President Barack Obama hailed Thursday’s 5-4 Supreme Court decision upholding the sweeping 2010 health care reform law as “a victory for people all over this country.”
But plenty of people rightly disagree with that assessment.
And the outcome of what was widely billed as the most important Supreme Court case since Bush v. Gore has not ended the crucial debate over the future of health care in America.
Nor has the health reform bill ended the long-term balance-sheet crisis facing our nation’s medical system.
The high court, with Chief Justice John Roberts surprising many legal experts by being part of the slimmest possible majority, did rule against the lawsuit by 26 states (including South Carolina) challenging the health reform law.
How did those five jurists find the law’s controversial “individual mandate,” which requires all Americans to have health insurance, constitutional?
Chief Justice Roberts, in the majority opinion, wrote that the mandate’s penalty for not buying insurance “functions like a tax,” and thus falls under Congress’ taxing authority. Yet the law’s authors and congressional supporters had consistently stressed that the mandate was not a “tax.”
The majority’s semantics sleight of hand failed to persuade Justice Anthony Kennedy, who has often cast decisive “swing” votes to break ties between four generally conservative colleagues (including Chief Justice Roberts) and four generally liberal ones.
Justice Kennedy, reading from the dissenting opinion, charged, “The majority rewrites the statute Congress wrote,” adding, “What Congress called a penalty, the court calls a tax.”
At least the court limited the law’s expansion of the states’ Medicaid obligations.
Regardless of the predictable furor over the court’s logic-twisting decision, including considerable conservative disappointment with Chief Justice Roberts’ defection to the other side, the legal test of the mandate and the law is done — for now.
The bottom-line difficulties confronting U.S. health care, however, are not.
For instance, that bewildering, 2,700-page law with the Orwellian title of the Patient Protection Affordable Care Act is plainly unaffordable. Even with the individual mandate rescued by the court’s excessive linguistic license, realistic projections of the law’s costs have consistently shown it to be financially unsustainable.
Polls also have consistently shown weak public support for the law.
So, in resounding fashion, did the 2010 congressional elections. The U.S. electorate’s verdict was loud and clear as Republicans, running hard against “Obamacare,” gained 63 House and six Senate seats.
And while Thursday’s court ruling was a major triumph for President Obama and his remaining Democratic allies, it instantly energized greater conservative zeal for the general election. The voters will render a fresh judgment in November.
Beyond legal arguments and ballot-box ramifications, though, lies the persisting puzzle of how to responsibly meet U.S. health care needs.
Ideally, the hard decisions required should come from bipartisan negotiations and consensus agreements.
Ponder the lopsided winning margins for such landmark 20th century legislation as the 1935 Social Security Act (77-6 Senate, 372-33 House), 1964 Civil Rights Act (73-27 Senate, 289-126 House), 1965 Voting Rights Act (79-18 Senate, 328-74 House), and 1965 Medicare Act (70-24 Senate, 307-116 House).
The health reform law falls far short of that unifying standard — contrary to the president’s absurd April assertion that it passed with a “strong majority” in Congress.
Actually, it passed the Senate on Christmas Eve 2009 with the bare 60 votes needed to thwart a filibuster threat. Three months later, the House approved it by a mere 219-212 count, with 34 Democrats voting against it.
Clearly, the Supreme Court isn’t the only institution of American government that has become sharply divided.
As for the hard case of how to fix what’s still wrong with American health care, it now returns to the political realm.
It’s up to our elected officials — and the people who vote them into their jobs — to bridge our vast ideological gaps and solve our shared problems.
That includes finding fair — and truly affordable — health care solutions.
And despite the Supreme Court’s decision, that’s a prescription Obamacare can’t fill.
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