObamaCare mandate according to Rasmussen’s latest poll. Now the Supreme Court will have to decide if the government’s need to “regulate commerce” in this heavy-handed manner trumps individual freedom to make choices about one’s own health.