The Common Good

Supreme Court Upholds Affordable Care Act

Ivone Guillen / Sojourners
Ivone Guillen / Sojourners

In a widely anticipated and extremely consequential decision, the Supreme Court ruled today in a 5-4 decision that President Barack Obama’s chief domestic 

achievement, the Affordable Care Act, is constitutional.

The main challenge to the law had focused on the “individual mandate,” which required people to purchase insurance or pay a fine. In its ruling, the Court upheld the mandate under the taxing power given to Congress in the Constitution.

Today’s ruling means the other pieces of the Affordable Care Act, such as allowing kids to stay on their parent’s plans until the age of 26 and preventing insurance companies from denying coverage to people with pre-existing conditions, are also constitutional.

The one provision of the law limited by the Supreme Court centered on covering more people by expanding the Medicaid program. Under the law, the federal government would have been able to punish states that didn’t expand their Medicaid programs by withholding all of the state’s Medicaid funding. The Court’s ruling allows the government to only withhold new funding for states choosing not to expand their programs.

While people will undoubtedly remain divided about the Affordable Care Act and today’s ruling, it does mean that millions of people will now have access to health insurance coverage and the overall  growth of spending on health care will be curtailed.

Read the full opinion HERE.

Beau Underwood is Campaigns Manager for Sojourners.

TRANSCRIPT: President Barack Obama's Remarks ACA Decision

The President:  Good afternoon.  Earlier today, the Supreme Court upheld the constitutionality of the Affordable Care Act -- the name of the health care reform we passed two years ago.  In doing so, they've reaffirmed a fundamental principle that here in America -- in the wealthiest nation on Earth – no illness or accident should lead to any family’s financial ruin. 

I know there will be a lot of discussion today about the politics of all this, about who won and who lost.  That’s how these things tend to be viewed here in Washington.  But that discussion completely misses the point.  Whatever the politics, today’s decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court’s decision to uphold it.

And because this law has a direct impact on so many Americans, I want to take this opportunity to talk about exactly what it means for you. 

First, if you’re one of the more than 250 million Americans who already have health insurance, you will keep your health insurance -- this law will only make it more secure and more affordable.  Insurance companies can no longer impose lifetime limits on the amount of care you receive.  They can no longer discriminate against children with preexisting conditions.  They can no longer drop your coverage if you get sick.  They can no longer jack up your premiums without reason.  They are required to provide free preventive care like check-ups and mammograms -- a provision that's already helped 54 million Americans with private insurance.  And by this August, nearly 13 million of you will receive a rebate from your insurance company because it spent too much on things like administrative costs and CEO bonuses, and not enough on your health care. 

There’s more.  Because of the Affordable Care Act, young adults under the age of 26 are able to stay on their parent's health care plans -- a provision that's already helped 6 million young Americans.  And because of the Affordable Care Act, seniors receive a discount on their prescription drugs -- a discount that's already saved more than 5 million seniors on Medicare about $600 each.

All of this is happening because of the Affordable Care Act. These provisions provide common-sense protections for middle class families, and they enjoy broad popular support.  And thanks to today’s decision, all of these benefits and protections will continue for Americans who already have health insurance.   

Now, if you’re one of the 30 million Americans who don’t yet have health insurance, starting in 2014 this law will offer you an array of quality, affordable, private health insurance plans to choose from.  Each state will take the lead in designing their own menu of options, and if states can come up with even better ways of covering more people at the same quality and cost, this law allows them to do that, too.  And I’ve asked Congress to help speed up that process, and give states this flexibility in year one. 

Once states set up these health insurance marketplaces, known as exchanges, insurance companies will no longer be able to discriminate against any American with a preexisting health condition.  They won’t be able to charge you more just because you’re a woman.  They won’t be able to bill you into bankruptcy. If you’re sick, you’ll finally have the same chance to get quality, affordable health care as everyone else.  And if you can’t afford the premiums, you'll receive a credit that helps pay for it. 

Today, the Supreme Court also upheld the principle that people who can afford health insurance should take the responsibility to buy health insurance.  This is important for two reasons. 

First, when uninsured people who can afford coverage get sick, and show up at the emergency room for care, the rest of us end up paying for their care in the form of higher premiums. 

And second, if you ask insurance companies to cover people with preexisting conditions, but don’t require people who can afford it to buy their own insurance, some folks might wait until they’re sick to buy the care they need -- which would also drive up everybody else’s premiums.

That’s why, even though I knew it wouldn’t be politically popular, and resisted the idea when I ran for this office, we ultimately included a provision in the Affordable Care Act that people who can afford to buy health insurance should take the responsibility to do so.  In fact, this idea has enjoyed support from members of both parties, including the current Republican nominee for President.

Still, I know the debate over this law has been divisive.  I respect the very real concerns that millions of Americans have shared.  And I know a lot of coverage through this health care debate has focused on what it means politically. 

Well, it should be pretty clear by now that I didn’t do this because it was good politics.  I did it because I believed it was good for the country.  I did it because I believed it was good for the American people.

There’s a framed letter that hangs in my office right now.  It was sent to me during the health care debate by a woman named Natoma Canfield.  For years and years, Natoma did everything right.  She bought health insurance.  She paid her premiums on time.  But 18 years ago, Natoma was diagnosed with cancer.  And even though she’d been cancer-free for more than a decade, her insurance company kept jacking up her rates, year after year.  And despite her desire to keep her coverage -- despite her fears that she would get sick again -- she had to surrender her health insurance, and was forced to hang her fortunes on chance. 

I carried Natoma’s story with me every day of the fight to pass this law.  It reminded me of all the Americans, all across the country, who have had to worry not only about getting sick, but about the cost of getting well. 

Natoma is well today.  And because of this law, there are other Americans -- other sons and daughters, brothers and sisters, fathers and mothers -- who will not have to hang their fortunes on chance.  These are the Americans for whom we passed this law. 

The highest Court in the land has now spoken.  We will continue to implement this law.  And we'll work together to improve on it where we can.  But what we won’t do -- what the country can’t afford to do -- is refight the political battles of two years ago, or go back to the way things were. 

With today’s announcement, it’s time for us to move forward -- to implement and, where necessary, improve on this law.  And now is the time to keep our focus on the most urgent challenge of our time:  putting people back to work, paying down our debt, and building an economy where people can have confidence that if they work hard, they can get ahead. 

But today, I’m as confident as ever that when we look back five years from now, or 10 years from now, or 20 years from now, we’ll be better off because we had the courage to pass this law and keep moving forward.

Thank you.  God bless you, and God bless America.

TRANSCRIPT: Mitt Romney's Reaction to ACA Ruling 

See video
class="p4">Republican presidential candidate Mitt Romney made the following statement Thursday following the Supreme Court's decision to uphold the constitutionality of the Obama administration's health care law. 

"As you might imagine, I disagree with the Supreme Court's decision and I agree with the dissent. What the court did not do on its last day in session, I will do on my first day if elected president of the United States. And that is I will act to repeal Obamacare.

Let's make clear that we understand what the court did and did not do. What the court did today was say that Obamacare does not violate the Constitution. What they did not do was say that Obamacare is good law or that it's good policy. Obamacare was bad policy yesterday.  It's bad policy today. Obamacare was bad law yesterday.  It's bad law today.

Let me tell you why I say that. Obamacare raises taxes on the American people by approximately $500 billion.  Obamacare cuts Medicare -- cuts Medicare by approximately $500 billion.  And even with those cuts and tax increases, Obamacare adds trillions to our deficits and to our national debt, and pushes those obligations on to coming generations. Obamacare also means that for up to 20 million Americans, they will lose the insurance they currently have, the insurance that they like and they want to keep.

Obamacare is a job-killer. Businesses across the country have been asked what the impact is of Obamacare.  Three-quarters of those surveyed by the Chamber of Commerce said Obamacare makes it less likely for them to hire people. And perhaps most troubling of all, Obamacare puts the federal government between you and your doctor.

For all those reasons, it's important for us to repeal and replace Obamacare.

What are some of the things that we'll keep in place and must be in place in a reform, a real reform of our health care system? One, we have to make sure that people who want to keep their current insurance will be able to do so.  Having 20 million people --
up to that number of people lose the insurance they want is simply unacceptable.

Number two, got to make sure that those people who have preexisting conditions know that they will be able to be insured and they will not lose their insurance.

We also have to assure that we do our very best to help each state in their effort to assure that every American has access to
affordable health care.

And something that Obamacare does not do that must be done in real reform is helping lower the cost of health care and health insurance.  It's becoming prohibitively expensive.

And so this is now a time for the American people to make a choice.  You can choose whether you want to have a larger and larger government, more and more intrusive in your life, separating you and your doctor,  whether you're comfortable with more deficits, higher debt that we pass on to the coming generations, whether you're willing to have the government put in place a plan that potentially causes you to lose the insurance that you like, or whether instead you want to return to a time when the American people will have their own choice in health care, where consumers will be able to make their choices as to what kind of health insurance they want.

This is a time of choice for the American people. Our mission is clear:  If we want to get rid of Obamacare, we're going to have replace President Obama.  My mission is to make sure we do exactly that:  that we return to the American people the privilege they've always had to live their lives in the way they feel most appropriate, where we don't pass on to coming generations massive deficits and debt, where we don't have a setting where jobs are lost.

If we want good jobs and a bright economic future for ourselves and for our kids, we must replace Obamacare. That is my mission, that is our work, and I'm asking the people of America to join me.  If you don't want the course that President
Obama has put us on, if you want, instead, a course that the founders envisioned, then join me in this effort. Help us. Help us defeat Obamacare. Help us defeat the liberal agenda that makes government too big, too intrusive, and that's killing jobs across this great country.

Thank you so much."

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