After having gone through portions of the decision, I have compiled some initial observations regarding the SCOTUS’ decision to partially uphold two major provisions of Obamacare. The first contested provision was the Individual Mandate requiring the purchasing a basic level of healthcare insurance or face a penalty. The second was the provision to expand of the Medicaid program to cover all individuals that are 133% and below on the federal poverty scale. This provision required the States to participate in the expansion or face the threat of losing all of their Medicaid funding if they don’t comply.
I have put the observations in bullet format to make them easier to read and to keep me from making this post longer than it needs to be. As I continue to move through the decision, I will post additional observations and insights.
· The SCOTUS opinion states Individual Mandate “penalty” is really a tax.
o The “individual mandate must be construed as imposing a tax on those who do not have health insurance.” (Syllabus pg. 3)
o “CHIEF JUSTICE ROBERTS delivered the opinion of the Court with respect to Part III–C, concluding that the individual mandate may be upheld as within Congress’s power under the Taxing Clause.” (Syllabus pg. 4)
o This takes the administration of the provision out of the hands of the federal bureaucracy and puts it into Congress where it belongs.
o Allows for a 51 vote repeal of the IM in the Senate rather than a filibuster proof 60 if had been upheld as a “penalty.”
· Throws out Medicaid expansion provision.
o Disallows HHS to cut all Medicaid funding if a state does not choose to provide healthcare coverage for all individuals who are under 133% of the federal poverty line (includes income ranges from $14,865 for a single individual to $51,724 for a family of eight).
§ “The Medicaid expansion thus violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion… The constitutional violation is fully remedied by precluding the Secretary from applying §1396c to withdraw existing Medicaid funds for failure to comply with the requirements set out in the expansion.” (Syllabus pg. 5)
o Retains a semblance of state sovereignty via the referencing the 10th Amendment.
§ “’[T]he Constitution simply does not give Congress the authority to require the States to regulate.’ New York v. United States, 505 U. S. 144, 178. When Congress threatens to terminate other grants as a means of pressuring the States to accept a Spending Clause program, the legislation runs counter to this Nation’s system of federalism.” (Syllabus pg. 5)
o Shuts down any attempt to force a single payer system through expansion of the Medicaid program as it is currently constituted and forcing states to comply with that expansion.
§ “CHIEF JUSTICE ROBERTS, joined by JUSTICE BREYER and JUSTICE KAGAN, concluded in Part IV that the Medicaid expansion violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion.” (Syllabus pg. 4)
§ “The threatened loss of over 10 percent of a State’s overall budget is economic dragooning that leaves the States with no real option but to acquiesce in the Medicaid expansion.” (Syllabus pg. 5)
o Now requires a massive, public legislative attempt in order to create a single payer program rather than solely expanding current programs beyond their original intent.
· Reiterated that the SCOTUS is there strictly to determine the constitutionality of a law.
o It is not in the SCOTUS’ authority to determine whether a law is good policy or not.
§ “Members of this Court are vested with the authority to interpret the law; we possess neither the expertise nor the prerogative to make policy judgments.” (Decision pg. 2)
o It is not the SCOTUS’ place to save voters from the legislative actions of those they elect. That is what elections are for. Unless, of course, that legislation is unconstitutional in nature.
§ “Those decisions are entrusted to our Nation’s elected leaders, who can be thrown out of office if the people disagree with them. It is not our job to protect the people from the consequences of their political choices.” (Decision Pg. 2)
· Government being able to force someone from inaction to action, i.e. purchasing a product of service solely because the government mandates it, is not a constitutionally viable argument under either the Commerce Clause.
o This really narrows the wiggle room for those who are pushing for a government mandated single payer healthcare system.
o “Allowing Congress to justify federal regulation by pointing to the effect of inaction on commerce would bring countless decisions an individual could potentially make within the scope of federal regulation, and—under the Government’s theory—empower Congress to make those decisions for him.” (Decision pg. 21)
o “Under the Government’s logic, that authorizes Congress to use its commerce power to compel citizens to act as the Government would have them act… That is not the country the Framers of our Constitution envisioned.” (Decision pg. 23)
o “The language of the Constitution reflects the natural understanding that the power to regulate assumes there is already something to be regulated.” ( Decision pg. 19)
o “The power to regulate commerce presupposes the existence of commercial activity to be regulated. If the power to “regulate” something included the power to create it, many of the provisions in the Constitution would be superfluous.” (Decision pg. 18)
As the reader can clearly see, this was not the big win that supporters of Obamacare claim it to be nor is it the horrible loss that many opponents claim. Obamacare is still very much alive and kicking to the joy or chagrin of Americans depending on their particular stance. So, for the time being, the Obama Administration will continue to move towards implementation at a breakneck speed. As everyone generally agrees on, there will be no changes to or repealing of Obamacare in the near future due to the political makeup of Congress. The two big questions that now remain is how far will implementation get before January 2013, when the results of the upcoming elections take hold, and what changes, if any, will be made from that point on.
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