The Supreme Court Has a Heart: Individual Mandate is Constitutional

by Dr Sam Girgis on June 28, 2012

The Supreme Court ruled on the legality of the Affordable Care Act (ACA), and stated that President Obama’s overhaul of healthcare is constitutional.  In fact, the ruling left the ACA almost completely unscathed with chief justice John Roberts being the swing vote.  Of particular note, the Supreme Court ruled that the so-called “individual mandate” of the ACA is constitutional.  The individual mandate requires that all Americans obtain healthcare insurance or face a penalty.  The Supreme Court’s finding that the individual mandate was constitutional came about from the rational that the penalty for not having health insurance could be considered a tax.

There have been many challenges to the legality and constitutionality of the law.  We have previously discussed the legal battle to overturn the ACA in the court of appeals of several states.  Today should settle the controversy and help the country move forward in an attempt to improve the healthcare that it provides to its citizens.  But what about the rest of the ACA, and how will it effect our healthcare?  The following is a brief synopsis:

1.  The individual mandate requires all Americans to obtain health insurance or pay a “tax”

2.  Young adults can stay on their parents healthcare till they are 26 years old

3.  Prohibit insurance companies from denying children with pre-existing conditions coverage

4.  Prohibit insurance companies from placing lifetime limits on coverage

5.  Increasing the Medicare Part A tax rate by 0.9% for high income individuals or households

6.  Creation of state healthcare exchanges that will provide affordable healthcare options

7.  Employers with 50 workers or more will be required to provide healthcare for their employees

8.  Expansion of Medicaid to cover even more individuals

The Supreme Court did limit a clause of the ACA that would have allowed the federal government to penalize states that don’t completely comply with the massive Medicaid expansion.

The ACA is a very ambitious and noble undertaking.  There are several problems that it has not addressed.  How are we going to pay for all the new medical expenses?  If families can’t afford to obtain health insurance, and they are living from paycheck to paycheck, how does adding to their tax burden help them?  How will small businesses afford to pay for their employee’s health insurance without limiting expansion, retirement contributions, or pay raises?  In addition, the primary care physician shortage was not addressed.  Who will take care of all the Americans that will now have medical insurance if we already are short staffed?  The primary care physician shortage will only become an increasingly bigger problem.  There needs to be incentives for medical students to enter primary care fields if we are going to solve the primary care shortage.  The ACA did not address the growing malpractice problem faced by our country’s physicians.  The government must limit malpractice awards in order to control defensive medical practices, which are done to limit liability instead of for the patient’s best interest.  Despite its shortcomings, I believe the ACA is a step in the right direction for the people of the United States.

After all is said and done… I have to conclude that the Supreme Court does have a heart.  How could the justices allow the healthcare insurance companies to deny medical coverage to young children with preexisting conditions?


See the following video that shows President Obama’s reaction to the healthcare ruling:



Adam Liptak and John H. Cushman Jr. “Supreme Court Lets Health Law Largely Stand, in Victory for ObamaNew York Times June 28, 2012

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