Open Forum on the ACA Decision

SCOTUS has ruled, and Chief Justice (and conservative Catholic) John Roberts single-handedly saved the Affordable Care Act. The Court’s right wing, joined in the minority by Justice Anthony Kennedy, would have overturned the entire Act. But Roberts joined with the liberal wing to rule that the individual mandate was unconstitutional under the Commerce Clause, but constitutional as an exercise of the Congress’s taxing power, thereby preserving the ACA pretty much intact.

What are your reactions??

UPDATE: The bishops have weighed in, essentially asking Congress to repair the Act in three areas. First, to formally detach any funding for abortions, either directly or indirectly, from the Act. Second, to include and/or expand conscience provisions. And, third, by permitting undocumented workers/illegal immigrants to purchase health insurance in state exchanges.

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What Are Your Thoughts?leave a comment
  • R.

    My reaction is to thank God. Reason and justice prevailed.

  • John Henry

    Mixed reaction. On the one hand, I’m glad that the Court finally identified a limit to the Commerce Clause; the conservative Constitutional argument won. I am also glad that any changes/fixes/etc will come from the legislature, which is where they should originate. It’s also good that there will be expanded access to insurance, although the Medicare holding may reduce that expansion to some degree. Also, my current projects at work involve implementing some programs which derive their authority from the Affordable Care Act, and so it’s good from a professional perspective.

    The downsides are that I find Roberts’ claim that the mandate is actually a tax disingenuous; even Kagan appeared to reject that argument at oral argument, as Obama and various members of Congress had publicly. Also, I think the ACA was fiscally irresponsible; it used up all of the easiest Medicare cuts that could be used to sustain and reform Medicare, and put them towards financing additional spending. That’s a problem that in the medium term is likely to lead to more significant rationing of care than otherwise would have been the case. But nothing is perfect in life, so there will always be pros and cons.

  • A Sinner

    So…can we tax people who refuse to buy broccoli?

    • Anne

      No, we can tax people who refuse to buy health insurance and thereby run up health care costs and premiums for the rest of us. Of course, nobody really has to pay that tax, since there’s no enforcement mechanism in the bill. Just as Romney’s immigration plan involves something he calls “self-deportation,” Obamacare will enforce universal coverage via “self-taxation.”

    • CT Michael

      Oh…please!!! This broccoli reference is belittling, demeaning and snotty. Why don’t we just leave it with Scalia where it seems to fit

  • Thales

    It means that the controversy over the ACA is not going to end because the HHS mandate fight will end up in the Supreme Court.

    • Jordan

      I am glad that the SCOTUS ruled in a (ok, barely) bipartisan ruling to uphold the mandate. A 5-4 either way, with a Kennedy swing vote, would’ve painted the Court as partisan. The decision on the individual mandate was a surprisingly moderate move from a Court which, in recent years, has often hewed to party lines.

      re: Thales [June 28, 2012 10:37 am]

      The American hierarchy should, if it hasn’t already, prepare a case against HHS and get it up through the circuit courts to the SCOTUS asap. A Supreme Court invalidation of the HHS mandate as unconstitutional would go further to protect the Church than a pro-Republican campaign in an presidential election year. It’s true that a tax-based mandate can be repealed through a conservative Congress and signed by a conservative executive. Still, it’s much better for the Church to gain permanent protection through the judiciary rather than fight years of partisan battles in Congress.

      • Thales

        The American hierarchy should, if it hasn’t already, prepare a case against HHS and get it up through the circuit courts to the SCOTUS asap.

        Already done. There’s a dozen or more cases percolating in courts across the country.

        • Jordan

          re: Thales [June 28, 2012 12:24 pm]

          Understood. EWTN, which is legally incorporated and therefore unconnected to the hierarchy, has sued HHS. Instead, the USCCB, and not proxies allied with the hierarchy, should sue HHS directly. The bishops themselves should set the precedent and not allied corporations or persons. That would be a much more bold statement than an allied group’s case overturning the HHS directive.

          On the other hand, a proxied approach might protect the Church’s public image. A direct bishop/SCOTUS showdown might tarnish the institutional Church’s reputation should it lose. Certainly, a non-for-profit institution such as the Church can sue a government agency, but perhaps it is easier for a corporation or persons to do so.

          re: A Sinner [June 28, 2012 3:34 pm]

          Thank you for the clarification.

        • Thales

          I’m not only talking about the EWTN lawsuit. A dozen or so dioceses have also filed their own lawsuits (Washington, New York, St. Louis, among others).

        • Jordan

          re: Thales [June 28, 2012 9:48 pm]

          I apologize Mark for my perseverance on this topic — this is my last post for the thread.

          Thales, discrete dioceses do not comprise the whole of the USCCB. I have proposed that the USCCB, that is the entire American episcopal conference as a single entity and sole plaintiff, sue HHS.

          I am quite aware that the bishops of American episcopal conference do not often agree politically. Perhaps this is why corporations, individuals, and lobbies (e.g. NRLC) have in the past taken up the legal and political standard against US abortion policy. National Catholic Register [“Bishops Critique Their Handling of Ryan Budget Before Approving New Statement on Economic Crisis”, 15 June 2012] offers a not unbiased review of American Catholic episcopal internal political dissent.

          Surely many bishops are aware that Catholic hierarchical politics-by-proxy has not yielded substantial progress in almost forty years since Roe and modern American pro-life activism? I do not want the ACA and the HHS directive to remain two more smoldering trenches in the culture wars forty years from now. Better that the Church temporal take the risk of public discredit and place its entire reputation before the SCOTUS than dilute its judicial and political effectiveness per past policy.

        • Kurt

          In defense of the USCCB and most dioceses and eparchies not being part of a lawsuit, the probelm is that they really have nothing to sue about. Their insurance companies are exempt from the mandate. They would have to work hard to find a favorable judge that would find that they have standing to sue.

          Even with the colleges and hospitals on the lawsuit, I think they know they risk being denied standing. The best legal case would be an insurance company and not one has come forward.

        • Devin

          I don’t believe the USCCB would have legal standing to sue other than in representing the people who work at the indivial USCCB offices and the insurance they provide. So the conference can’t act on behalf of all the other diocese and catholic organizations in this issue.

        • Thales

          I have proposed that the USCCB, that is the entire American episcopal conference as a single entity and sole plaintiff, sue HHS.

          What Devin said. If you want to sue, you have to be a plaintiff with standing — that means you have to be directly affected by the rule in a negative way. I doubt the USCCB has a strong claim that it specifically is being harmed by the HHS rule. A Catholic Charities organization in a particular diocese is definitely being specifically harmed by the rule, which is why it can be a plaintiff in a lawsuit, and not the USCCB.

          Though it hasn’t sued, it seems to me that the USCCB is “taking the risk of public discredit” and putting itself out there publicly on this issue. Consider all the public statements it’s been making on the topic.

      • A Sinner

        Just to clarify, it WAS 5-4 with a Kennedy “swing vote,” Jordan. The big difference was Roberts joining the “liberal wing.”

  • Mark Gordon

    Over at National Review, Andy McCarthy is claiming that Republican and conservative opposition to the ACA was focused on the wrong thing, the mandate, and not on the broader issue of Congress’s power to tax:

    we remain focused on the wrong issue because conservatives and Republicans do not want any part of the right issue. Congress would not be able to tax anyone a penny if the subject matter on which lawmakers sought to spend the money raised was not within Congress’s constitutional authority to address. Health care and health insurance are precisely such issues. So why does Congress get to raise taxes for and spend money on them? Because the country — very much including Republican leaders and many conservatives — has bought on to the wayward progressive premise that the General Welfare Clause of the Constitution empowers Congress to spend on anything it wants to spend on as long as their is some fig-leaf that ties the spending to the betterment of society. That, and not an inflated understanding of the Commerce Clause, has always been the problem. Republicans are afraid to touch this because, if you follow the logic, you’d have to conclude that Congress has no constitutional authority to set up a social security system, a Medicare or Medicaid program, or most to the innumerable Big Government enterprises that Republicans support while, of course, decrying Big Government.

    I actually think he’s got a point about the consistency of those who claim to oppose “big government.” Can we get conservatives here to agree with him that Social Security and Medicare are illicit government programs and should be eliminated?

    • John Henry

      That argument is just bizarre. “General Welfare” has been interpreted broadly because the wording is very broad. McCarthy’s view is very far outside the consensus.

    • tausign

      No agreement from this conservative. Just yesterday I commented on another VN post that this matter would have been no contest if it were correctly labeled and treated as a tax. Everyone needs healthcare and we all know this to be the case…the only issue has always been containing the cost. Sadly, this program will be in the same state as SS, Medicare and Medicaid in short order.

      So my concern is that we won’t have the wherewithal to fund the required cost and soon the circle will have to be squared and very difficult choices made. Forget about healthcare being a right, no way, it will turn into desperate fights of who receives what benefits…that’s if things go well.

      To make an analogy…I see pension schemes as superior, more effecient and more just than cash balance schemes, but if they are not funded (and they haven’t been) the promises will fail. Just as the entire nation has abandoned the pension approach because of fiscal incontinence (except the public sector so far), so too we will need an escape clause when the healthcare system buckles under pressure. Sorry to be so pessimistic about this subject. My opinion will change if I see a generalized shift in sentiment meaning that workers are willing to trade wages for healthcare…but if the sentiment holds that employers and government should handle the entire cost increase then you will know we are doomed.

      • Anne

        I’ve seen polls where a majority of respondents have said they’re willing to
        pay higher taxes for better, more secure government services, so I don’t think the fat lady has sung on that point. But since polling is usually done to elicit opinion either supporting such services or objecting to tax increases, the polls rarely give a full picture. Americans seem ridiculously confused when it comes to this particular health care bill (with a majority claiming they’re opposed to it and the mandate, but supporting almost everything in the bill when asked about its individual features), but I wonder how much of that’s due to the way the polls are worded. That, and the fact that Americans are becoming less and less informed in general.

      • tausign

        “I’ve seen polls where a majority of respondents have said they’re willing to pay higher taxes for better, more secure government services, so I don’t think the fat lady has sung on that point.”

        Actually she has…and her name is Warren Buffett. But my point is that it doesn’t matter whether the people support it because the promised level of healthcare benefits are unsustainable. Consider that the most simple entitlement program SS is nearly impossible to reform with either an increase in tax or a reduction of benefits…indeed the payroll tax is currently on holiday! How can we possibly believe that this ACA scheme has any chance of success.

        Fortunately, we maintain some relative financial strength as the European crisis unfolds and money flows to our shores. We can enjoy our borrowed benefits as we watch Europe redefine its social promises. But when they eventually right their ship with their own scaled back entitlements the attention will turn to our woes.

  • Kurt

    Politically, a huge win for the President. Everybody loves a winner.

    While only about 55% of American supported the DREAM Act, the President’s actions were supported by 67% of the public– a sign that folks appreciate a strong leader who delivers. Expect the same on this. Even with an electorate mixed on Obamacare, the fact he pulled it off will be favorably received.

    I don’t like to get over confident, but I need to make sure my tux still fits for the Inaugural ball.

    • Mark Gordon

      I agree that this will help Obama, but I still believe that Carville and Begala had it right in 1992: “It’s about the economy, stupid!” And outside the Beltway the economy is in the shitter.

      • Anne

        Yes, but haven’t you seen the polls showing more in favor of Obama’s views on the economy than on Romney’s? Ohio polls, in particular, have shown this consistently even during recent hiccups in the recovery. At least some aren’t blaming Obama for the bad times they’ve been suffering since well before he took office..

  • Kyle R. Cupp

    I’m not qualified to comment on the correctness of the SCOTUS ruling, but as I have no moral objection to a mandate and think universal healthcare is a swell idea, I’m glad and hopeful.

  • Agellius

    The ruling has made me realize how much I hate private insurance. My son had an accident a couple months ago where he broke his arm and his jaw. He’s fine, and we have insurance. But ever since the accident I have been bombarded with invoices demanding that I pay or else have my credit report dinged. In other words, it’s on me to “make” my insurance company pay the invoices, otherwise I’m held liable. This is BS.

  • Kurt

    Leader Pelosi thanked Senator Kennedy in heaven for this victory. I got a little teary over that.

    • Mark Gordon

      Perverse in more ways than one. :-)

    • John Henry

      Please, Kurt, I’m trying to eat here…

  • Julia Smucker

    I’m basically with Kyle in being “glad and hopeful”. But I also love that the bishops’ concerns with parts of the ACA (note that they don’t reject it wholesale) include abortion funding AND unfair treatment of immigrants, and that they still mention “the moral imperative to ensure decent health care for all”. That’s what I call a transpartisan and thus truly prophetic stance.

    • brettsalkeld

      I too was very impressed by the Bishops statement (at least as summarized above).

    • Julia Smucker

      It’s all about protecting the vulnerable, wherever and whoever they are.

  • M.Z.

    Another deceptive statement from the USCCB.

    First, ACA allows use of federal funds to pay for elective abortions and for plans that cover such abortions, contradicting longstanding federal policy.The risk we identified in this area has already materialized, particularly in the initial approval by the Department of Health and Human Services (HHS) of “high risk” insurance pools that would have covered abortion.
    “initial” is doing the work here. No high risk plan is offering abortion funding. This controversy was addressed almost a year ago. There has been no documented use of federal dollars to pay for abortions under the ACA. The claim that the ACA allows it is fatuous. At some point contributors at this site should recognize that the USCCB is as accurate in their ACA claims as Lifesite news is in their reporting.

    • M.Z.
    • Paul DuBois

      I think the claim is that it could be used to pay for abortions, not that it is or will be. The Stupak amendment that the USCCB supported would have guaranteed abortions would not be paid for. The President won passage through an executive order, one that he went above and beyond with the high risk pools. That is to his credit that he stuck not only to the letter of his agreement, but to the spirit as well. But a later president could change all that with the stroke of a pen, that is the fear of the bishops. If one Republican Senator had offered to vote for the ACA with the Stupak amendment, we would have that as law now.

  • Julia Smucker

    Here’s President Obama being his old articulate self, and making a good case for the common good: