Supreme Court upholds health care law

In one of the most dramatic cases in recent history, the Supreme Court of the United States voted 5-4 to uphold a 2010 law known as the Affordable Care Act or "Obamacare."

The law, which has been a point of political controversy for several years, seeks to decrease the number of Americans without health insurance.

The stated objective of the ACA is to "increase the number of Americans covered by health insurance and decrease the cost of health care." Two of its key provisions are that it prevents insurance companies from turning away customers who may be a liability and it subjects individuals who do not buy insurance to a penalty, which the court ruled is a tax.

Many opponents of the bill have challenged its constitutionality, arguing the bill represents a massive expansion of government power. The Supreme Court has dispelled these claims, asserting that the actions of the government are acceptable under spending and taxation powers.

Many experts believe the Supreme Court’s decision to uphold the ACA was both logical and progressive.

"One can demonstrate that when the government has been proactive in expanding health care coverage for Americans, that there has been an improvement in health care quality," said L. Christopher Plein, associate dean for the School of Applied Social Sciences at West Virginia University and an expert on health care policy.

Plein was quick to challenge a common claim made by ACA’s opponents – that the government has no right to intervene in health care services.

"It’s not like this is revolutionary," he said.

Plein said the federal government has been reforming health care for decades, creating programs such as Social Security, Medicare and Medicaid, all of which provide millions of dollars in aid to millions of Americans.

"There is clearly a precedent for the federal government to take a role in increasing health care access in this country," he said. "The ACA is literally the latest chapter in a decades-long effort to extend health care services to Americans."

According to a 2010 report by the World Health Organization, the United States ranked 37th in health care quality worldwide while scoring first in the amount of money spent.

Plein believes the ACA is the federal government’s solution to these ratings.

"The numbers suggest that we have a significant problem with the uninsured and the underinsured in the United States," he said. "This act is intended to fix those numbers."

The ACA imposes legislation that would create a more consistent flow of money in the economic relationship between hospitals, insurance companies and consumers.

"The bill is asking the uninsured to buy insurance, basically," Plein said. "In doing so, it’s lowering the costs for everybody and lifting the cost risks any individual may have."

Plein said the often-sensationalized bill actually doesn’t differ much from other laws.

"As a society, we have lots of rules and regulations. We have to pay property taxes, we have to get a driver’s license," he said. "Assessing the adequacy of insurance is actually a very normal governmental function."

Perry Bryant, executive director for West Virginians for Affordable Health Care, believes the ACA is a major boon for the state.

"There’s a lot of positive things in the Affordable Care Act for West Virginians," he said. Bryant said the ACA will help extend health insurance to approximately 150,000 uninsured West Virginians.

"We’re going to fundamentally change insurance rules so they’re more fair to consumers," he said. "This will ensure that insurance companies will spend the greater portion of their income on paying claims."

According to Bryant, these changes will create better rural health care, extensive preventative medicine and financial security for all parties involved.

"We’ve had several other similar pieces of legislation, and this is the greatest attempt to make insurance coverage universal and affordable," he said.

WVU constitutional law professor Robert Bastress disagreed with rhetoric that challenges the ACA’s constitutionality.

"It’s really not terribly earthshaking as a constitutional concept," he said. "You’re either going to have your own insurance, or you pay it through the tax."

Individuals who choose not to have insurance will have to pay a tax. Similar policies have been used throughout history to enforce federal legislation.

"It’s a very straightforward exercise of the spending and tax power as a means of enforcement," he said.

While Bastress would agree that the ACA’s attention to individual behavior is novel, he doesn’t believe the legislation poses a threat to individual Americans’ rights.

"We tend to be libertarian in our attitudes," he said. "Individual mandates are not politically popular."

He believes the mandate was a political compromise.

"The political obstacle was the insurance companies, who have a lot of lobbying power and muscle in Congress," he said. A universal, tax-funded style of health care would bankrupt insurance companies.

"The mandate was the only way to get the insurance companies to go along with it," Bastress said.

Opponents of the ACA have vowed to begin a repeal vote July 11. Under current legislation, the ACA will go into full effect in 2014.

To read the Supreme Court’s ruling, visit http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf.