Thursday, January 16, 2014

If Beavers and Pody Have Their Way, Can a Person Use Obamacare at the University of Tennessee Medical Center?

Posted By on Thu, Jan 16, 2014 at 5:30 AM

So, this is interesting. According to Post Politics, Senator Mae Beavers and Representative Mark Pody are introducing legislation to prohibit the State from implementing Obamacare.

Senator Mae Beavers (R-Mt. Juliet) and Representative Mark Pody (R-Lebanon) announced Wednesday that they will sponsor a bill to resist implementation of the Patient Protection and Affordable Care Act in Tennessee. Based on similar legislation already introduced in Georgia, the Tennessee Health Care Freedom and ACA Noncompliance Act would prohibit any cooperation by the state or its agencies in implementing or administering the federal health care program commonly referred to as ObamaCare.

The lawmakers say the bill rests on the legal foundation known as the anti-commandeering doctrine in which Printz v. US serves as the cornerstone.

If this passes, I foresee two interesting legal questions someone is going to have to answer. The obvious one is what Beavers and Pody have latched on to: Printz v. US. Now, I wouldn't call Printz v. US the "cornerstone" of anything. At least not yet. As far as precedents go, it's pretty new. But the relevant part is that, in 1997, the Supreme Court decided that the federal government couldn't force local law enforcement officers to enforce portions of the Brady Bill. (It also found that Congress couldn't pass a law that took the President out of the federal law enforcement business, but I don't think that's relevant to Obamacare.)

So, Beavers and Pody are hoping that, if local police officers can't be forced to enforce federal gun laws, then local and state entities can't be forced to cooperate with Obamacare. There are some obvious differences. Commandeering local police is not really the same as encouraging people to buy insurance. However, there's long been a tension in this country between what states have control over and what the federal government has control over and I think it's worth reviewing the law in this light.

On the other hand, considering how much of our budget comes from federal money, the idea that we're some kind of sovereign state is hilarious. We suckle at Uncle Sam's teat like we'd starve to death without him (and, let's be honest, we would). So, it's not like we're really going to suddenly go it alone (or frankly, even ever be able to) without massive Federal intervention. And it's a weird strategy to take money from someone (or something) you're constantly insulting, but okay, whatever.

The real question, and one that Beavers and Pody haven't addressed is what "no powers, assets, employees, agents or contractors of the state or its local government subdivisions, including higher education institutions, can be used to implement or administer the federal health care program" means, specifically, what "implement or administer" in this context means.

Because at every hospital in the state, including ones run by state and local governments, there's an army of people whose sole job it is to figure out how to bill insurance companies. So, say this law passes and I bought my insurance through the Obamacare website. Now, say I show up at the University of Tennessee Medical Center (a higher education institution) with my Obamacare-procured insurance and an emergency. Could the hospital take my insurance or would that be aiding in the implementation (since I don't really, practically, have insurance unless a hospital will take it) or administering (since the hospital's billing department will have to work with my Obamacare-procured insurance company in order to get paid) of the Affordable Care Act?

Since the law "empowers the General Assembly to enact sanctions, fines and penalties for violation of the proposed law and gives the state’s Attorney General the right to file a lawsuit against violators," will hospitals have to figure out not only if patients have insurance but how they got it before they risk treating them?

And, if so, are taxpayers going to be on the hook for paying for those people's healthcare, even though they have insurance?

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