In this morning’s big news, the U.S. Supreme Court has upheld the validity of President Barack Obama’s 2010 Patient Protection and Affordable Care Act. By a 5-4 ruling based on the power of Congress to impose taxes, the court preserved the law’s “individual mandate” requiring that most Americans obtain health insurance by 2014 or pay a tax. The justices also preserved, with some changes, a provision of the law expanding the Medicaid health insurance program for the poor.
President Obama calling the ruling “a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court’s decision to uphold it. We will continue to implement this law and we’ll work together to improve on it.”
From my Australian perspective and having seen some of the appalling waste, I am astounded that the United States spends 18% of GDP on healthcare, more than any other country, while tens of millions Americans have no medical insurance at all. The Australian system which delivers good health outcomes with a mix of mandate and a thriving private sector would have been a better model to apply than the Obama reforms.
In the Supreme Court majority, Chief Justice John Roberts was joined by the court’s four liberalmembers – Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan – in upholding the law’s pivotal “individual mandate” provision. The four dissenters, all from the court’s conservative wing, Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito, would have struck down the entire law.
The Court’s majority ruled that Congress’s taxing authority allowed the mandate. The majority held the “requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax. Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”
The court held invalid the provision which requires states to expand the government’s Medicaid health insurance program for the poor with the goal of covering more of the uninsured. The court said this problem can be fixed by precluding the federal government from stripping states of existing Medicaid funds if they did not comply with the expansion, and that this did not require striking down other parts of the law.
This issue will remain a crucial part of the presidential election campaign.
While I like Mitt Romney, I find his position on these reforms lacking credibility as the reforms are based on his reforms while Governor of Massachusetts. Today he said, “What the court did today was say that Obamacare does not violate the Constitution. What they did not do is say that Obamacare is good law, or good policy…. If we’re going get rid of ‘Obamacare’ we’re going to have to replace President Obama. My mission is to make sure we do exactly that.”
Mitt Romney puts his position very clearly in this interview recorded today.
In polling, a clear majority of Americans say they oppose the law.
House of Representatives Speaker John Boehner, the top Republican in Congress, said, “Today’s ruling underscores the urgency of repealing this harmful law in its entirety.”