On 28 June, the United States Supreme Court ruled that President Barack Obama’s healthcare reform act, The Patient Protection and Affordable Care Act, is constitutional. Of the 9 judges, Chief Justice John Roberts’ vote was decisive in the 5-4 ruling in favor of the law. The court upheld a core requirement known as the “individual mandate”, which requires individuals to buy insurance or pay a fine. It found that the penalty falls within Congress’s taxation powers granted by the US constitution. However, the court did impose a ride on the law’s expansion of Medicaid, the federal-state health program for the poor.
The ruling comes months before the US election, which will take place in November 2012. So, while it upheld the law, the Supreme Court made a clear effort to remove its ruling from the divisive political nature of the debate. Chief Justice Roberts highlighted the fact that the ruling was only on the constitutionality of the provisions, saying: “We do not consider whether the Act embodies sound policies. That judgment is entrusted to the Nation’s elected leaders.”
As the ruling was closely divided, both the supporting and opposing justices were given a voice in the decision. Justice Roberts wrote that the mandate can be regarded as establishing a condition (lack of insurance) which triggers a tax (the fine). The dissenting justices said that the power of Congress to regulate commerce and raise taxes cannot be such that it enables the federal government to regulate all private conduct.
The nature of the debate – constitutionality, individuals, and the Federal Government
When Obama signed the Patient Protection and Affordable Care Act into law on March 23rd 2010, he achieved what no other Democrat had: he moved America decisively towards universal health insurance. However, within minutes, 13 states had filed suit against the law in Florida, and they were later joined by the National Federation of Independent business, four private individuals, and 13 more states. The challengers insisted that the mandate would bring a “revolution in the relationship between the central government and the government”. They said that it raised questions on the extent of the power of the federal government and that the law’s expansion of Medicaid was unduly coercive because if states did not abide by the law’s rules, they would lose their federal Medicaid money.
Obama’s lawyers stated that the constitution gives Congress the power to regulate interstate commerce and that when uninsured people consume health care they cannot pay for, the tab is covered by those with insurance and that the mandate was a way to fix these problems. It should be noted that nearly 50 million or 16.3% of Americans are uninsured. However, these percentages are higher in specific ethnic groups, up to 30.7% for Hispanics. As for Medicaid, they argued that Congress regularly ties state funding to particular requirements.
It should be noted that the court did not invoke a law that could have prevented the justices from ruling on the case. Under the Anti-Injunction Act, taxes cannot be legally challenged until after have been levied. In this case, this could have delayed the verdict until 2015, after the individual mandate came into effect and the first round of penalties had been paid. They were also not required to rule on the issue of “severability”, which would determine whether other parts of the healthcare law could stand even if the mandate was struck down.
Victory for Democrats, Obama looking to move forward
Speaking after the ruling, Obama called the decision a victory for the people and stated that he is certain that the law is a sound one and that while it could be improved on, the country and the people will be better off for passing it. He further emphasized that “what we won’t do – what the country can’t afford to do – is re-fight the political battles of two years ago or go back to the way things were. With today’s announcement, it’s time for us to move forward.” Democrats are hoping to move on from the ruling to the implementation of the law.
Republicans outraged, look to election
Republicans have vowed to push for a repeal of the bill. Romney stated that while the Supreme Court had ruled the law constitutional, he still felt that it was bad policy because “it makes [businesses] less likely to hire people”. He went on to call Obamacare a tax rise that would add to the national debt and a “job-killer”, and said it would put the federal government “between you and your doctor”.
However, the Romney campaign feels that the decision could work in their favor over the long term as some 50% of the public dislike the law, while only 40% approve, and the individual mandate is the most unpopular section of the law. Furthermore, they can now claim that the ballot box in November is the only remaining path to repeal, galvanizing voters opposed to the law to vote against Obama in November. Romney put it clearly when he said: “If we’re going to get rid of Obamacare we’re going to have to replace President Obama.” However, even if Romney does win, it will be hard to repeal the law without a Republican majority of 60 in the 100-member senate, an outcome the party is unlikely to achieve in November.
CNN reported the wrong ruling on the Affordable Care Act decision both on its online version, where it announced “Mandate struck down: High court finds measure unconstitutional”, and on its air, where it announced that “it appears as if the justices have struck down the individual mandate”. Fox News also misreported the event and both quickly corrected their mistake.
Report: “Obama hails supreme court’s health care ruling as a victory for America” [28 June 2012]
Report: “Dewey Defeats Truman, LIVE! CNN Gets It Wrong on the Health-Care Ruling” [The Atlantinc, 28 June 2012]
Report: “Obamacare and the Supreme Court: A Clean Bill of Health” [The Economist, 28 June 2012]
Report: “US Supreme Court upholds healthcare reform law” [BBC, 28 June 2012]