On June 28, 2012, the U.S. Supreme Court in a 5-4 decision, declared the controversial Obama’s Healthcare plan constitutional. The court ruled that the individual mandate provision requiring all Americans to possess health insurance is not unconstitutional; meaning that the issue of ObamaCare which has dominated politics and the 2012 campaigns, has finally passed a judicial review. No doubt the decision has outraged conservatives in Congress who hoped that if tested, the healthcare plan would fail the highest court scrutiny.
The decision of the court is a victory for Democrats in Congress who have been pushing relentlessly, to have the Affordable Care Act passed. Also many liberals who for decades had been campaigning for a Federal law to provide healthcare for all Americans, see this development as a boost for the Obama administration since the agenda has once failed under the Clinton administration, when the then First Lady Hillary Clinton, tried but failed to push the plan through Congress.
Among the issues brought before the court was to determine: the question of “ripeness” as to whether the case may be brought before the court since the Affordable Care Act, if passed will not go into effect until 2014; however, based on the oral proceedings, the justices seemed ready to focus mainly on the issue dealing with whether the individual mandate itself was unconstitutional.
The court was also asked to determine whether another part of the law dealing with Medicaid expansion, is burdensome on the states; to this the court agreed since states have the right to either join Medicaid program or not and because states also contribute to Medicaid costs, they cannot be forced to expand Medicaid program for the poor. However, the court left it to the states to opt-in or out of Medicaid at their own discretion. Normally, when a Federal law creates a burden on the state, the Federal law will pass a constitutional review if the government can show a compelling and convincing interest why the law must go through.
In this case, the proposal on Medicaid expansion may have failed because (1) the Obama administration failed to show a compelling interest which outweighs the States interest or (2) the Court determined that since States are contributors to the Medicaid program, they also have a compelling interest in a fiscal policy that will help cut costs through limitation on Medicaid expansion. overall, the provision on Medicaid expansion was declared unconstitutional based on the ruling. The court made it clear that, Congress may not penalize states that choose not to participate in the new program, by taking away the Medicaid funding they receive from the Federal.
Based on the Court’s ruling, the individual mandate provision of the Act passes constitutional muster if tested under the power of Congress to tax. Article 1 § 8(1) gives Congress the power to lay and collect taxes for the general welfare of the country and Congress may derive such income from wherever it sees fit; Therefore, the individual mandate, is a form of tax within the power of Congress. On the other hand, the individual mandate provision, will fail constitutional scrutiny if tested based on the Commerce Clause; which under Article 1 § 8(3) of the Constitution gives Congress the power to regulate commerce among the several states. However, the court made clear that while Congress may regulate commerce, it cannot force individual states to participate in commerce.
Mitt Romney in answer to the court’s ruling, said because the court has ruled the ObamaCare constitutional does not mean it is “good law.” The U.S. Supreme Court is the highest court in the nation, opinion and decisions of the court are considered law of the land; and only an act of Congress can repeal decisions of the court thereby, declaring it unconstitutional. Until that happens, the ObamaCare as ruled by the court, is constitutional and can be deemed “good law.”
As it stands, the Affordable Care Act will allow children to stay on their parents insurance plan until age 26, insurance companies will no longer be able to deny coverage to people with preexisting conditions and every American will be able to purchase affordable insurance without fear of increasing premium based on their conditions. It will extend coverage to about 50 million Americans currently uninsured, reduce the amount paid on insurance and alleviate an already $2.6 trillion U.S. healthcare system.
The Obama plan was modeled after the healthcare system implemented in Massachusetts under the then governor Mitt Romney, but so far, the Republican Presidential candidate has called the ObamaCare a “job killer;” claiming that if implemented, ObamaCare will force insurance companies to fire people. Those who disagree have said the plan will do exactly the opposite by bringing insurance companies more customers as more Americans begin to purchase insurance under the new plan; in exchange, insurance companies would guarantee more coverage and implement required consumer protection, such as allowing students to stay on their parents’ plan and extending coverage to people irrespective of their health conditions.
No doubt the Democrats will continue to see these developments as victory while the Republicans on their side will hammer its validity and paint it as unsuitable for the American people. The issue has already been politicized and will remain a center of debate throughout the campaign for the White House. It is still a question whether Congress under GOP pressure, will move to repeal the Court’s decision as indicated by some House lawmakers. With the Democrats holding the majority of seats in the Senate, a repeal of the ruling may be difficult even with a GOP majority in the House.
Dr. Adeyemi Oshunrinade [E. JD] is an expert in general law, foreign relations and the United Nations; follow on Twitter @san0670.