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Supreme Court should uphold the Affordable Care Act
Alexander J. Cotoia
Allowing the Affordable Care Act to stand is both legally sound and practically expedient. If conservatives truly were champions of judicial restraint, they would agree.
In a matter of days, the U.S. Supreme Court will weigh in on the future of the Patient Protection and Affordable Care Act (“ACA”), as it issues its much-anticipated decision governing the constitutionality of the law under the federal Constitution.
Exhaustively discussed in legal and political circles, the ACA contains a number of controversial provisions, including the hotly contested “individual mandate” or “minimum coverage provision” that conservatives view as anathema, an impermissible encroachment on an individual’s economic liberty.
If the court were to accept this argument and strike down the ACA or any portion of the act as constitutionally incompatible, it would be engaging in an egregious act of judicial activism, upending the principle of congressional deference and subverting the justification for “rational basis” review, which long recognized that Congress possesses plenary, or exclusive, power over the regulation of interstate commerce.
As Justice Breyer noted in dissent in the landmark case of U.S. v. Lopez — the seminal case in which the court departed from nearly a half century of settled jurisprudence — the court’s function is to assess “not whether the regulated activity sufficiently affected interstate commerce, but, rather, whether Congress could have had a rational basis for so concluding.”
That a rational basis exists for regulating the health insurance market is beyond legitimate contention. The unique nature of American health care, coupled with the inability of an individual to opt out (even those with the strongest immune systems are likely to fall ill at least once during their lifespan) left Congress little choice but to fashion legislation that included a minimum coverage provision to curb skyrocketing health care costs, and eradicate the “cost-shifting” that is largely responsible for escalating premiums. Far from being without precedent, this is exactly the kind of “broader regulatory scheme” that the Supreme Court has consistently deemed constitutionally permissible, even in cases where the regulated activity was of a “wholly intrastate [and] . . . non-economic” character.
(For a more detailed discussion about Commerce Clause jurisprudence, see opinion by a federal judge upholding the constitutionality of the ACA here.)
Not perfect, but politically realistic
I’m not saying the ACA is perfect — it isn’t. In a world in which the United States stands alone among our industrialized counterparts who provide health care as a matter of right to citizens, the better, but far more controversial option would have been to expand Medicare and eliminate the private insurance market altogether.
But this president recognizes political reality, and chose to pass legislation that dramatically expanded health care coverage to uninsured Americans, banned discrimination based on pre-existing conditions, and required insurance companies to cover a host of preventative care services without requiring a co-payment from the consumer. On balance, the ACA is a positive first step in recognizing that access to quality, affordable health care is an integral part of American competitiveness.
If Americans are to have an edge with our competitors the world over, it is imperative that we live both productive and healthy lives.
For this reason, the court would do well to reject the frenzied contentions of the reactionary right and give new meaning to the principle of stare decisis. Allowing the ACA to stand is both legally sound and practically expedient. If conservatives truly were champions of judicial restraint, they would agree.
Cotoia is a member of the Democratic Party State Central Committee and has written several guest columns for this site. He is employed as a paralegal with Holt Mynatt Martinez P.C. in Las Cruces and was a Democratic candidate for the District 2 seat on the Doña Ana County Board of Commissioners in this year’s primary.
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Had the Republicans been doing their jobs for the past 50 years there would have been no need for the ACA. Nature and politics abhors a vacuum. The Republicans of late have not only ignored their civic duties to the American public in veering wildly to the extremist right, they have allowed others to do what they would not do, namely, start the long and arduous job of fixing a system even they admit is broken. If the Republicans had crafted a bit of legislation that helped cover the 30 or 40 million American citizens who did not previously have access to or were able to afford health care insurance there would have been no room for Democrats and President Obama to step in and get done the ACA. Republicans have nobody to blame except themselves. Now all they can do is negative, destructive and unhelpful acts with apparently no plan to fill the void they plan to, again, create.
Just got the incredibly wonderful news and wanted to log on to admit I was wrong about the Affordable Health Care Supreme Court decision. Thankfully, joyously wrong.
Sad day for America, but I guess all nations fall eventually.
Yup, a sure sign of a country’s downfall is a slow, incremental increase in the number of people who receive access to health care.
Guess we were all wrong.
I was wrong in believing SCOTUS would stem the tide of government.
Those believing that Republican appointees somehow controlled the SC were also wrong.
Sad day for America, but I guess all nations fall eventually.
Skeptic – you sound like George W. when he was trying to instill fear with wild and untrue speculations regarding WMDs. Those false predictions ended up killing 4000 plus Patriots and left our enemies in Afghanistan with more power and freedom. Why do people use fear when they try to predict a future? Skeptic, if you had your ways would you increase tax cuts for the 2 and 3 percenters as well?
The Supreme Court has exposed itself for what it is…a group of Republican operatives who are neither blind or just.
an obvious affront to individual liberty
Japan, the Netherlands, Switzerland, and Massachusetts all have individual health insurance mandates. Do their citizens think that they have less liberty than the other 49 states of the US?
FWIW the individual mandate is a bad deal, but not for any theoretical damage it does to liberty. But I guess we’ll see what the SCOTUS thinks about it.
The individual mandate is an obvious affront to individual liberty which will clearly be struck down.
But beyond that the failings of this mess should never proceed.
By imposing costs on employment, this act will decrease jobs
By promoting fee for service, this act will raise health care spending, not reduce it.
By implementing another unfunded mandate, this act worsens the budget deficit.
By imposing a fee, this act may very well induce employers to pay the fee but dump the coverage,
which might actually REDUCE the percentage of people covered by insurance.
We all see what the results were of the Republican controlled Supreme Court’s decision to select George W. Bush in 2000. The Great Recession, 9/11, two wars (one bogus), unprosecuted War Crimes committed by the Executive Branch of the United States government, the shooting of a Judge by a sitting Vice President, continued bigotry and outright hatred and exclusion of Gays and of course global warming denials which left the US far behind technologically and left the world in a lurch. Within the next forty eight hours I expect to see the Republican controlled Supreme Court screw over 40 million uninsured citizens of the United States and another 200 million most of them having been duped by insurance companies and Fox News which is owned by an Australian. The real coup d’etat was the Republican controlled Supreme Court’s Citizens United decision which magically turned corporations (foreign and national) into human beings.
Weak pathetic sad horrific downfall catastrophic to humanity, yep, that is our eyes wide open Republican controlled Supreme Court.
Hi Alex, you wrote, “In a world in which the United States stands alone among our industrialized counterparts who provide health care as a matter of right to citizens… ”
This is just a bit ambiguous. I suggest a more emphatic statement would be ‘In a world in which the United States is the lone dissenter among industrialized nations who provide health care as a matter of right to citizens…. “
hotly contested
The individual mandate was hotly contested? When? Where? By whom? Yeah it was part of the ACA that was tricked through the House and Senate but hotly contested? Its been discussed at great length since but I’m sure it didn’t take up much time when Ben Nelson was taken care, probably not included in the Lousiana Compromise, or a big part of Stupak’s agenda.
If your going to make a legal argument, leave out the hyperbole.