That’s where economics and law collide. Economically, the individual mandate and insurance reforms form an unbreakable pair. Legally, they are separate. So the mandate could be ruled unconstitutional while the insurance reforms are not. After all, there is no question that health insurance is interstate commerce, and no question that the federal government can regulate interstate commerce

So what happens if the justices void the mandate but leave the insurance reforms in place? The answer is: We get incoherence. Which, of course, is why you don’t want judges making economic policy.

This is another real shame. If we are going to have political decision-making, at least elected politicians should do the deciding. Come to think of it, they already have.

Some insurers are chasing after much smaller customers with new plans designed to limit employer payouts for big claims using what’s called stop-loss policies. This guarantees that businesses won’t be responsible for anything over a certain amount per employee, perhaps as low as $10,000 or $20,000, with the rest paid by an insurer. Regulators and health-policy experts say this arrangement undercuts the notion of self-insurance since employers aren’t bearing much of the risk, and it allows companies to circumvent some state insurance rules.

“This is not real self-insurance. This is clearly a sham,” said Mark Hall, a professor of law and public health at Wake Forest University who has studied the small-business insurance market. “Regulators have good reason to be concerned about the potential harm to the market.”

Self-insurance is attractive for many reasons, particularly the prospect of lower costs. It’s exempt from state insurance regulations such as mandated benefits, granting employers the flexibility to design their own benefit package and the opportunity to reap some of the savings from employee wellness programs. A federal law, the Employee Retirement Income Security Act, or ERISA, governs self-funded plans. Some aspects of the Affordable Care Act do apply to self-insurance, such as the elimination of caps on lifetime benefits and some preventive care at no cost.

Yeah, it’s a scam.

• Traditional catastrophic insurance against large, unexpected, bankrupting charges
• Third party payment / capitation for entirely routine and expected health expenditures, from physicals to contraception
• Crony payoffs for favored constituencies, mainly via mandated benefits rules. This payoff may be to consumers, e.g. young women like Sandra Fluke who have the rest of us pay to maintain her sex life; or it may be to corporate cronies, who are able to get their particular device or procedure or service included in the mandated benefits, guaranteeing a large stream of customers who don’t care a bit what the product or service costs because it is now paid for by a third party.
• Social engineering, in the form of embedded incentives to promote certain favored behaviors like seeking preventative care or eating better. And when the government is paying the bill, the policy becomes a Trojon horse for government micro-management of our lives in the name of health cost reduction.

…the outcome of the case, and fate of the president’s most significant legislative achievement, will likely hinge on how the court views the Commerce Clause. One of the most widely debated parts of the Constitution, the Commerce Clause grants Congress the power “to regulate commerce with foreign nations, and among the several states.” And as the size and scope of the federal government has grown throughout the nation’s history, the Supreme Court has grappled with how broadly or narrowly to interpret the phrase. …If the court allows the mandate to stand, opponents claim, it would effectively give the federal government unlimited power to regulate individual behavior.

Article 1, Section 8 of the U.S. Constitution grants Congress the power “to regulate commerce…among the several states.” The framers and ratifiers of the Constitution understood those words to mean that while congress may regulate commercial activity that crossed state lines, Congress was not allowed to regulate the economic activity that occurred inside each state. As Alexander Hamilton—normally a champion of broad federal power—explained in Federalist 17, the Commerce Clause did not extend congressional authority to “the supervision of agriculture and of other concerns of a similar nature, all those things, in short, which are proper to be provided for by local legislation.” In other words, the Commerce Clause was not a blank check made out to the federal government. Yet in its decisions in both Wickard v. Filburn andGonzales v. Raich, the Supreme Court held otherwise, allowing Congress to regulate the wholly intrastate cultivation of wheat and marijuana, respectively. Those decisions cannot be squared with the original meaning of the Commerce Clause. As Justice Clarence Thomas remarked about the majority’s reasoning in Raich, “If Congress can regulate this under the Commerce Clause, then it can regulate virtually anything—and the Federal Government is no longer one of limited and enumerated powers.”

Ideally, your total cholesterol and LDL cholesterol levels should fall in these ranges: Total cholesterol below 200 milligrams per deciliter (mg/dL), or 5.2 millimoles per liter (mmol/L)LDL cholesterol below 100 mg/dL (2.6 mmol/L) — or below 70 mg/dL (1.8 mmol/L) if you're at very high risk of heart disease