Supreme Court and Obama’s healthcare reform

The Supreme Court in Washington on 18th June 2015, upheld the nationwide tax subsidies underpinning President Barack Obama’s health care overhaul, rejecting a major challenge to the landmark law in a ruling that preserves health insurance for millions of Americans. So the end result of this decision is to provide both the intended beneficiaries, the fruits of this hard fought battle. The justices said in a 6-3 ruling that the subsidies that 8.7 million people currently receive to make insurance affordable do not depend on where they live, as opponents had contended.
The outcome is the second major victory within a week for Obama in the politically charged national atmosphere, in which the Supreme Court (SC) tested his most significant domestic achievement. And this decision came the very same day the court gave him an unexpected victory, by preserving a key tool the administration uses to fight housing bias.

I must say a good word at the outset about the court ruling provided to the world by the Chief Justice. He is same person who was appointed to this highest judicial office in the country by President Bush, just before the Republican went ahead with his second term in office. Chief Justice John Roberts again voted with his liberal colleagues in support of the health care law. His term in office was thus starting from being the junior most of the justices to become the senior most judicial officer in a country wherein the SC is destined to play a pivotal role in the constitutional history. Roberts also was the key vote to uphold it in 2012. Justice Anthony Kennedy, a dissenter in 2012, was part of the majority on Thursday.
“Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Roberts declared in the majority opinion. Limiting the subsidies only to individuals in states with their own exchanges could well push insurance markets in the other states “into a death spiral,” Roberts wrote. Justice Antonin Scalia, in a summarized dissent from the bench, strongly disagreed. “We should start calling this law SCOTUScare,” he said, using an acronym for the Supreme Court and suggesting his colleagues’ ownership by virtue of their twice stepping in, to save the law from what he considered worthy challenges by its opponents. His comment drew a smile from Roberts, his colleague and the object of Justice Scalia’s apparent anger.

Scalia had indeed said that Roberts’ 2012 decision that upheld the law and his opinion on Thursday “will publish forever the discouraging truth that the Supreme Court of the United States favors some laws over others, and is prepared to do whatever it takes to uphold and assist its favorites.”
Justices Samuel Alito and Clarence Thomas joined the dissent, as they did in 2012.

I give here a few statistics: Nationally, 10.2 million people have signed up for health insurance for Obama’s healthcare overhaul. That includes the 8.7 million people who are receiving an average subsidy of $272 a month to help pay their insurance premiums. Of those receiving subsidies, 6.4 million were at risk of losing that aid because they live in states that did not set up their own health insurance exchanges.
The US health insurance industry is visibly the happiest at this decision of the court and a national organization representing state regulators from both political parties, said, the court’s decision will mean stable markets for consumers. However, the Republicans maintained the ruling would not mean the end of the political fight over the law, widely politically dubbed in the media as “Obamacare”. Sen. Lindsey Graham of South Carolina, a Republican presidential contender, said that for 2016 candidates for Congress or the White House health care would be the “most dominant issue in the country.”

Similarly the Senate Majority Leader Mitch McConnell said Democrats who support the law “now have a choice: crow about Obamacare’s latest wobble toward the edge, or work with us to address the ongoing negative impact of a 2,000-page law that continues to make life miserable for too many of the same people it purported to help.”

The challenge devised by die-hard opponents of the law relied on four words — “established by the state” — in the more than 900-page law. In the challengers’ view, the phrase “established by the state” demonstrated that the subsidies were to be available only to people in states that set up their own exchanges.

The federal government congressional Democrats and 22 states responded that it would be senseless to construct the law the way its opponents wanted –the central idea behind this derive was to decrease the number of uninsured. The law prevents insurers from denying coverage because of “pre-existing” health conditions. It requires almost everyone to be insured and provides financial help to consumers who otherwise would spend too much of their paycheck on their premiums.

Several portions of the law indicate that consumers can claim tax credits no matter where they live. No member of Congress said that subsidies would be limited. The 2012 case took place in the midst of Obama’s re-election campaign, when Obama touted the largest expansion of the social safety net since the advent of Medicare nearly a half-century earlier. But at the time, the benefits of the Affordable Care Act were mostly in the future.

In 2015, the landscape has changed, although the partisan and ideological divisions remain for a law that passed Congress in 2010 with no Republican voting in this law. Accordingly it is now hoped that this decision will be genuinely respected and implemented beyond political expediency.

The writer is barrister at law (US and UK), senior advocate of the Supreme Court of Pakistan and professor at Harvard University.

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