Supreme Court upholds health care reform

[D H]

Including the mandate!

Chief Justice Roberts on the mandate:

Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.​

Everything I read/heard beforehand predicted either a split decision or a complete repudiation. I don't think anyone expected the Court to uphold the mandate. The oral arguments went so very, very badly. That's usually indicative of a problem.This is of course all over the news. Here's one:
http://www.cnn.com/2012/06/28/politics/supreme-court-health-ruling/index.html

 

[russ_watters]

I thought there was a chance it would be upheld, but based on the ICC. I'm shocked they used the power to tax as justification. Doesn't this mean Congress has the power to do absolutely anything they want as long as there is a tax attached to it?! Sheesh, the ICC trump card was bad enough!

(caveat: haven't read the decision yet)

 

[nitsuj]

I haven't read anything, but what was here, the cnn article & the video.


Russ_watters does the US not have required mandatory insurance for vehicle drivers?

I wonder how upset the health insurance companies are about the ruling, specifically the health "insurance profiteers".


Also sounds like allot of people already have coverage.

 

[D H]

I'm shocked they used the power to tax as justification.

That was shocking. Not the commerce clause, not the necessary and proper clause. The "Okay, maybe its a tax then" argument was a last minute ..., well, this sports video from 1984 says it best.

 

[jtbell]

Also sounds like allot of people already have coverage.

By the numbers: Health insurance

49.9 million -- The number of uninsured Americans in 2010. That's 16.3% of the total population.

 

[Angry Citizen]

This is certainly unusual. No one really expected Roberts to be the deciding vote. Kennedy, whom everyone thought would at least be slightly sympathetic to the government, ended up casting a vote to nullify the whole thing. I think Obama dodged a major bullet here.

FIGURATIVELY SPEAKING OF COURSE.

 

[D H]

This is certainly unusual. No one really expected Roberts to be the deciding vote. Kennedy, whom everyone thought would at least be slightly sympathetic to the government, ended up casting a vote to nullify the whole thing.

I've just started reading the decision itself. It appears to me that severability was the deciding issue to both Roberts and Kennedy. How much judicial intervention is acceptable? To Roberts, not much. To Kennedy, it's less of a problem.

To Roberts, that one couldn't just nullify the mandate without destroying the whole thing entailed too much judicial intervention. Perhaps he saw that last minute hail mary pass about the mandate as a tax as the way out? To Kennedy, that one couldn't just nullify the mandate without destroying the whole thing meant that the whole thing had to be tossed. Kennedy didn't buy that mandate as a tax argument. That's my take on this weird split (in other words, my opinion, not fact).

The court did reject a couple of items in this case. They rejected the commerce clause argument, and this rejection will have ramifications in completely unrelated future cases. They also rejected a mandate on the states to beef up their Medicaid programs.

 

[CAC1001]

I'm no expert, but how does the 16th Amendment prevent the government from being able to tax for whatever they want? I've always thought they could do that...

Regarding the Commerce Clause, some say this limits the powers of the Congress which uses the CC as a way to regulate so much. Some also say that, ironically, the concurrence was written as a dissent, and the dissent was written as a full opinion.

 

[Redbelly98]

I'm no expert, but how does the 16th Amendment prevent the government from being able to tax for whatever they want? I've always thought they could do that...

I would think the prospect of getting voted out of office if they "tax for whatever they want" should be enough.

 

[Vanadium 50]

I'm no expert, but how does the 16th Amendment prevent the government from being able to tax for whatever they want? I've always thought they could do that...

It does. However, one does not have standing to challenge a tax in the courts until one has paid it.

When the Left is done with their partying, they are going to have a terrific hangover when they realize what Roberts has done to them. With the help of the four reliably liberal justices, he managed to:

1. Shoot down the legal theory that the Commerce Clause and the Necessary and Proper Clause give Congress the ability to do whatever they feel is a good idea.

2. Reenergize the 10th Amendment and limit the federal government's ability to coerce states.

3. Allow the Republicans to portray ObamaCare, already deeply unpopular, as the largest tax increase in history, one that was sold as not being a tax, and one that needs to be even bigger to cover the costs. (Remember, 10 years of taxes goes to paying 6 years of benefits)

4. Allows opponents a second bite at the apple once this tax is paid and they have standing to challenge.

 

[D H]

With the help of the four reliably liberal justices[/I], he managed to:

1. Shoot down the legal theory that the Commerce Clause and the Necessary and Proper Clause give Congress the ability to do whatever they feel is a good idea.

2. Reenergize the 10th Amendment and limit the federal government's ability to coerce states.

3. Allow the Republicans to portray ObamaCare, already deeply unpopular, as the largest tax increase in history, one that was sold as not being a tax, and one that needs to be even bigger to cover the costs. (Remember, 10 years of taxes goes to paying 6 years of benefits)

4. Allows opponents a second bite at the apple once this tax is paid and they have standing to challenge.

Except for #3, I have to disagree with you. I agree that items #1 and #2 are key parts of the judgement, but the four liberal members did not play a supporting role here. They dissented. It was the four conservative members plus Kennedy who made this a reality. This part of the judgement will have future ramifications completely unrelated to health care.

Item #4, now the liberals have a judgement that strongly implies that the tax is constitutional -- and before anyone has paid a dime. This too will have some unexpected consequences.

Item #3 is a biggy (as are #1 and #2). The program was sold in part as not being a tax increase. Well, now it is a tax increase. And it's disproportionately a tax increase on people who overwhelmingly voted for Obama in 2008.

 

[CAC1001]

Except for #3, I have to disagree with you. I agree that items #1 and #2 are key parts of the judgement, but the four liberal members did not play a supporting role here. They dissented. It was the four conservative members plus Kennedy who made this a reality. This part of the judgement will have future ramifications completely unrelated to health care.

Item #4, now the liberals have a judgement that strongly implies that the tax is constitutional -- and before anyone has paid a dime. This too will have some unexpected consequences.

Item #3 is a biggy (as are #1 and #2). The program was sold in part as not being a tax increase. Well, now it is a tax increase. And it's disproportionately a tax increase on people who overwhelmingly voted for Obama in 2008.

#2 involved the liberal justices. The Court voted 7-2 to strike down the aspect of Obamacare that let's them threaten to cut off all Medicaid funding for states that opt out of the program's expanded Medicaid coverage.

 

[russ_watters]

I'm with you on all except this one (the political implications are vast and fascinating here - this is so multi-dimensional!):

2. Reenergize the 10th Amendment and limit the federal government's ability to coerce states.

If Congress can pass whatever law they want as long as there is a tax attached as the form of coercion (even if they call it a penalty!), then they have at best replaced one end-around the 10th Amendment (the commerce clause) with a new one.

It's a good thing Obama no longer has a filibuster proof majority anymore: otherwise, he could get a law passed that "taxes" voters for voting for Republicans!

Also:

5. "If the court had struck down Obamacare, you wouldn't have to vote for me to get it repealed. But since they didn't, the only way to get rid of Obamacare is to vote for me." [/Romney speech writer]

What disturbs me most so far is an excerpt from Roberts' decision I heard on the radio that appeared to say the Roberts voted to uphold because he wanted to defer to Congress and wanted us to sleep in the be we made (voting for Obama and a Democratic Congress) rather than overturn a law he believed to be unConstitutional. I can't imagine an action more damaging to the court than for them to shirk their most sacred responsibility.

That's also a different - worse, imo - take on Judicial Activism than I had heard before: essentially it says that judicial activism isn't about upholding laws they think are Right even if they are unConstitutional, but rather upholding laws because they don't wan't to go against Congress.

 

[russ_watters]

Cato Institute paraphrasing me:

In short, we have reaped the fruits of two poisonous trees of constitutional jurisprudence: On the one (liberal activist) hand, there are no judicially administrable limits on federal power. On the other (conservative pacifist) one, we must defer to Congress and presume (or construe) its legislation to be constitutional.

http://www.cnn.com/2012/06/28/opinion/shapiro-health-ruling/index.html?hpt=hp_bn7

 

[russ_watters]

Text of the decision: http://msnbcmedia.msn.com/i/msnbc/Sections/NEWS/scotus_opinion_on_ACA_from_msnbc.com.pdf

 

[QuarkCharmer]

This might be a bit off topic, but does anyone have a link to a place where I can figure out what exactly this means for me? All I can find are things describing the effect on the typical American, the poor, the rich etc..

What about us zero-income non-insured student types?

 

[Borek]

Can't say I understand much of the whole story (and your discussion) as legalese and details of US system are a Greek to me. What struck me was the fact that the decision - nominally taken by the court, so it should be taken solely on the legal ground - seems to be strictly political. At least according to CNN article linked to in the very first post those seen as liberal voted for, those seen as conservative against.

Perhaps I am surprised just because of my naivety and that's the way the system works, still, I am in stupor. First, 2:0 for Italy, now, 5:4 for Obamacare. What a day.

 

[Evo]

Can't say I understand much of the whole story (and your discussion) as legalese and details of US system are a Greek to me. What struck me was the fact that the decision - nominally taken by the court, so it should be taken solely on the legal ground - seems to be strictly political. At least according to CNN article linked to in the very first post those seen as liberal voted for, those seen as conservative against.

Perhaps I am surprised just because of my naivety and that's the way the system works, still, I am in stupor. First, 2:0 for Italy, now, 5:4 for Obamacare. What a day.

The health reform was badly needed. Now my kids can get medical care.

 

[Ryan_m_b]

My knowledge of this issue is limited and observing any healthcare topic from the east side of the Atlantic looking west is bound to have some cultural confusion* but I'd gathered from various sources that the expectation that the bill would be overturned was very hyped.

If someone could clarify something for me though, the individual mandate requires that everyone must buy healthcare but millions of people can't afford healthcare so what provisions are there to deal with this? I understand that there will be greater regulation on whether or not insurance companies can discriminate based on pre-existing conditions and an expansion of medicare but for your run of the mill lower income family how will this help?

*Though I am extremely happy about any move the US takes towards healthcare for all.

 

[Angry Citizen]

If someone could clarify something for me though, the individual mandate requires that everyone must buy healthcare but millions of people can't afford healthcare so what provisions are there to deal with this?

For one, anyone who makes less than 133% of the poverty line automatically qualifies for Medicaid, which is a government-ran health insurance program without a premium. For two, you are allowed to claim tax breaks and subsidies if you don't make very much money in order for you to afford the premium. In addition, any corporation with more than 50 employees must offer employer-subsidized health insurance, which itself will likely be subsidized for many small business owners. Plus premiums themselves are likely to decrease markedly given that at least 80% of the expenditures of a given health insurance company must be in the form of actual, honest-to-god medical care - and they must refund part of your premium if they don't meet that.

Those are just the parts I'm currently aware of.

 

[Angry Citizen]

Can't say I understand much of the whole story (and your discussion) as legalese and details of US system are a Greek to me. What struck me was the fact that the decision - nominally taken by the court, so it should be taken solely on the legal ground - seems to be strictly political. At least according to CNN article linked to in the very first post those seen as liberal voted for, those seen as conservative against.

Perhaps I am surprised just because of my naivety and that's the way the system works, still, I am in stupor. First, 2:0 for Italy, now, 5:4 for Obamacare. What a day.

It is clear that Justices Scalia, Thomas, Alito, Ginsberg, Kagan, Sotomayor, Kennedy, and Breyer all voted according to politics. Roberts seemed to have some measure of integrity after all, however, and voted completely against his politics.

As an ardent lefter-than-liberal, I can't say I agree with their decision, even though it was almost the best possible outcome for my side. Here in America, in order to challenge a law in court, you must have what's called "standing" - in other words, the law must have wronged you in some fashion. No one has been wronged by the mandate at this time, so SCOTUS should have punted this until 2015 when the first penalties began to be paid.

 

[Ryan_m_b]

For one, anyone who makes less than 133% of the poverty line automatically qualifies for Medicaid, which is a government-ran health insurance program without a premium.

In that case the pertinent question would be is earning more than 133% of the poverty line (a bit of googling places that at ~$30k/~€25k/~£20k) enough to afford health insurance after all other expenses (food, rent, utility bills, travel etc) are taken into account? Out of interest how much would the average American pay for health insurance?

 

[Vanadium 50]

Item #3 is a biggy (as are #1 and #2). The program was sold in part as not being a tax increase. Well, now it is a tax increase. And it's disproportionately a tax increase on people who overwhelmingly voted for Obama in 2008.

And those people who then-candidate Obama said he would not raise taxes on. This will surely be exploited by the Republicans: "They say they will only tax the rich - but look where they actually levied the most tax - on you!"

It is clear that Justices Scalia, Thomas, Alito, Ginsberg, Kagan, Sotomayor, Kennedy, and Breyer all voted according to politics

Politics? Or honest disagreements about jurisprudence and the roles played by the federal government?

 

[russ_watters]

Can't say I understand much of the whole story (and your discussion) as legalese and details of US system are a Greek to me. What struck me was the fact that the decision - nominally taken by the court, so it should be taken solely on the legal ground - seems to be strictly political. At least according to CNN article linked to in the very first post those seen as liberal voted for, those seen as conservative against.

Perhaps I am surprised just because of my naivety and that's the way the system works, still, I am in stupor. First, 2:0 for Italy, now, 5:4 for Obamacare. What a day.

The toughest part is probably that we are referencing specific clauses in the Constitution by name. Supreme court decisions are supposed to be based on [a] specific line in the Constitution that the law either fits with or violates. At issue:

1. The Interstate Commerce Clause (ICC): Congress has the power to regulate interstate commerce. This is what the lawyers for Obama argued the law fit and should be allowed under. That argument was rejected.
2. The Necessary and Proper Clause: Congress may pass laws necessary and proper for carrying-out its delineated powers. This is a little sticky/sloppy in that it is sometimes used as an attempted catch-all justificiation (I can do whatever I think is necessary).
3. Taxation and spending clause: Congress has the power to collect taxes and spend money to fund the execution of its laws.
4. 10th Amendment: This clarifies that the Constitution doesn't say what Congress can't do, only what it can and that that's the limit. Congress can't do anything that isn't specifically justifiable.

 

[CAC1001]

The health reform was badly needed. Now my kids can get medical care.

I don't think anyone disagrees that health reform was needed, but many disagree that this particular form of health reform was best. If this results in a single-payer style system, then while many people will get coverage, they will not necessarilly get care when they need it. They may instead be put onto a waiting list.

 

[CAC1001]

My knowledge of this issue is limited and observing any healthcare topic from the east side of the Atlantic looking west is bound to have some cultural confusion* but I'd gathered from various sources that the expectation that the bill would be overturned was very hyped.

If someone could clarify something for me though, the individual mandate requires that everyone must buy healthcare but millions of people can't afford healthcare so what provisions are there to deal with this? I understand that there will be greater regulation on whether or not insurance companies can discriminate based on pre-existing conditions and an expansion of medicare but for your run of the mill lower income family how will this help?

*Though I am extremely happy about any move the US takes towards healthcare for all.

Everyone who can afford health insurance but chooses not to purchase it, either must purchase it or pay the tax. There is a large number of such people. Those who outright cannot afford either the tax or to purchase health insurance will be subsidized.

 

[CAC1001]

And those people who then-candidate Obama said he would not raise taxes on. This will surely be exploited by the Republicans: "They say they will only tax the rich - but look where they actually levied the most tax - on you!"

One thing I wish the Republicans would point out is that European-style social democracy isn't funded primarily by taxing the rich, it's a good deal funded by taxing the poor and the middle-class. That's why gasoline costs around the equivalent of $10 a gallon in European countries and their cost of living is higher, because of the VATs they have (Value Added Tax). America has no VAT. Obamacare, to pay for itself, has the mandate, along with additional other taxes hidden within it that will kick in so as to theoretically make the systme sustainable.

 

[russ_watters]

Now my kids can get medical care.

What was stopping them before?

 

[D H]

1. The Interstate Commerce Clause (ICC): Congress has the power to regulate interstate commerce. This is what the lawyers for Obama argued the law fit and should be allowed under. That argument was rejected.
2. The Necessary and Proper Clause: Congress may pass laws necessary and proper for carrying-out its delineated powers. This is a little sticky/sloppy in that it is sometimes used as an attempted catch-all justificiation (I can do whatever I think is necessary).
3. Taxation and spending clause: Congress has the power to collect taxes and spend money to fund the execution of its laws.
4. 10th Amendment: This clarifies that the Constitution doesn't say what Congress can't do, only what it can and that that's the limit. Congress can't do anything that isn't specifically justifiable.

If I were a strict constructionist (which I am not), I would find myself worrying about the original intent of striking the word "expressly" from the 10th. I'm a broad constructionist, so the general fuzziness/vagueness of the Constitution, its intentionally weasel worded clauses such as the three you mentioned plus others, and the express deletion of the word "expressly" from original drafts of the 10th all give me comfort.

Just look at the utter mess of the California, Alabama, and Texas constitutions. California's is perfect example of what not to do. Alabama, 1/72 the size of the US, 1/64 the population, has a buttinski constitution that is 40 times as long as the US Constitution. Texas, we don't have weasel word clauses. Everything has to be spelled out. So we have a Railroad Commission that does not regulate railroads but does regulates the oil and gas industry. The most extreme of strict constructionist worry about the constitutionality of the Air Force, Marines, Coast Guard, NASA, etc. There would be no doubt (all unconstitutional!) were the US Constitution worded along the lines of the Texas State Constitution.

 

[ThinkToday]

I've just started reading the decision itself. It appears to me that severability was the deciding issue to both Roberts and Kennedy. How much judicial intervention is acceptable? To Roberts, not much. To Kennedy, it's less of a problem.

To Roberts, that one couldn't just nullify the mandate without destroying the whole thing entailed too much judicial intervention. Perhaps he saw that last minute hail mary pass about the mandate as a tax as the way out? To Kennedy, that one couldn't just nullify the mandate without destroying the whole thing meant that the whole thing had to be tossed. Kennedy didn't buy that mandate as a tax argument. That's my take on this weird split (in other words, my opinion, not fact).

The court did reject a couple of items in this case. They rejected the commerce clause argument, and this rejection will have ramifications in completely unrelated future cases. They also rejected a mandate on the states to beef up their Medicaid programs.

I think you pretty much got it correct. As some of the talking heads have noted, Roberts voted as a true conservative and not as a Republican. For a true conservative, it's about upholding limited powers of the court, judicial restraint, basically telling people you get what you vote for, and it's not the job of the courts to bend to the changing will of the people. In short, "we" (not me for sure) voted these guys in, and we live with our choices. I am disapointed with the outcome, but it was the right choice to base the determination on the taxing authority of Congress. In all honesty, IMO it was clear the democrats called it a penalty just for political consumption. Roberts saw through the polical calculation using the term "penalty" and saw it for the tax it is.

IMO, we are a long ways from the end of this, and I don't mean the election. For example "At companies with fewer than 50 workers, the employees must obtain insurance themselves." source http://www.cnn.com/2012/06/28/politics/obamacare-what-we-learned/index.html?iref=allsearch With the folks at the lowest income end that don't fall within the 110% of poverty line $11,170. Who pays for their REQUIRED health insurance? Here's the answer from the same source "Not obtaining insurance in 2014 will cost a person $95 or 1% of his or her income, whichever is higher. In 2015, it's $325, or 2% of income. For families, the penalty will be $285 per household or 1% of income, whichever is greater. By 2016, it goes up to $2,085 per family or 2.5% of income. Penalties will rise each year."

No folks, it ain't free health care.

 

[Ryan_m_b]

With the folks at the lowest income end that don't fall within the 110% of poverty line $11,170.

Do you have a source for the poverty line stat? I tried to find one earlier and found something very different. Otherwise I agree with you that the individual mandate seems to have a potential problem for the squeezed middle; if you have enough surplus income to afford it no problem, if you don't have enough money no problem, if you lie in between it will be a huge strain on your personal finances but you get no help.

No folks, it ain't free health care.

*No* healthcare is free, there are just various levels of social provision across the world.

 

[ThinkToday]

Do you have a source for the poverty line stat? I tried to find one earlier and found something very different. Otherwise I agree with you that the individual mandate seems to have a potential problem for the squeezed middle; if you have enough surplus income to afford it no problem, if you don't have enough money no problem, if you lie in between it will be a huge strain on your personal finances but you get no help.

*No* healthcare is free, there are just various levels of social provision across the world.

Same article from CNN.

"Cash-strapped entrepreneurs can buy insurance at state exchanges and can get tax credits if their annual individual income ranges between 100% and 400% of the poverty line, which this year translates to $11,170 and $44,680."

 

[Evo]

What was stopping them before?

The high cost. And my older daughter has a pre-existing condition, and was turned down by everyone.

 

[daveb]

The high cost. And my older daughter has a pre-existing condition, and was turned down by everyone.

The same applied to my girlfried. She has epilepsy, and she couldn't get any insurance until her recent disability approval.

 

[Angry Citizen]

Same applies to me. I found out I was a diabetic when I was twenty. No insurance company in the world would touch me without exorbitant fees, and none of them would've helped pay for my insulin for at least a year and only after I met my deductible.

Thankfully, the city has a program that helps people such as myself not die - it's much like how Medicaid will be in 2014.