Guest blogged by Ernest A. Canning
In case you were watching the misreporting by CNN and Fox “News”, it was a win for the Obama Administration and a crushing defeat to the Republican opponents of health care insurance reform in this nation. It’s that simple.
With the exception of that portion of the Act which permitted the federal government to punish states by cutting off the entirety of their federal Medicaid funds if they declined to expand state Medicaid services from limited categories of individuals to all individuals with incomes below 133% of the poverty level, the U.S. Supreme Court, by its 5-4 decision in National Federation of Independent Business v Sebelius [PDF], upheld all provisions of the Affordable Care Act of 2010 [ACA] against the constitutional challenges that had originally been filed in U.S. District Court by FL, 12 other states and business organizations…
The majority opinion, written by Chief Justice John Roberts, was joined by Justices Ginsberg, Breyer, Sotomayor and Kagan in all respects except the Medicaid expansion ruling.
Roberts explained the rationale for the individual mandate:
While the Court ruled that the imposition of an “individual mandate” was not authorized under Congress’s power to “regulate commerce” because it amounted to creating commerce where none exists, it upheld provisions requiring individuals, who fail to obtain insurance, to make an additional payment to the IRS under Congress’s power to tax.
So what was not allowed under the Commerce Clause, is allowed if it’s just seen as a plain old tax.
Roberts reasoned that the expansion of Medicaid from “the disabled, the blind, the elderly and needy families with dependent children” to “all individuals under 65 with incomes below 133% of the federal poverty line” was tantamount to the creation of a new Medicaid program. He determined the U.S. can withhold federal funds for the new program from those states which decline to participate in it, but it cannot threaten to cut-off all Medicaid funding from those states who decline to participate in the ACA’s Medicaid expansion. Doing so, he wrote, exceeds Congress’s authority under the Spending Clause.
There will undoubtedly be a plethora of news articles dealing with the political significance of today’s Supreme Court ruling. There has been and will be valid reasons to criticize the ACA. However, given the early misreporting by CNN and Fox to the effect that the Court had struck down the individual mandate, it is important to simply report what the Court did or did not rule.
Ernest A. Canning has been an active member of the California state bar since 1977. Mr. Canning has received both undergraduate and graduate degrees in political science as well as a juris doctor. He is also a Vietnam vet (4th Infantry, Central Highlands 1968). Follow him on Twitter: @Cann4ing.
I still don’t understand it Ernie. If the mandate doesn’t pass the constitutional muster, how can those who don’t abide by the mandate be penalized? Its the same thing..
Perfectly valid question, Steve.
Here’s how it works.
In his opinion, Justice Roberts notes, “the Government asks us to read the mandate not as ordering individuals to buy insurance, but rather as imposing a tax on those who do not buy that product.â€
Later, he adds that this means “the mandate can be regarded as establishing a condition — not owning health insurance—that triggers a tax — the required payment to the IRS.â€
The issue, under rules of constitutional interpretation, is not whether the government’s tax argument offers “the most natural interpretation of the mandate, but only whether it is a ‘fairly possible’ one…’every reasonable construction must be resorted to, in order to save a statute from unconstitutionality.’â€
Roberts was simply following classic constitutional law dating back to the early 19th Century that , as he explained at the outset of his opinion, entails “a general reticence to invalidate the acts of the Nation’s elected leaders.â€
It is rather basic that a court will invalidate an act only where “lack of constitutional authority…is clearly demonstrated.”
The Court didn’t approve a “mandate” per se. The federal government can’t force you to buy insurance. But, if you choose not to buy insurance, the government can impose a special tax upon you for failing to buy insurance.
Note: Roberts argument on this issue is similar to questions of the extent of the federal government’s power over states on issues like Medicaid. The government cannot command a state to provide Medicaid. But it can condition receipt of federal Medicaid funds on a state’s compliance with federal Medicaid standards. In this instance, however, Roberts treated the Medicaid expansion as a totally new Medicaid program because it covers a huge class of people not covered by the original Medicaid. The federal government can condition a state’s receipt of Medicaid expansion monies on a state’s acceptance of the expansion, but it cannot threaten to take away all Medicaid funds unless a state fails to comply with the original Medicaid conditions.
Ernest, a hypothetical opinion, please.
If, instead of the ACA, congress had passed “Medicare for all” (e.g. HR 676) would there have been as obvious an issue on which to base a legal challenge as was afforded by the ACA “mandate”?
In response to John Puma @3:
From the PNHP website:
“Both sides agree that Congress has the constitutional power to enact a national health care system that raised taxes to support a single government agency that pays all medical bills, just like Medicare,†said Walter Dellinger, who served as acting solicitor general in the administration of President Bill Clinton and supports the law.
So, yes, John. This entire legal battle could have been avoided if a single-payer system, which removed the parasitic middle men (insurance companies), were adopted.
Methinks the biggest sigh of relief yesterday, maybe even more so than the president, emanated from those insurance companies
Thanks, Ernest.
As Steve suggests, the insurance companies had a lot to lose here and that is why the ruling doesn’t seem like such a surprise.
And intimately related, is the blow this “victory” is to hopes of ever attaining a single-payer system, certainly if the ACA remains intact or because this ruling will keep Romney’s supporters in a rabid frenzy that increases his chances for victory in November.
Ironically, WingnutSteve, much of the GOP opposition to the ACA was funded by the same healthcare insurance industry which engineered the bill from inside Sen. Baucus’ office.
That said, I’m all for removing the insurance companies from the healthcare equation.
For an extended discussion as to why the ACA falls well short of real reform, go to the website of Physicians for a National Health Program.
Also, I don’t totally agree with John Puma. The ACA does contain significant improvements over the existing system. The fact that it passed and has now been found constitutional should, by no means, deter advocates of a single-payer Medicare for All system. Our goal is to educate those who have been taken in by right-wing propaganda as to what real reform would look like.
As an addendum to my @7 response to John Puma, please see, Michael Moore: Supreme Court Healthcare Ruling a Victory on the Path to Single Payer
Interesting that the stocks went up right after Obamacare made it through the Supreme Court.