The Patient Protection and Affordable Care Act, also known as ObamaCare refers to one of the most significant pieces of legislation regarding healthcare in the United States (Rosenbaum, 2011). Among many other things, the law, enacted in 2010, was primarily aimed at reducing the general cost of health care and increasing the coverage of affordable healthcare to common American citizens. The Affordable Care Act (ACA), as it is also known was to realize these goals through two key provisions stipulated in the law. The first of these provisions was the Individual mandate which stipulated that every person who is not insured by the employer, is not under Medicaid or Medicare, and does not have any other insurance policy ought to pay a penalty to the government as a shared responsibility payment collected together with the individual's taxes (Aggarwal & Rowe, 2011). This provision was meant to discourage the trend of people waiting until they got sick to purchase an insurance policy. Consequently, every citizen not covered by the government program would have to buy a policy from a private company hence curtailing the hike in prices enacted by private businesses when the same individuals wait until they are sick before they purchase a policy.
Pros and Cons of ObamaCare
The second major provision was the expansion of Medicaid, which forced States to increase the eligible bracket or risk losing all the federal funding for the Medicaid program. As such, States were required to provide coverage to adults, regardless of their marital status or the number of children, whose income was a certain percentage of the federal poverty level and who were previously ineligible for coverage. In the National Federation of Independent Businesses v. Sebelius case, the petitioners, National Federation of Independent Businesses et. al were seeking to challenge the constitutionality of the ACA, particularly regarding the two main provisions ("National Federation of Independent Business V. Sebelius, Secretary of Health and Human Services,", 2016). However, the Supreme Court affirmed in part and reversed the ACA in part. In its ruling, the Supreme Court found that the Individual Mandate requirement stipulated by the ACA was not constitutional on the basis that Congress violated its powers to regulate commerce. To reach the verdict, the court argued that forcing people to participate in commerce by purchasing insurance or risk fines went against the mandate of Congress aimed at regulating trade rather than initiating it. Additionally, the bench noted that upholding the provision would be tantamount to giving Congress the power to dictate what people do not do and would open the doors for it to compel commerce rather than regulate it (Bass, n.d.).
The Supreme Court also ruled that the Medicaid expansion infringed and violated the constitutional rights, which assure that Congress has within its powers, to pay debts, and provide for the general welfare of the entire country. The basis for this ruling was Article I section 8, cl. 1. of the Constitution which only gives Congress the power to establish cooperative state-federal partnerships. Furthermore, this clause emphasizes that such relationships are only valid if the States voluntarily and knowingly agree to the terms stipulated. However, by coercing states to participate in the Medicaid expansion or lose funding, Congress, and the ACA went against the national system of federalism stipulated in the constitution (Shor, n.d.). Nevertheless, the Supreme Court upheld all other clauses and stipulations of the Affordable Care Act.
The courts were tied by the law in making their decisions. Consequently, the ruling cannot be considered to be in the best interest of the people. The overturning of the two clauses means that premiums on policies will continue to be high as people still wait until they are sick to purchase policies. Furthermore, by curtailing the expansion of Medicaid, more and more people continue to fall prey to private companies that offer dubious policies with very little coverage at high prices.
Aggarwal, N. & Rowe, M. (2011). The Individual Mandate, Mental Health Parity, and the Obama Health Plan. Administration And Policy In Mental Health And Mental Health Services Research, 40(4), 255-257. http://dx.doi.org/10.1007/s10488-011-0395-3
Bass, E. Health Care Reform: Has the Supreme Court Already Embraced the Individual Mandate?. SSRN Electronic Journal. http://dx.doi.org/10.2139/ssrn.2070325
National Federation of Independent Business V. Sebelius, Secretary of Health and Human Services,. (2016). LII / Legal Information Institute. Retrieved 15 September 2016, from https://www.law.cornell.edu/supremecourt/text/11-393
Rosenbaum, S. (2011). The Patient Protection and Affordable Care Act: Implications for Public Health Policy and Practice. Public Health Reports, 126(1), 130–135.
Shor, B. ACA Implementation Votes in the States: Insurance Exchange, Medicaid Expansion, and Anti-Mandate Provisions. SSRN Electronic Journal. http://dx.doi.org/10.2139/ssrn.2271783
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