The Supreme Court and Health Care Reform

Health Care Reform Supreme Court Justices

By Esmeralda Mercado

This blog is intended to give an overview of the latest Health Care Reform news with the Supreme Court, and to invite people to share their own questions and theories.

The Supreme Court Marathon
The Patient Protection and Affordable Care Act (“PPACA” or “ACA”) was signed into law on March 23, 2010. Two years later, the Supreme Court considered its constitutionality after 26 states challenged the law. The case proceedings spanned a three day marathon, from March 26 through March 28, 2012. Many were surprised to find that the lawsuit was not dismissed automatically. Oral arguments revealed that the justices were divided on the law. Many tough questions were asked and remain unanswered. The arguments boiled down to a question of jurisdiction or boundaries of power: Does the Constitution’s Commerce Clause give the government the right to force its citizens to buy medical insurance? How much control does the federal government have over the states?

Will Health Reform be more costly in the long run?
The premise of the Health Reform Law is to provide affordable medical insurance to all Americans. To help accomplish this, more healthy people are needed to pay into the health care pool, thus lowering the cost for people with adverse and costly health conditions. Now, questions arise on the constitutionality of the mandate, as well as the funding of it. In 2008, it cost $43 billion to provide medical services to uninsured people. The cost was ultimately absorbed by insured Americans. Some have argued that Health Care Reform would end up decreasing the national debt by $100 billion, while others contend that the Affordable Care Act would increase the national debt by $80-$530 billion.

What questions will the Supreme Court be dealing with related to the Affordable Care Act?
The Supreme Court consists of one chief justice and 8 associate justices. A total of five votes are needed to decide the outcome of the Health Reform Law. The justices have until June 2012 to make a ruling on four main aspects of the law:

  1.  The Anti-Injunction Act: Can the Supreme Court rule on this now, or must they wait until after 2014, after the law goes into effect? If the penalty associated with the mandate is deemed to be a “tax”, then the Anti-Injunction Act might require the Supreme Court to decide on this case after the law is already in place.
  2. The Mandate: Will the mandate be deemed unconstitutional? Can the federal government require individuals to buy health insurance or pay a penalty?
  3. Severability: If the individual mandate is deemed unconstitutional, must all the other Health Reform provisions also be nullified? Can the Supreme Court overrule part of the Affordable Care Act without overruling all of it? Also, if the mandate is deemed unconstitutional and the rest of the legislation stands while this part is severed from the ACA, what affects will that have on the implementation of the other 450-some provisions in the law?
  4. Medicaid: Can the federal government require states to pay more into Medicaid? Some states are arguing that this would overly burden their state economies, and beyond that, they argue that this is unconstitutional. However, according to The Patient Protection and Affordable Care Act, if they do not comply, the states risk losing federal funding.

Historically, the Supreme Court has not struck down a regulatory law of this magnitude since President Franklin Roosevelt’s New Deal program in 1936. That law was drafted to provide relief and recovery to people and businesses during the Depression. However, it faced challenges as some argued that the regulatory codes could not be enforced and were too cumbersome to follow. For more information on the outcome of that case, click The Supreme Court and the New Deal.

While the nation waits for June’s decision, no doubt we all have questions. Here are some questions to ponder, answer, or comment on:

• What happens to parts of the Health Reform Law that have already been implemented? One of these is the provision that forbids health insurance carriers from denying children ages 0 to 18. Another provision allows children up to age 26 to remain as covered dependents on family plans.
• If the individual mandate is voted down and the other provisions are upheld, how will that affect health reform? Some reports say insurance premiums could rise around 20% if the mandate is removed. If premiums rise drastically like this, what affects will that have?
• How will the Affordable Care Act affect our economy as a whole?
• How will the Supreme Court’s decision affect the overall cost of health care in America?

What are your thoughts on Health Care Reform?

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