The news cycle on June 28 2012 was a frantic hive of activity. It didn't matter if you watched television, listened to the radio, or checked aggregators online; journalists and pundits from worldwide sources scrambled to produce content at a rate that seemed almost cartoonish. Serious newspapers and fun viral websites all got in on the action -- but what caused such a fervor? In short, the Supreme Court of the United States finally announced their ruling on the constitutionality of the Patient Protection and Affordable Care Act (PPACA).
United States has long lagged behind other developed nations when it
comes to health care. It is one of the only developed countries
without a form of universal coverage; more than 30 million citizens
do not have insurance, and the government spends up to twice its GDP
on health costs compared to Canada. The PPACA , signed into law in
March 2010, sought to reform health care policy on virtually every
level; insurance companies could no longer deny coverage for people
with pre-existing conditions, and plans would be more affordable for
everyone. The PPACA included a provision called the individual
mandate, which required that all Americans buy insurance if they
could afford it, or else pay a yearly penalty fee.
This Will Not
This mandate was one of the most controversial aspects about the PPACA, splitting the country along political party lines. Twelve states filed lawsuits within hours of the PPACA being signed, protesting that the government was seriously overstepping its regulatory bounds by forcing American citizens to engage in commerce. Eventually, twenty-six states got involved in the challenge, along with the National Federation of Independent Businesses. After conflicting decisions from multiple federal judges, it became clear that the constitutionality of the mandate was only one part of the problem. Another question was whether the PPACA could survive without the mandate; it provided a majority of the funding for the rest of the bill's helpful provisions. The decision eventually came to the bench of the Supreme Court.
of the PPACA insisted that the individual mandate was a necessary
first step towards a form of universal health care. It would actually
bring health care premiums down when it worked with the new insurer
regulations. Most citizens could agree that the current health care
system was patently unfair; the mandate was the way to fund real
change and make sure that the uninsured had coverage. But opponents
were just as convincing; they saw the mandate as a violation of
individual rights. It was a first step towards complete government
control, and unfairly crippled the insurance industry. They argued
that the mandate was a violation of the Commerce Clause, which gives
Congress the power to " regulate
commerce...among the several states" but cannot actively require
Americans to buy anything.
The Supreme Court heard arguments for three days in March 2012, and
debated several questions. First: did Congress have the right to
enact the individual mandate under the Commerce Clause? Second: did
the individual mandate exceed Congressional powers, and if so, could
the mandate be severed from the PPACA without the entire bill
collapsing? Third: did Congress have the right to force states to
accept new Medicaid provisions, under threat of losing all funding?
After months of debate, the Court ruled on June 28 2012: the
individual mandate was constitutional, if it was considered a tax.
Rather than collecting federal taxes for health care revenue (which
is how a single-payer health system works), the mandate directly
funded the insurance companies that were already in place. Chief
Justice John Roberts, a conservative, ended up breaking the tie; he
ruled in favor of the mandate, shocking his Republican supporters.
Crowds outside of the D.C. courthouse erupted in celebration; news
channels scrambled to get their stories straight. Republicans vowed
to get the bill overturned, and Democrats cheered their successful
health care reform. Both parties prepped to discuss the PPACA at
length on the election campaign trail.
No matter your stance, it's clear that health care in the U.S is
going to change. By 2014, the mandate will be fully in place, and
millions of Americans will have access to affordable health insurance
-- some for the very first time in their lives.