U.S. Supreme Court Upholds Constitutionality of Health Care Law

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ANALYSIS
by Glynn Wilson

The United States Supreme Court surprised media organizations and pundits of all stripes on Thursday by upholding the constitutionality of the first ever law regulating the health care industry in the country’s storied history, including the individual mandate conservatives were sure the court would strike down. (Read the full decision here in PDF format).

The potentially game-changing, election-year decision — a major victory for the White House less than five months before the November elections — will help redefine the power of the national government and affect the health-care choices of millions of Americans, according to the Washington Post.

Chief Justice John G. Roberts Jr. sided with the majority in voting to uphold the law, saying the mandate is permissible under Congress’s taxing authority.

The decision means the overhaul of health care in the U.S., which won’t go into effect on all fronts until 2014, will proceed and affect the way Americans receive and pay for their personal medical care.


The justices rejected two of the administration’s three arguments in support of the insurance requirement. But the court said the mandate can be construed as a tax.

“Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness,” Roberts wrote.

The court found problems with the law’s expansion of Medicaid, but even there they said the expansion could proceed as long as the federal government does not threaten to withhold states’ entire Medicaid allotment if they don’t take part in the law’s extension, according to AP.

The court’s four more liberal justices — Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor — joined Roberts in the historic decision that is the signature domestic issue of President Obama’s first term.

The far right conservatives justices — Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas — dissented, making the decision another 5-4 ruling on a court that is about as divided as the American populace itself.

Passage of the legislation by the Democratic-controlled Congress in 2010 capped decades of efforts to implement a national program to regulate health care in the only industrialized democracy in the Western World that did not have such a program.

The legislation is expected to eventually extend health-care coverage to more than 40 million Americans whithout any coverage, which is a major drain on the economy and contributes to driving health care costs up for everyone.

Republicans in Congress and GOP presidential challenger Mitt Romney have vowed to try and repeal the measure after the November elections, but many pundits say the unexpected decision may very well be the tipping point issue to hand President Obama a second term.

The court reviewed four central questions in the ruling. Whether it was within Congress’s constitutional powers to impose an “individual mandate” to purchase health insurance, the most important question, and a majority of the court said yes. Whether all or any additional parts of the law must be struck down if the mandate is rejected became moot. Whether an expansion of Medicaid was unduly coercive on the states was another question, and whether all of those questions can even be reviewed before the mandate takes effect.

On the Medicaid question, the judges found that the law’s expansion of Medicaid can move forward, but not its provision that threatens states with the loss of their existing Medicaid funding if the states declined to comply with the expansion.

“The finding immediately raises questions as to how effectively the federal government will be able to implement the expansion of the joint federal-state insurance program for the poor,” the Post analysis indicates.

The most crucial issue before the court was considered to be the individual mandate, known technically as the “minimum coverage” provision, because striking it down would jeopardize the ability of insurers to comply with other, more popular elements of the health-care law without drastically raising premiums. Under those other provisions, for example, insurers can no longer limit or deny benefits to children because of a preexisting condition, and young adults to up age 26 are eligible for insurance coverage under their parents’ plans.

Much will be written and said about this ruling, but it will be received as good news to anyone without health insurance, people who understand the importance of national health care to the recovery of the U.S. economy, and Democrats everywhere.

The Republicans will wring their hands and say all kinds of things to bash the court for this, and the attack has already started on Fox News.

But the fact is, this is a conservative court that recognized the importance of health care for the national economy and did not want to “legislate from the bench” and encroach on the power of the president and Congress to make laws. That is at the heart of this decision, and it should be welcomed by conservatives, since their cause célèbre in judicial races is that courts should review the constitutionality of laws, not make laws from the bench.

In his decision, George W. Bush’s choice for chief justice went out of his way several times to portray the court as a neutral arbiter of the facts, adjudicating matters of law, not passing judgment on the wisdom of the health-care legislation.

“Those decisions are entrusted to our nation’s elected leaders, who can be thrown out of office if the people disagree with them,” Roberts said. “It is not our job to protect the people from the consequences of their political choices.”

© 2012, Glynn Wilson. All rights reserved.

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