President Obama, distraught by last week’s Supreme Court oral arguments, which do not appear to bode well for his health care plan, gathered his inner circle. Inspired by Shakespeare’s tragedy “Hamlet,” he recited a tormented health care soliloquy:
A tax or not a tax, that is the question.
Would it have been nobler for middle-class citizens to openly suffer the slings and arrows of new taxation, necessitated by my federal overhaul of America’s health care system, or better that we disguise our new taxes as “penalties and mandates” instead?
There is a cost for expanding coverage to those without health insurance — a cost for mandating that private insurers cover pre-existing conditions and offer many other goodies that we politicians like to promise voters.
Only a naif would think that a 2,700-page law would not require new taxes to pay for it!
But the middle class does not understand what is best for them. And so we were forced to conceal and contort many complexities that would only frighten them and weaken their favor!
To get my health care bill passed by Congress two years ago — to win support from fence-sitting politicians — we had to avoid all mention of taxes on the middle class. We had to use the term “penalty” to conceal these taxes.
One way to create revenue without calling it a tax was to create an individual mandate. It would force able-bodied citizens who do not have health insurance to either buy it or pay a “penalty.”
Our plan worked at first. By the skin of our teeth, we passed our bill into law! How clever we thought we were at the time. Now our cleverness cuts deep like a bare bodkin!
Twenty-six states and the National Federation of Independent Business have challenged our law’s individual mandate. They say it is not a tax, but a federal mandate that far exceeds the limited and enumerated powers of Congress under the Constitution.
Regrettably, their challenge made it all the way to the Supreme Court. We had to reverse course. We had to proclaim to all that our individual mandate, and its associated penalties, is really just a tax!
Had we created a tax in the beginning, rather than an individual mandate, the seas would be smooth, the skies without clouds — and we would not have found our solicitors standing before the highest court in the land.
Why? Because the Supreme Court agrees that the government is allowed, under the Constitution, to create a national health insurance program. We already have Medicare and Medicaid.
The Supreme Court agrees that the Constitution gives the federal government the right to levy new taxes to pay for such a program.
How we tried to convince the justices that our individual mandate is indeed a tax — that our individual mandate is a necessary requirement unique to health care, since everyone will need health care sooner or later. How we tried to convince them it is therefore constitutional!
But the conservative justices did not bite. They said that if the federal government can make private individuals buy health insurance, what can’t it make them buy? Broccoli? Cellphones?
The writing appears to be on the wall. The Supreme Court may cut, with a bare bodkin, my entire plan, the crown jewel of my presidency!
My woe is great, my heart heavy.
A health plan, a health plan, my kingdom for a health plan!