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Supreme Court: Affordable Care Act Is Constitutional
This morning the U.S. Supreme Court ruled 5-4 that the Affordable Care Act is constitutional. The health insurance mandate, also known as "Obamacare" was found to be "permissible under Congress's taxing authority." The full ruling (PDF) is now available, and the court's opinion begins on page 7. Amy Howe from SCOTUSblog summarized the ruling thus:
"The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding."
Further coverage is available from CNN, the NY Times, and Fox.
First dissent
If you don't do what the government wants, you will find a new "tax" will appear to make you do it.
I already have health insurance. It's expensive and overly complicated, but I do have it. So, will this actually change anything for people like me? Hopefully I won't be picking up the tab for so many others who opted not to buy insurance before getting sick. But otherwise I don't see a huge impact.
What ever happened to the public option? You know, cutting the profit motive out of funding health care, so that people do not have to fight with their insurance companies or with hospitals just to get the treatment they need?
Palm trees and 8
I got MY healthcare.
You and your family can take a FLYING LEAP.
The most selfish American generation says SCREW YOU!!
Medical insurance is not only incredibly frustrating to deal with, but a huge unnecessary expense in the system.
It's not a tax. Obama even said so. We have a honest man in the house. Why are you all doubting him?
Life is not for the lazy.
Quite surprising to see Roberts cross the aisle on this decision. For all of its flaws (and there are many), the Affordable Care Act is a step in the right direction. Health care is one of the major issues of our time, and it's not realistic to suppose that a single piece of legislation can resolve it.
I find it interesting that it was found Constitutional under taxing power. I don't recall anyone pushing that angle to support the law in the court of public opinion.
There, FTFY.
But, I wanted socialized health insurance!
The whole problem with this is the insurance angle. This becomes a guaranteed income stream for private insurance companies. They have so many ways to hide their finances, people will pay ever higher costs for reduced care. There are a thousand studies saying health care costs will increase in the future, not including inflation. There are many ways the government could improve health care and reduce the cost of it, but this is not it. If the government was the insurance company that would be different, all they would have to do is add .5 % to the current medicare deduction. Simple. Let anyone that wants join a government health plan (with no existing condition clause). Simple.
The individual mandate was designed (by Republican think tanks) to avoid freeloaders, who we've all been paying for when they show up in the emergency room.
I also have insurance and the 2 big things it does for me are that it'll be tougher for an insurance company to deny benefits based on a pre-existing condition (which has been interpreted ludicrously loosely at times) and that if I (or someone close to me) ever does have huge medical bills, it will be less likely to bankrupt me.
I'm already taxed for not having a mortgage, not producing "clean" coal, not having children, and numerous other things that we as a culture have decided should be incentivized. The former two items in your list would be a clear violation of the first amendment, which this case did not rest on, whereas the third would be constitutional(but also kind of silly).
Nobody had to. According to Roberts, it is the court's duty to seek out and find any possible angle to keep a law constitutional. If it fails by one interpretation, use another. Only if everything fails is it struck down.
Everything is better with chainsaws.
It was argued as a side argument at SCOTUS. basically the argument was that 'this is permissible under the Commerce Clause, but oh, even if it isn't then it is a tax and is permissible as that'. Always smart to give the court multiple possible reasons something can be constitutional as this case clearly shows.
"There are laws that enslave men, and laws that set them free. " - Sean Connery as King Arthur
It's a new tax to cover the healthcare costs of those who end up in the hospital without insurance.
You can get a tax break for having your own insurance, as proof that you won't be costing taxpayers anything when you end up defaulting on $200k of hospital bills after an accident.
I don't know why the democrats couldn't shape the message that way. That's really what it is, and sounds better than "pay up or pay up".
Nonsense.
There are all sorts of contingent taxes.
Wrong. The tax is the PENALTY if you do not get insurance, not the insurance payment.
As the mandate is to give money to private insurers, and not the government itself.
No, there is a fine if you don't don't have insurance, which does go to the government. This is the tax in question and the Supreme Court held it to be valid. Given the all the millions of other special cases that our tax code includes, all of which penalize people for not doing what the government wants, this isn't surprising. If the bill made it a crime with criminal penalties for not holding insurance, then the Supreme Court may have ruled otherwise, but it didn't. You still have the full right to not hold insurance, you will just be taxed up the wazoo for it.
have been for decades
when someone uninsured shows up at the hospital with a broken arm, then avoids the bill or declares bankrupcty, we bail out the hospital from bankrupcty and you pay the bill
the only thing that has changed is that irresponsible people, people who think freedom means not to taking responsible for their healthcare, now have to do that, and stop freeloading off of us
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
Probably so--the individual mandate was a Republican idea to begin with.
I admire the Democrats for helping to tackle health care reform. There are some really good things in there--preventing insurance companies from rescinding coverage, allowing parents to insure kids up to 26, etc. But as a Democrat, I have mixed feelings about today's decision. I do not like the individual mandate, as like you, I feel that Congress shouldn't have the power to make you buy something from a private company.
I was actually hoping that the law would stand as-is, except for the individual mandate, which I was hoping would be overturned. At that point, insurance companies would be screwed--they'd still be forced to cover those that they traditionally worked so hard to drop off the rolls, but without money coming in from those who are statistically healthier and less likely to pay for insurance. At that point, one of two things would happen: either 1) the insurance companies would lower prices on their policies to reasonable levels to be more conducive for healthy people to buy, or 2) the insurance industry would basically petition government to expand Medicare to cover those that they don't want to. Either way, it would be win/win.
Ultimately, the only answer is a single-payer system. As long as you have private companies in the insurance business, there is a perverse incentive to screw their customers over. People whine and complain about government's incompetence, and I'd never say there's no waste or that government is perfect. However, I trust government a hell of a lot more than I trust the insurance industry, which has proven time and again that they're scum.
For political reasons, it couldn't be called a tax. The Supreme Court wasn't impressed by the semantics.
I don't practice what I preach because I'm not the kind of person that I'm preaching to.
I assume to know who will get 'taxed' on this? There are swaths of exemptions, eg if you already have your own insurance you won't to pay the monthly $286 per family tax, military is exempt, VA exempt, religious organizations who oppose are exempt, the poor are exempt etc. The people who the tax is targeted at are those who can pay but refuse because they'd rather be parasites on the rest of us who do pay, such as yourself I can only assume.
Justice Roberts had this little gem hidden in his commentary.
"The individual mandate cannot be upheld as an exercise of Congress's power under the Commerce Clause.That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it.
But in the odious 1942 Wickard V Filburn case the Court ruled exactly the opposite. The Court decided that Filburn's wheat growing activities reduced the amount of wheat he would buy for chicken feed on the open market, and because wheat was traded nationally, Filburn's production of more wheat than he was allotted was affecting interstate commerce. Thus, Filburn's production could be regulated by the federal government.
In essence, they ruled that he can't grow wheat for his own use he MUST BUY IT IN THE MARKET.
I wonder if this ruling can be used as precedent to challenge Wickard v Filburn?
Learning HOW to think is more important than learning WHAT to think.
My favorite is the conservatives who, upset that the SCOTUS upheld the individual mandate, say they're moving to Canada because America is just too socialist.
At least the ACA forces private health insurance companies to spend 85% of the premiums they receive on health care and limits overhead to 15%. A lot of people received rebates from their insurers this year because of that provision.
is they can't get cheap preventive care
now they can
so they get $100 worth of care and stay healthy and stay working, rather than $100,000 worth of care later when they are already sick, because they don't have the financial resources to attend to their healthcare
sanity prevails
thank you justice roberts, you have a human conscience
we'll talk about the citizens united thing later
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
doing those things, then why shouldn't you have to pay it?
Or do you think the rest of us should have to subsidize your desire to save a few bucks by destroying the earth and not pay a cent for your health care? Because I guarantee that when you have some devasting health problem you will show up at an ER and demand quality care.
I am surprised and disappointed by this ruling. But not for the reasons you might expect.
I want the US to have universal health care, but I think the mandate was a back-asswards way of getting it and I dont think it will be successful.
It would have been far better to just make it a tax. This mandate only helps the health insurance industry slow its inevitable downward spiral.
Accoding to a 2007 study by Kaiser Permanente, http://www.kff.org/insurance/7692.cfm
Healthcare spending has risen steadily and has outpaced wages. This means that less and less people can afford healthcare, and in turn less people will be purchasing insurance. Of course this is cyclical, since with less people buying insurance, the insurance sompanies will ahve to increase their premiums.
And so the health insurance industry is already in a downward spiral that will eventually collapse.
I fear that the health insurance mandate will not stop this downward spiral, since it will be less expensive for healthy people to just pay the fine than to buy insurance. Eventually, the US government will have to intervene.
Taxpayers already pay for a large percentage of the populations medical services. If you count Medicare, Medicaid, Federal, State, and Local governments, that makes up over 100 million users, or 30% of the population. As less people can afford healthcare, the government will be shouldering a higher percentage.
Dont fool yourself. You are paying for this one way or another. Either by taxes, or by rising insurance costs. If your company is paying the premiums, you may want to ask them why you did not get a raise this year and they will tell you it was eaten up by premiums. insurance is after all a 'tax' that you pay in order for 'services' to be available when you need them. The healthy people end up paying for the sick people with chronic problems caused by obesity, diabetes, heart disease, lung and liver diseases, all could be prevented by good diet, exercise, and staying away from drugs, alcohol, tobacco, fat, and sugar. How does that make you feel when your hard earned dollars are going to pay for someones lung cancer treatment who has chain-smoked for 20 years?
Not that I am bitter or anything. i paid more for health care in the last 5 years than I did in taxes. The last 2 years I paid more in health care than I did for my mortgage. And that is with an employer sponsored plan and a healthy family. But the good news is that this will HAVE to change. We know it and there is a clear path to where we need to go. In the next 5-10 years we will have universal healthcare whether we vote for it or not.
oldhack: "Security is a waste of money until shit hits the fan. 5 minutes later, it becomes waste of money again. "
Obama's lawyers said that it is independently authorized under both the commerce clause and the taxing authority, and then made the case [with precedent] that in cases where a law would be constitutional under one clause of federal authority but unconstitutional when read under another clause of federal authority then the Supreme Court is obligated to interpret under the clause which renders the law constitutional, regardless of the language within the law or political verbage utilized when debating the law outside the courtroom.
The majority opinion said that it was unconstitutional under the commerce clause, but clearly constitutional under the taxing authority, regardless of the labels used.
That argument makes a lot of sense to me as an engineer who is far more concerned with mechanics than with labels.
What should concern everyone, and the reason John Roberts supported the mandate, is that it sets a precedent to allow privatization of taxation.
The "Left" supported it because the mandate was attached to health care, but this is a step towards corporatism much bigger than Citizens United.
gasoline is already taxed (eventhough this tax doesn't cover the full society cost of gasoline): so isn't that tax an unfair imposition on your freedom in the same way that this health care tax is?
> If he doesn't have a tankless heater, he's the one paying the gas bills for the heater.
> If he doesn't have a programmable thermostat, he's the one paying the utility bills.
The taxes on those items don't cover their societal cost. If you think they do then you are naive.
> Yes, you mentioned the ER. The fix to that isn't to impose insurance, it's to remove the requirement that the ER treat those who won't pay their bills.
Now you've crossed from naive to stupid. I would bet every dollar I have that your opinion on this changes as soon as you or a loved one is in the position of needing emergency health care.
Except that it isn't public health care. It is private health care, mandated publicly. You'll notice private companies handle health insurance like Aetna, Blue Cross, and so on. And they still will. These companies are not going away.
Which is, ironically, why this legislation sucks.
Americans pay 16-18% of our per capita GDP in health care costs. France and Switzerland, the two consistently highest rated health care systems on planet Earth, which both offer true universal coverage to all their citizens, cost their people around 11% of per capita GDP.
You will not hear these numbers being touted by Democrats, Republicans, or the media. It isn't in there interests for you to understand how bad things have really gotten in the USA.
Do you think part of this may be that the French and Swiss are on average much healthier than the typical U.S. citizen? Since our average population is so incredibly unhealthy the overall risk to insurance companies is much higher, causing costs to rise for all involved.
I'm not stating this as a fact, but asking the question.
I for one look forward to our new DMV styled medical overlords. I hope I don't have to visit a medical center with an artery spouting blood....and get put at the back of the line because my paperwork wasn't filled out quite right.
Yes, I am sure that is what is going to happen. The Tea Party called, and they want their hysterical idiocy back.
This is why the right wing comes off like a pack of retarded children. They take the perfectly acceptable point of view that government should be minimalistic and non-intrusive, and warp it until they look like a pack of asylum escapees.
HA! I just wasted some of your bandwidth with a frivolous sig!
Oh I agree. But even the little baby steps we're taking with Obama's health care reform act are being met with all kinds of illogical resistance. It boggles me. People standing in the streets with signs wanting to repeal Obamacare. Even though it has provisions like how you can't be dropped or denied for a pre-existing condition. How in the world could someone be against that? I could see a CEO of a health care company not liking it, but the rest of us? How?
We're so screwed up in this country that you can actually get nearly half the people in the streets shouting that this is a bad idea. I have no idea how you accomplish that, but there you go.
So yeah, anything more invasive like what France has and it's ARRGH SOCIALISM and people would totally lose their minds. Even though it would be in their best interests.
Weaselmancer
rediculous.
People do not like not being excluded due to pre-existing conditions.
People do not like being force to buy insurance.
Sorry, you can't have it both ways. Otherwise young healthy people wait until they have a problem and then expect to start paying the same rate as everyone else. The function of insurance is to amortize the costs of unexpected (randomly occurring?) events over time and over population. This is broken both by people selectively participating and by companies selectively allowing people to participate. You must eliminate the cheaters on both sides or you really screw one side.
Not passing judgement, just pointing out one of the fundamental issues this law attempts to address.
Calm down and have another diet Coke with your double Whopper.
Well two things.
First thing, if you don't have health insurance and you get sick, who pays? That's right - I do. And everyone else who contributes to the system. But you don't. It's not fair.
Second thing. Health insurance just got a whole lot less scammy now that the reform act is in place. Go read it - you'll see. There's a ton of lousy crap they're not allowed to do now.
Weaselmancer
rediculous.