It is perhaps on such considerations that, with respect to subsidies for medical insurance generally, the authors of the AHCA replaced the means-based subsidies of the ACA with ones that were simply based on age.Under this approach, consumers of the same age—and so representing the same general medical risk—would receive the same subsidy, rich, affluent, or poor.It did not say, however, that such medical consumers—however uncollectable at the time of service they might be—could not be charged for such services; they could.If, subsequently, a consumer’s financial situation improved sufficiently, he or she would have a legally enforceable obligation to pay for some or all of the medical expense incurred. Under both the Affordable Care Act and its proposed replacement, the American Health Care Act, not only has the scope of medical services provided expanded greatly, but the medical consumer that uses them incurs no deferred liability that might be collected at a later time. To put it another way, the objective of government-provided healthcare is now not simply to ensure that Americans receive the medical care that they need, but also to ensure that they will not suffer financial hardship, or even bankruptcy because of their receiving it Let’s ponder that for a moment.
This is not to say, of course, that bankruptcy is not a serious hardship. To make no concession to the needs of the creditor at all?
There is no answer to that question that is not arbitrary.
If we are to be guided by a clear legal principle, our options are binary—either the same benefits are received by all, or they are received by none.
Nonetheless, in asserting that wealth is a valid basis for discriminatory application of a law against those who are affluent, it fosters a presumption that the role of government is not to be an objective arbiter between its citizens, rich or poor, but is rather to favor the poor over the affluent.
Moreover, the partisanship is guided by no clear, distinct principle of law.Bankruptcy itself, it must be noted, was conceived as a humanitarian alternative to other possibilities—debtor’s prison, or being burdened by overwhelming debts for the rest of one’s life.