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Supreme Court upholds health-care law, individual mandate

 
 

The Supreme Court on Thursday upheld the individual health-insurance mandate that is at the heart of President Obama’s landmark health-care law, saying the mandate is permissible under Congress’s taxing authority.

The potentially game-changing, election-year decision — a major victory for the White House less than five months before the November elections --will help redefine the power of the national government and affect the health-care choices of millions of Americans.

 

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President Obama’s path to achieve his vision of health care overhaul has been a rocky one. As we await the Supreme Court’s decision on the law, we look back on how we got here.

President Obama’s path to achieve his vision of health care overhaul has been a rocky one. As we await the Supreme Court’s decision on the law, we look back on how we got here.

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What will the ruling mean for you?

What will the ruling mean for you?

This tool estimates what the three most talked about health care ruling scenarios could mean for your coverage, based on your info.

 
 

Is the mandate constitutional?

Is the mandate constitutional?

MAKE YOUR CASE | Tell us if you agree with the individual mandate by voting, then explaining your view in the comments.

 
 

Health care and the Supreme Court

Health care and the Supreme Court

THE BIG STORY | Keep track of full coverage of the health-care decision and the political fallout.

 

Chief Justice John G. Roberts Jr. sided with the majority in voting to uphold the law, Obama’s signature domestic initiative.

 

Passage of the legislation by the Democratic-controlled Congress in 2010 capped decades of efforts to implement a national program of health care. The legislation is expected to eventually extend health-care coverage to more than 30 million Americans who currently lack it.

 

Republicans in Congress and GOP presidential challenger Mitt Romney have vowed to try and repeal the measure after the November elections.

 

The health-care issue thrust the Supreme Court into the public spotlight unlike anything since its role in the 2000 presidential election. The court’s examination of the law received massive coverage — especially during three days of oral arguments in March — and its outcome remained Washington’s most closely guarded secret.

The court reviewed four questions: whether it was within Congress’s constitutional powers to impose an “individual mandate” to purchase health insurance; whether all or any additional parts of the law must be struck down if the mandate is rejected; whether an expansion of Medicaid was unduly coercive on the states and whether all of those questions can even be reviewed before the mandate takes effect.

 

On the Medicaid question, the judges found that the law’s expansion of Medicaid can move forward, but not its provision that threatens states with the loss of their existing Medicaid funding if the states declined to comply with the expansion. The finding immediately raises questions as to how effectively the federal government will be able to implement the expansion of the joint federal-state insurance program for the poor.

 

The most crucial issue before the court was considered to be the individual mandate, known technically as the “minimum coverage” provision, because striking it down would jeopardize the ability of insurers to comply with other, more popular elements of the health-care law without drastically raising premiums. Under those other provisions, for example, insurers can no longer limit or deny benefits to children because of a preexisting condition, and young adults to up age 26 are eligible for insurance coverage under their parents’ plans.

 

During oral arguments in March, conservative justices indicated they were skeptical about the individual mandate, the provision in the 2,700-page health-care law that requires nearly all Americans to obtain health insurance by 2014 or pay a financial penalty.

 

Arguing the case for the Obama administration, Solicitor General Donald B. Verrilli Jr. defended the law as a constitutional exercise of congressional power under the charter’s commerce clause to regulate interstate commerce. He said lawmakers were regulating health insurance to deal with the problem of millions of people who lack coverage and therefore shift costs to the insured when they cannot pay for their medical care.

 

The court rejected the commerce clause argument, but ruled that Congress nevertheless had the power to impose the mandate because it can be considered a tax.

 

Paul D. Clement, representing Florida and 25 other states objecting to the health-care law, argued that Congress exceeded its power in passing the law, which he said compels people to buy a product.

 

Although the most controversial provisions of the law are not scheduled to take effect until 2014, a complex web of new rules has already extended coverage and expanded benefits across the country.

 

No initiative has exemplified Obama’s progressive domestic agenda or inflamed his conservative opponents like the health-care law, officially called the Patient Protection and Affordable Care Act.

 

The court’s decision will resonate throughout the election season, not only in the presidential campaign but in House and Senate races across the country.

 

The law provoked an unlikely debate about the Constitution. Opponents saw it as a trespass on individual and state’s rights by an omnipotent federal government, and supporters viewed it as a long-sought guarantee of health care to Americans regardless of where they live or work.

 

As a mark of the case’s importance, the justices spent more than six hours over three days hearing oral arguments on the constitutional questions and related issues. It was the most time than the court has spent on any issue in nearly half a century.

 

As soon as Obama signed the health-care bill in March 2010, opponents raced to challenge it. Early court decisions followed a predictable pattern, with district judges appointed by Democratic presidents upholding the law and Republican appointees striking it down.

 

But at the appeals court level, that changed. In a decision by the U.S. Court of Appeals for the 11th Circuit in Atlanta, Judge Frank Hull, an appointee of President Bill Clinton, joined with a Republican colleague in saying that the individual insurance mandate in the “unprecedented” legislation exceeded congressional authority. The judges said that if the law were constitutional, it would be impossible to say what action on the part of the government would go too far.

 

At the U.S. Court of Appeals for the 6th Circuit in Cincinnati and the U.S. Court of Appeals for the D.C. Circuit, two prominent Republican-appointed judges agreed that the law is intrusive but said it is within Congress’s powers.

 

In Cincinnati, Judge Jeffrey Sutton, a George W. Bush appointee, was the deciding vote to uphold the act. In Washington, Senior Judge Laurence Silberman, named to the bench by President Ronald Reagan, wrote an opinion saying that the question was political, not constitutional.

“It certainly is an encroachment on individual liberty,” Silberman wrote. But then — alluding to other cases in which the Supreme Court has ruled that the commerce clause gives Congress power — he added that “it is no more so than a command that restaurants or hotels are obliged to serve all customers regardless of race, that gravely ill individuals cannot use a substance their doctors described as the only effective palliative for excruciating pain, or that a farmer cannot grow enough wheat to support his own family.”

 

Even as the legal wrangling grew to a crescendo, some aspects of the law were already being enforced. Those include requirements that many insurance plans allow young adults to stay on their parents’ policies until age 26; cover a range of preventive services, including birth control, without imposing co-payments or other out-of-pocket costs; eliminate lifetime dollar limits on coverage; and begin phasing out annual caps.

 

The three cases the Supreme Court considered were National Federation of Independent Business v. Sebelius; Florida, et al., v. Department of Health and Human Services; and Department of Health and Human Services v. Florida, et al.

 

 

 

 

 

 

 

 

 

 

 

 

 

"I'm just trying to make a way out of no way, for my people" -Modejeska Monteith Simpkins

 

AFRICAN AMERICA IS AT WAR

THERE IS A RACE WAR ON AFRICAN AMERICA

THERE IS A RACE WAR ON AFRICAN AMERICANS

THERE IS A RACE WAR ON BLACK PEOPLE IN AMERICA

AMERICA'S RACISTS HAVE INFILTRATED AMERICAN POLICE FORCES TO WAGE A RACE WAR AGAINST BLACK PEOPLE IN AMERICA

THE BLACK RACE IS AT WAR

FIRST WORLD WAR:  THE APPROXIMATELY 6,000 YEAR WORLD WAR ON AFRICA AND THE BLACK RACE

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Actually, don't you think that the individual mandate is really no different than having to have car insurance (which in and of itself is an individual mandate); where it would be unfair for one or some to drive around without insurance, and when they are in an accident the person/people with insurance have to pay for that person's lack of insurance? 

 

The biggest thing wrong with the healthcare law is the fact that there is not public option, which leaves Big Insurance as monopoly because they have no competitor, that an the fact that the Supreme Court ruled against: ". . . expansion of Medicaid can move forward, but not its provision that threatens states with the loss of their existing Medicaid funding if the states declined to comply with the expansion . . ." , which only means that republican run states are going to refuse to expand Medicaid for the hell of it, just because Healthcare is an Obama/Black man's/democrat's Bill.

 

Ok is this issue about having health care insurance OR having access to good health care??? For me definitely about access to good health care at an affordable rate. Will we get that if we are made to carry health insurance?? What are the initiatives to recruit students to become good doctors and care about their patients??

Originally Posted by sunnubian:

Actually, don't you think that the individual mandate is really no different than having to have car insurance (which in and of itself is an individual mandate); where it would be unfair for one or some to drive around without insurance, and when they are in an accident the person/people with insurance have to pay for that person's lack of insurance? 

 

 

 

 

You know ... it's not that I object to the idea of a "mandate," so to speak, for everyone to have to pay for their own health insurance.  But I actually better liked the idea of paying for it more like we pay into Social Security ... as a payroll or income tax.

 

For one, I think that way the government would have a better chance of collecting it .. and also, it wouldn't be the same as people having to come out of their pocket with a large chunk of cash all at once.

 

That was pretty much the one and only difference between Candidate Obama and Candidate Clinton's health care proposals during the 2008 election.  I just liked her's better. 

Originally Posted by Yemaya:

Ok is this issue about having health care insurance OR having access to good health care??? For me definitely about access to good health care at an affordable rate. Will we get that if we are made to carry health insurance?? What are the initiatives to recruit students to become good doctors and care about their patients??

 

Well, I read just last week that there was a provision put into the health care law that requires insurance companies to spend at least 80% of the premiums they collect from people on medical care or they have to return the difference between what they spent and what they collected back to the patients as a rebate. 

 

Most people will see a decrease in their premium payments from their paychecks.  Those who buy it directly, will be getting actual checks.  The companies are about to give back something to the tune of $1 billion, if I'm not mistaken. 

 

Now ... I don't know if that means the insurance provider simply did NOT provide that much quality medical care ... or that they're just collecting too damn much money for the care they are willing to give !!

Originally Posted by sunnubian:

 

The biggest thing wrong with the healthcare law is the fact that there is not public option, which leaves Big Insurance as monopoly because they have no competitor, that an the fact that the Supreme Court ruled against: ". . . expansion of Medicaid can move forward, but not its provision that threatens states with the loss of their existing Medicaid funding if the states declined to comply with the expansion . . ." , which only means that republican run states are going to refuse to expand Medicaid for the hell of it, just because Healthcare is an Obama/Black man's/democrat's Bill.

 

 

Looks like your esteemed Republican governor is planning to do just that!! 

 

 

Deal: Major Health Policy Decisions “In a Holding Pattern”

 

 

 

Governor Nathan Deal expressed displeasure with the U.S. Supreme Court decision on federal health care reform during a Thursday afternoon news conference, describing it as “the largest tax increase in the history of the United States, at least $500 billion and perhaps significantly more.”  The Governor also admitted he was surprised by the decision because he thought the Court had given “pretty strong signals” that it had problems with the individual mandate.

 

The Governor appeared alone when he spoke to reporters and a large crowd that assembled in mid-afternoon inside the State Capitol.  Deal said the state will likely hold off making decisions on several questions until after the November national elections.  Presumptive Republican Party Presidential nominee Mitt Romney has vowed to dismantle the health care law if he is elected.

 

Deal said Thursday morning’s Supreme Court’s decision does appear to leave states with some flexibility, in particular, whether they will be forced to expand their Medicaid eligible populations.

 

Governor Nathan Deal

“There was at least an area of indication that it was not an absolute mandate,” Deal said.  “The discretion for a state to participate in the expansion of Medicaid was a door that was left open.  The Court has said that would have been an unconstitutional mandate on states.”

(Click here to watch Governor Deal’s news conference on the Public Policy Foundation YouTube channel.)

 

Georgia estimates its Medicaid eligible population would increase by 620,000 in 2014 based on requirements in the Patient Protection and Affordable Care Act.  On Thursday, Governor Deal said that increase would cost $76.3 million additional state dollars in 2014, and it would result in 24.2 percent of all Georgians being Medicaid eligible.  The current number is 17.6 percent.

 

“As you know, the original legislation (said) that if you did not accept the mandate for expanding the Medicaid coverage up to, in our case 138 percent of the federal poverty level, that you would have lost your federal participation in your existing Medicaid program,” Deal said.  “The Court has ruled that leverage and that coercion was not appropriate.”

 

Because the law was upheld, Georgia faces a mid-November decision about whether it will create some version of a state health insurance exchange or default to a federal exchange.  Deal said that decision also will likely not be made before the November election.  “We probably are going to be in a holding pattern until we see what the events of November bring us,” he said.

 

A special committee that considered health insurance exchange models last fall reported to the Governor that while it preferred no exchange, a Georgia created exchange would be preferable to one imposed by the federal government.  The Georgia model could be a state-operated exchange or, the committee recommended, a largely private model with some state oversight.

 

Responding to a question from the Public Policy Foundation, Governor Deal acknowledged that a regional, multi-state health insurance exchange “is an idea worth exploring.”  The Governor noted, however, that the state passed a law that would allow insurance companies licensed by other states to offer policies in Georgia but, “No company has taken us up on that offer.”

 

Governor Deal said decisions that need to be made this year – in particular, whether to expand Medicaid eligibility and what kind of exchange to create – should not require a Special Session of the Georgia General Assembly.  However, he thinks one might be necessary next year.

 

“We’re probably going to be finished with our 2014 budget before we know the answers to those questions that only Congress and the White House can provide,” the Governor said.  The 2013 General Assembly will likely concluded in late March or April, possibly well before Washington has given clear guidelines to states if there is a new administration.  Deal said that could require bringing lawmakers back to Atlanta.  “I will do everything in my power to avoid that,” he said.

 

The Governor opposed and fought against President Barack Obama’s federal health care reform law during the last of his nine terms as a congressman from Georgia.  “I was surprised by the decision,” Deal admitted.  “I honestly felt that the issue of the constitutionality of the individual mandate was one that the Court had given pretty strong signals that they had problems with.

 

“It is somewhat ironic to me that it is now constitutional not because it is a proper exercise of the power of federal government under the commerce clause but that it is appropriate only because of the federal exercise of taxation authority over the states and over its citizens.  That’s why I said, if we really want to know what the largest tax increase is, we have just now been given that opinion by the Supreme Court.  It is this piece of legislation that, ironically, is called the Affordability Act.”

Originally Posted by EbonyRose:
Originally Posted by Yemaya:

Ok is this issue about having health care insurance OR having access to good health care??? For me definitely about access to good health care at an affordable rate. Will we get that if we are made to carry health insurance?? What are the initiatives to recruit students to become good doctors and care about their patients??

 

Well, I read just last week that there was a provision put into the health care law that requires insurance companies to spend at least 80% of the premiums they collect from people on medical care or they have to return the difference between what they spent and what they collected back to the patients as a rebate. 

 

Most people will see a decrease in their premium payments from their paychecks.  Those who buy it directly, will be getting actual checks.  The companies are about to give back something to the tune of $1 billion, if I'm not mistaken. 

 

Now ... I don't know if that means the insurance provider simply did NOT provide that much quality medical care ... or that they're just collecting too damn much money for the care they are willing to give !!

My insurance went up in January 2012 and my coverage amounts went down. I took my sons for a school physical. My doctor billed $100 and the insurance company only paid $47. Last year they would've paid the entire bill. Just to give you an example of what is to come. While I hear what you are saying EbonyRose, what's going on out in the world is something different. Does that give me access to decent health care?

Well, that's been the case for pretty much everybody I know ... one story said that insurance premiums have gone up by 30% yearly over the past 5 years for a lot of people!!!  And, of course, with that comes a decrease in the services that are provided. 

 

Considering that many of the changes that will actually affect premiums, payments, services and quality have not gone into effect yet .... and won't for another two  years ... whether or not health care will be more or less expensive than it is today or how or if quality will improve can only be a matter of speculation, at best.

 

Republicans said the hundreds of billions they gave to banks would spur job growth and get the economy going ... yet, what REALLY happened is that the banks took the money and have refused to spur anything with it!!  They also said that bailing out the auto industry would be a failure and the money would be wasted.  But what REALLY happened is that American cars are now the biggest sellers in the world, and the auto industry is expanding their operations and creating more jobs everyday.

 

Of course there's no way to predict the future ... but, the fact that the Republicans say it will not work out for the better, makes me think that it probably will!!  And while I understand that you're already convinced that the health care reform law will be a failure .... I think I'm gonna take a page from the 'old wives tales' ... and not count that chicken until it is actually hatched!! 

 

I'm not a fan of the individual mandate, but before we continue debate on which way is right how about some accountability? If a person can afford it but doesn't want to opt in and they get sick, then sin loy.

I think everyone agrees that something needed to be done other than the usual congressional hot air, but we will have to see if this was the right decision ofr not. From what I've read, it is estimated that if nothing was done then cost were expected to nearly double by 2016.

  I love my prez....lord  knows I do.  But! I'm gonna have to come to his defense on this.  Cuz my thinking is....folks care MORE about their cars than their own bodies.  And you can always get a new car....but not a new body.  And if a person wants to drive a car, he/she must register that car, have insurance to drive that car and have current tags.  Now we would make sure those things get done for our cars, but we don't wanna pay health care for ourselves.  Folks call it tax, others can it fees.  But what do we call the monies we pay for our cars....and I'm not included toll fees in places where you have to pay that if  you wanna get to your destination.  Makes no sense.  I rather pay for my healthcare, making salary negotation more benefical for me.  Cuz they cannot bribe YOU and say we are paying you a lower salary cuz we are giving you all these benefits.  Well....if your healthcare if covered like the fees on your car, then you have more power to do several things...one:  be your own boss....most folks get these jobs to get healthcare packages...if you always have one you can put your toe in the water of owning your business...two: go after jobs you love doing but didn't cuz  it doesn't offer health benefits....now that won't be a deterrent.....three: you can negotitate your own salary much better based on your experience and acadamic achievement.....the ball will be in YOUR court and employers can no longer pimp you for your benefits and give you less...they have to straight out PAY YOU.  Now if folks felt more about their healthcare than their cars....then PROGRESS will begin.  But!  As long as we continue to have that "slave" mentality....hoping massa will give us something....we will continue to be in prison with a key.   We must LEARN to think outside the box of rheotrical comfort.  We need to begin to think differently.  We are worth MORE than our cars!  But!

Originally Posted by ocatchings:

I'm not a fan of the individual mandate, but before we continue debate on which way is right how about some accountability? If a person can afford it but doesn't want to opt in and they get sick, then sin loy.

I think everyone agrees that something needed to be done other than the usual congressional hot air, but we will have to see if this was the right decision ofr not. From what I've read, it is estimated that if nothing was done then cost were expected to nearly double by 2016.

 

I think for me one of the most interesting bits of information that have come out of the discussion about this is the fact that the U.S. spends billions of dollars more on health care than any other developed country ... almost doubt the percentage of GDP in some cases, yet we are sicker, die younger, and less of our children survive birth than at least 30 other industrialized countries.

 

It's also pretty much agreed that we also spend double the amount of money paid for health care costs on non-medical "administrative costs" .... i.e., which means insurers are pocketing more of the money that is taken in than they are spending it on care and quality and efficiency.

 

Just those facts, if nothing else, makes it seem to me like SOMETHING needed to be done in the area of reforming health care!!    And, it's unlikely that ANY attempt at reforming the health care industry could have made things any WORSE than they already were.

 

No other president before President Obama had been a strong enough person to INSIST and eventually FORCE the issue of changing the health care industry from what it was (and had always been and the unfair, overpriced system it had evolved into).  And for all the people who are complaining about the "imperfections" of this new reform plan ... I wonder if they would have preferred that yet another presidency went by with nothing having been done to at least try to make it better ... and that we were continuing to be charged (at the whim of insurance companies) 30%-per-year annual premium hikes yet receiving less services for those increases ... without any possibility of regulation or control in sight??

 

I mean, I can understand that it's not a "perfect" plan ... but is it REALLY worse than the our-of-control "no plan" that we had before?

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