There are a lot of words in the 1,017 pages of HR 3200, even by my standards. The bill is poorly written from what I can tell, since it constantly directs the reader to consult other laws and regulations to see the way a particular section is to be applied. If the Democrats were listening to me, the first piece of advice I would offer is to rewrite this thing in plain English, with a simple Table of Contents and page listing, along with a synopsis of each section to explain its intent and function. People tend to resent a piece of legislation which involves a lot of tax money, will be permanent, and which seems to be rushed, when it is difficult to understand and discuss. It may be that the Democrats have put together a really effective piece of legislation, but if so they should be happy to discuss it in detail, not act defensively and as if they have something to hide.
Anyway, to the bill. HR 3200 is a huge piece of work, but to start its examination, we see that it has three “Divisions”, seventeen “Titles”, and fifty “Subtitles”. Division A is titled “Affordable Health Care Choices” and Title I therein addresses the description of heath care plans, access, benefits, and consumer protections. Title II is important, as it creates the government entity known as the “Heath Insurance Exchange”. Section 201 lays out how it works, as follows:
The government will set up a new bureaucracy called the Health Choices Administration, with a Commissioner who reports directly to the President. The HCA will create and supervise an entity known as the Health Insurance Exchange, wherein all nominal insurance coverage will be administered at the federal level. The HCA would have complete authority to determine whether individuals, employers, or insurance companies met the requisite criteria to participate, and the tone of the Title implies that the final decision will be made only with government approval. The function of the HCA invites legal challenge on at least two constitutional grounds – first, the traditional separation of powers does not allow the Executive Branch authority to control domestic commerce in this way; on a practical level imagine the fallout if this bill becomes law and if/when a Congressman or Senator wishes to look more closely at the HCA’s activities he/she is told that Congress is excluded from such authority? The second conflict is that creation of the HCA would effectively eliminate the state insurance boards, as all insurance would be controlled and directed from the federal level, in what appears to be a direct violation of state’s rights under the U.S. Constitution.
There’s a lot more to consider, but for now it might be interesting to consider the almost certain legal challenges which this bill would face were it actually to become law.