Sunday, November 10, 2019

National Federation of Independent Business v Sebelius Essay

Life was different back in the 1880s. The telephone had just been invented, James Garfield was president, and doctors used heroin and cocaine as medicine. Alas, many doctors knew very little about medicine. Oftentimes unsafe and unsterile practices were used on patients. The NY Times reports that, â€Å"At least a dozen medical experts probed the President [Garfield]’s wound, often with unsterilized metal instruments or bare hands, as was common at the time. Historians agree that massive infection, which resulted from unsterile practices, contributed to Garfield’s death. One man suggested that they turn the president upside down and see if the bullet would just fall out. † Because of their usual lack of success, doctors did not charge very much for their services; it was very affordable most of the time, even for middle class families. However, as time and technology progressed, the cost of healthcare and medical instruments dramatically rose. In his â€Å"New Deal† package, President Roosevelt proposed a state-run healthcare system with compulsory health insurance for state residents, but states could choose whether to participate. The federal government would provide some subsidies and set minimum standards that the state had to adhere by. While the proposal did not pass, the idea of universal healthcare coverage for everyone stuck. Since Roosevelt, every single Democratic President elected into office has attempted to pass a version of universal health care, but none have achieved the feat. That is, until President Obama was sworn into office in January 2009. In his 2008 presidential campaign, he made healthcare reform a central issue. Both parties adopted their version of reform, but since Democrats held a majority in the House and the Senate at the time, their version was the one that passed. On March 23rd, 2010, President Obama signed into law the Patient Protection and Affordable Care Act (dubbed by many Republicans as â€Å"ObamaCare†). According to the White House, it claims four key components of the law: stronger consumer rights and protections (which includes a ban on lifetime limits, a ban on denying children health insurance based on pre-existing conditions, and a ban on coverage cancellations), more affordable coverage (Private insurers must provide justification for double-digit increases in premiums), better access to care (Preventative screenings for cancer are now free), and stronger Medicare (Provides relief to seniors who cannot afford prescription drugs). Since insurance companies are required to provide care, it makes sense to buy insurance only when you need it. In other words, wait until you get sick to buy insurance, because they cannot turn you down. In order to combat this, the law includes an individual mandate, which requires anyone that can afford it to buy health insurance, or pay a penalty to the IRS. In essence, this is the part of the law that pays for it all. This is also the section many Republicans hate. In their philosophy, the government cannot force someone to buy something they may or may not need. They argued that this law was unconstitutional, and they sued in federal court to have the law nullified. There were three cases overall: one from the states (Florida v. U. S. Dept. of Health and Human Svcs. ), one from the federal government (U. S. Dept. of Health and Human Svcs. v. Florida), and one from the National Federation of Independent Business (Nat’l Fed. of Independent Bus. v. Sebelius). Due to conflicting rulings from the lower courts in different jurisdictions, the Supreme Court decided to hear the case to settle the differences. From March 26th to March 28th, 2012, the Supreme Court heard oral arguments from both sides. On the first day, the court heard argument over whether the Tax Anti-Injunction Act passed into law in 1867 barred the Supreme Court from even making a decision in this case. The Tax Anti-Injunction Act says, â€Å"No suit for the purpose of restraining the assessment or collection of any tax shall be maintained in any court by any person, whether or not such person is the person against whom such tax was assessed. † Basically, it means that you cannot sue the government for a tax you believe is unfair, until you have already paid that tax. This was passed into law to prevent people from filing lawsuits against the government to avoid paying taxes. Potentially, this could mean that no one can challenge the constitutionality of the ACA (Affordable Care Act) until someone has actually paid the penalty. At the earliest, they could sue on April 15th, 2015. The Supreme Court held that since Congress specifically labeled the consequences of the mandate as a penalty rather than a tax, the Anti-Injunction Act did not apply to this case, and that the court had the authority to hear the arguments. On the second day, the court heard arguments over whether the ndividual mandate component of the ACA fell under the constitutional powers of Congress. There were two arguments from the Solicitor General’s side (the ones supporting the constitutionality of the ACA): the ACA was constitutional under the commerce clause, and that the ACA was constitutional under the taxing power of Congress. The states (the ones claiming the ACA is unconstitutional) argued that Congress could not create commerce for it to regulate, and that the law described the consequences of the mandate a â€Å"penalty†, therefore it is not a tax. On the third day, the court heard arguments on the severability of the law. They questioned whether the ACA could survive if the court struck down the individual mandate. In the end, in a 5-4 decision, the court upheld the individual mandate component of the ACA as a valid exercise of the taxing power of Congress. They concluded that a financial penalty for not buying something constituted a non-direct tax. Because it is a non-direct tax, it is not required to be apportioned among the several states. The justices that voted for the constitutionality of the law are the four liberal justices Sonia Sotomayor, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan, and the conservative Chief Justice John Roberts. The justices that voted against the constitutionality of the law are the other four conservative justices: Anthony Kennedy, Samuel Alito, Antonin Scalia, and Clarence Thomas. John Roberts was the key swing vote. When asked why he voted for a law he is personally against, Chief Justice John Roberts responded, â€Å"The Framers created a Federal Government of limited powers, and assigned to this Court the duty of enforcing those limits. The Court does so today. But the Court does not express an opinion on the wisdom of the Affordable Care Act. Under the Constitution, that judgment is reserved to the people. In my opinion, I applaud the decision of the Court. From the beginning, I thought the penalty was a tax; I assumed it was called a penalty for political purposes. People would not like the idea of a tax increase. In reality, the penalty is collected in the same manner as a tax, so there are no real differences between the two. I have also gained a newfound respect for Chief Justice John Roberts. I think it is commendable to put the law in front of your personal beliefs. He has done exactly what is expected of a Supreme Court justice. If I were a Supreme Court justice, I would have made he same decision that he and the four liberal justices made. There are two types of consequences this law holds: political and provisional. The provisional consequences of the law are the ones directly stated in the law: a ban on lifetime limits, Medicaid expansion, etc. The political consequences of this law are not explicitly stated, however they can be inferred and speculated upon. There are three major political consequences. The first consequence is that Obama can claim a major victory. He can now say his law withstood a Supreme Court challenge and passed the constitutionality test. A defeat would have been bad for the administration and the campaign. Instead, he has a chance to re-energize his base and reinstate the flow of campaign cash. The second consequence is that now that the law is no longer a legal issue, it becomes a campaign issue. Both Obama and Romney must sell voters on Obamacare. The court ruling could have stir a shift in public opinion among independent voters, and both candidates must appeal to this shift. Obama will insist this law was the right thing to do, while Romney will propose a new healthcare reform bill. The third consequence is that the ruling will enrage Republicans and make them more eager to vote for Romney so he can repeal the law. Voter turnout is expected to be lower than it was in 2008, and anything that can increase the turnout will be beneficial for Romney. This law and its subsequent legal challenge have major political consequences. Whether you live in the 1880s or in the present day, chances are you will need health care at some point in your life. Ever since President Roosevelt proposed universal health care back in the 1930s, many politicians have tried to pass it into law. Until the ACA, it was considered politically impossible; the idea just did not appeal to voters. The law has withstood a major legal challenge, and it will be up to Obama and Romney to convince independent voters that their version of healthcare reform is the best. If Obama wins the election, in 2014 everyone that can afford it must buy health insurance, whether they want to or not. If they don’t, they will pay a tax equivalent to 1% of their income. If Romney wins the election, he will try to repeal the ACA and replace it with a reform package of his own. Only time will tell what will happen.

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