Affordable Care Act v. Roberts Court

By on March 26, 2012 in Barack Obama

Supreme Court to decide if being smart about health care is constitutional.

The fact is: We’re already mandated to pay for our fellow Americans’ health care. The question is: Will we be mandated to pay for our own?

This week the Affordable Care Act faces its first big challenge of the year. The Supreme Court will hear arguments about the individual mandate, Medicaid expansion and how these  both affect the constitutionality of the entire law. The court’s decisions on these matters are expected before the election, which is the second big challenge of the year.

Here’s the first thing you should know: 85% of Supreme Court watchers believe the ACA will survive this challenge.

Some think it’s clearly constitutional; others think Justice Roberts wants to maintain some credibility as his court revisits Roe V. Wade or has to decide on gay marriage. Roberts knows that the combination of Bush v. Gore and Citizens United has undermined the Court to the left in much the same way Roe did for the right.

In my cashew of a brain, I don’t see how the Affordable Care Act will be overturned. For this, you should blame Ronald Reagan. Reagan, you’ll remember, socialized medicine in the United States.

FACT IS: We already have a mandate that forces us to pay for others’ health care (in the stupidest way possible). The Affordable Care Act just mandates that we pay for ourselves, too.

So here’s Ezra Klein with a must read brief about the case. You should also follow Ann Arbor’s own Jonathan Cohn blogging for the New Republic. He’s in the Court. Expect him to keep you updated on how the arguments for and against the law are shaping up. For instance, he just linked this piece from the ACA Litigation Blog “Some things to look for tomorrow”. Good stuff.

BUT KNOW THIS: The real battle will be in November.

This election will be the real battle for affordable health care for 30 million more Americas (along with the battle for gender equity, mental health parity and the first serious insurance regulation on health insurer’s expenditures ever.)

This election cannot be close. If we don’t soundly defeat a Republican Party that exists to only to cut taxes and reduce responsibility for the richest and their corporations, we will be circling around this question of how we should provide health care for everyone for another decade.

KNOW THIS: We pay for each others’ health care—because if you can’t pay, everyone pays for you. The question is: Will we do this in an smart way or silly way that wastes money and lets people die?

The ACA’s opponents’ argument is silliness. This system is the alternative to single-payer they came up with. Now that it has been co-opted they are proving they’d do nothing to fix a private insurer system so broken that SICK KIDS WERE BEING DENIED HEALTH CARE ON A DAILY BASIS.

Not to mention the 45,000 Americans experts believe die every year for a lack of insurance.

MEANWHILE: We pay MORE than anyone in the world for this insane system where the very rich can basically get bionics and working families struggle to afford even the most basic coverage.

This is a broken health care system. And this summer we’ll find out if we have a broken Supreme Court would rather keep it that way.

[CC Image from Leader Nancy Pelosi. Wish every Democrat released images to use on Flickr. Just smart.]


  • CB_Demented

    I agree that it’s a broken health care system. I don’t agree that a 2k page bill that was passed in 48 hours “so we could find out what’s in it” is the way to fix it.

    It answers some good questions, and has some good intent. I like the provisions for pre-existing conditions, for example.

    But I don’t see how it can be constitutional to force someone to pay for care…nor do I think we can afford much of what’s in the bill.

    What will be interesting is if the Court decides to kick the can down the road until after the elections, which they can do by simply deciding that the bill amounts to a tax, as one of the lower courts did. If that’s the case, they can’t rule on it until 2014.

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  • Soundpam

    CB – You already spend more money paying for those without healthcare to get very EXPENSIVE care @ emergency rooms. Everyone having insurance means that costs will go down & it will cost us all a lot less. Simple math. Simple economics. The bill is far less expensive than the status quo.

    • CB_Demented

      If the bill was about handling emergency room care, I suspect you’d find a lot less opposition to it. Certainly a lot less from me.

      The math for what we pay for uninsured emergency care, vs what we’ll pay for ongoing health care, as well as emergency health care, doesn’t work out. The emergency room is still going to get used, but we’ll be paying for long term health care as well.

      And even that isn’t the real bone of contention. The mandated health care is the biggest problem, as are all the little things that got thrown in that 2k page monstrosity that are questionable at best.

      Then there’s the overall cost. No matter how great a thing is, if you can’t afford it, you can’t afford it.

  • bitterenvy

    I do have to disagree with this common misconception that those who do not have health insurance have their way paid by others. I do not have insurance and I either pay my own friggin’ bills or I don’t get health care. No one pays for me but me. Mostly I just do without. And if the Repugs have their way, I will continue to do without and likely die an early death. Thank you, GOP, for not giving a damn.

    • CB_Demented

       It’s not a question of not giving a damn. It’s a question of plain fiscal reality.

      We can’t afford to insure everyone.

      What the focus should have been was finding a way to take care of basic medical needs and wellness for people who aren’t insured as well as finding ways to control cost, and excessive tort.

      By coming up with a solution that not only covers those without, but everyone, and structuring it in such a way that everyone must follow suit, it’s caused an increase in costs across the board, didn’t address high costs in the first place, and covered people who don’t need coverage. In fact, according to the CBO, 3-5 million people who have their own health care, will lose it because of the Affordable Care Act, and will be put on it instead. This flies in the face of Obama’s promise that if you have health care now, you’ll be able to keep it, as does the testimony before congress of several of the largest companies in the country who stated flat out that the fine they will pay will be a fraction of what they pay for insurance premiums, and thus they will drop insurance for their employees.

      The bill is also festooned with crap that the government has no business mandating and in some cases, like the individual mandate, may be unconstitutional. It’s one thing to provide health care for those who need it..it’s quite another to force everyone to buy it.

  • bitterenvy

    It IS a question of not giving a damn because the GOP is not offering anything “better.” Instead we get Paul Ryan wanting to drastically cut anything in the budget which helps veterans, the elderly, children and the poor.

    “We can’t afford to insure everyone.”

    I don’t want you to insure me. I just want to be able to afford to see a doctor once in awhile. Or to be able to go to the emergency room when I have symptoms of a heart attack rather than to just DIE because I know it took me 2 years to pay for that the last time it happened. And now my income is even less and current hospital policy will only give me a year to pay.

    I started working when I was 12 and I’m 61 now. There are no jobs here and no one will hire me anyway because I have untreated health issues. I don’t get disability. We live on my husband’s Social Security and what money I can earn buying/selling antiques and collectibles.

    My only hope for some kind of health care was the ACA. Yes, it’s imperfect but it might have given me some of what others get: the option to do something other than just die. And the GOP has done nothing but scream “Obamacare! Socialism! BAD!” without offering me any hope at all. But I’m supposed to believe they give a damn? 

    • aielman

       If you want to see a doctor once in awhile, that’s insuring you. That’s the way it works.

      And you’re not everyone. You’re uninsured. This mandate doesn’t cover the uninsured. It covers everyone. And it mandates that everyone be insured. That’s too much. Instead of coming up with a solution to handle the 15-30 Million Americans that need insurance (depending on who you believe), they came up with one for 300 Million.

      How many people will we be insuring if we end up like Greece, and the whole thing crashes down because we overspent by $15+ Trillion dollars? What do you think happens to Medicare, Medicaid, Veterans Benefits, Social Security and everything else if we go into full default…taking half the world with us?

      I started working at the same age, and I’m 46. I’m one paycheck way from where you are and I’ve watched my healthcare deteriorate over the last 10 years as people keep trying to come up with solutions for the symptom and not the problem, and in the meantime chipping away at my benefits. Why is health care so much more expensive in the US than anywhere else in the world?

      Instead, the GOP gives us next to nothing, and the Democrats gives us slow suicide with lots of fun surprises we don’t get to know about until we pass the bill to see whats in it.

      I’d kind of like to have a country when I get to be your age, so forgive me if I can’t get behind a spending plan that’s going to not only bankrupt the country, but kill the crappy insurance I do have prior to doing so.

      • bitterenvy

        I said the ACA was imperfect. But at least it’s a start. Clearly, to some people even a  small start is too much.

        “forgive me if I can’t get behind a spending plan that’s going to not only bankrupt the country, but kill the crappy insurance I do have prior to doing so. ”

        Yep. The ‘I’ve got mine; to hell with you’ sentiment. 

        “I’d kind of like to have a country when I get to be your age’

        If you get to where I am, it won’t matter much to you if you have a country. You will be too busy worrying about your health and the lack of any way to fix it. 

        • aielman

           A start that bankrupts us isn’t a start…it’s a catastrophy. You’ll be insured for a few years at the cost of everything and everyone else.

  • Katmardon

    Healthcare costs will bankrupt us whether it is via the somewhat free market or socialized medicine.  It will do so as long as we believe that medical care is synonymous with health.  If the products and services of the medical profession equal health, there is no limit to our willingness to pay what they require.  

  • aielman

    So is it a good sign that the attorneys for the government, including the Solicitor General, got laughed at multiple times throughout the testimony, not only by the gallery, but by the Justices, on day two and couldn’t seem to make up their mind if the penalty was a tax or not between day one and day two?

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