At this point, you probably have heard what happened yesterday in the world of politics. The big story: President Obama’s signature accomplishment, the Patient Protection and Affordable Care Act (ACA), commonly referred to as “Obamacare,” was held to be constitutional by the United States Supreme Court in a 5-4 ruling.
In what was seen by many as a surprising twist ending to the case, Chief Justice John Roberts (a traditionally conservative justice appointed by President George W. Bush) sided with the court’s four “liberal” justices to preserve the ACA in (more or less) its entirety. Anthony Kennedy, often viewed as the “swing” justice on the court, dissented, siding with the more conservative members of the court.
The heart of the question before the justices was whether or not Congress had the authority to enact the cornerstone of the Affordable Care Act, the individual mandate. The individual mandate, when it goes into effect, would require that all Americans be covered by health insurance. The more popular aspects of the legislation (forcing insurers to cover people with preexisting medical conditions, and just generally making insurance more available), ACA proponents argue, would not be feasible without greatly increasing the rolls of the insured. Basically, the idea is this: if you make it so that sick people can get insurance after they are already sick, you have to increase the number of healthy people getting insurance in order to offset the cost. Otherwise, the doomsday argument goes, every sick person in the country would run out to their nearest Health Insurance Mart and purchase policies, and the cost of treating these sick folks would put every insurance company in the country out of business. As I said, doomsday scenario, and doomsday scenarios traditionally sound a little far-fetched. Regardless, the mandate would prevent that sort of thing from happening.
Why was that relatively reasonable measure put through the Supreme Court’s wringer? Because opponents of the ACA argued that while the U.S. Constitution does indeed say that Congress has the power to make laws relating to commerce (which the nation’s massive patchwork of health care systems no doubt is), what Congress did in this instance was to make a law (the ACA) that related to the lack of commerce (the state of not having health insurance). Confused? Totally reasonable, because this is incredibly confusing. Perhaps because, as Ezra Klein of the Washington Post points out, pretty much no one thought that this was actually an issue wayyyy back in 2009-10 when the law was being written (or before that, when the mandate was an idea endorsed by Republicans and conservative think-tanks).
Now that we’ve got all that background, however, we can see what happened with the high court’s decision yesterday. Opponents of the ACA said that Congress had exceeded its power in passing a law that would “force Americans to engage in commerce”, notably using the argument that if the Affordable Care Act was constitutional, what could stop Congress from passing a law that said every American had to go out and buy broccoli. In the opinion written by Chief Justice Roberts, the Court decided that the ACA was not constitutional under Congress’s power to regulate commerce. Instead, the Court found that the law was constitutional under the power of Congress to “lay and collect taxes,” since the penalty for failure to purchase health insurance could be viewed as a tax.
Well, that was a doozy, but we got through it! To sum up: “Obamacare” is constitutional, in a 5-4 decision, with the court’s four liberals and the conservative Chief Justice in the majority. The individual mandate is a tax, and not a penalty, and Congress cannot make you buy broccoli. The end.