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SCOTUS: Individual mandate will become a tax
OneNewsNow-Associated Press - 6/28/2012 9:00:00 AM

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WASHINGTON - The Supreme Court on Thursday upheld virtually all of President Barack Obama's historic health care overhaul, including the hotly debated core requirement that nearly every American have health insurance.


The 5-4 decision meant the huge overhaul, still taking effect, could proceed and pick up momentum over the next several years, affecting the way that countless Americans receive and pay for their personal medical care.

The ruling hands Obama a campaign-season victory in rejecting arguments that Congress went too far in approving the plan. However, Republicans quickly indicated they will try to use the decision to rally their supporters against what they call "Obamacare," arguing that the ruling characterized the penalty against people who refuse to get insurance as a tax.

Obama declared, "Whatever the politics, today's decision was a victory for people all over this country." GOP presidential candidate Mitt Romney renewed his criticism of the overhaul, calling it "bad law" and promising to work to repeal it if elected in November.

Breaking with the court's other conservative justices, Chief Justice John Roberts announced the judgment that allows the law to go forward with its aim of covering more than 30 million uninsured Americans. Roberts explained at length the court's view of the mandate as a valid exercise of Congress' authority to "lay and collect taxes." The administration estimates that roughly 4 million people will pay the penalty rather than buy insurance.

Even though Congress called it a penalty, not a tax, Roberts said, "The payment is collected solely by the IRS through the normal means of taxation."

Roberts also made plain the court's rejection of the administration's claim that Congress had the power under the Constitution's commerce clause to put the mandate in place. The power to regulate interstate commerce power, he said, "does not authorize the mandate. "

Stocks of hospital companies rose after the decision was announced, while shares of insurers fell sharply. Shares of drugmakers and device makers fell slightly.

The justices rejected two of the administration's three arguments in support of the insurance requirement. But the court said the mandate can be construed as a tax. "Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness," Roberts said.

The court found problems with the law's expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to withhold states' entire Medicaid allotment if they don't take part in the law's extension.

The court's four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.

Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.

Kennedy summarized the dissent in court. "In our view, the act before us is invalid in its entirety," he said.

The dissenters said in a joint statement that the law "exceeds federal power both in mandating the purchase of health insurance and in denying non-consenting states all Medicaid funding."

In all, the justices spelled out their views in six opinions totaling 187 pages. Roberts, Kennedy and Ginsburg spent 51 minutes summarizing their views in the packed courtroom.

The legislation passed Congress in early 2010 after a monumental struggle in which all Republicans voted against it. House Majority Leader Eric Cantor, R-Va., said Thursday the House will vote the week of July 9 on whether to repeal the law, though such efforts have virtually no chance in the Democratic-controlled Senate.

House Speaker John Boehner, R-Ohio, said the health care law makes it harder for small businesses to hire workers. "Today's ruling underscores the urgency of repealing this harmful law in its entirety," he said.

But Senate Majority Leader Harry Reid, D-Nev., heaped praise on the court's decision, and the 2010 law, in a Senate speech. "Passing the Affordable Care Act was the greatest single step in generations toward ensuring access to affordable, quality health care for every American, regardless of where they live or how much money they make," he said.

After the ruling, Republican campaign strategists said Romney will use it to continue campaigning against "Obamacare" and attacking the president's signature health care program as a tax increase.

"Obama might have his law, but the GOP has a cause," said veteran campaign adviser Terry Holt. "This promises to galvanize Republican support around a repeal of what could well be called the largest tax increase in American history."

Democrats said Romney, who backed an individual health insurance mandate when he was Massachusetts governor, will have a hard time exploiting the ruling.

"Mitt Romney is the intellectual godfather of Obamacare," said Democratic consultant Jim Manley. "The bigger issue is the rising cost of health care, and this bill is designed to deal with it."

More than eight in 10 Americans already have health insurance. But for most of the 50 million who are uninsured, the ruling offers the promise of guaranteed coverage at affordable prices. Lower-income and many middle-class families will be eligible for subsidies to help pay premiums starting in 2014.

There's also an added safety net for all Americans, insured and uninsured. Starting in 2014, insurance companies will not be able to deny coverage for medical treatment, nor can they charge more to people with health problems. Those protections, now standard in most big employer plans, will be available to all, including people who get laid off, or leave a corporate job to launch their own small business.

Seniors also benefit from the law through better Medicare coverage for those with high prescription costs, and no copayments for preventive care. But hospitals, nursing homes, and many other service providers may struggle once the Medicare cuts used to finance the law really start to bite.

Illegal immigrants are not entitled to the new insurance coverage under the law, and will remain one of the biggest groups uninsured.

Obama's law is by no means the last word on health care. Experts expect costs to keep rising, meaning that lawmakers will have to revisit the issue perhaps as early as next year, when federal budget woes will force them to confront painful options for Medicare and Medicaid, the giant federal programs that cover seniors, the disabled, and low-income people.

The health care overhaul focus will now quickly shift from Washington to state capitals. Only 14 states, plus Washington, D.C., have adopted plans to set up the new health insurance markets called for under the law. Called exchanges, the new markets are supposed to be up and running on Jan. 1, 2014. People buying coverage individually, as well as small businesses, will be able to shop for private coverage from a range of competing insurers.

Most Republican-led states, including large ones such as Texas and Florida, have been counting on the law to be overturned and have failed to do the considerable spade work needed to set up exchanges. There's a real question about whether they can meet the deadline, and if they don't, Washington will step in and run their exchanges for them.

In contrast to the states, health insurance companies, major employers, and big hospital systems are among the best prepared. Many of the changes called for in the law were already being demanded by employers trying to get better value for their private health insurance dollars.

"The main driver here is financial," said Dr. Toby Cosgrove, CEO of the Cleveland Clinic, which has pioneered some of the changes. "The factors driving health care reform are not new, and they are not going to go away."

The Medicaid expansion would cover an estimated 17 million people who earn too much to qualify for assistance but not enough to afford insurance. The federal and state governments share the cost, and Washington regularly imposes conditions on the states in exchange for money.

Roberts said Congress' ability to impose those conditions has its limits. "In this case, the financial `inducement' Congress has chosen is much more than `relatively mild encouragement' - it is a gun to the head," he said.
The law says the Health and Human Services Department can withhold a state's entire Medicaid allotment if the state doesn't comply with the health care law's Medicaid provisions.

Even while ruling out that level of coercion, however, Roberts said nothing prevents the federal government from offering money to accomplish the expansion and withholding that money from states that don't meet certain conditions.

"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," he said.

Ginsburg said the court should have upheld the entire law as written without forcing any changes in the Medicaid provision. She said Congress' constitutional authority to regulate interstate commerce supports the individual mandate. She warned that the legal reasoning, even though the law was upheld, could cause trouble in future cases.

"So in the end, the Affordable Health Care Act survives largely unscathed. But the court's commerce clause and spending clause jurisprudence has been set awry. My expectation is that the setbacks will be temporary blips, not permanent obstructions," Ginsburg said in a statement she, too, read from the bench.

In the courtroom Thursday were retired Justice John Paul Stevens and the wives of Roberts, Alito, Breyer, Kennedy and Thomas.

Read more reaction below ...



What's your reaction to this ruling? VOTE


Reaction ...

Senator Orrin Hatch (R-Utah), ranking member of the Senate Finance Committee: "The American people know that this law violates our deepest constitutional principles of limited government, despite the Supreme Court's ruling today. President Obama's $2.6 trillion health spending law is an unprecedented power grab ... that will increase health care costs, add to our skyrocketing national debt, and put Washington bureaucrats in between patients and their doctors .... The American people will have the last word at the ballot box this November ...."

Liberty Counsel founder Mat Staver: "Chief Justice John Roberts sided with the left-leaning justices of the court to say that although Congress has no authority to pass this under the Commerce Clause, which we clearly argued and which is true, but they also said they will uphold this as a tax. Yet at the same time, Congress did not intend this as a tax. So they ignored the intent of Congress -- and I think, frankly, they ignored the true understanding of the Constitution of the United States." Staver continues: "This is a devastating ruling because it damages the Supreme Court. I think it's devastating to the American people -- ObamaCare is an economic disaster. It is the biggest funding of abortion in American history. What this court has done is make the November election the most important election in American history."

Speaker of the House John Boehner (R-Ohio): “The president’s health care law is hurting our economy by driving up health costs and making it harder for small businesses to hire. Today’s ruling underscores the urgency of repealing this harmful law in its entirety. What Americans want is a common-sense, step-by-step approach to health care reform that will protect Americans’ access to the care they need, from the doctor they choose, at a lower cost."

Former Justice Department attorney turned whistle-blower J. Christian Adams: "I have people telling me who are very measured who follow American financial issues that this law will bankrupt the nation in time. This is on a scale that we have never seen in this nation -- a government power grab of epic proportions, both over the economy and over religious liberty. And this is really the time to awaken because liberty is a precious thing that will not survive for long if people who love it don't say something about it."

Dr. Charles Dunn, Regent University political scientist: "This gives President Obama a victory -- but if Republicans, recognizing that the majority of Americans do not like the healthcare law, especially the mandate, they must resist too strong of a reaction. If they react too negatively to this, they'll come off as poor losers."

Senator Rand Paul (R-Kentucky): "You are allowed taxing authority by the Constitution, but you're only allowed to tax for things that are constitutional. In other words, the Constitution says that Congress has certain enumerated powers. [The Constitution] gives us about 19 different things we're allowed to do up here. We're not allowed to do anything else, if you read the Constitution according to its original meaning." Dunn adds: "The economy is the fundamental issue [and] Republicans need to keep it as the fundamental issue. President Obama would call it a victory if the Republicans were to make the healthcare mandate the issue, or the Arizona [immigration] ruling of the court the issue, or the contempt proceeding against [Attorney General Eric] Holder."

Brad Dacus, president of the Pacific Justice Institute, calls the decision upholding the individual mandate of Obamacare "a huge setback for freedom and liberty" in America: "The court has renamed ObamaCare as a tax in order to avoid the whole issue of expanding federal powers under the Commerce Clause. But nonetheless, it is what it is -- and that is, an overt control and intrusion into the lives of individuals." In a video statement, Dacus calls the ruling a "clear violation" of Article 1, Section 8 of the Constitution.

Alliance Defense Fund attorney Steven Aden says the decision upholding ObamaCare forces people to go against the religious and moral beliefs of Americans. He points to provisions using tax dollars to pay for abortion: "For the first time in American history, the Supreme Court has declared that Congress has the power to tax the conscience of the American people, and to require them to pay a tax, a penalty, if they do not want to have insurance coverage that destroys human life."

Dr. Gene Rudd, senior vice president of the Christian Medical Association: "We now have a ruling that says Congress can come in and tax things that we don't do -- not things that we do. In fact, if Congress wants us to do something, they can create a tax to force us to do it -- especially with spending our monies. I think that precedent is going to be something we look back upon with disdain."

Tony Perkins, president of the Family Research Council: "The government can compel you to do things that you don't want to do, and tax you if you don't. So, this is a significant issue, a historic day for the country, I would say, going in the wrong direction. And I think a majority of Americans would agree. I think we do need to be prepared … if Congress doesn't act soon enough to repeal this, that we say we're not going to comply. I think this goes beyond what the Constitution allows in terms of what the government can do. But more importantly, it goes beyond what the American people want the government to do."


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