Whatever one thinks of the legal reasoning and immediate impact of Thursday’s U.S. Supreme Court decision to uphold the Affordable Health Care Act, the fallout will dominate the political landscape this year.
That may not be a bad thing. While we can expect loud and shrill voices full of misleading and partisan rhetoric on the issue, those on opposing sides should tend to balance each other out. American voters will be challenged to do their homework, sorting out the facts from the propaganda and reaching informed and intelligent views about what’s best for the nation’s health care policy. If this year’s presidential and congressional campaigns become a debate on health care, it will place the reins of government where they belong — in the hands of the voters.
Problems clearly exist with the nation’s health care system. President Barack Obama was right Thursday when he said, “Here in America — in the wealthiest nation on Earth — no illness or accident should lead to any family’s financial ruin.” Beyond that, determining what needs to be fixed and how to do it, there’s little consensus. Recent polls show less than half of Americans support so-called Obamacare, yet those opposing it are divided between people who think the law goes too far and those who think it’s a giveaway to the health care industry that still doesn’t do enough for ordinary Americans.
Saying the federal government should leave the system alone is not enough. Federal activity is already a structural part of the system, through regulation, provision of funding and services and support for research. But giving the federal government unchecked power to interfere in people’s lives, private business practices and the affairs of the states is also alarming. Does the Affordable Care Act go too far? That’s the question and it remains unanswered.
In a narrow 5-4 decision, the justices said the law did not so severely cross into unconstitutional areas that it should be swept away. Eight of the nine justices agreed that a portion of the law threatening to yank Medicare funding from uncooperative states cannot be constitutionally enforced as written. Most justices agreed that the controversial “individual mandate,” to levy a penalty against people who refuse to buy health insurance is not constitutionally justified under the rationale put forward by the White House, which said it was just a regulation of commerce. But a court majority found that it was still justified by the power Congress to enact a tax, since the measure, to be enforced by the IRS, essentially is a tax. So the law stands as legal.
But Chief Justice John Roberts’ comments show the court wasn’t acting to “back” the law, as some unfortunate news media headlines proclaimed after the decision was handed down. “It is not our role to forbid it, or to pass upon its wisdom or fairness,“ Roberts said, maintaining consistency with his philosophy against judicial activism.
North Carolina libertarian-conservative pundit John Hood, writing Thursday for National Review, assessed the resulting political situation with great insight: “First, those who dislike the mandate — which includes a majority of U.S. voters — will now have no recourse but to vote for Mitt Romney to repeal it. Second, the only way the administration prevailed was to have Obama’s main legislative accomplishment redefined as one of the largest middle-class tax increases in the history of the country. Does that really sound like a good political outcome to you?”
Roberts put the ball squarely in the political court with comments written into the opinion: “We do not consider whether the act embodies sound policies. That judgment is entrusted to the nation’s elected leaders. We ask only whether Congress has the power under the Constitution to enact the challenged provisions.”
Partially in reaction against the Affordable Care act, American voters acted during 2010 elections to punish the leaders who had enacted it. A more clear, and perhaps better-informed referendum on this policy now will take place in November. As Roberts wrote, elected leaders are entrusted to judge sound policies. It’s now up to We the People, not the courts or the news media, to sit in judgment of those elected leaders.