Health care reform works for students

Not only is the PPACA a moral good, it’s practical necessity

By Andy Liang Feb. 11, 2011

Last week, I woke up with the right side of my face paralyzed. When I used some mouthwash, the right corner of my lip quivered, dripping liquid. Then I wiggled my ears (because I can): only the left ear wiggled. I looked into the mirror, and laughed at seeing my face with unmatched expressions. Then it wasn’t so funny anymore.

I left for MIT Medical.

In Urgent Care, the doctor reported I had a condition called Bell’s palsy which was swelling in my seventh cranial nerve, responsible for facial movements. I have to take prednisone to reduce the swelling. I took her prescription notes and left for MIT Medical’s pharmacy. Waiting for my drugs, I came to appreciate how quickly I was taken care of. As an MIT student, I am comforted knowing that no matter how close I might get to passing out from all-nighters, or from anxiety on a test, or from missing meals, I am insured.

But this is still not the case for all college students. According to the 2008 Government Accountability Office report, among the many uninsured, 1.7 million are college students. This makes up 20 percent of all college students from ages 18 to 23. Reasonably, this age group would need insurance the least because they are the most unlikely to have health complications. So why make those who need insurance the least buy it? Premiums. Less students on insurance plans means higher premiums. Colleges everywhere are raising tuition fees to account for the national premium increase of 7 percent, as cited by the College and University Professional Association for Human Resources.

Indeed, tuition fees are mightily expensive as they are, but there is good news. These financial burdens on students and their families will be relieved under the new policies of ObamaCare, passed last year. Under the bill, uninsured students will be covered by their parents’ insurance plans until they are 26, and they cannot be exempt from insurance for their pre-existing conditions. For students who cannot rely on their parent’s insurance plans, and dislike their school’s plan, they can enroll in GradGuard, launched by College Parents of America, a non-profit organization which offers broad coverage for college students.

Also thanks to the Patient Protection and Affordable Care Act (PPACA), there will now be more competition among insurance companies. This means we have more plans to choose from — and more freedoms, like being able to take a year off without being cut from insurance. Thus, we are not limited by our college insurance. Altogether, the Democrat’s health care bill helps provide more students with coverage, so it is hard for college students to not like the new plan.

But is forcing students to get insurance analogous to forcing them to get the meal plan — making students enroll to keep costs down? No. Students have the freedom to cook for themselves, or eat in the dining halls. Choosing the latter simply means that the student will have to pay more. This is predictable economic behavior — paying more for luxury goods.

But the health care market is unique. Consumers are not in control of their choices. Consumers do not know when they will need medical services, such as trips to the emergency room, or surgeries, so the consumers’ economic behaviors are not predictable. For some students, there may be monumental repercussions for not being insured. If they find themselves in need of hospital care, they are putting themselves at risk of paying more than what they can afford, possibly a payment as much as their college tuition. So, in mandating students to get health care, colleges are taking preventive measures to ensure that their students do not fall into financial ruin.

This is the watered-down version of the battles currently happening in the federal district courts. The question at hand: Is our government allowed to be given unprecedented extensions of the Commerce Clause under ObamaCare? Judges Henry B. Hudson and Roger Vinson ruled that this mandate is unconstitutional because it gives the government unprecedented control over citizens by making them all buy insurance. That’s one way to look at it — the big-government slippery slope way. But this is the welcoming of universal healthcare into America. Two judges who first presided over similar cases, George Steeh and Norman Moon, upheld the law as constitutional because they think that insurance substantially affects interstate commerce.

This goes back to my argument of why, in colleges everywhere, all students should be insured. Health care is not a predictable market. Families can lose their life-savings from paying hospital fees. The fact that the government can mandate health insurance coverage is exceptional because everyone should be able to afford to not live with the fear that one day they might just end up bankrupt.

The PPACA may eventually end up for review by the Supreme Court. But considering that the Court has already dismissed a challenge to the health care act, it is unlikely that they would about-face now. And since mandatory coverage will not kick in until 2014, the case will run its course through the judicial system. The date for the Fourth Circuit to hear the Justice Department’s appeal of Hudson’s ruling is set for May.

And that would be about the time my face heals.

2 Comments

Anonymous almost 14 years ago

The issue in the cases which struck down the individual mandate was not whether "insurance substantially affects interstate commerce." The issue was whether inactivity -- refusal by an individual to participate in a market -- can be regulated under the commerce clause. Practically all refusals to buy some product ultimately affects interstate commerce. If you can't refuse to buy something, then there are practically no limits to what the government can compel you to buy. Since other non-economic behavior also affects interstate commerce, there are no limits to what the government can tell you to do either.

Judge Vinson crystallizes this point very simply:

"It is difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place. If Congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the Constitution would have been in vain for it would be 'difficult to perceive any limitation on federal power' [Lopez, supra, 514 U.S. at 564], and we would have a Constitution in name only."

"But is forcing students to get insurance analogous to forcing them to get the meal plan making students enroll to keep costs down? No."

Yes. This was precisely the government's argument in the court case, that the individual mandate was necessary for PPACA to work. If the young and healthy did not buy health insurance, costs would rise for those who do buy it -- the elderly and sick. That's one of the ways the act attempts to reduce costs for everyone, by spreading the wealth around.

This argument came back to bite the Obama administration in the butt in Judge Vinson's ruling, in deciding whether the individual mandate can be severed from the rest of PPACA or if PPACA needed to be voided in its entirety. Since the government had argued that the individual mandate was so essential to the law, because the individual mandate is unconstitutional, the whole law needed to be thrown out. It's not for the judge to second-guess the elected branches on the design of the law, or to determine whether the remainder of the law can still fulfill the legislature's intent if one part is voided.

"But the health care market is unique. Consumers are not in control of their choices. Consumers do not know when they will need medical services, such as trips to the emergency room, or surgeries, so the consumers economic behaviors are not predictable."

Again, this is the opposite of the government's argument in the court case. Farm from "not know[ing] when they will need medical services," the government presented statistics showing that everyone does need medical care at some point in their lives, so everyone eventually participates in the health care market, which falls under the government's power to regulate under the interstate commerce clause.

It may be beneficial to read the text of the court decisions before asserting that you have presented a "watered-down" version of the cases winding their way through the courts.

http:www.scribd.comdoc47909640vinsonruling1-31-11

http:www.scribd.comdoc45215911Virginia-Health-Care-Law-Ruling-Dec-13-2010