An odyssey that began during the presidency of Teddy Roosevelt and dominated much of President Barack Obama's first term in the White House could conclude Thursday at the Supreme Court. With it could end the best hope to date for the nearly 50 million Americans without health insurance and the hundreds of millions more burdened by rising costs.
The Supreme Court is expected to issue a decision sometime after 10 a.m. Thursday in a lawsuit brought by 26 states and the National Federation of Independent Business that challenges the constitutionality of the Affordable Care Act, the health care reform law Obama signed on March 23, 2010. Chief Justice John Roberts and his fellow justices could side with the president and allow the law to take root as intended by Congress. But the Supreme Court may elect to overturn the entire law, or just components of it, and in the process destroy or at least derail the most ambitious effort ever taken to address the shortcomings of the American health care system.
Health care has become the "issue from hell" and politicians won't tackle it again for many years if Obama's law goes down, said Drew Altman, the president and CEO of the Henry J. Kaiser Family Foundation, a health-care research institution in Menlo Park, Calif. "It's hard to imagine this Congress under almost any scenario, Democrats and Republicans in this Congress, agreeing on substantial health reform legislation."
Instead, the nation would be stuck with a status quo in which the ranks of the uninsured continue to swell, more workers lose their company health insurance, premiums rise, benefits shrink and more people skip medical treatments because of cost. Meanwhile, the nation's health care bill, which was an estimated $2.7 trillion last year, will continue to devour an ever-larger share of the economy.
A ruling against the law would be a major blow to Obama, who achieved a goal that eluded presidents from Roosevelt to Richard Nixon to Bill Clinton, though the issue bedeviled him from the start and voters remain sharply divided over it. The Supreme Court's decision will also shape public opinion about its role in American politics and redefine the limits of Congress' power. And the fate of the health care reform law will also influence the presidential contest between Obama and Mitt Romney, the presumptive Republican nominee who has vowed to repeal the law if elected. Opponents view the law as an unaffordable expansion of the federal government's role in the health care system that places burdensome regulations on health care companies, employers and citizens.
But the stakes are higher for the the tens of millions of Americans who lack access to health care. Fully overturning the Affordable Care Act would deny about 30 million uninsured Americans access to the health benefits that would have been provided under the health care reform starting in 2014. Invalidating health care reform also would eliminate consumer protections built into the law that would prohibit health insurance companies from refusing to cover people with pre-existing conditions, charging higher rates to women, kicking sick people off the rolls and setting lifetime limits on coverage of medical bills, among other practices permitted before the law took effect two years ago.
If this law goes away, so does the guarantee of access to health care for children like Wesley Josephson and Jackson Whaley who have pre-existing conditions and big medical expenses. Adults with serious illnesses like Sarah Lewis and Martha Olson would continue to face significant obstacles to finding health insurance. Older Americans like Wister Adrine and Patricia Morrison would lose extra help with their prescription drug costs.
Striking down the law would upend initiatives that aim to slow skyrocketing growth in health care costs. In addition to reducing Medicare spending by $455 billion through 2019, the health care reform law includes a plethora of programs designed to encourage medical providers to cut down on waste, improve safety and employ techniques known to be more effective. Health care reform also would levy a tax on the most expensive health insurance plans beginning in 2018 that is intended to encourage people to choose less costly plans. In addition, the law would establish an independent board tasked with constraining Medicare spending.
But the Supreme Court may not go that far and instead opt to invalidate only parts of the law. At the heart of the constitutional challenge is the health care law's so-called individual mandate, a requirement that almost all Americans obtain some form of health care coverage or face a financial penalty. The plaintiffs contend this mandate represents an overreach by the federal government into the personal and economic decisions of American consumers. The Obama administration insists it is within its rights to regulate how Americans pay for the health care services they inevitably will consume during their lives.
The Supreme Court could rule that the mandate is unconstitutional and strike it down while leaving the remainder of the law in place. But the Obama administration views the mandate as an essential counterpart to the regulations that require health insurance companies to sell plans to anyone regardless of health, age or gender and that limit those companies' ability to charge some people more than others. Cutting out the mandate alone will reduce the number of newly covered Americans and make health insurance more expensive, the administration argues, because only sick people would be motivated to purchase insurance. If the mandate goes, according to the administration, so too must those regulations.
But if the Supreme Court goes this way -- striking down the mandate and the regulations -- then health insurance companies could carry on discriminating against the sick and the old and making women pay higher premiums than men, and the number of people who would gain health insurance coverage would be millions fewer.
Speaker John Boehner
"Today, in upholding the Affordable Care Act, the Supreme Court has shown that, even at a time when Washington seems to have reached a new level of dysfunction, there remains a respect for the rule of law, for precedent, and for the ability of Congress to legislate on matters that affect the American people," Rep. Jerrold Nadler (D-N.Y.) said in a statement. "By not caving in to the most craven political calls, it appears the Court has stood by more than 70 years of legal precedent to ensure that: some 32 million Americans will have access to health insurance; we stop the unnecessary deaths of 42,000 Americans annually who die simply because they lack health insurance; insurers can no longer deny a child health care because of pre-existing conditions; millions of young adults receive coverage on their parents' plans until age 26; insurers can no longer impose lifetime limits on coverage; millions of Americans receive free preventive care; and, seniors save billions of dollars on prescription drugs. "The Affordable Care Act will now assume its rightful place, along with Social Security and Medicare, as powerful testimony to what our nation can achieve to benefit the lives of all Americans. Today's decision will, I truly hope, put to rest the partisan attacks from the Right against the law and many of its provisions. Republicans have threatened to continue their attempts to repeal these provisions, but let us all hope that they will respect the Court's ruling and put the health and wellbeing of the American people ahead of insurance companies."
"Today's decision makes one thing clear: Congress must act to repeal this misguided law," said Sen. Republican Leader Mitch McConnell. "Obamacare has not only limited choices and increased health care costs for American families, it has made it harder for American businesses to hire. Today's decision does nothing to diminish the fact that Obamacare's mandates, tax hikes, and Medicare cuts should be repealed and replaced with common sense reforms that lower costs and that the American people actually want. It is my hope that with new leadership in the White House and Senate, we can enact these step-by-step solutions and prevent further damage from this terrible law."
Virginia Gov. Bob McDonnell (R)
Republican Governors Association Chairman Bob McDonnell issued the following statement regarding the Supreme Court's decision to uphold the Patient Protection and Affordable Care Act: "Today's ruling crystallizes all that's at stake in November's election. The only way to stop Barack Obama's budget-busting health care takeover is by electing a new president. Barack Obama's health care takeover encapsulates his Presidency: Obamacare increases taxes, grows the size of government and puts bureaucrats over patients while doing nothing to improve the economy. It's never been more important that we elect a President who understands the marketplace and will make job creation his top priority. By replacing Barack Obama with Mitt Romney, we will not only stop the federal government's healthcare takeover, but will also take a giant step towards a full economic recovery."
Sen. Tom Coburn (R-Okla.)
"Dr. Coburn will be reviewing the ruling and will respond with an updated plan to repeal and replace this unworkable law. The Court affirmed Congress' power to tax people if they don't eat their broccoli. Now it's up to the American people to decide whether they will tolerate this obscene abuse of individual liberty," said John Hart, a spokesman for Sen. Coburn.
RNC Chair Reince Preibus
"Today's Supreme Court decision sets the stakes for the November election. Now, the only way to save the country from ObamaCare's budget-busting government takeover of health care is to elect a new president," said RNC Chairman Reince Priebus. "Under President Obama's signature legislation, health care costs continue to skyrocket, and up to 20 million Americans could lose their employer-based coverage. A panel of unelected bureaucrats now has the unprecedented authority to come between elderly patients and their doctors. Meanwhile, the rules and regulations placed on job creators and small businesses make it nearly impossible to hire new workers at a time when Americans desperately need jobs. "We need market-based solutions that give patients more choice, not less. The answer to rising health care costs is not, and will never be, Big Government. "We must elect a president who understands the economy, respects free enterprise, and can provide the leadership we now so desperately need. On Election Day, we must elect Mitt Romney and put America on the path toward a brighter economic future and successful health care reform."
Rep. W Todd Akin
Rep. Keith Ellison
Gov. Bobby Jindal
Today, House Majority Leader Eric Cantor (R-VA) released the following statement on the Supreme Court ruling on the President's health care law: "The Supreme Court's decision to uphold ObamaCare is a crushing blow to patients throughout the country. ObamaCare has failed to keep the President's basic promise of allowing those who like their health care to keep it, while increasing costs and reducing access to quality care for patients. In this tough economy, jobs and economic growth are on the minds of most Americans, but ObamaCare has increased uncertainty for small businessmen and women and forced them to put their hiring decisions on hold. "During the week of July 9th, the House will once again repeal ObamaCare, clearing the way for patient-centered reforms that lower costs and increase choice. We support an approach that offers simpler, more affordable and more accessible health care that allows people to keep the health care that they like. "The Court's decision brings into focus the choice the American people have about the direction of our country. The President and his party believe in massive government intrusions that increase costs and take decisions away from patients. In contrast, Republicans believe in patient-centered, affordable care where health care decisions are made by patients, their families and their doctors, not by the federal government."
House Democratic Whip Steny H. Hoyer (MD) released the following statement today after the Supreme Court's decision on the Affordable Care Act: "Our highest court has weighed in, and its decision to uphold the Patient Protection and Affordable Care Act is a victory for all Americans who have ever worried about being able to access or afford the care they need. Democrats are proud to have worked hard to pass this landmark legislation in 2010 and of our efforts to make sure it is implemented in a way that continues to yield new benefits for patients, employers, and care providers. "The Affordable Care Act made it illegal for insurance companies to discriminate against patients on the basis of pre-existing conditions, allowed young people to remain on their parents' plans until age 26, and prohibited insurance companies from charging women higher premiums than men. The Medicare Part D 'donut hole' is closing, and seniors on Medicare now have access to free preventive services like mammograms and colonoscopies. Moreover, the Affordable Care Act provides deficit savings of more than $1 trillion over the next two decades. The Affordable Care Act further brought peace of mind to the 30 million uninsured Americans who will finally be able to access affordable coverage once the law is fully implemented. "Republicans have been trying to repeal the Affordable Care Act since the day it was enacted, and they have been eagerly awaiting today's ruling. But they must now accept that the Affordable Care Act will remain in place and that the time for litigation and partisan posturing on this issue ought to come to an end. Republicans now have a responsibility to work with Democrats to implement the Affordable Care Act, and I call on them to do so in order to make care affordable and accessible to Americans."
Following the Supreme Court's decision affirming the constitutionality of the Affordable Care Act, former Governor and U.S. Senate candidate Tim Kaine today released the following statement: "The Affordable Care Act is an important first step in curbing discriminatory insurance company practices and increasing access to health care, but more needs to be done to bring down costs. Our government, businesses, and citizens cannot continue to spend more than any other nation on health care while getting second-rate results. As Senator, I am committed to working with all stakeholders to find additional improvements to the Affordable Care Act that give all Americans affordable access to high quality services. "While there is more work to do, it is worth noting what has already been accomplished under the Affordable Care Act. Nearly 63,000 more young people in Virginia have health coverage, more than 800,000 Virginia seniors have received free preventive care, millions of small businesses are now eligible for tax credits, and twenty million American women have access to cancer screenings and contraception without co-pays. And we've put an end to the egregious abuses by insurance companies that denied coverage to children with preexisting conditions, charged women higher premiums for the same coverage, and dropped folks when they got sick. "My opponent regularly calls for a full repeal of this law, despite the positive results it's already delivering for Virginia. In the decade encompassing George Allen's six years as a U.S. Senator, the average insurance premium for families more than doubled and over 12 million more Americans were uninsured. Clearly, inaction was not a solution, and neither are continued calls for repeal. Instead we must work together to strengthen this existing program and improve cost controls."
Senator Jeff Merkley
Sen. Robert Menendez
Rep. Nancy Pelosi
"In passing health reform, we made history for our nation and progress for the American people. We completed the unfinished business of our society and strengthened the character of our country. We ensured health care would be a right for all, not a privilege for the few. Today, the Supreme Court affirmed our progress and protected that right, securing a future of health and economic security for the middle class and for every American."
Rep. Marcia Fudge
"This is a victory for all Americans. In my district alone an estimated 7,000 children with pre-existing health conditions can no longer be denied coverage by health insurers; thousands of seniors will receive Medicare preventive services with no out-of-pocket co-pays or deductibles; thousands of seniors on Medicare will receive an average discount of $490 per person on the cost of prescription drugs. Now, 470 small businesses in the district will have the opportunity to receive tax credits to help maintain or expand health care coverage for their employees, insurance companies can be banned from establishing lifetime coverage limits for 160,000 residents, and $4 million in public health grants will make their way to community health centers, hospitals and doctors to improve the community's health."
Rep. John Boehner
"The president's health care law is hurting our economy by driving up health costs and making it harder for small businesses to hire. Today's ruling underscores the urgency of repealing this harmful law in its entirety. What Americans want is a common-sense, step-by-step approach to health care reform that will protect Americans' access to the care they need, from the doctor they choose, at a lower cost. Republicans stand ready to work with a president who will listen to the people and will not repeat the mistakes that gave our country ObamaCare."
Rep. Peter Welch
"Amidst the contentious national health care debate over the last two years, there has been widespread consensus on one thing: America's health care system is broken. The only beneficiaries of the status quo are insurance companies and their executives. Working families need the peace of mind and that comes with quality and affordable health care coverage. And businesses need to compete in a global economy without the heavy burden of skyrocketing employee health care premiums. With this landmark decision now behind us, both parties should set political differences aside and make this law work for the American people. It won't be easy, but it's time to get back to work."
"Prior to the passage of ObamaCare, Speaker Pelosi infamously said Congress had to pass the bill to 'find out what is in it,' and two years later Americans now know that ObamaCare is making things worse," said Sen. John Thune (R-S.D.). "Worker health insurance costs have gone up 17 percent, family premiums have increased by $1,700, and small businesses and individuals throughout the country now face costly mandates and taxes. "While today's decision is disappointing, Congressional Republicans will not rest until ObamaCare is fully repealed. Rather than jam a nearly 3,000-page bill through Congress using political favors and backroom deals, as was the case with ObamaCare, Congressional Republicans are committed to working across the aisle in a step-by-step manner to improve and expand access to health care, while reducing costs for Americans."
"The Supreme Court's ruling is a victory for America's families, who deserve affordable health care," said Sen. Barbara Boxer (D-Calif.) "The decision is great news for the millions of Californians who have already seen the benefits of this law - including the six million who now have access to free preventive health services, 355,000 young adults who now have coverage on their parents' health plans and 320,000 seniors who have received help in paying for their prescription drugs. "Now Americans will have the certainty of knowing they won't be denied coverage because of a preexisting condition. Women won't be charged a higher premium because of their gender. And families struggling with serious illnesses will not face lifetime limits on coverage. "We will continue to fight Republican efforts to repeal these important health benefits while we work to make sure every American has access to quality, affordable health care."
"I continue to oppose ObamaCare," said Wisconsin Gov. Scott Walker. "One of my first acts as Governor was to authorize Attorney General J.B. Van Hollen to add Wisconsin to the federal lawsuit opposing ObamaCare. Wisconsin will not take any action to implement ObamaCare. I am hopeful that political changes in Washington D.C. later this year ultimately end the implementation of this law at the federal level. If there is no political remedy from Washington and the law moves forward, it would require the majority of people in Wisconsin to pay more money for less healthcare. Additionally, it would increase the size and cost of government, decrease the quality of healthcare and, in our state, reduce access for those truly in need of assistance." The federal government should not tell individuals and families what to do with healthcare. The alternative is more transparency and a more active role by consumers, so we can truly control costs.
"Just because a couple people on the Supreme Court declare something to be 'constitutional' does not make it so," said Sen. Rand Paul (R-Ky.) "The whole thing remains unconstitutional. While the court may have erroneously come to the conclusion that the law is allowable, it certainly does nothing to make this mandate or government takeover of our health care right." "Obamacare is wrong for Americans. It will destroy our health care system. This now means we fight every hour, every day until November to elect a new President and a new Senate to repeal Obamacare," Paul continued.
"The United States Supreme Court has ruled to uphold the Patient Protection and Affordable Care Act by extending the power of the United States Congress to tax Americans' behavior," said Rep. Allen West (R-Fla). "This is a sad day for Americans, as they will be taxed to pay for benefits they may not need or want as part of the insurance they are forced to buy. With this decision, Congress has been granted infinite taxation power, and there are no longer any limits on what the federal government can tax its citizens to do. "The Patient Protection and Affordable Care Act will hit the middle class especially hard, as hundreds of thousands of jobs will be lost as businesses try to avoid the penalties and costs created by the healthcare law. The healthcare law will cost trillions of dollars, raise costs for employers and create huge incentives for them to drop health insurance. "Benjamin Franklin did indeed state, 'In this world, nothing can be said to be certain, except death and taxes.'However, Dr. Franklin never envisioned the federal government would use its power of taxation to punish people for not purchasing health care. Today, individual sovereignty in America has been defeated."
"Today's ruling demonstrates that health care is not the third rail in American politics. It demonstrates that reform is possible. It demonstrates that Medicare for All is inevitable," said Rep. Dennis Kucinich (D-Oh.) "The Affordable Care Act provided health care to those most vulnerable among us - those of the lowest income - by expanding Medicaid, a health insurance program for low-income Americans. It provided much-needed benefits. "In today's ruling, the Supreme Court held that states have the power to reject that expansion and maintain the status quo. That means that in states in which the governor decides not to prioritize providing health care to the poor, even though the federal government is paying for the vast majority of the expansion, the poor can be left out in the cold. "Today is an important day for millions of Americans who will not be denied benefits under the Affordable Care Act. But this is not the end of the conversation. Medicare for All is the solution America needs to stop the ever-rising costs of health care and provide full coverage for everyone. I supported the Affordable Health Care Act as a step in the right direction, but it is only the first step in a long journey. "States are not waiting for Congress to act. Vermont is moving forward on a single payer system, led by a push from small and medium-sized businesses who are getting crushed by health care costs. California has passed a Medicare for All system out of their legislature twice only to be vetoed by the Republican governor. Fourteen of the fifteen studies have showed that if a state went for a Medicare for All system, it would be cost neutral or save up to $19 billion per year while at the same time insuring everyone and improving the quality of care. Congress must help the states fulfill the will of their constituents," said Kucinich.
"On this day, history was made in America. This is a victory for the people, and makes clear that help is on the way for 30 million Americans who need access to affordable health insurance," said Sen. Frank Lautenberg (D-NJ). "Middle class families are struggling to afford health insurance and Obamacare will throw them a lifeline. It is time for the Republicans to stop the politically inspired attacks and work with us to extend this law's help to as many people as possible. With this ruling, Americans finally will have the peace of mind to know that their families will be taken care of when they get sick. President Obama has courageously stood up to false, political attacks, and his hard work was vindicated today."
"I applaud today's Supreme Court decision to uphold the health care reform law," said Sen. Tim Johnson (D-SD). "This is a huge win for South Dakotans and the nation. I have always believed health care reform was constitutional. Critically, the Supreme Court upheld the individual mandate. "From kids to seniors, health care reform has made a positive difference in the lives of tens of thousands of South Dakotans. More than 9,000 young adults in South Dakota have been covered under their parent's health insurance policies since the beginning of the year. "Nearly 100,000 South Dakotans on Medicare received free preventive services like mammograms and colonoscopies as a result of health reform. Already this year, beneficiaries reaching the donut hole have saved an average of $690 on prescription drugs with the help of health reform. "I look forward to continue working with members of both parties to reduce health care costs and increase health insurance coverage. The Supreme Court decision upholding the health care reform law gives us the foundation to do just that."
"After my daughter was born, our family had to give up health insurance because we couldn't afford it--a situation too many other Montana families have faced," said Sen. Jon Tester (D-Mt.) "I'm pleased the Supreme Court has validated Congress' work to ensure access to health care for all Montanans. "Today's ruling doesn't mean this responsible, constitutional law can't be improved. But it is an important step forward in the fight to fix a broken system and hold big insurance companies accountable to Montana families. "Insurance companies will now continue to insure people who are sick or have pre-existing conditions--like being pregnant. Young people will stay on their parents' health insurance plans. Seniors will continue paying less for prescription drugs. And 14,000 Montana veterans will now receive health insurance."
"When Congress and President Obama first took up this issue, we knew it wouldn't be easy," said Sen. Tom Udall (D-NM). "The Supreme Court's decision to uphold the Affordable Care Act is the best possible outcome for the American people. Today, quality, affordable health care is a major step closer to becoming a reality for millions of Americans who live one accident or diagnosis away from losing everything. For these families, health care is an economic matter with the very real consequences of life, death and bankruptcy. As a nation, and across New Mexico, we cannot afford to go back to just a short time ago when insurance coverage for all was further from reach, when children with cancer could be denied coverage, and when unemployed, recent college graduates would be kicked off their parents' insurance by age 22. "We can still improve upon the law we've put into place, but today, New Mexico has already received more than $200 million in grants and loans to establish an insurance exchange, strengthen community health centers, train new health professionals and so much more. Since passing the law, more than 26,000 young adults under 26-years-old in our state have been allowed to stay on their parents' insurance plans. Almost 20,000 New Mexico seniors on Medicare received a rebate to help cover prescription costs when they hit the donut hole in 2010. And 285,000 New Mexicans with private health insurance no longer have to pay a deductible or copayment for preventive care like physicals, cancer screenings and vaccinations. More is yet to come. "Today's decision marks another turning point in our country's approach to health care equality. Now's the time to put aside partisanship and work together to make our health care policy even stronger."
"I am pleased the Supreme Court reaffirmed the hard fought progress that was made to ensure that no one can be denied coverage for a pre-existing condition, being a woman will no longer be a pre-existing condition, young adults will be covered, prescription drug costs for seniors will be reduced, preventive care including life-saving mammograms will be accessible and that insurance companies can't cancel their coverage when you get sick," said Sen. Kirsten Gillibrand (D-NY). "It is time to get beyond scoring political points and get back to finding common core values and passing legislation that will help grow our economy and get more people back to work."
"The Supreme Court may have failed to stop this government takeover of health care, but the American people will not," said Sen. Jim DeMint (R-SC). "Since the day this law was rammed through Congress, the American people have demanded repeal, and today's ruling doesn't make Obamacare any less dangerous to our nation's health. Freedom-loving Americans are disappointed, but we cannot be discouraged. "The President's health care law must be fully repealed as all of its promises have proven false. We were told it was not a tax hike, but this ruling confirms it is an unprecedented and enormous tax on the poor and middle class Americans. President Obama needs to explain why he is enacting this middle class tax hike over the objections of the American people during the worst economic recovery since the Great Depression. "We were told it would lower health costs, but health care premiums are exploding. We were told that Americans could keep their personal health plans, but millions will now lose it. We were told it would improve our economy, but it is now the largest obstacle to employers hiring new workers. "This government takeover of health care remains as destructive, unsustainable, and unconstitutional as it was the day it was passed, unread, by a since-fired congressional majority. Now as then, our first step toward real health care reform and economic renewal remains Obamacare's full repeal, down to the last letter and punctuation mark. "I urge every governor to stop implementing the health care exchanges that would help implement the harmful effects of this misguided law. Americans have loudly rejected this federal takeover of health care, and governors should join with the people and reject its implementation." "The President's health care law will not reform anything, but is already undermining what does still work in America's health care system. We cannot build a free market health care system on this flawed structure of centralized government control, we must repeal all of it and start over with commonsense solutions that make health care more affordable and accessible for every American. We can allow Americans to purchase lower cost plans from other states, support state high-risk pools to cover those with pre-existing conditions, medical-malpractice reform to end frivolous lawsuits, and tax equity so Americans who don't get their health insurance from an employer are not penalized." "Today's decision, however unfortunate, nonetheless represents an opportunity to all Americans, to claim their right to create a health care system of, for, and by the people, not government or special interests. The American people now have the chance and Congress has the responsibility to fully repeal this Washington takeover and reform health care ourselves, together, around the principles of individual liberty, not government mandates. "The same freedom that made America strong and prosperous will make us healthier, too, so long as politicians remember that the health care system is supposed to serve our people, and not the other way around."
"This is a dark day for the American people, the Constitution, and the rule of law," said Virginia Attorney General and Republican gubernatorial candidate Ken Cuccinelli. "This is a dark day for American liberty. "This decision goes against the very principle that America has a federal government of limited powers; a principle that the Founding Fathers clearly wrote into the Constitution, the supreme law of the land. The Constitution was meant to restrict the power of government precisely for the purpose of protecting your liberty and mine from the overreaching hand of the federal government. "This unprecedented decision says that Congress has the authority to force citizens to buy private goods or face fines - a power it has never had in American history, and a power King George III and Parliament didn't have over us when we were mere subjects of Great Britain. Since the federal government itself could never articulate to the court a constitutional limit to this power, Congress has gained an unlimited power to force citizens to buy anything. "I am disappointed with the court's ruling and with the unprecedented attack on American liberty the president and the previous Congress have created with this law. "We are currently reading the decision and I will have more comment at the news conference at noon."
"The winners today are the American people," said Rep. Sander Levin (D-Mich). After nearly five decades - spanning eight presidents - we have succeeded in enacting comprehensive health care reform. Americans are already benefitting from the law's provisions that prevent the worst insurance company abuses, expand preventive care, reduce prescription drug costs for seniors, and allow young adults to stay on their parents' insurance. "Now we can move forward and implement the law's provisions that will expand coverage, and reform our overall system to reduce costs for middle class families. I urge my Republican colleagues to respect the opinion of the Court and end their misleading and partisan all-out assault on health care reform."
"The Supreme Court missed an historic opportunity to rein in the federal government," said Rep. Justin Amash (R-Mich). For decades, Congress has stretched the Constitution to authorize whatever new mandate it invents. Instead of acting as an impartial referee, the Court has been complicit in allowing Congress and the President to expand their power at the expense of state governments and the people. "The Court's decision green lights the continued expansion of the size and scope of the federal government. It also underscores the need to have congressmen who resist the impulse to aggrandize power in Washington. Now more than ever, Congress must commit itself to following the Constitution and limiting the federal government. We can begin to fulfill that commitment by repealing the President's health care law in its entirety."
"I've been clear from the very beginning that I do not believe a one-size-fits-all health care program works for the entire country and that each governor should have the ability to make decisions about what works best for their state," said New Jersey Gov. Chris Christie (R). "Today's Supreme Court decision is disappointing and I still believe this is the wrong approach for the people of New Jersey who should be able to make their own judgments about health care. Most importantly, the Supreme Court is confirming what we knew all along about this law - it is a tax on middle class Americans."
The USA Today/Gallup poll is the first out of the gate with a national survey gauging reactions to Thursday's Supreme Court decision upholding the 2010 health care reform law. They found sharp division, with 46 percent agreeing and 46 percent disagreeing with the decision.
The partisan polarization in the reactions is striking. Most Democrats (79 percent) said they agree with the decision, most Republicans (83 percent) said they disagree and Independents were divided almost evenly (45 percent agree and 42 percent disagree). This result comes in response to a neutrally worded question that made no reference to President Obama, Congress or either political party.
The survey was based on 1,012 adults called by live interviewers on Thursday as part of the Gallup Daily tracking survey. Interviews were conducted with respondents on both landlines and mobile phones.
-- Mark Blumenthal
Republican governors and officials from numerous states won't commit to expanding their Medicaid programs to more of their poorest residents after the Supreme Court ruled Thursday they could opt out. The Obama administration believes they're bluffing.
A top official at the Department of Health and Human Services predicted Friday that all states will take the federal money on the table to expand Medicaid, which is jointly funded and managed by the federal and state governments, to anyone earning up to 133 percent of the poverty threshold, which is $14,856 for an individual this year. The federal government will pay the full cost of covering an estimated 17 million new Medicaid enrollees from 2014 to 2017 and 90 percent of the costs into the future.
"We believe that, now that the court has clearly ruled on the constitutionality of the Medicaid expansion, that states, in fact, will take advantage of the coverage of these individuals," Mike Hash, the interim director of Center for Consumer Information and Insurance Oversight, said during a conference call with reporters.
That's an optimistic prediction, if the early reactions from Republican governors like Bobby Jindal of Louisiana, Bob McDonnell of Virginia, Sam Brownback of Kansas and Scott Walker of Wisconsinare any guide. These and other Republican governors haven't specifically committed to refusing to cover more poor people through Medicaid, but they continue to maintain they will take no steps to implement the health care law in their states.
The administration will "keep working with states and other partners to implement the law," Health and Human Services Secretary Kathleen Sebelius said. "What we can't afford to do is spend any more time refighting political battles."
The lawsuit that could have felled Obamacare was brought by 26 states, and states will continue to be major battlegrounds on which the future of health care reform will be determined. In addition to the uncertainty about the Medicaid expansion, many states haven't taken steps to establish the health insurance "exchanges," where people can obtain health plans or Medicaid benefits. Like the Medicaid issue, some Republican governors simply refuse to take part in the health care reform. Only 14 states and the District of Columbia have begun creating exchanges, and the remainder have until Nov. 16 to submit proposals to the federal government.
Hash offered another rosy assessment on this score: "Our objective is that every state will operate a state-based exchange," he said. "We will be ready to ensure that every American has access to affordable, high-quality coverage in Jan. 1 of 2014."
-- Jeffrey Young
HuffPost readers were still writing in on Friday with reactions to the Supreme Court's health care ruling, expressing everything from jubilation to a desire to leave the country. Read their responses below, and read more from our citizen journalists covering the election over at Off The Bus, our open-source reporting project.
I'm excited about Obamacare passing but I pray that Obama will spend the next four months educating people about the helpful things in the plan: it has already saved seniors over a billion dollars in prescription costs, for instance, and not with taxpayer money; kids up to age 26 will have coverage; and most importantly, insurance companies cannot deny coverage to people with pre-existing conditions. Once hospitals can stop charging high prices for caring for indigents in emergency rooms, I believe health costs will fall.
This is a brilliant plan. I say long live Obamacare!
-Mary Lindsay Dickinson
Personally, I have three 20-something children and without Obama's health care law, they would not be able to afford health care. I can do so through my job with this law. More broadly, this ruling restores my faith in our democracy and gives me hope for our country's future. Health care should be a right in this great country.
I have relatives in North Carolina who, after their furniture companies left for Mexico, were left without medical coverage and pensions. They made very little in wages to begin with, so their Social Security payments are abysmal.
One has cancer and her doctor has to write to a cancer care facility in New York to provide her care. With this ruling they will be able to afford insurance and get the help they need.
Please make it known that if one does not pay the "tax" or penalty, they will not be jailed, and show the small amount they will be fined! Thank you.
I am on Social Security disability benefits and Medicare. I live on less than $13,000 a year and receive $16 in food stamps per month. I live in North Carolina in Section 8 housing, and Medicaid already pays my Medicare premiums.
At first I was hoping to be covered for co-pays, but with the caveat added that states may or may not expand care, well, I may not benefit one bit. And as it is, I do my best to stay away from doctors and expensive treatments, and I often turn down care I should probably have.
What would have been nice is a needs-based Medicare system with the co-pay and premiums based on income and resources for all -- or universal health care coverage along the same lines.
Former Rep. Anthony Weiner (D-N.Y.), who resigned in June 2011 after lewd online behavior, gave his first radio interview since the scandal to WNYC's Brian Lehrer.
He dismissed the argument over whether to call the individual mandate a tax or not, and had another idea. "I was like, let's let our Republican friends vote against the freeloader tax ... it is ironic at the end of the day that that's all people are talking about," he said.
During the health care debate, Weiner was a frequent voice in the media in support of the law, even appearing on Fox News to argue for it as the network editorialized against it.
He also said that health care advocates should not be too happy about the court. "We should not be cheering that they did the right thing, shouldn't overlook that they did consistently the wrong thing," he said. "I think there's no question that it was constitutional."
Lehrer asked if he was "dipping his toe" to test a run for public office.
"You called me, this is an issue I care deeply about ... I'm not putting my toe anywhere," he responded.
He also denied a rumor that CNN had been planning a political show in the style of "Crossfire" for him and conservative commentator Andrew Breitbart, whose site posted the lewd photos of Weiner, before he died suddenly in March. CNN has also denied plans for the show.
-- Luke Johnson
|@ samsteinhp : O'Malley on McDonnell and R Govs: "The only health care mandate they embrace are trans-vaginal probes for woman"|
|@ aterkel : Clarification: Jindal said "Obamney--" then said "Obamacare instead.|
Several newspapers' editorial boards in battleground states offered their own take on the Supreme Court's decision. The Cleveland Plain Dealer's board suggested it was time to move on from the mandate debate:
What everyone, but especially the law's opponents, need to remember is that the status quo is unacceptable. Americans want coverage that's accessible and affordable. Businesses that pay for their employees' coverage need lower costs, and both they and health care providers need certainty about the rules of the road.
In that light, Obamacare's opponents should stop fighting the mandate and focus on building a workable system. In Ohio, that means Gov. John Kasich and Lt. Gov. Mary Taylor need to move ahead to design a statewide insurance exchange where consumers can shop for the best deals. In Washington, that means the Obama administration should encourage competition and innovation to fight health care inflation.
After two contentious years, the court fight is over. It's time to craft reforms that work.
The Detroit Free Press' board was even more blunt: "Don't repeal." The board writes this morning:
Improve and perfect.
But don't repeal.
That should be the mantra for health reform going forward in Washington, now that the U.S. Supreme Court has done away with the legal challenges to the president's landmark law.
The old status quo -- under which health care gobbled an ever growing percentage of the economy while the ranks of the uninsured continued to grow -- just isn't acceptable. It was crushingly expensive. And it was immoral.
The board of the Richmond Times-Dispatch expressed disappointment in the ruling:
In Kelo, the high court said government can commandeer your property. Thursday's supine surrender allows government to commandeer your paycheck, too. Many liberal commentators have condemned the Roberts court as activist. If only it were.
The Pittsburgh Post-Gazette said the ruling's fate is up to the American people:
The decision gives some 30 million uninsured people hope. It addresses the concerns of those who feared Obamacare was robbing them of freedom by reminding them that Congress certainly does have the constitutional power to levy taxes. It has also helped restore the Supreme Court's damaged reputation as an independent arbiter of the law
By the time the people next exercise their judgment, Mr. Obama and his fellow Democrats must make the case like never before that this legislation will cut health care costs and not lead to rationing of services or a shortage of doctors. Mitt Romney and the Republicans have to face the fact that the bill is constitutional and come up with an attractive plan that goes beyond just ending it.
-- Jason Cherkis
Republican presidential nominee Mitt Romney told supporters at a fundraiser in New York on Friday morning that the Supreme Court did not do what was "necessary" when it ruled that President Obama's health care law was constitutional.
"I think many people assumed that the Supreme Court would do the work that was necessary in repealing Obamacare," Romney said, a tip of the hat to the fact that his own campaign was caught off guard by the ruling, as several of his advisers told The Huffington Post.
"It did not get that job done," Romney continued. "It instead came up with an interpretation to allow it to stand."
He added: "But the people of America, I think, recognize that this legislation is not right for America."
Romney also said that the court's decision adds "greater urgency" to the election this fall.
"I think people recognize that if you want to replace Obamacare, you’ve got to replace President Obama. And the urgency of doing that is something which is galvanizing people across the county," Romney said.
Romney spokeswoman Andrea Saul also described the election as "more urgent" in a morning round-up email to the press.
"Yesterday, the urgency of this election became even more urgent," Saul wrote.
Here is the full text of Romney's remarks on the topic, via a pool report from the fundraiser:
What happened yesterday calls for greater urgency, I believe, in the election. I think people recognize that if you want to replace Obamacare, you’ve got to replace President Obama. And the urgency of doing that is something which is galvanizing people across the county. I think many people assumed that the Supreme Court would do the work that was necessary in repealing Obamacare. It did not get that job done. It instead came up with an interpretation to allow it to stand.
But the people of America, I think, recognize that this legislation is not right for America. It will cost $500 billion in taxes, it cuts Medicare by $500 billion. The CBO has estimated that up to 20 million people will lose the health insurance they want and own as a result of it. I’m convinced it will cause premiums to go up significantly, and that it will add to the deficit by trillions of dollars. And for those reasons, among others, including the fact that you will now have a government bureaucrat between you and your doctor, I think the American people are going to do the right thing and on Nov. 6, they’re gonna vote to replace Obamacare and replace President Obama. We’re going to get that done.
-- Jon Ward
If former GOP presidential candidate Rick Santorum is trying to be a good surrogate for Mitt Romney, he didn't succeed Thursday night during his appearance on "Piers Morgan Tonight." The former Pennsylvania senator trashed Romney's health care law that he signed as Massachusetts governor.
"I think what you're seeing is it hasn't worked in Massachusetts," he said. He added that people pay the penalty for not complying with the state's individual mandate, rather than buy insurance, because it's cheaper. According to the Associated Press, the number of people who have paid the penalty has declined in the years after the law took effect.
When asked why Romney, who Santorum has endorsed, would be a good president if his health care law "hasn't worked," Santorum defended his comments.
"What he [Romney] said is they did some things right. They did some things wrong. He learned from those mistakes. I'm using his language," Santorum said.
-- Luke Johnson
House Majority Leader Eric Cantor (R-Va.) said on Friday that the U.S. Senate would use a budget reconciliation bill to repeal Obama's health care law.
On MSNBC's "Morning Joe," he said that since the Senate used the reconciliation process to pass the bill, then the Senate, if controlled by Republicans, will use the same process to overturn it.
He also pledged to replace the law with a "patient-based" plan.
However, ThinkProgress' Igor Volsky noted why repealing the bill through such a process would be imperfect at best:
Without the necessary 60 votes in the Senate for full repeal, Republicans are pledging to use a budget reconciliation bill to undo the ACA. But this process would only apply to the budget-related elements of the law and would thus leave many portions -- including the mandate -- intact.
-- Luke Johnson
The New Yorker's Ryan Lizza reports:
Mitt Romney, speaking just before noon today, declared that on his first day in office, “I will act to repeal Obamacare.” I think he chose his words carefully. As President, he may indeed “act” to repeal it on Day One, but I don’t believe he will actually be able to overturn the law.
If Romney were to win in November, the first matter he’d have to deal with would be the fallout from the so-called fiscal cliff of December 31st, the day when some five hundred billion dollars worth of tax increases and spending reductions take effect, which could put the economy into another recession (if it’s not already in recession by then). This moment would perhaps be Romney’s greatest chance at repeal. Because the fiscal-cliff negotiations will be an enormous fight over the size and scope of the federal government, every government policy will theoretically be open to debate—including, Romney might insist, repeal of the A.C.A.
Click here to read more.
Obama campaign manager Jim Messina sent out an email to supporters Thursday evening. It reads:
It's been a good day.
But this is a three-step process.
1. Pass historic health care reform. Check.
2. Get affirmation from the highest court in the country. Check.
Step three? Win the damn election.
Mitt Romney has been clear he'd repeal Obamacare on Day One. Just another reminder of how much is at stake in November.
Donate $3 or more today:
Virginia Gov. Tim Kaine, running for senate in Virginia, sent out an email to supporters today. It reads:
The Supreme Court just upheld the individual mandate and the Affordable Care Act.
It's good news. We must continue to stand together and use the momentum from this ruling to get started on the work that remains to be done.
Not only do we need to continue to make improvements to the law and work together to find ways to reduce our health care costs, we also need to fight back against a massive effort by George Allen and right-wing special interest groups who want to roll back the progress we've made.
Today, my opponent said he wants to be the deciding vote to repeal this health care law. I want to be a vote to make it better.
They want us to go back to the days when insurance companies could refuse coverage when people get sick -- back to the days when they could discriminate against you for having a pre-existing condition. If they get their way, young people will be kicked off of their parents' plans, and health insurance premiums will rise for countless families across the country.
We can't afford to go back -- and this election could make all the difference. Can you make a contribution of $5 or more before the FEC fundraising deadline on Saturday?
With Karl Rove and the Koch brothers flooding the airwaves with false attacks against me, I'm counting on your help right now to make our case and get our message out. In fact, just now, it is being reported that the Koch Brothers will launch millions in new ads tomorrow in swing states like Virginia attacking health care reform and those of us who support it.
I need your help to fight these attacks. We only need 206 new donors to reach our goal -- a gift of just $5 puts us that much closer to having the resources we need.
HuffPost readers are still writing in with reactions late Thursday. The responses recorded below are part of Off The Bus, HuffPost's open source reporting project.
The ruling may be too late for our household because of the timing. My husband worked 34 years for the local power company. After retiring he developed end stage renal disease. At the time he had over $300,000 remaining in his lifetime insurance plan. My husband went on home dialysis requiring a midday and overnight treatment. We were struggling trying to keep up with his health issues and mine when we received a letter stating my husband had used his lifetime benefits. We reviewed invoices and determined that the home dialysis cost over $20,000 per month in addition to the oral medications. We sincerely regret the Affordable Care Act had not been enacted sooner.
Coming from a large family, I am grateful for a niece who will now have insurance coverage. She has had asthma from the time she was a toddler. About four years ago I learned she had tried to "ride out" asthma attack because she did not have insurance or medication. My sister used home remedies and a friend borrowed medication from a relative. I began praying for the health care program when Senator Kennedy was alive and trying to help President Obama get it passed because of what had happened to my niece. She is now in school to become an x-ray technician and will then have medical insurance. My fear has been what happens if she has an attack before then?
-- Irma Jenkins
This Supreme Court decision just sealed the deal for me to leave the country! This decision is the last straw for me, I will be moving from this country. Not because the Supreme Court leans so right wing but because the Democratic Party and many of the so-called progressive citizens in the U.S. are so dang stupid! I can't tolerate the ignorance on the left any longer! Obamacare is for the most part a huge gift to Big Pharma and Big Insurance period -- end of story! Mandated customers will raise the insurance rates just like it did in Massachusetts! We do not have to argue or speculate, all we have to do is take a truly objective look at what has happened in Massachusetts to all sectors of the socioeconomic strata! Insurance rates have gone up in Massachusetts -- not everyone can afford insurance and those numbers are growing every day. More importantly not everyone can even afford to go to the doctor even though they have been forced to buy insurance, so they are not actually getting health care!
If we had not tolerated anything less than single payer health care, then we all would be covered for the real emergency stuff that bankrupts millions, the kind of stuff that Western medicine is good at, attaching your legs back on when they are severed in an auto accident or starting your heart back up if you are struck by lightening -- that kind of stuff. We in America do emergency care very well and we all deserve that kind of care when we are really struck down!
But Western medicine sucks at keeping us well and managing acute low grade or chronic diseases, and we all deserve the freedom to go to alternative practitioners and get it paid for by our single payer health care coverage! I am leaving, I am going to an intelligent and progressive country where they actually understand when they are being chumped!
-- Lora Chamberlain
Makes a world of sense as we have two adult children out of college (early twenties). Our daughter had a health emergency last February that would have cost her well over $20K (two night stay, emergency room care). As a nanny, working three days a week and going to grad school, 20K would have destroyed her earning power for a long time.
As for pre-existing conditions, a relative has had multiple sclerosis for 20-plus years. Her husband never could switch jobs because even if it was an increase in pay/responsibility, the new company’s insurance wouldn’t cover her health bills.
It’s nice to think we’re trying to be progressive. I was prepared for the worst.
-- Diane Andrick
I am delighted with the overall decision of the supreme court today. I am a small business owner and a liberal. As an aging baby boomer (60) I will only be affected for a few more years, however I am a healthcare provider also. I have seen the results of our failed healthcare system for almost three decades now. Our system offers wonderful care for certain segments of society (those who have good insurance) and for certain kinds of medical problems (cancer, heart disease, the terminally ill, acute and severe injuries, etc.). For millions of others the promise of healthcare is remains out of reach.
The Affordable Care Act has many flaws. It carries all the scars of a failed attempt to compromise two diametrically opposed views of how to solve a very complex social/political dilemma. As a result no one was pleased with the outcome. I favored a single payer system as did most progressives. What we have is better than the conservative position of do nothing. It is a flawed step in the right direction and I applaud the president for having the courage and tenacity to stay with it to the bitter end.
The ACA will not solve many complex systemic problems with our healthcare system, but it will provide a remedy for many of its most immoral consequences. A long time ago conservatives predicted that Medicare would turn us into a socialist state. One of the spokesmen for that position was conservative icon Ronald Reagan. We have short and selective memory. The ACA and its legislative descendants will someday be as accepted and untouchable as Medicare and Social Security. Conservative attacks on the basic rationale behind the ACA are on the wrong side of history just as surely as those who oppose gay marriage and other social reforms granting basic rights to all or citizens have been. Health care should be basic right, not a commodity subject to the demands and profit goals of the marketplace. The ACA doesn't accomplish that goal, but it moves us closer.
-- Jim Snowden
This is great for our family ... I think. We just need all provisions of the Act to come into being now. This phased roll-out is killing us financially.
I am a self-employed consultant so I have to pay for my own private Blue Cross Blue Shield policy for me and my two-year-old daughter. When the bill was initially passed, our rates went through the roof. As I understand it this was because insurers were immediately required to accept people with pre-existing conditions in addition to a couple of other very expensive new requirements. But these new regulations came into play years before the mandate was to take effect, which I understand is the only way the rest of the bill is economically viable. So the insurance companies raised rates to cover these massive extra costs (no surprise there). How could the Obama administration not have predicted this? Or maybe they did but just saw it as an unfortunate political reality. Regardless, it really sucks. I only hope that rates come down once the mandate kicks in and the insurers books are flooded with new premiums (dare I be so naive). Or better yet maybe I can get into one of those private insurance pools that are supposed to be available soon, though I admit I really don't know anything about those yet.
Bottom line: I'm very happy about the law and this ruling in theory as it will surely give many more people access to health care. But whether this law is the answer to our country's health insurance problems we won't know for quite a while.
-- Brian Zellmer
-- Lucia Graves
Rep. Charlie Rangel (D-N.Y.) is holding out on reading the Affordable Care Act's survival as a mandate for Democrats to ask for more progressive health care reform.
"Only the outcome of the November elections could tell," Rangel said Thursday, when asked whether he would strengthen the bill now that the Supreme Court has mostly upheld it.
Rangel said he was "so pleasantly surprised" when he heard the ruling and wanted to say sorry to anyone who heard his previous remarks on whether the health care reform legislation would be ruled constitutional.
"If I could apologize about some of the things that I said about the direction in which the Supreme Court is going, I would be glad to do it," Rangel said. "I do hope that this decision, although split, that the court can become even-handed in these type of cases."
-- Patrick Svitek
Frank Rich writes in New York Magazine that he thinks the SCOTUS ruling allows the president an opportunity to resell health care reform. He writes:
"That the law was largely upheld allows Obama the miraculous opportunity to get right what he screwed up before and after the bill was passed: a fresh chance to explain to voters exactly what this bill is and what is good about it."
Whatever Obama's new message might be, the president may not be able to overcome the money advantage his opponents have. The New York Times recently reported the conservatives have far outspent the democrats in the health care reform battles:
In all, about $235 million has been spent on ads attacking the law since its passage in March 2010, according to a recent survey by Kantar Media’s Campaign Media Analysis Group. Only $69 million has been spent on advertising supporting it.
-- Jason Cherkis
|@ andreamsaul : Just crossed $2 million in donations & 20,000+ donors for #FullRepeal of Obamacare. #Mitt2012|
Sen. Sherrod Brown (D-Ohio) sent his supporters a message seeking campaign contributions pegged to the SCOTUS ruling. The Brown campaign writes:
Today was a great day for millions of Americans.
But the special interests and the far right aren’t about to give up in their effort to erase basic protections for middle class families -- and they aren’t going to let up in their attacks on me.
Make no mistake, they are about to pile on to the $10 million they’ve already spent to defeat us. Click here to help us fight back.
The truth is I need you on my side before the deadline -- it’s just a few days away.
We don’t need to out-raise the millions in Citizens United cash being spent against us, we just need to raise enough to win.
And if you donate now to help us reach our goal this quarter, that’s exactly what you’ll be doing.
Thank you for all you do for our grassroots organization.
Divided in their reactions, some small business owners say the Supreme Court's decision will enable them to offer their employees affordable health coverage, while others say it will force them to start cutting jobs.
Click here to read more.
-- Janean Chun
Shortly after the Supreme Court upheld the constitutionality of the Affordable Care Act, Democratic Senatorial Campaign Committee Chair Patty Murray (D-Wash.) sent an email to supporters asking for donations.
"It's a historic day in America: the Supreme Court just upheld President Obama’s health care reform," she wrote. "But, mark my words: Mitt Romney and the GOP will do everything in their power to shred Obamacare. Right now Romney is polling only two points behind President Obama, and he has already pledged to repeal it on day one if he gets elected."
People who donated $5 or more will receive an "I Heart Obamacare" sticker:
The DSCC refused to say how much money it had raised, although spokesman Shripal Shah said "thousands" of people would be getting stickers.
The campaign began shortly after the Supreme Court decision was announced and will run for a few weeks.
-- Amanda Terkel
Religious leaders and pundits reacted swiftly to the Supreme Court's ruling on the America's Affordable Health Choices Act or 'Obamacare.'
First Lady Michelle Obama praised the court's ruling Thursday while speaking in Memphis, Tenn.
"When it comes to health care, please, please tell people about the historic reform this president passed,” she said. “Tell them that today’s Supreme Court decision was truly a victory for families all across this country."
-- Luke Johnson
New York Times columnist Paul Krugman is on vacation, yet he blogged on the ruling with the headline "Double Scotch Time." He writes that before the decision, he was "so hyper" that he "needed medication."
"Health reform may yet be killed," he wrote. "But not today. And never mind the horserace politics: ordinary Americans have just won big."
-- Luke Johnson
Sen. Chuck Schumer (D-N.Y.) was disappointed about one thing in the Supreme Court's health care ruling: Chief Justice John Roberts' contention that the Commerce Clause of the Constitution did not apply.
"I can say in my view that it certainly merited upholding under the Commerce Clause," Schumer told HuffPost. "I do worry in the future about the Court's limiting the Commerce Clause as a way of limiting the ability of the federal government to help average families."
He also noted that Roberts gave the impression in his confirmation hearings that Roberts believed the Commerce Clause gave Congress broad powers.
"If you read his testimony about [1942's Wickard v. Filburn] and some of the more recent commerce clause cases at the hearing, and looked at what he said here, it's quite different," Schumer said.
Roberts was actually somewhat cagey about the Commerce Clause. In the health care ruling, he said it could not be used to regulate people who were not engaging in commerce, or compel them to engage in commerce by buying insurance.
-- Mike McAuliff
Video has been released of the press conference House Majority Leader Eric Cantor held earlier today to express his disappointment in the Supreme Court's ruling. As previously reported, he says the decision further "underscores the importance of this election."
Cantor said that he has scheduled a vote to repeal President Barack Obama's health care law for July 11.
-- Jason Cherkis
The editorial board for the National Review joined conservatives in slamming Chief Justice John Roberts for his decision in a scathing editorial Thursday:
The Constitution does not give the Court the power to rewrite statutes, and Roberts and his colleagues have therefore done violence to it. If the law has been rendered less constitutionally obnoxious, the Court has rendered itself more so. Chief Justice Roberts cannot justly take pride in this legacy.
The Court has failed to do its duty.
-- Luke Johnson
|@ VP : Today’s decision is a really big – important – deal. Find out what it means for you: http://t.co/fSApvV13 –VP|
In an email to supporters, Santorum's Patriot Voices group writes:
Today's Supreme Court ruling on ObamaCare is the worst of all outcomes. Not only are our rights being taken away and Americans are being forced to do something we don't want to do, but now we are being burdened with the biggest permanent tax increase in our nation's history.
This is a sad day, and we must fight back.
Patriot Voices believes so strongly that if we do not defeat President Obama this November and elect more conservatives in the House and Senate, our country's future prosperity is at risk.
But we need your help to make that happen.
We saw the absolute disregard President Obama showed for the Supreme Court's ruling on the Arizona immigration law, that I have no doubt that he sees today's ruling in his favor as a mandate that he can now do whatever he chooses by any means possible.
President Obama believes he is above the law, entitled to abusing his power to get what he wants, and willing to violate the constitution and the oath he was sworn to uphold. He has proven to be a very dangerous person to have this kind of power, and if he is not stopped this November, I am fearful that the make-up of this country as established by our founders will never be the same.
We at Patriot Voices will use every tool at our disposal to support candidates running in the House and Senate who have pledged to repeal ObamaCare. Will you help us in this fight? Please consider making a contribution to Patriot Voices of $25, $50 or whatever you can afford so we can take our fight straight to Election Day and ensure that President Obama is only a one term president, and that we elect conservatives in the House and Senate who will stand with us in this fight.
-- Jason Cherkis
Sen. Mike Lee (R-Utah), one of a handful of lawmakers who were actually in the Supreme Court chamber when the justices handed down their decision on the health care law, described "a palpable tension" in the air when the justices first entered the room.
"The tension remained for quite some time because it took quite a while for Chief Justice John Roberts in announcing the opinion of the court to get to the point of actually saying the mandate is going to stand, albeit as a tax," Lee said.
Lee said Roberts spent the first 15 minutes explaining why the individual mandate couldn't be upheld under the Commerce Clause and then "worked his way through" his argument about how the mandate is constitutional per the Tax Clause.
"It took him several minutes into that before people realized that was actually happening, that they were going to let it stand," Lee said. "All of a sudden you saw people raising their eyebrows, turning to their neighbors, turning to the left, turning to the right, smiling, frowning. Reacting as either horrified or overjoyed."
Lee said Sens. John Barrasso (R-Wyo.) and Orrin Hatch (R-Utah), among others, were also in the Supreme Court chamber when the decision was announced.
-- Jennifer Bendery
HuffPost asked readers to write in with reactions to today's decision. Their verdict: Most are overjoyed, though some threatened to leave the country. The responses submitted below are part of Off The Bus, HuffPost's open-source reporting project.
Let us know how the ruling will affect your family by writing to us at email@example.com (include your phone number if you are willing to be interviewed).
I'm saved! The Affordable Care Act is of utmost importance to my survival as a contributing member of society. I am uninsurable. Even before my accident last September, in the ultimate extreme of good health, I could not qualify for insurance that wasn't a group plan through my employers. Thirteen years ago, I had severe bone marrow and kidney diseases. I was told I was terminal. Fortunately, that prediction was wrong. Not only did I recover, but I went on to give up my car for a bicycle, riding hundreds of miles (probably thousands) in the Colorado Rockies. I was the epitome of health. Then, disaster struck.
While riding on Mount Evans, the highest paved road in North America, high winds pushed me over the side of the mountain. I fell 30 feet, tumbling to the granite boulders below. Had two cyclists from Switzerland not found me, I most likely would have died. I had fractured 9 vertebrae, shattered my rib cage, shattered my right shoulder blade, punctured both lungs, and my left kidney and spleen were lacerated so badly that my doctors seriously considered removing them. I later had to have four vertebrae in my neck fused in order to preserve, and hopefully recover, my failing use of my left arm and hand. I still may require further spinal surgery, as I remain in severe pain. In total, three vertebrae in my neck -- including two that would have meant instant death had they been displaced -- and six in my upper back were fractured. Without my helmet, I'd have certainly died.
I've been on medical leave ever since my accident. I've had to go onto COBRA for my insurance plan. I've been fighting with Social Security and the state for disability benefits. I've lived in fear for what my future holds for me, and in fear that without the federal mandate, I could be without insurance, out of luck, and disabled for the rest of my life.
Yet there's hope. I'm walking. I've regained some use of my left arm. I've even been back on my bicycle a few times.
The ACA has already positively affected my family. I have a son who (at the time) was 24. I was (and am) unemployed and was forced to pay out-of-pocket for health insurance for my son. He plays soccer overseas, so the risk of him being uninsured and getting injured was too high a risk to chance. The monthly expense was also quite high. When the portion of the ACA kicked in regarding uninsured children being eligible up to age 26 to be covered under their parent's employer health insurance, we were able to sign him up for coverage under his step-father's employer insurance plan. Insurance costs: cut in half! He will be 26 in February 2013, and now with the Supreme Court ruling (and hopefully, the reelection of the president), he will be able to purchase affordable health care when the time comes.
I am thrilled and relieved that the law was upheld. I have a 19-year-old daughter who is not able to be a full-time student at this time due to a pre-existing condition that would have made it very difficult for her to get insurance. I have had many sleepless nights worrying about what would happen if the law was struck down and she lost the ability to be covered until the age of 26 on our health insurance and the protection that, when she does need her own insurance, she will not be discriminated against. I intend to work hard to protect this law. I do not want our country to continue to allow people to die because they cannot purchase health insurance once they are ill.
In reading Dawn Garcynaski's email to you, I realized that this is exactly why the bill is unpopular. Everything she says is wrong: If it is true that she can barely afford to keep a roof over her head (unless it's a 500K+ Mcmansion), she will not pay a penalty for not having insurance -- the cut-off is around $80K a year or higher. She will receive huge subsidies from the government to purchase care, it will not cost her $500 to $700 a month.
This shows how misinformed the general public is about the law. While it's not perfect, its faults have been exaggerated and misconstrued. It's no wonder when the key provisions are pointed out separately, they all receive favorable ratings in the 70 percent plus.
And with the mandate, the Democrats messed up: they should have labeled it a "stop people from free loading off the system and casting YOU money fee." I'm pretty sure that'd be viewed favorably, too.
I only wish that this law was in place a decade ago. I am self-employed. A decade ago I had a very thin melanoma removed. There it was, the pre-existing condition. I was completely uninsurable by any other company and had no choice but to accept being pushed into higher risk pools, eventually paying high rates for huge deductibles and no coverage at all for routine and diagnostic care. Recommended preventative actions, like a colonoscopy at age 50, were delayed because we couldn't afford their cost and also because we were a little worried that if they found something, it would be another pre-existing condition that would push us into an even more unaffordable risk bracket. We knew it was a gamble, but frankly we couldn't afford the safe route. Well, the gamble went bad. My spouse was diagnosed a little over a year ago with Stage 4 colorectal cancer.
I know one cannot really know how things might have otherwise turned out, but I do know that the last decade would have been very different if this law was passed a decade ago. I would not have seen myself become locked into one carrier because of a pre-existing condition. I would not have seen my rates skyrocket as a result. Basic long-term, cost-effective preventative measures would have been covered. And we might have found my spouse's cancer at a curable stage.
So I strongly believe that, since my life would have been so much better if this law had been in place a decade ago, coming decades will be better for so many other people.
With health care reform free to move forward, there is some good news and some bad news for young people.
Young adults comprise the largest portion of the uninsured. This is partly because they make less money at the start of their careers, and so often forgo the purchase health insurance if they tend to be healthy and expect not to need such coverage any time soon.
Starting in 2014, though, young adults will be required to purchase health insurance or face a penalty from the federal government. They can also opt to remain on their parents' insurance plans until they reach the age of 26.
Click here to read more.
In a press statement, National Nurses United argued that there continues to be a need to improve healthcare in the U.S. The union wrote: "The 175,000-member National Nurses United pledged to step up a campaign for a reform that is not based on extending the grip of a failed private insurance system."
NNU Co-President Jean Ross, RN, stated: "It is not time to stop, but a reminder to begin that effort anew."
-- Jason Cherkis
One University of California at Berkeley professor thinks so. Professor Brad DeLong, writing on his blog, uncovered a few bits of evidence in the SCOTUS dissent that suggests the court's right-wing faction believed they were in the majority. DeLong notes:
Scalia refers to Ginsburg's concurrence -- agreeing with the Court that the mandate stands, but for different reasons than the opinion of the Court expresses -- not as a concurrence, but as a "dissent":
Our test's premise of regulated activity is not invented out of whole cloth, but rests upon the Constitution's requirement that it be commerce which is regulated. If all inactivity affecting commerce is commerce, commerce is everything. Ultimately the dissent is driven to saying that there is really no difference between action and inaction, ante, at 26, a proposition that has never recommended itself, neither to the law nor to common sense...
The professor finds a similar confusion in Thomas:
When the Scalia opinion became the Scalia dissent, Thomas forgot to change the first "joint opinion" to "joint dissent" -- although he did change the second "joint opinion" to "joint dissent".
-- Jason Cherkis
Presumptive Republican nominee Mitt Romney's website says he will nominate judges "in the mold of Chief Justice John Roberts." Roberts ignited the fury of conservatives when he sided with the majority and upheld the constitutionality of the Affordable Care Act Thursday.
From Romney's website:
"As president, Mitt will nominate judges in the mold of Chief Justice Roberts and Justices Scalia, Thomas, and Alito. These justices hold dear what the great Chief Justice John Marshall called “the basis on which the whole American fabric has been erected”: a written Constitution, with real and determinate meaning. The judges that Mitt nominates will exhibit a genuine appreciation for the text, structure, and history of our Constitution and interpret the Constitution and the laws as they are written. And his nominees will possess a demonstrated record of adherence to these core principles."
Former Rep. Anthony Weiner (D-N.Y.), one of the health care law's most pugnacious defenders, gave Politicker's David Freedlander his reaction to the court's ruling.
"In these big cases, I don’t believe the law matters all that much. The court has become an extension of the political debates of the day," he said.
He later accused the president of bungling the debate. "[A] large percentage of people in the country started hitting the streets and writing their Congressman to defend the health insurance industry. That was the surest sign that we had fucked up this debate somehow."
Weiner also said that he had "fallen in love" with SCOTUSblog.
-- Luke Johnson
HuffPost's Mark Gongloff reports:
The Supreme Court's decision to uphold President Barack Obama's health care reform law was surprising at least partly because a financial market had predicted that the opposite would happen, and financial markets can do no wrong. Crowds are wise. Markets are efficient.
Not so much, however, on the prediction market Intrade, where traders earlier this month assigned a nearly 80 percent chance that the Supreme Court would declare unconstitutional the health-care law's mandate that people buy health insurance. That had fallen to about 70 percent just before this morning's ruling, which is still a relatively sure thing.
But the individual mandate was of course upheld, meaning a lot of people making bets against it lost some money today. The contract price for betting on a mandate reversal has tumbled 97 percent today on Intrade.
Click here to read more.
HuffPost's Mark Gongloff and Bonnie Kavoussi report:
Hope you're happy with yourself, Supreme Court. You just killed America's economy.
That was the snap conclusion CNBC and Fox Business Network reached in the minutes following the Supreme Court's surprising decision to uphold President Obama's signature health-care reform law.
But let's take a look at just how terribly damaging this ruling actually was to the stock market.
The Dow Jones Industrial Average was down about 100 points at 10:00 a.m. ET, minutes before the court's ruling was announced. It was down about 89 points at 10:20 a.m. ET, after most of the world (excluding CNN and Fox News) realized the court had upheld health care reform.
By 10:40, it is true, when CNBC was interviewing Barry Knapp, the Dow was down to its worst levels of the day, off by nearly 160 points. But it has since "rebounded," if you can call it that, to a 120-point decline.
That's not an awful lot of movement for a fairly surprising decision that will supposedly destroy the economy. And in any event there is no surer way to make an idiot of yourself than in trying to hang great significance on minute-by-minute moves in the stock market.
Click here to read more.
HuffPost's Jennifer Bendery reports:
Rep. Raul Grijalva (D-Ariz.) said Thursday that the Supreme Court's decision to uphold the constitutionality of President Barack Obama's health care law means progressive lawmakers won't be pushing for a single-payer option anymore, though the concept will live on in their minds.
The idea of a single-payer option, such as a Medicare-for-all approach to health care, will continue to be "a fundamental political point that we all support," said Grijalva, co-chairman of the Congressional Progressive Caucus. "But the reality of what just happened today probably puts the emphasis on making the law work as opposed to trying to get a new plan."
Click here to read more.
HuffPost's Dan Froomkin reports:
The Supreme Court on Thursday upheld the Affordable Care Act's individual mandate, but not before rejecting the government's main argument -- that it was valid under the Constitution's Commerce Clause.
The majority opinion written by Chief Justice John Roberts bluntly insisted that the clause does not vest Congress with "police powers … to regulate an individual from cradle to grave." It also explicitly embraced the conservative argument regarding health care and broccoli.
Click here to read more.
Last week, Indiana GOP Senate candidate Richard Mourdock had an embarrassing stumble when his campaign accidentally released four videos reacting to all the possible scenarios in the Supreme Court's yet-to-be-announced decision on health care reform.
When reporters noticed the misstep, the campaign took them down.
On Thursday, Mourdock's campaign put out a statement, saying he was "disappointed" that the Affordable Care Act would be allowed to "stand as a massive tax on Americans."
On his YouTube page, however, there were no video reactions from Mourdock.
The Mourdock campaign did not return a request for comment as to whether it would be posting one of the four videos.
-- Amanda Terkel
HuffPost's Janell Ross reports:
The court’s decision will be dissected today by legal scholars, health care experts, sharp-tonged commentators and ordinary Americans. But what may not be so widely discussed or understood is the sweeping effect that the court’s decision will likely have on minority health in the United States, according to health care economists and policy analysts. That broad benefit to minorities is a point the Obama administration itself has made -- though somewhat infrequently -- and one that's likely to be invoked more often after the favorable ruling, as the presidential election fight intensifies.
Black and Latino Americans are expected to see substantial gains in insurance coverage under the ACA. The bill was designed to offer the greatest assistance to those with low and moderate incomes. And with income, race and ethnicity still closely linked in the United States, just over 48 percent of the nearly 24 million people likely to gain health insurance as the law’s provisions are implemented across the country will be people of color, according to a May Urban Institute analysis.
Click here to read more.
In a surprise move, Tea Party godfather Rick Santelli said conservatives should respect the Supreme Court's decision on health care. "You know what, the Supreme Court did what it thought best. I believe in that process, whether I agree with it or not," said Rick Santelli, CNBC's on-air editor, on CNBC on Thursday after the Supreme Court ruled in a 5-4 decision that the Affordable Care Act was constitutional. "I challenge the conservatives in Congress to take this decision with respect. With respect!"
Click here to read more.
Politico's Jake Sherman reports:
In a closed door House GOP meeting Thursday, Indiana congressman and gubernatorial candidate Mike Pence likened the Supreme Court's ruling upholding the Democratic health care law to the Sept. 11 terrorist attacks, according to several sources present.
He immediately apologized.
Click here to read more.
Don't expect the cost of health care to get cheaper as a result of the Supreme Court's decision largely to uphold the Affordable Care Act and its individual insurance mandate.
In fact, health care costs will likely keep rising, just as they have for some time.
Click here to read more.
-- Emily Cohn
Senator Rand Paul's (R-Ky.) statement, via Mike Riggs at Reason.com:
“Just because a couple people on the Supreme Court declare something to be ‘constitutional’ does not make it so. The whole thing remains unconstitutional. While the court may have erroneously come to the conclusion that the law is allowable, it certainly does nothing to make this mandate or government takeover of our health care right."
Rahm Emanuel, President Barack Obama's former chief of staff, famously warned Obama over and over again the political costs of pursuing health care reform in his first term.
On Thursday, Emanuel praised the Supreme Court decision and expressed relief that Obama did not heed his advice.
"I told him many times (about) the political cost of doing this,” Emanuel said, according to the Chicago Tribune. “And thank God for the country, he didn’t listen to me.”
-- Sabrina Siddiqui
The effects of today's Supreme Court decision on efforts to create single-payer health care, which would provide something like Medicare for all Americans, are difficult to judge at this early point.
But one state is already moving ahead: Vermont, where Governor Pete Shumlin (D) signed into law a "framework" for single-payer on May 26. The Green Mountain State's progressive politics make "Medicare For All" an easier sell there than probably anywhere else in the country, as does the fact that its biggest insurer is a nonprofit.
Turning an idea into a health care system, however, will take time. Not until 2017 will some form of single-payer be in place. If Justice Anthony Kennedy's dissent had swung the court on Thursday, the state would have lost around $200 million in annual Medicaid funds provided under the Affordable Care Act. Now it will get to use that money once single-payer is in place and pass on the savings to taxpayers.
"We were certainly pleased with the results of the U.S. Supreme Court decision," said Robin Lunge, the state's director of health care reform. "For us it's full steam ahead."
Former presidential candidate Herman Cain released a statement, calling the ruling a 'temporary setback.'
The Obama Administration sold the individual mandate again and again with the argument that it was not a tax. Then they argued before the Supreme Court that it was a tax, because that was the only way to defend it constitutionally.
Justices Scalia, Thomas, Kennedy and Alito clearly saw through this exercise in semantics, and they deserve our thanks for their commitment to the Constitution and the law in their dissent. The best that can be said for Chief Justice Roberts, in voting to uphold the law, is that he rejected the administration’s argument that the mandate was permitted by the commerce clause.
That said, it should never have been the job of the Supreme Court to clean up a terrible piece of legislation perpetrated by Congress and the White House. ObamaCare may have been declared constitutional by five justices – although not in the manner the White House sold it, which is telling – but that doesn’t change the fact that it is a horrible law that will bankrupt this country, explode health care costs and diminish the quality of care throughout this nation.
Government tyranny has been slowed, but not stopped. What today’s ruling means is that anything government can call a tax, it has the power to do. Regardless of the semantics, we are subjected to government tyranny.
|@ JackKingston : With #Obamacare ruling, I feel like I just lost two great friends: America and Justice Roberts.|
A small business group representing over 150,000 firms and more than 300,000 entrepreneurs and investors applauded today's Supreme Court ruling that upheld most of President Barack Obama's health care reform law.
"The Court’s ruling means that businesses will continue to enjoy important provisions which have already reduced their health insurance costs, and enabled them to cover more of their employees. This will help businesses to expand and step up their hiring," said David Levine, CEO of the American Sustainable Business Council, in a written statement.
Although congressional Republicans have spent years portraying Obama's Affordable Care Act as a job-killing disaster for small businesses, many entrepreneurs and mom-and-pop shops have long supported the bill for reducing their health care costs.
"Today marks an extraordinary day for American businesses, which will continue to benefit from health care tax credits and reduced insurance costs," said Frank Knapp Jr., vice chair of ASBC and head of the South Carolina Small Business Chamber of Commerce. "Not only does the ACA help small businesses to be more profitable, but it can level the playing field with big businesses that pay lower rates simply because of their size."
The National Federation of Independent Business, a Republican coalition of the nation's small business owners, has opposed the reform legislation and spearheaded the lawsuit against the bill. NFIB has dominated talking points about small business in Washington, but several other groups, including the Main Street Alliance and the ASBC, have significantly expanded their once-minor influence in recent years.
Tax credits provided by the health care law have already cut costs for many small firms. Once the full bill takes effect, major provisions like the individual mandate and the new system of health insurance exchanges are expected to enhance competition for insurance, drive down prices for all healthcare and thus result in lower costs for businesses.
Moreover, big companies with hundreds of thousands or millions of employees, have long been able to secure cheaper, better health care plans from insurance companies, simply by offering insurers a bigger pot of business. Small firms that employ a few dozen people or fewer must pay more for the same quality care or offer weaker plans to their workers. The new insurance regulations under the Affordable Care Act will require all insurance plans to offer a stronger slate of options for employees of any company, making it easier for small companies to attract talent.
-- Zach Carter