In a dramatic move with significant political and economic implications, a majority of the U.S. Supreme Court on Thursday (June 28) voted to uphold President Obama's landmark health care reform law. The vote, at least in regard to the key conflict, was 5 to 4, with Chief Justice John Roberts writing the opinion and joining the four justices on the liberal wing.
The decision is a big relief to people with costly illnesses, including people with HIV or breast cancer. It is an enormous political victory for the Obama administration, because health care reform was Obama's signature achievement thus far in his first term. And it creates an awkward issue for Republican presidential nominee Mitt Romney to negotiate. Romney worked for a similar plan for Massachusetts, when he was governor, but has since joined the majority of Republicans in arguing vigorously against requiring citizens to buy coverage or pay a "tax" for not doing so.
The Affordable Care Act (ACA) "individual mandate" requires every citizen, by 2014, to either buy health coverage or pay a penalty that helps mitigate the burden on the health care system when they seek medical care without insurance.
All three of the nation's major LGBT legal groups had signed onto a brief in support of the ACA, noting that 30 percent of people with HIV are not able to obtain health insurance.
Among other things, the ACA prohibits insurance companies from limiting or refusing coverage for a person with HIV, breast cancer, or any other disease. It also prohibits insurance companies from dropping a person's coverage after the person became ill.
Justice Anthony Kennedy, writing for the dissent, said he believes the entire law is unconstitutional. He was joined by the court's conservative wing, including Justices Antonin Scalia, Clarence Thomas, and Sam Alito.
Lambda Legal, Gay & Lesbian Advocates & Defenders, the National Center for Lesbian Rights, the National Center for Transgender Equality and others submitted a joint brief in support of the ACA. They argued the law ensures health coverage for people with HIV and, in doing so, stems the spread of the virus to others. That, they said, also helps contain the enormous burden that HIV infection puts on the health care system.
The 30-page brief was one of more than 130 briefs filed in HHS v. Florida and several other lawsuits seeking to strike down the ACA, signed into law two years ago by President Obama.
The gay groups' brief, like most media reports, focused on the ACA individual mandate that everyone purchase health coverage. Under ACA, with some exceptions (including religious-based objections and poverty), everyone would have to obtain health coverage starting in 2014. Those who failed to do so would have to pay one percent of their income annually as a penalty. Over the years, the penalty rises, but there are limits to how high it can go.
With the individual mandates, argued the gay groups' brief, "thousands of livesand billions of dollarscould be saved each year, and the HIV/AIDS epidemic could be dramatically curbed."
Carl Schmid, Deputy Executive Director of The AIDS Institute, said his group was "extremely pleased" with the upholding of the ACA.
The court upheld other points of contention in the law, including whether states can be required to cover the expanded number of people qualifying for Medicaid under the ACA. Some states opposed that expansion, saying it unfairly increases the state's obligation to share the Medicaid costs. The majority opinion said the federal government could not withdraw existing Medicaid funding from states that were unable to fund the expanded pool.
In other Supreme Court news this week, the high court voted 5 to 3 (with Justice Elena Kagan recusing herself) to strike down three provisions and at least temporarily sustain one provision of Arizona's controversial immigration law. Lambda Legal said the one provision retained allowing law enforcement officers to stop any person they suspect is in the United States without the federal government's permission is especially harmful to LGBT people.
"LGBT immigrants and LGBT people of color remain particularly vulnerable because this provision… requires police to stop and question people based on their appearance," said Lambda, in a statement released about the decision. "The LGBT community knows all too well how easily people who are perceived to 'look different' or 'act different' can be singled out for harassment and persecution."
Lambda said it would join other groups in staging a constitutional challenge to the provision. The Supreme Court did not declare the provision to be constitutional but said it could be enforced until such time as a court does rule it to be unconstitutional.
The majority struck down three other controversial provisions of the Arizona law as overstepping state authority and encroaching on the purview of federal authority.
Justice Anthony Kennedy wrote the majority opinion, which was joined by Chief Justice John Roberts and Justices Ruth Bader Ginsburg, Stephen Breyer, and Sonia Sotomayor.
© 2012 Keen News Service. All rights reserved.
NEWS RELEASE: THE WHITE HOUSE, Office of the Press Secretary
June 28, 2012
REMARKS BY THE PRESIDENT ON THE SUPREME COURT RULING ON THE AFFORDABLE CARE ACT
East Room, 12:15 P.M. EDT
THE PRESIDENT: Good afternoon. Earlier today, the Supreme Court upheld the constitutionality of the Affordable Care Act — the name of the health care reform we passed two years ago. In doing so, they've reaffirmed a fundamental principle that here in America — in the wealthiest nation on Earth — no illness or accident should lead to any family's financial ruin.
I know there will be a lot of discussion today about the politics of all this, about who won and who lost. That's how these things tend to be viewed here in Washington. But that discussion completely misses the point. Whatever the politics, today's decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court's decision to uphold it.
And because this law has a direct impact on so many Americans, I want to take this opportunity to talk about exactly what it means for you.
First, if you're one of the more than 250 million Americans who already have health insurance, you will keep your health insurance — this law will only make it more secure and more affordable. Insurance companies can no longer impose lifetime limits on the amount of care you receive. They can no longer discriminate against children with preexisting conditions. They can no longer drop your coverage if you get sick. They can no longer jack up your premiums without reason. They are required to provide free preventive care like check-ups and mammograms — a provision that's already helped 54 million Americans with private insurance. And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses, and not enough on your health care.
There's more. Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parent's health care plans — a provision that's already helped 6 million young Americans. And because of the Affordable Care Act, seniors receive a discount on their prescription drugs — a discount that's already saved more than 5 million seniors on Medicare about $600 each.
All of this is happening because of the Affordable Care Act. These provisions provide common-sense protections for middle class families, and they enjoy broad popular support. And thanks to today's decision, all of these benefits and protections will continue for Americans who already have health insurance.
Now, if you're one of the 30 million Americans who don't yet have health insurance, starting in 2014 this law will offer you an array of quality, affordable, private health insurance plans to choose from. Each state will take the lead in designing their own menu of options, and if states can come up with even better ways of covering more people at the same quality and cost, this law allows them to do that, too. And I've asked Congress to help speed up that process, and give states this flexibility in year one.
Once states set up these health insurance marketplaces, known as exchanges, insurance companies will no longer be able to discriminate against any American with a preexisting health condition. They won't be able to charge you more just because you're a woman. They won't be able to bill you into bankruptcy. If you're sick, you'll finally have the same chance to get quality, affordable health care as everyone else. And if you can't afford the premiums, you'll receive a credit that helps pay for it.
Today, the Supreme Court also upheld the principle that people who can afford health insurance should take the responsibility to buy health insurance. This is important for two reasons.
First, when uninsured people who can afford coverage get sick, and show up at the emergency room for care, the rest of us end up paying for their care in the form of higher premiums.
And second, if you ask insurance companies to cover people with preexisting conditions, but don't require people who can afford it to buy their own insurance, some folks might wait until they're sick to buy the care they need — which would also drive up everybody else's premiums.
That's why, even though I knew it wouldn't be politically popular, and resisted the idea when I ran for this office, we ultimately included a provision in the Affordable Care Act that people who can afford to buy health insurance should take the responsibility to do so. In fact, this idea has enjoyed support from members of both parties, including the current Republican nominee for President.
Still, I know the debate over this law has been divisive. I respect the very real concerns that millions of Americans have shared. And I know a lot of coverage through this health care debate has focused on what it means politically.
Well, it should be pretty clear by now that I didn't do this because it was good politics. I did it because I believed it was good for the country. I did it because I believed it was good for the American people.
There's a framed letter that hangs in my office right now. It was sent to me during the health care debate by a woman named Natoma Canfield. For years and years, Natoma did everything right. She bought health insurance. She paid her premiums on time. But 18 years ago, Natoma was diagnosed with cancer. And even though she'd been cancer-free for more than a decade, her insurance company kept jacking up her rates, year after year. And despite her desire to keep her coverage — despite her fears that she would get sick again — she had to surrender her health insurance, and was forced to hang her fortunes on chance.
I carried Natoma's story with me every day of the fight to pass this law. It reminded me of all the Americans, all across the country, who have had to worry not only about getting sick, but about the cost of getting well.
Natoma is well today. And because of this law, there are other Americans — other sons and daughters, brothers and sisters, fathers and mothers — who will not have to hang their fortunes on chance. These are the Americans for whom we passed this law.
The highest Court in the land has now spoken. We will continue to implement this law. And we'll work together to improve on it where we can. But what we won't do — what the country can't afford to do — is refight the political battles of two years ago, or go back to the way things were.
With today's announcement, it's time for us to move forward — to implement and, where necessary, improve on this law. And now is the time to keep our focus on the most urgent challenge of our time: putting people back to work, paying down our debt, and building an economy where people can have confidence that if they work hard, they can get ahead.
But today, I'm as confident as ever that when we look back five years from now, or 10 years from now, or 20 years from now, we'll be better off because we had the courage to pass this law and keep moving forward.
Thank you. God bless you, and God bless America.