The US Supreme Court will rule this week on the Affordable Care Act, the federal health care overhaul. There are four issues opponents think could sink the law.
Under the health care law, the uninsured would be required to buy health coverage with federal subsidies to help them make premium payments. If they don’t buy a policy, they’ll pay a penalty. Number one: the Justices must decide if that penalty is actually a new “tax”.
“The wording in the law itself says it’s a penalty. But the opponents of that say if it looks like a duck, walks like a duck, and quacks like a duck, then it’s a duck. That’s the first issue the court will address,” Dr. Forney Fleming said. He’s a professor of health care management at the University of Texas at Dallas.
Fleming says at issue is a law called the Anti-injunction Act. It says you cannot file a legal challenge to a tax until that tax takes effect. And the Affordable Care Act penalty does not take effect until 2014.
Texas Attorney General Greg Abbott was quick to sue over a second issue: the individual mandate – the requirement that most people without health insurance buy some. Abbott says the mandate is unconstitutional. And, he sees bad consequences down the road if it survives in the Supreme Court’s ruling.
“If this law is upheld, there could be potentially no limits to the power that Congress tries to assume, forcing Americans to go out and purchase all kinds of products,” said Abbott.
Anne Dunkelberg, health care policy expert with the Center for Public Policy Priorities says the mandate has grabbed the majority of attention in this debate, but it’s not well understood.
“I think the important thing to understand which most Texans probably don’t know is that, number one, very few people would actually be affected by the individual mandate,” said Dunkelberg. “It’s not a mandate that you have to go out and get something different from what you have today.”
Three: what happens if the mandate to buy insurance is struck down? Again, UTD’s Forney Fleming:
“Then the court will have to move to if you declare one clause unconstitutional do you declare the entire act unconstitutional”? asked Fleming.
And fourth: is the law’s expansion of Medicaid coercive to the states – forcing them to spend more tax money when most states are struggling to balance their budgets? Attorney General Abbott says the Medicaid expansion would require Texas to spend billions of tax dollars during the first ten years of the program.
Abbott says he hopes the entire law is thrown out. He says that would be good for Texas. Anne Dunkelberg believes the individual mandate may go, but other provisions will stay. And she says that is good for Texas.