For 30 million Americans, the cheers of the Democrat Party over today’s SCOTUS ruling are falling on deaf ears. The biggest loser in America today are the 30 million Americans who may not be eligible for new coverage under the ACA.
While the majority of President Obama’s supporters are rallying around today’s ruling, the Court struck down the ability of Obamacare to coerce state participation in the ACA’s expansion of Medicaid, a provision which was intended to cover up to 30 million currently uninsured Americans.
Chief Justice John Roberts held that the law was a valid exercise of Congress’s power to tax.
"The Affordable Care Act is constitutional in part and unconstitutional in part,” Roberts wrote.
• “The individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause. That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it.”
• But “it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but (who) choose to go without health insurance. Such legislation is within Congress’s power to tax.”
He said “The question is not whether that is the most natural interpretation of the mandate, but only whether it is a ‘fairly possible’ one.”
Judge Kennedy, writing the descenting opinion, found the ACA wholly unconstitutional.
What cannot be overlooked is the major victory by the states who challenged the ACA.
The court said that the Obama administration cannot coerce states to go along with the Medicaid insurance program for low-income people.
The financial pressure which the federal government puts on the states in the expansion of Medicaid “is a gun to the head,” Roberts wrote.
“A State that opts out of the Affordable Care Act’s expansion in health care coverage thus stands to lose not merely ‘a relatively small percentage’ of its existing Medicaid funding, but all of it,” Roberts said.
Congress cannot “penalize states that choose not to participate in that new program by taking away their existing Medicaid funding,” Roberts said.
The Medicaid provision had been projected to add nearly 30 million more people to the insurance program for low-income Americans, but the court’s decision left states free to opt out of the expansion if they choose.
How many, if any, states will volunteer to expand Medicaid coverage remains to be determined as the ACA’s cost to provide this additional coverage represents a major long-term liability to state budgets already facing shortfalls.
What SCOTUS has effectively ruled is, the 2,700 page ACA whose annual price tag is estimated at full implementation of just under $200 Billion annually just lost 30 Million American’s it believed it had legislated guaranteed coverage for.