Decisions on Affordable Care Act (ACA)

Back in March the Supreme Court heard three days of oral arguments regarding the Affordable Care Act. The 2010 Affordable Care Act, which constitutes $2.6 trillion and our healthcare system’s biggest overhaul in 50 years, provides health insurance to more than 30 million previously uninsured Americans and designed to slow down rising health care costs. The four areas in question were the Tax Anti-Injunction Act, the Minimum Coverage Provision, the Severability issue, and the Federalism and Medicaid question.

The Tax Anti-Injunction Act of 1867 was argued that this law prevents the court from even hearing the case because no one has paid penalties from the law. The Minimum Coverage or individual mandate was argued that it is unconstitutional to force people to buy a product (health insurance) from the private sector. The Severablility issue argued that striking the mandate would leave the law unsustainable so the whole law should go. 26 States argued the all or nothing participation of Medicaid Expansion was coercion.

Decisions were given yesterday on all the arguments. Most people relate “shock and awe” with a military maneuver but apparently the SCOTUS can do it to. It is obvious the 1867 Act wasn’t a factor and there was no striking down of the whole law. It all came down to the mandate and the Medicaid expansion.

In a 5-4 vote Chief Justice John Roberts wrote the court’s majority in the opinion, Congress can’t use its powers to regulate interstate commerce to require people to buy insurance but they do have the taxing power. He said, “The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax. Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness,” And so the mandate is upheld.

And finally, the Court said that while the Medicaid Expansion program is legitimate, State’s must have the right to opt out of just that program. It can’t be an all or nothing option. This decision will certainly effect the overall outcome of the law putting 30 million uninsured into the system. Which States will take the money or choose not to expand their uninsured? Will we see another political divide?

Tune In today for Voice of the Doctor with Dr. Nick van Terheyden. Dr. Nick will be discussing the SCOTUS decisions in his monthly News Round Up. Voice of the Doctor airs every Friday at 2:30 pm ET on