US Supreme Court upholds healthcare reform law

[frigidmagi]

bbc

The US Supreme Court has said President Barack Obama's landmark healthcare reform act is constitutional.

The court upheld a core requirement known as the "individual mandate" that Americans buy insurance or pay a fine.

Of the nine justices on the bench, Chief Justice John Roberts' vote was decisive in the Supreme Court's 5-4 ruling in favour of the law.

The ruling comes months before the US election, with Republicans vowing to push for a repeal of the bill.

Healthcare is a deeply polarising issue in the US and Republicans strongly opposed Mr Obama's legislation.

They were later joined by 13 more states, the National Federation of Independent Businesses and several individuals.

'Implement and improve'
Speaking afterwards, President Obama called the court's decision a victory for the country, saying people would not need to "hang their fortunes on chance" or fear financial ruin if they became sick.

"The highest court in the land has now spoken. We will continue to implement this law and we'll work together to improve on it where we can," Mr Obama said, speaking at the White House.

"What we won't do - what the country can't afford to do - is re-fight the political battles of two years ago or go back to the way things were. With today's announcement, it's time for us to move forward.

peaking afterwards, President Obama called the court's decision a victory for the country, saying people would not need to "hang their fortunes on chance" or fear financial ruin if they became sick.

"The highest court in the land has now spoken. We will continue to implement this law and we'll work together to improve on it where we can," Mr Obama said, speaking at the White House.

"What we won't do - what the country can't afford to do - is re-fight the political battles of two years ago or go back to the way things were. With today's announcement, it's time for us to move forward.

"We will be better off because we had the courage to pass this law," Mr Obama added.

Republican presidential candidate Mitt Romney said the healthcare bill was "bad law yesterday, it's bad law today".

"This is a time of choice for the American people. If we're going to get rid of Obamacare we're going to have to replace President Obama. My mission is to make sure we do exactly that."

He called "Obamacare" a tax rise that would add to the national debt, a "job-killer", and said it would put the federal government "between you and your doctor".

Congressional leaders also responded quickly to the verdict. Senate Minority Leader Mitch McConnell, a Republican, said: "We've passed plenty of terrible laws around here that were constitutional."

On the Senate floor, he said the only way to fix the law was "full repeal".

Meanwhile, the Senate's Democratic majority leader, Harry Reid, disagreed: "Now that this matter is settled, let's move on to other things. Like jobs."

'Triggering a tax'
The mandate was eventually upheld by the justices, citing the taxation powers granted to Congress by the US constitution.

Chief Justice Roberts said: "We do not consider whether the Act embodies sound policies. That judgment is entrusted to the Nation's elected leaders.

"We ask only whether Congress has the power under the Constitution to enact the challenged provisions."

A majority of justices agreed that the penalty individuals must pay if they refuse to buy health insurance falls within Congress' power to levy taxes, upholding the "individual mandate".

"The mandate can be regarded as establishing a condition - not owning health insurance - that triggers a tax - the required payment to IRS," Justice Roberts wrote.

The government's main argument was that the law was legal under Congress' ability to regulate "interstate commerce" - but a majority of justices did not agree with this view.

Four dissenting justices said that limits on the power of Congress to regulate commerce and raise taxes "cannot be such as will enable the Federal Government to regulate all private conduct and to compel the States to function as administrators of federal programs."

"That clear principle carries the day here," they added.

In an opinion written by Justice Anthony Kennedy, the dissenting justices went further, to say: "In our view, the entire Act before us is invalid in its entirety."

Medicare clause limited
While the court described the penalty as a tax, it did not invoke a law that could have prevented the justices from ruling on the case.

Under a law called the Anti-Injunction Act, taxes cannot be legally challenged until after they have been levied. This could have delayed a verdict till 2015 - after the "individual mandate" comes into effect and the first round of penalties have been paid.

They were also not required to rule on the issue of "severability", which would determine whether other parts of the healthcare law could stand even if the mandate was struck down.

In addition to the individual mandate, the Supreme Court was asked to consider another part of the law that deals with the expansion of Medicaid, a government healthcare programme for low-income citizens.

The court ruled to limit that provision but did not strike it down altogether, saying Congress could place conditions on the use of federal funds.

"What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding," the Supreme Court's opinion said.

Some hospital and health insurance stocks were trading higher in the wake of the Supreme Court's ruling.

I did not expect Judge Roberts to jump ship like that. That's bloody amazing. That said, this is a stiff body blow to the GOPs hope. Now they have to hope for a blow out in November to repel this, because once it takes effect... Ain't no one gonna back them in tearing it down.

[LadyTevar]

When does it take effect again? :)

[General Havoc]

It has been taking effect progressively, and will continue to do so until 2020 I believe.

[Josh]

Whoever wins, we lose on this one.

[Josh]

Heh, out of morbid curiosity I went to see what flashing screaming headlines Drudge would have, and he had at least three linked articles about how Roberts is on medication that compromises his judgement.

[General Havoc]

Whoever wins, we lose on this one.

You want to explain that one?

[Josh]

Whoever wins, we lose on this one.

You want to explain that one?

Contrary to the cries of communism, Obamacare is essentially a love-note to the insurance industry. We get a mandate, but without price controls. Yes, they'll point out that there are subsidies and the virtually guaranteed result is that it will follow the pattern of subsidization of education, which means that the expenses will be baselined around the median income.

Double-irony for this being essentially based off the alternative bill to Hillarycare that the Republicans threw out there in '93.

As for the 'whoever wins' portion, the fact is that our system is pretty fucked up and unusable. So going nowhere allows it to continue to deteriorate, whereas this 'solution' and the energization of the opposition on the subject means that a government contingency care program expanded beyond medicaid is off the table. So if the Republicans had won this round, we would be as fucked over by the old system as ever. Now we get a golden opportunity to get fucked by the new system.

Unless you're a major shareholder in the medical insurance industry, this ain't a win.

[General Havoc]

Translation: Sorry guys, this thread does not digress sufficiently into the topic of how the world is ending and everything is awful. We should all leave and go back to one that does.

[Josh]

Translation: Sorry guys, this thread does not digress sufficiently into the topic of how the world is ending and everything is awful. We should all leave and go back to one that does.

Yes, that's exactly what I said. I didn't point out, with some bit of detail, as to why this law's passage and survival constitutes a goodly fucking for the average middle-class citizen. Also, I wasn't specifically making direct reference to, you know, the topic at fucking hand.

To borrow the phraseology of OWS, this is a law for the 1%.

Will the republic survive? Sure. Do people not endure far worse conditions on a daily basis in far more fucked up systems? Sure. But given that we're now slotted in for mandatory insurance coverage from agencies that can calibrate the cost to what the market can bear, we are getting fucked over in the favor of business interests here. PPACA is crony capitalism at its finest, and as I said the winners here are the shareholders for the insurance companies, and the politicians they subsidize. The health industry has been buying Democrats ever since the big Hillarycare scare of '93, and this is where it's paid off for them.

[General Havoc]

The "topic at fucking hand" was the supreme court overruling the challenges to the law. You decided that the topic at hand should instead of that be the uselessness of the health care law in question, literally changing the subject of the conversation to the unimportance of the original conversation. Your one-sentence reply indicated quite strongly to me an impression that we were rather foolish for even caring about the original topic.

But you want to talk about how we're fucked either way? How the existence of this bill doesn't matter? How we're fucked in either case? Let me explain something to you very carefully:

I haven't had health insurance in seven and a half years. Despite full time employment for six and a half of them. In that seven and a half year period, I have never seen a doctor except for the two occasions in which I collapsed and went to the emergency room. On both occasions I had to ignore their requests for follow ups and other such activities because I could not afford to do any of them. Ever. Thanks to this bill, and some of the programs stipulated by it, I may get health insurance for the first time in nearly a decade. I am therefore particularly fucking interested in this assertion that this bill is for the 1%, and exists solely to enrich insurance companies, fucking over the rest of us. I do not define being permitted to continue living as fucking you over. Nor do I consider my continued existence as 'incidental' next to your outrage that this bill is not another, better bill you would have preferred to see.

You don't like this bill? Fine. You'd prefer some other, better bill? So would I. But don't tell me about how a bill that runs to more than nine hundred and seventy pages is "simply" anything. And do not tell me about how the existence or non-existence of it is a wash. Because I hope to God you never find out how wrong you are.

And finally, if you want to make pithy, dismissive statements about how everyone's fucked, and the conversations concerning them aren't important, there's a Venting thread in Down Below. This is ostensibly a place for discussion and debate, not for political hipsterism. I know it makes you feel all smart and cynical to blanketly dismiss the bill, the process leading up to the bill, and incidentally every democratic politician for the last two decades as "bought", but I'm too old to be impressed by a cynic who gesticulates wildly in the direction of corruption and thinks that proves everything concerning his thesis. This bill, clunky and bloated as it is, promises to help a lot of people. If you can't see that, then I pity the poverty of your solipsism.

[Comrade Tortoise]

Josh, I am with Havoc here. Could this bill be improved on? Yes. Is it a massive give-away to the insurance companies that created the healthcare situation in the first place? Yes. Should the executives of said insurance companies and their lobbyists be scourged and crucified along every interstate in the US? Yes.

On the other hand, this bill does something that the US has never done before. It keeps people from dying because they had the audacity to be born poor and sick. While the lack of cost control and the additions to the risk pool will drive up premiums (probably more than is warranted by the new losses...), there are subsidy provisions and an extension of federal health benefits to a large group of people.

Is it perfect? No. Is it the best we can do right now given our fucked up political system? Yeah. Will it save people's lives? Hell yes. As it stood previously, if you are born with a problem like cystic fibrosis, it was impossible to get health insurance. If you contracted a chronic condition while uninsured, it would be very difficult without group policies from an employer (and fewer employers were offering insurance). You would simply die unless you happened to be born wealthy. I lost a dear friend this way, and I cannot accept the idea that the worth of a person's life has a dollar value.

With the Patient Protection and Affordable Care Act, we might actually be able to crawl out of the moral atrocity that is our healthcare system, even if it is only a stepping-stone, and have something that resembles something a civilized and decent society might put together. One might actually, some day, look at our healthcare system and mistake it for something created in the developed world. I know, it is a bit of a shock. Our system was as bad as it could possibly be without an unstable third world or former soviet Clusterfuck government at the helm. Fucking Colombia, the UAE and Saudi Arabia have a better healthcare system than we do despite the highest per capita healthcare expenditures in the god damn world. That situation is neither economically, morally, or nationalistically acceptable.

[Josh]

Havoc: You're not the only one who's spent lengthy periods uninsured. From the age of 21 to 38 I've had about a cumulative of seven years on insurance. And in my present situation, I'm on a rather wretched plan provided by one of the colleges I'm attending, one that sends the cost of a routine doctor visit over a hundred bucks and doesn't cover any sort of incidentals. The deductible is through the roof and I am sitting on medical debt because of it. About the only upside to it is that I'm not as frequent a visitor to the ER as I was in my younger days.

So I'm not sitting on some throne of privilege sneering at the proles who think this law fixes things.

Here's my main contention with this law: I concede Ben's point about care in extreme cases, but for the country overall this is a huge fucking step in the wrong direction precisely because it does stall development in a better direction. I don't concede at all that this was the best bill that could be produced in this political environment, it was produced in a specific fashion as to eliminate the prospect of single payer as a threat to the bottom line of the insurance industry through a process of smoke and mirrors- there was a new Democratic senator being the stall-up every week or so during the process. The fact that large portions of the political base in this country still tend to associate the Democratic party with the whole 'championship of the little guy' meme is a huge part of the problem.

What's far, far worse is now that we're going to have a program that's going to raise expenses on the average citizen without a discernible increase in services, and likely a decrease because that's how corporate models trend when given these sort of powers, the public isn't going to trust the government to improve health care again for a loooooong time. So we're going to be stuck with a crony capitalist system essentially crafted to extract the maximum amount of cash from the middle class. Which means that in the long-term we've socialized the expense across the backs of the middle class and created still-more impediment to social mobility. It's a retrograde move cloaked as progress.

As for the rest, I'm done debating attitude with you. You don't like the way I look at things, whatever. If you want to talk facts, great. But if you just want to whine about about my depressingly cynical worldview, hey, it's a free world and all but I'm not going to bother with you on the subject anymore. I think you're generally a smart guy and I actually appreciate and respect your desire to be optimistic, even when I think it's naive or in cases like these actually empowering Those Who Fuck Us. Despite that latter part, I don't feel this overwhelming urge to jump in and mis-characterize what you say, as in your bullshit reframing of my point about the purchase of Democratic officials as being all fucking Democrats.

I don't do that SDN-style argumentation that punctuates every point with 'retard' and 'fuckmonkey' anymore, but god damn if your belligerent pollyanna routine doesn't make that tempting. You might want to refer to Ben's post to see how a point can be made, intelligently, vehemently, and with passion while avoiding style over substance and psychoanalysis of the opposition.