adult children, Obamacare, contraception, disbelief
Missouri state Rep. Paul Joseph Wieland (R) has two adult daughters, presumably covered by his insurance plan.
And he doesn’t want to pay for contraception, so he’s sued the Dept. of Health and Human Services under the HL decision, Wieland v. Department of Health and Human Services.
So I just have to wonder: he has a choice, too. He can tell his adult daughters to get their own insurance or pay the penalty, he doesn’t have to spoil all the pretty things and create new regulatory structure where the government and insurance has to maintain records of our religious beliefs and morals.
Think progress reports:
Missouri state Rep. Paul Joseph Wieland (R) does not want his daughters’ health plan to cover birth control — even though two of those daughters are adults. So he and his wife sued the Obama administration. Though this lawsuit was rejected on jurisdictional grounds by a federal trial court, a panel of three appellate judges reinstated the suit on Monday. Should the Wielands ultimately prevail in their effort to deny birth control coverage to their daughters, the decision could have implications far beyond the Wieland family, potentially forcing insurance companies to maintain elaborate records to track many of their customers’ views on religion and sexual morality.
That last really disturbs.
Note: I’m traveling, will not be able to respond much.
“potentially forcing insurance companies to maintain elaborate records to track many of their customers’ views on religion and sexual morality.”
not really so different as needing to know whether someone is a Jehovah’s Witness to know whether to offer blood transfusions (n.b.: I know people were considering tracking this… I’m not sure if it was supposed to be “customer service” or something “necessary for legal reasons”).Report
Not to nitpick, zic, but is there a reason you eschew capitalization in your titles?Report
Because Likko has a lock on all the big cases at this site.Report
Makes her look a bit shiftless, if you ask me.Report
The anti-capitalist sentiment around here has gone too far.Report
Down with the imperialist uppercase pigs!Report
Those puns seem a bit labored…Report
https://dov5cor25da49.cloudfront.net/products/1034/636x460design_01.jpgReport
capitals are unbecummingsReport
Now that’s actually really clever.Report
Interesting question is whether or not this guy’s daughters WANT insurance with contraception or not. I’m thinking these daughters on on his plan for the sole purpose of allowing him to object to the contraception issue and sue.Report
I agree that this may be a mechanism to get standing. The question presented to the court is an interesting one.Report
No doubt his insurance covers many conditions for which he will never cash in. For example, his insurance probably covers treatment for ED. However, even if he develops the conditions — about which, there is nothing shameful — but if it happens, then he may or may not decide to treat it. That’s a deeply personal decision and not my business.
However, it is right for insurance companies to cover things such as ED. It is a medical issue. There is a medical treatment. Insurance should cover it.
If you work for my employer, your insurance will cover transgender health. You will pay for this. Now, most of you will never use this feature of your healthcare. Some of you, in fact, may dislike transgender people. But that is beside the point. The American Medical Association believes our conditions should be covered. My employer agrees. Our insurance covers it.
In fact, all insurance should. It is simply a result of bigoted history that makes my medical condition questionable and others not.
[cw: over-the-top example, fat shaming] For example, why should we cover diabetes? Can we debate that? Maybe those fat fuck sugar addicts should just pound sand. (I don’t believe this, obviously. But it has no more rational justification than denying my healthcare.)
So we come to birth control. Pregnancy is not a sickness, but it is medical. And while some may dislike birth control, it is a standard medical procedure these days, alongside a wide array of preventative care. To say “Let nature take its course,” if made a general principle, would deny vaccines. How is birth control different, except according to the religious preoccupation with gender and sex?
None of this is not rational. In fact, it is clearly based on the rantings of weird old religions that are detached from the scientific world. We should look side-eyed at this just the same as we look side-eyed at those people who spend church time handling poisonous snakes.
You are free to worship in such a faith, but you are not free to expect others to do so. Nor can you deny science.
This man can wish that his adult daughters would avoid birth control. But he does not own their bodies. Likewise, they can personally choose to avoid birth control, either according to their own beliefs or according to their father’s. It’s a free country. Their choice. But the law is what it is for a good reason. Women need birth control. This man wants to deny it to his children, as all monstrous old patriarchs want to control women.
Do not give him more tools to do this. Let this hateful breed die out as quickly as we can.Report
Accepting the TPM narrative at face value, my guess is that this guy has no real legitimate personal grievance, but is pursuing a political goal instead. With that in mind, I preface my comment by stating that this guy sounds like a tool. I’m not a fan of the ACA, but I am a fan of democracy and, to paraphrase H.L. Mencken, giving the people what they deserve, and good. If this is the way that the majority of people and their elected representatives have decided to structure the health care market, I am content to make my own personal accommodations and hedges and go on living my life much the same way that I did before the ACA.
Lots of people, however, are not like me. Lots of people are very invested in which way the laws of the land push and nudge us and are always looking to push back. That is part of the democratic system, as well. If the law purports to force Weiland to do something that he does not want to do, he has every right to seek redress through the courts. The idea that he should stifle his own personal preferences, so that other people can have their pretty things is a fairly illiberal sentiment. Laws ought to exist to stop people from doing direct harm to other people and not to force people to accept our preferred social and ethical norms.
More importantly, what else do you expect? If you start from the premise that the personal is political and that justice demands that we adopt collective means to bring about personal justice, don’t be surprised when the people who disagree with you start adopting the same strategy. This is Newton’s Third Law translated to politics.Report
Oooh, turning this into a discussion of First Amendment rights!
We can question whether people who are arguing disagree when other people petition the government for redress of grievances!
If we could somehow tie cultural appropriation into this, we could turn it into a good, old-fashioned food fight.Report
I wasn’t thinking about the First Amendment. I was simply noting that the ACA is an overtly legal and political solution to the question of how to provide people with a specific basket of health care goods and services and what that basket should contain. Of course, people who disagree with what is in that basket are going to pursue political and legal means to change it.Report
Of course its only going to be the bad people with ill intent that would question the govts efforts.Report
Of course he has the right to pursue his claim, but has no right for the court to accept his arguments. As with Hobby Lobby, my problem here comes from the fact that he’s putting forth a claim in which somebody else having access to a particular type of health services is an offense to him, based upon some arcane theory whereby he is complicit in the hypothetical provision of that health service to some other person. Nobody’s making his daughters use birth control, nobody’s making him prescribe or dispense birth control, and it’s entirely possible that including birth control isn’t increasing his premiums, so he’s likely not in any way paying for it either. So I can’t help but hear the subtext that what he really wants is for his daughters to not be able to use birth control.Report
The idea that he should stifle his own personal preferences, so that other people can have their pretty things is a fairly illiberal sentiment. Laws ought to exist to stop people from doing direct harm to other people and not to force people to accept our preferred social and ethical norms.
Ever been pregnant? How are you so certain his preferences don’t do direct harm? I’m so freakin’ tired of ALWAYS having to point this shit out. Just because women get pregnant, men freakin’ go around and take it for granted that it’s no big deal.
Well, it is. It’s physical, life changing, potentially life threatening, and economically havoc-wreaking. It’s definitely filled with the potential of harm, and I’m not letting this squeak by just because it’s the way it used to be. If he was suing to prevent his insurance from paying for insulin or antibiotics or vaccines, would you think ‘doing no harm?’ If no, those things do harm, than the answer here is also, no, because he wants to do great harm.Report
Perhaps you are ALWAYS having to point this shit out because you are ALWAYS conflating two things that are not the same.
Also, the fact that you started this comment with “ever been pregnant?” tells me that you are missing the point of my comment. I have no desire to defend Wilson, who as far as I can tell is an ass. But you cannot have your cake and eat it too.
Once you use legal and political means to establish a mandatory basket of health care goods and services, then you have de facto made the composition of that basket a matter of legal and political debate.Report
Dont you know that the “ever been pregnant” card stops any rational discussion of an issue and means that zic wins the debate? That’s why it is so fun to play it.Report
Also, the Thirteenth Amendment made race a political issue.Report
True, race wasn’t a political issue until slavery was abolished.
And health care coverage wasn’t a political issue until Obamacare.
I actually agree with j r that this is how it’s going to play out, but I disagree that this isn’t how it’s been playing out, in one way or another, for a really long time. Obamacare is just the current stage on which it is playing out, because it’s the health care stage now.Report
Once you use legal and political means to establish a mandatory basket of health care goods and services, then you have de facto made the composition of that basket a matter of legal and political debate.
This. I’d say that j r’s point here is almost trivially true even tho what he’s saying isn’t remotely trivial. I actually don’t know what the fuss is about, to be honest. The fact that conservatives (for anti-gummint reasons) or religious folk (for religious reasons) push back against the contraception mandate ought to come as no surprise to anyone who’s been paying attention to these debates. And they have a legitimate right to use whatever political and legal means present themselves to achieve their preferred outcomes, especially (as j r notes) since the mandate itself resulted from a political/legal process. That’s just politics, yes?
I think the debate here, if it’s actually a debate rather than a difference of opinion, revolves around a disagreement regarding what constitutes a harm in this case. Wieland’s argument (presumably, and giving him the benefit of the doubt here) is that compelling him to act against his “sincerely held religious beliefs” (scare quotes!! for obvious reasons!! given the case!!) constitutes a harm. zic’s argument appears to be that failing to include contraceptives in the basket of goods covered by health insurance requirements constitutes a harm to women. And if that’s right, then I think j r’s point takes on even greater importance here since the resolution of competing harms is essentially a political/legal issue. Even if, as zic thinks, Wieland’s claim of being “harmed” is completely bogus.Report
NO. That is not zic’s argument. It has never been zic’s argument.
zic’s argument has been 100% forever that Wieland’s religious expression has NOTHING TO DO WITH SOMEONE ELSE’S HEALTH CARE.
His religious expression might be reflected in the health care choices he makes for himself. But not for his daughters; he does not believe for them, they believe for themselves.Report
NO. That is not zic’s argument.
Well, I’m at a loss as to what your argument actually is then. I mean, I get that you think Wieland’s argument is unsound. But your affirmative argument re: mandating contraceptive coverage seems to be expressed (for example) here:
It’s physical, life changing, potentially life threatening, and economically havoc-wreaking. It’s definitely filled with the potential of harm, and I’m not letting this squeak by just because it’s the way it used to be. If he was suing to prevent his insurance from paying for insulin or antibiotics or vaccines, would you think ‘doing no harm?’ If no, those things do harm, than the answer here is also, no, because he wants to do great harm.
I guess I’m wrong, but it seems to me this is an argument that not including contraceptive coverage in the basket constitutes a harm to women.
If not that, then what’s the basis of rejecting Wieland’s position (other than that his argument borders on the frivolous)?Report
@stillwater
You’re thinking of the basket of goods; and whatever’s in the basket of goods is a policy decision.
Access to that basket of goods for one person, however, should not be shaped by another person’s religious beliefs.
Contraception was included (along with stuff like maternal care and cancer screenings) because the law mandated women’s unmet needs be covered; not that contraception be covered; it’s in the basket as part of the unmet need as was historically documented. How can his adult daughters insurance need be shaped by his religious beliefs? Does his religious freedom and expression mean he believes for them? They do not have the right to their own belief and expression?Report
You’re thinking of the basket of goods
Guilty as charged. I thought that’s what we were all talking about. Even Wieland.
and whatever’s in the basket of goods is a policy decision.
Presumably, what’s in the basket is subject to debate and justified by argument.
Access to that basket of goods for one person, however, should not be shaped by another person’s religious beliefs.
Yes, it’s clear you hold that view. But to rephrase jr’s comment that started this subthread, since the inclusion of contraception in the basket resulted from the political/legal process, it’s fair game use that process to try to remove it. All that should be clear enough, I’d think. I mean, you assert that a person’s religious beliefs should ot shape what’s in the basket, but that claim requires argument, it seems to me. And obviously the question asked is: why not? And it’s at that point that a positive argument justifying contraceptions inclusion is necessary. I offered one: that failing to include it constitutes a harm to women. You’ve rejected that you hold that view. So I’m at a loss as to how you respond to the substantive part of Weiland’s challenge here.
Another way to say it this: the view that Wieland’s religious views regarding the contraception mandate ought not be imposed on others requires that the mandate is otherwise justified. I’m just wondering what that justification is given that you disagreed with what I attributed to you.Report
Yeah, thinking about that some more, I unfortunately have to stick with what I wrote earlier and that “unmet needs” doesn’t really cut any ice (for me!) unless I interpret that phrase to mean something like “a harm is incurred if contraception is taken outa the basket”. The thing is, as lots of folks here at the ole OT have said over the years, taking contraception outa the basket doesn’t entail that the need goes unmet, but it may (it seems to me) constitute a harm.Report
@mike-schilling
That quip might make sense if I were arguing that the ACA was the genesis of this debate. I am not. The debate over birth control didn’t start here, but it is another iteration of it.
I do not approach these situations naively. I understand the history. And I have very little sympathy for SoCons in any of their rearguard reactionary movements, whether it be birth control or same-sex marriage or civil rights. All of that, however, is tangential to the point that I am making here.
As @stillwater points out, my point is so obvious as to be possibly be trivial, but it does has implications. I do think that Weiland’s claim to harm is bogus, but the very nature of the ACA itself (the legally mandated, publicly subsidized basket of health care goods and services) is one of the things allows the SoCons to continue advocating against access to birth control.Report
It is not about a basket of goods, @j-r
It’s about a right to access a basket of goods without someone else sticking their nose into it.Report
This is demonstrably false. Once the government dictates the contents of the basket, mandates that everyone have access to the basket, and decides to fund access through collective means, the basket is already everyone’s business. You can wish that it were not, but it is, whether you want it to be or not.Report
” Laws ought to exist to stop people from doing direct harm to other people and not to force people to accept our preferred social and ethical norms.”
But this only makes sense if there exists some set of norms which are objectively true and independent of moral intuition.
But empirical observation of the world around us demonstrates that this is not so.Report
If he were to prevail and if insurance companies were to decide to offer policies that lacked contraception coverage, those policies would be more expensive. Unplanned pregnancies aren’t cheap.
Is this really the path that SoCons want to follow? Here’s Policy A which covers all necessary and appropriate procedures. Here’s Policy B — you can opt out of various coverages, but we’re going to have to charge you an enormous sum of money just to price the policy (underwriting isn’t free) and then the policy is likely to be more expensive (because we have to cover the cost of the consequences of the refusal).
Bizarre.
ETA: Isn’t this just Hobby Lobby, but for an insurance policy issued to government employees? Query whether a government can have the religious beliefs necessary to invoke Hobby Lobby. Also query whether Hobby Lobby applies to plan beneficiaries.Report
Isn’t this just Hobby Lobby, but for an insurance policy issued to government employees?
I don’t think it’s like Hobby Lobby at all. I mean, it’s about contraceptive coverage in health insurance, but that’s where the similarities end. The owners of Hobby Lobby were the ones buying the insurance, and objecting, quite rightly, to the government butting into their business and telling them what kind of insurance they had to provide. This guy is complaining about a perquisite his employer (namely the state government) is offering him. He’s not the one doing the buying, which was the whole basis for the Hobby Lobby case.Report
Brandon Berg,
So I suppose the theory here is that the health insurance is part of his compensation package and, as such, requiring contraceptive coverage as part of that package is somehow equivalent to forcing him to pay for that?
Hmm… well, it is similar to HL in certain respects, but I agree with you that it’s more dissimilar. I think his case is going to flounder on the simple fact that he’s not actually writing any checks for the coverage and also possibly due to the fact that, as non-monetary compensation, it’s not taxed as income.
I think he might have a more plausible argument if he was a private citizen purchasing the policy on the state exchange.Report
The article says adult daughters, but I am curious what the actually ages are. With the expansion of insurance to cover children of policy holders up to age 26, the law gives parents room to complain about what those plans cover for the dependents. If the children were to choose their own plans, they would get the choice of what they wanted, and that would possibly lessen the power of the complaint, at least in my eyes.
While I am a fan of BC, I am not a fan of top down social engineering. There are many, many, deeply religious people in this country and lawsuits such as this are the outcome of what they see as government overreach.Report
Really? Because I find it particularly stupid. It covers birth control? Great. You don’t have to actually buy it. The law doesn’t make you touch the pills, much less take them.
90% of what my insurance covers I’ll never need in my entire life. I’ll never use it. I’m not suing Aetna because they cover pregnancy and labor costs, or because they cover the procedures for repairing birth defects I don’t have (and since I’m done having kids, won’t have kids that have).
If I have some sort of moral complaint with something I DO qualify for, the simple thing to do is…not get that procedure or medicine.
Complaining to high heaven that I’m somehow being tainted because my insurance covers something I won’t use is ludicrous and asinine.Report
Well, they don’t see it that way, obviously. The question remains whether the courts will see it the way you do, or the way they do.Report
What is the curtailent of birth control, if not “top down social engineering”?Report
Prices on your head, too.
North Korea really, really sucks.Report
Because every liberal knows their social engineering is better for the children. Liberals got upset when the insurance co. got to decide what coverage they would offer.Report
Liberals get upset when the insurance companies get coverage enshrined in law.
You know, like bicycle helmets?
Make no mistake, this Universal Healthcare was a sop to the insurance companies, who get tons of new patients.Report
So, this is a really, really creepy case.
After all, as mentioned above, Paul Weiland is under no obligation to pay for his daughter’s health insurance. The law says he can, but nothing says he must. While Hobby Lobby faced a slew of potential penalties for not paying for its employees coverage, Weiland isn’t in the same boat.
And, what really skeeves me out is that Weiland and his wife are suing regarding their daughters. If their objection was to paying for birth control, why not just sue on behalf of his wife’s coverage. His wife, after all, is a party to the suit, and presumably objects to paying for birth control coverage for herself. With the added twist, though, it seems like this dude is creepily intruding on his daughter’s sex lives for kicks and/or votes.
And that’s pretty disgusting.Report
I was thinking about this point, and while I agree the structure of the law-suit creeps me out, suing on behalf of the daughters makes some kind of sense. If the lawsuit was on behalf of the wife, the court could argue that she has the option not to purchase birth control and thus no Weiland money would be going to birth-control. With the dependents, however, Weiland cannot prevent them from purchasing birth-control, and so he has no guarantee that his money doesn’t go to directly fund something he is against.Report
Let’s see we changed the law and instead of saying that EVERY plan had to include contraception coverage, employers simply had to offer a choice of plans, one of which DID include contraception coverage and another of which DID NOT. That would seem like a pretty good compromise, right?
But what if the latter plan cost more because the insurance adjusters determined it was cheaper for them to provide contraception than to cover unwanted pregnancies. They did this through no malice… simply running the numbers.
That meant folks who didn’t want contraception coverage… which would seem to skew male, Christian, and older… would pay more. Disparate impact! Impacting older Christian men!
What do you think the response would be?Report
I think that if we are going to have something like the ACA, than this is a much better solution. I don’t have a problem with disparate impact if it is based on something real, and it is always possible that other insurers would step in with different products that covered as necessary but in novel ways that reduced the cost.
Sure, some people would complain, but that would happen with any law. Your solution would remove a lot of reasons. Then again, it might create problems in other areas, due to disparate impact being OK in this case.Report
When SoCons were getting their way, a lot of people were unhappy with a lot of things government did, but invocations of ‘religious liberty’ in order to avoid those obligations were pretty rare.
If SoCons really want ‘religious liberty’ to be an escape hatch, they should understand that the next time the Republicans pass a law by 51% the lawsuits from Pastafarians, Satanists and Yesterdaists (as in i made up my religion yesterday) will come fast and furious.
I would hope that we could just make reasonable accommodations instead. But somehow I doubt that Mr Weiland is going to be all that happy about paying the premium associated with a no-contraceptive insurance policy.Report
I think @francis gets at my own concern.
I, too, have zero problem with us making reasonable accommodations. But because of the other banners carried by the people demanding ‘religious liberty,’ I have a hard time believing these arguments are anything but entirely specious.
Which would still be OK with me (just because the argument is made speciously doesn’t mean it is wring), but for the fact that I do not believe that this is a movement that will tolerate compromise. Combined with the tactics used when the liberals/Dems give an inch — shutting down of the govt is one such example, blocking every appointee just for the sake of doing so is another — it makes me less inclined to want to be accommodating at all.Report
This is the interesting question isn’t it? To what extent are socons waving the white flag and asking for quarter and to what extent are they simply regrouping for a counter attack.
My guess is that it is neither one nor the other.Report
I think the biggest problem with you argument is that a massive, intrusive law was passed that absolutely cuts up against a huge minority of peoples personal beliefs. Coupled with a legal system that absolutely gives them voice, this is to be expected, certainly with a law that has never had 50% exceptence. Would they bitch if pastafarians or satanists claim the same sort of exemptions? Probably, but does that change the legitimacy of the claim? No. So, lets open up the law for ANY dissenting religious claimant. One could argue that the first amendment makes all religions a protected class. We would say that just because we have a new immigrant who is LBGT that they are to be given the same protections as US citizens. So, if a religion is new it shouldn’t be given the same rights? I say yes, it should.Report
Religious liberty exemptions to laws of general applicability are one way to make it very difficult to pass broad laws.
According to the Bible, man is to take dominion over the earth. Can I claim a religious exemption from pollution control laws? Federal environmental permitting can be terribly intrusive and I’m sure that there are less intrusive ways of accomplishing the same thing. (They just can’t get through Congress.)
My version of Yesterdayism claims abortion as a sacrament. Can I now refuse to comply with Texas laws regulating clinics?Report
Well, @francis I think you can try to make a case for all of those, I got nothing against that. I think the more mainstreet your views are the easier to get traction with the legal system, but that is true of everything as far as I can tell.Report
According to the Bible, man is to take dominion over the earth. Can I claim a religious exemption from pollution control laws? Federal environmental permitting can be terribly intrusive and I’m sure that there are less intrusive ways of accomplishing the same thing. (They just can’t get through Congress.)
Not to mention biblical marriage crap. Does this mean that, for instance, a wife would not be able to divorce her husband because it violates his religious beliefs?Report
They object to what, exactly? The concept of health insurance? Requiring someone to hold health insurance?
Or do they object to the definition of “health insurance” — that is, what a “health insurance” plan must cover to be considered health insurance for these purposes?
Because it seems the latter, which is strange — because pretty much every state already had such laws, and in fact — as we found out — a number of people suddenly very, very, very religious upset over their new coverage were….already using coverage that covered contraceptives.Report
I’m sorry to get pedantic here, and of course IANAL, but I believe one would be wrong to do so. The concept of “protected classes” stems from Federal (and state?) anti-discrimination laws, the Title “X” stuff you read and hear about.
More generally, the Constitution is law about laws. It variously requires and limits the actions of government, including what laws Congress may or may not pass. As I understand it, it’s not even really logically possible for a private citizen to violate the Constitution. So, for example, the administrators of this site can tell me I can’t say certain kinds of things (commenting policy) or even forbid me from speaking at all (ban-hammer) without the First Amendment being implicated, but the government can’t do so beyond very narrowly defined exceptions.
The Hobby Lobby case wasn’t brought on First Amendment grounds since Congress, in passing PPACA, was not attempting to “establish a religion.” Instead, it was argued as a violation of RFRA, a Federal statute.Report
” The concept of “protected classes” stems from Federal (and state?) anti-discrimination laws, the Title “X” stuff you read and hear about. ”
@road-scholar
I don’t think that would negate what I am saying. (But also, IANAL) The Consititution specifically says “prohibits the making of any law respecting an establishment of religion, impeding the free exercise of religion” That is pretty protected, no? In other words, taking a clean reading of the cons. leaves one with, well, just what it says. It was a protected class, before it was (title X) cool.Report
impeding the free exercise of religion,
Riffing off something Francis wrote – “According to the Bible, man is to take dominion over the earth. Can I claim a religious exemption from pollution control laws?” – does it follow that EPA regulations impede free exercise? I mean, I say that rhetorically since it seems obvious to me that they do, according to a strict reading of the first amendment and the logic being offered.Report
Really don’t disagree with anything you said, but probably the reason Religious Liberty didn’t come up is because the left has a different view of the place religion has in relation to the state than the right has. But that is just a guess, as I am not of the right. Or left for that matter.Report
When SoCons were getting their way, a lot of people were unhappy with a lot of things government did, but invocations of ‘religious liberty’ in order to avoid those obligations were pretty rare.
One of the things that I think illuminates this is the situation that inspired the RFRA: Employment Division, Department of Human Resources of Oregon v. Smith.
How did the SoCons respond to Smith?Report
My memory on this is pretty hazy. My recollection is that RFRA had broad bi-partisan political support initially. (Don’t want to have the local priest arrested for serving minimal amounts of alcohol). Since then, support has waxed and waned depending on which lunatic (sorry) is in the White House.Report
I think this would be a great compromise in a sane world, as long as the higher cost was in the direction of the conscience-based decision. I don’t have a problem with disparate impact based on personal choice (e.g. Kosher food often costs more than non-Kosher food), but I do have a problem when it’s based on inherent qualities like gender. The problem, though, is once you open the door to ala carte plans like that, you have to set very specific parameters: can someone demand a plan that doesn’t cover blood transfusions be offered? one that only covers homeopathic treatments (where the plan would cost so little as to be undetectable by your bank account)? I think the decision was made not to go down that road and simply allow people to opt out, pay the fine, and the enter into whatever unregulated medical cost-sharing plan they wanted (just don’t call it insurance).Report
The problem is that the ACA has multiple moving parts that all have to work together, and so there are a lot of paths through which one can destroy the entire law. In particular, one major aim of the law is to cover people with pre-existing conditions. As has been discussed many times, this creates an obvious free-rider problem, so the law also has to create some baseline thing called “insurance” that covers basic services; if you don’t like it, pay the fine and now you’re not a free rider anymore. HOWEVER, once you start *requiring* that people purchase something it’s discriminatory to make women pay more than men, so you can’t have plans that cover (baseline + women’s health stuff) and be more expensive than plans that cover the baseline. So that’s how we get to a situation where men are required to sign up for insurance plans that cover women’s health stuff they don’t like.
It’s possible that this case will be dismissed on issues of standing or some other technicality, but it’s inevitable that eventually such a case will have to be heard. I hope that the court looks at the two-pronged goal of the ACA – universal coverage and no discrimination – and sees that this goal cannot be achieved if men are effectively allowed to opt-out of paying for services that they don’t like.Report