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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
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
Which is counterpoint to granting tax breaks to get people to do something.
If you don't do what the government wants, you will find a new "tax" will appear to make you do it.
Yes, especially when the government (AKA "we the people") wants you to stop freeloading on the health insurance system we're paying for.
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.
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.
You were already doing that before, partly through your taxes, partly through effectively paying higher amounts to hospitals, in order to compensate hospitals for the all the ER visits they get from people without insurance (and thus likely never pay). You potentially could have ended up in the situation you were worried about if the Supreme Court struck down the individual mandate, but kept the rest of the law.
Which is counterpoint to granting tax breaks to get people to do something.
Carrot or Stick, you have your choice.
Don't like it? Blame those broad powers granted through phrases like "provide for the general welfare" in the Constitution.
A feeling of having made the same mistake before: Deja Foobar
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".
The majority of the country didn't want this legislation.
Yeah, funny thing about that.
When people were polled about specific parts OF the bill, with the exception of the mandate, everything had a solid majority of support.
Of course, the mandate is the keystone that pays for the rest of the parts people like.
So, all that really proves is people want the great taste WITH less filling, which isn't how economics works.
It's more of a pudding after meat situation.
Odds are your taxes will go up to support enforcing this program, as will your health insurance costs as they struggle to compete with it.
Insurance rates will likely go up LESS fast since those WITH health insurance have ALWAYS been paying for those WITHOUT. Now we will no longer have to do that in many cases. Of course, healthcare and insurance being what they are, insurance will still go up, just not as fast.
At this point most of the law has already been priced in insurance anyway.
"There are laws that enslave men, and laws that set them free. " - Sean Connery as King Arthur
Most people don't know what's in the ACA.
Most people like what's in the ACA.
What doesn't kill you only delays the inevitable
typical americans. like everything about it except the bill. I'm in favor of everything about it except that "I have to pay for it" part....
I work for the Department of Redundancy Department.
This is no different than a "tax break" for mortgage interest, or any other similar tax break, which is just a tax raise for the rest of us (i.e. people who rent their homes and therefore don't get the mortgage interest deduction) If the government can raise your taxes for not having a mortgage, it follows it can raise your taxes for not having health insurance. The Supreme Court decision is logical given prior precedent.
I got MY healthcare.
You and your family can take a FLYING LEAP.
The most selfish American generation says SCREW YOU!!
Thanks for sharing the GOP platform on this.
"There are laws that enslave men, and laws that set them free. " - Sean Connery as King Arthur
carrot for the top 1%, stick for the rest.
Yes, I'm left. You have a problem with that?
The majority of the country didn't want this legislation. It was voted down in congress and they had to resort to some trick to pass it.
Uhhhh...
1) The majority of the country has no idea what's even in the bill. Vast majorities of America (even conservatives) support its provisions, however. http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/06/26/poll-republicans-hate-obamacare-but-like-most-of-what-it-does/
2) Congress passed the law with a majority vote. And now it's been proven constitutional. Do you have a suggestion how to make laws more democratically?
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.
Taxation has always been an instrument of social engineering how a society operates. By any other name, it's a behavior modifier. The fact many of you don't already know this is quite frankly, scary as hell!
Life is not for the lazy.
or bailing out banks ? "there is money for banksters, but not for sick people - just let them die!" *applause*
Wow, are you likely to get an earful over this. Here's my perspective (not a neutral one):
The "individual mandate" part of the Affordable Care Act (ACA) requires you to carry health care insurance. However, supporters claim that because the risk associated to insurers is now spread out over a much larger segment of the population (those who would normally decline health insurance are obviously less likely to need it), the cost to individuals in terms of premiums is likely to decline. In other words, they're betting that the cost of your insurance is likely to decline. Personally, I think that's likely... for insurers, anyway. Whether insurers pass these cost savings to individuals is a craps shoot. When Massachusetts (under, ahem, Governor Romney) passed a law with an individual mandate, premiums fell something like 40% at the same time that it was rising nationally.
Another big part of the bill is the "pre-existing condition" clause: basically, an insurer cannot deny you coverage because you already have a medical condition that they don't want to cover. There was some worry among ACA boosters that the court might strike down the "individual mandate" part without the "pre-existing condition" part, which would have been catastrophic to the risk pools: seven states have tried passing pre-existing condition laws without the individual mandate, and it went very badly for all of them. So if it turns out that you come down with some kind of chronic or severe condition, it can no longer be used as a reason for an insurer to deny you insurance.
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.
I have health insurance. It is not a tax on me. It is a tax on the irresponsible Americans who decide to leech off of the system instead of getting health insurance. If you get sick (or in an accident) and do not have health insurance then I have to pay for it (the hospital will still treat you, and the costs will be passed on to me as higher premiums when you cannot pay and file for bankruptcy). So yes, it is a tax on dumb/irresponsible people.
When put that way, this starts to sound like a really good idea. Maybe we can find a way to expand it to other areas.
Yeah, this is a loser for all Americans. The majority of the country didn't want this legislation. It was voted down in congress and they had to resort to some trick to pass it. The entire time the Obama Administration kept saying that this was NOT A TAX ... that it was a Mandate. Now the SCOTUS says that it is unconstitutional as a Mandate, but it's ok at a TAX. So the bill that was passed was not only against the wishes of the majority of the people, it doesn't even work the way the minority said it would when it was voted upon.
Not really factually correct. A majority of Americans like a majority of the acts of this law. The 'no preexisting condition' portion is particularly popular as is the 'no lifetime maximum' and the 'no copay for preventative care' portions. The one part that more unpopular with most people is the 'must buy insurance part'. But the rest of it doesn't work without that.
"There are laws that enslave men, and laws that set them free. " - Sean Connery as King Arthur
This is about taxes. "General welfare" or "regulation of interstate commerce" (which was rejected) don't apply. If congress wants to tax people who don't enter into a business agreement with a third party, they can (and, did).
Do you even lift?
These aren't the 'roids you're looking for.
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.
carrot for the top 1%, stick for the rest.
The 1% can have carrot top.
Meanwhile, everyone ignored the actual universal healthcare bill that would have paid for itself, not with a fundamental, constitutionally questionable mandate / giveaway to insurance companies, but, shock and appall, a tax. Can't have that! Let's just force people to pay for it directly, except that they have to buy it from private insurance companies who can still dictate their care or lack thereof. It's not a tax if the forced payment of money doesn't go to the government!
But I'm not bitter. Not at all.
When this blows up in everyone's faces in a couple of presidencies (you know, after insurance premiums shoot through the roof and price fixing is commonplace), don't say I didn't say I told you so.
The really annoying thing to me is that this is still probably the closest Obama could have got to universal care in the current political climate. I don't even really blame him.
It's better to vote for what you want and not get it than to vote for what you don't want and get it.
- E. Debs
It's cheaper for my employer to drop my insurance *now* and pay *zero* tax, but they haven't because they use it as an incentive to keep me around. Your argument is a completely moot point.
--Jeremy
Jesus was a liberal
1. Congress has the right to force citizens to enter into commerce, under the commerce clause -- the mandate penalty was just that, a penalty.
2. Congress has the right to tax any behavior it sees fit -- the mandate penalty was, for this purpose, a tax.
SCOTUS rejected the first claim (proving that they do see limits to the commerce clause sometimes), and accepted the second claim. SCOTUS did not create the idea that it was the mandate was a new tax -- the government did.
Healthcare should be disconnected from employment....
Light travels faster than sound. This is why some people appear bright until you hear them speak.........
While I agree that not having health insurance is really risky and dumb, taxing someone for not buying / wanting something goes against freedom.
It's only freedom if no-one else has to pay when you get sick or are in an accident. Otherwise you are just saving yourself some cash at other people's expense, taking away their freedom.
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SJW, n: "Someone I don't like, and by the way I'm a fuckwit" - AC
If you thought that your premiums were not going up over the next two years anyway I have a bridge to sell you.
No, you don't. If you're in a low enough income bracket, you don't have to pay the penalty, and in fact get a subsidy to purchase insurance.
These aren't mysterious hidden details, unless you spend all of your time watching Fox News. They've been right up front about this the whole time. It amazes me how much general ignorance there is about the Affordable Care Act. There are legitimate gripes about the bill, but usually the people griping about it are just spewing complete bullshit like Grishnakh and sycodon here.
--Jeremy
Jesus was a liberal
Apparently you haven't been paying attention. Health care has gone up in cost every year, well over the cost of inflation. The only difference is that this year your insurer has a convenient scapegoat.
--Jeremy
Jesus was a liberal
This is about taxes. "General welfare" or "regulation of interstate commerce" (which was rejected) don't apply. If congress wants to tax people who don't enter into a business agreement with a third party, they can (and, did).
This specific part is about fixing the pre-existing loophole that someone who decides not to pay for insurance but piggy backs on the healthcare system by using the ER (which is more expensive than regular visits and pushes the burden on the rest of us through higher medical and insurance costs). As costs got higher, more and more people made this decision (or it was made for them). This isn't the primary reason for health care costs going up, but it's contributing to it.
At some point in time, this gap was going to need to be filled in some way (otherwise you and I will continue to pay for their insurance). I would have preferred a carrot rather than a stick (or a stick disguised as a carrot), but I personally can't think of a better solution. Can you?
It was disconnected until 1973 (or so) when the government required large businesses to offer it. Over the years "large business" was redefined to be 50 or more employees. My employer presently has 49 employees and has no interest in increasing by even one employee... that 50th employee will be an expensive chap.
Yeah but then we will have to -- gasp -- cover the medical expenses of people who are just above the poverty line (and think of how terrible it is that we cover the costs of people who are below the poverty line!).
The popular sentiment these days is that everyone should just fend for themselves, compete with each other as vigorously as possible, and those who are unable to compete do not deserve to live in our society. The entire outlook can be summarized in just three words: greed is good.
Welcome to America!
Palm trees and 8
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.
Actually, Obama's lawyers told the Court that, firstly, it was not a tax but a valid use of the government's Commerce-Clause powers. Then they outlined two alternative arguments:
Alternative A: Even if the Court finds it was not within the scope of the Commerce Clause, the ACA is nonetheless Constitutional under the Necessary and Proper clause, because the insurance mandate is both necessary and proper to enacting Congress's reform scheme.
Alternative B: Even if the Court finds it is neither within the scope of the CC or the N&P clause, the ACA should nonetheless be upheld because it is functionally equivalent to a tax, and if treated as a tax, is within Congress's powers under the Tax Clause.
The Court rejected Obama's lawyers' primary and Alternative A arguments, but accepted Alternative B. This is fairly common in legal cases. You first say what you think is true, but then you go through several alternatives that argue that, even if the Court disagrees with you in some way, you should nonetheless win for several backup reasons.
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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. "
that's awesome
so when you break your arm, and you have no insurance, and you go to the hospital, and avoid the bill because you don't have a $50,000 healthcare fund in your checking account and you live paycheck to paycheck like most americans, the rest of us will have to pay that $3,000 to fix your arm
to people like you, freedom means freedom from responsibility
you're a freeloader
go ahead, vote for romney. and if enough vote for romney for the same reason, that they don't want to take responsibility for financing their own healthcare, then this country is doomed to ever increasing healthcare costs
i however have faith that most americans are more intelligent and responsible than you are, and with single payer, we will eventually bring our healthcare costs in line with most other modern countries in this world, who have unviersal healthcare, and spend far less per capita than the usa does. because how they finance their healthcare system is predicated on common sense and economies of scale, and not predicated on satisfying corporate rent seeking parasites like healthcare corporations, whose talking points you apparently swallow hook line and sinker like a good little faithful propagandized moron
intellectual property law is philosophically incoherent. it is your moral duty to ignore it or sabotage it
You don't get it. The "mandate' or more appropriately described tax penalty is accompanied by tax credits which means if you truly cannot afford the premiums, they will be partially or fully offset by a lower withholding from your paycheck or even a tax refund beyond withholdings for the extremely poor. If you can afford it, you should have insurance lest you offload your emergency care costs and overall higher cost of servicing to those who do. You are not required to but if you don't, it is entirely reasonable you pay a tax to support the higher cost of service you are imposing upon the rest of us.
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You notice how much of the criticism of the law comes from sheer ignorance about what it actually does? Even on Slashdot.
Check out my world simulator thingy.
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.
You've got two choices.
Choice 1) You need hospitals and doctors who will throw you out and let you die if you can't pay for your care, and will do a credit check or check your bank account before they begin providing care.
Choice 2) Some form of universal insurance, whether it's a 'tax', an individual mandate in a private system (What we have now), or a true public option (More like what you have in other countries).
There is no other option. Medical care isn't free. Someone has to pay for the doctors, for the drugs, for the operating rooms, for the sterilization, all of it. This is not a theoretical problem, either. We've waited long enough with our current slapdash system - where the insured subsidize the uninsured - that it's already in the midst of collapse, and is slated to collapse within 15 years. The bills are too high. Giving care to everyone without insurance for everyone is just wrecking us, especially because the only care you get while uninsured - emergency care - is the most expensive kind.
Do you want to die on the hospital floor, do you want to be forced to show the minimal planning that health insurance -is- (Providing for your ability to continue living), or do you want to continue to throw a tantrum like a five-year-old?
Holy cripes, man! "...money you never had?!?" It was money that was forcibly removed from you before you ever saw it!
Like the man said, it is money he never had.
Add up that missing 1/3 from your paycheck. What could you do with that?
If he could somehow evade paying taxes, his lifestyle would improve. If everybody else could do it too, his lifestyle would get much worse. Any furthur questions?
Why, with all that extra money, you could pay to send your kids to school, hire a policeman to protect you, hire some firemen to keep your house from burning down, build some roads (if you can get your neighbors to chip in)...
-- Sent from a computer.
You really think the cost of losing weight is more than the cost of being obese? Really?
I live ze unknown. I love ze unknown. I am ze unknown.
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.
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.
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.