At issue was National Federation
of Independent Business, et al, Petitioners v. Kathleen Sebelius, Secretary
of Health and Human Services, et al (NFIB v. Sebelius).
Voting 5 - 4 on Thursday, the Supreme Court upheld what should have
been rejected. Pro-business High Court rulings aren't new.
Since the 19th century, what business wants matters most. Santa Clara
County v. Southern Pacific Railway stands out. It granted corporations
Ever since, they've had people rights without responsibilities. Their
limited liability status exempts them. As a result, they've profited
hugely and continue winning favorable high and lower court rulings.
Another big one came on June 28. Health giants won. People lost. At
issue was challenging Obama's Patient Protection Affordable Care Act
(PPACA) - aka Obamacare.
From March 26 - 28, oral arguments on its constitutionality were heard.
Contentious issues include:
mandating all adults have health insurance or be taxed to compensate;
PPACA's Medicaid expansion provisions;
whether the Anti-Injunction Act bars courts from reviewing the individual
mandate until it's effective in January 2014; and
"severability:" namely, whether one issue can be struck down while leaving
Many PPACA provisions took effect. Key ones, including the individual
mandate, begin January 2014.
Twenty-six states sued to overturn Obamacare. The Supreme Court heard
the Florida case. It included the others as plaintiffs.
A record pro and con 136 amicus briefs ("friends of the court") were
filed for Court consideration.
In 2010, Ralph Nader called Obamacare a boon to predatory giants. They
profit hugely. Ordinary people lose. Nader called PPACA "a pay-or-die
system that's the disgrace of the Western world."
Former CIGNA vice president Wendell Potter said Obamacare shifts costs
to consumers, offers inadequate or unaffordable access, forces Americans
to pay higher deductibles for less coverage, and ends up scamming them.
Physicians for a National Health Program (PNHP) headlined their press
release " 'Health law upheld, but health needs still unmet:' national
doctors group," saying:
Modest PPACA benefits don't remedy "our health care crisis."
Unresolved issues include:
excluding a public option and universal coverage;
millions left uninsured;
many more underinsured;
unaffordability for most people "because of high co-pays and gaps in
coverage that leave patients vulnerable to financial ruin in the event
of serious illness;" and
rising predatory costs.
At issue is empowering private insurers. They "siphon off hundreds of
billions of health care dollars for overhead, profit and the paperwork
(they) demands from doctors and hospitals."
Bottom line priorities deny care by making it unaffordable for millions.
They and other industry giants obstruct reform.
In contrast, universal coverage assures comprehensive affordable care.
Predatory middlemen are excluded. Doing so saves $400 billion annually.
Using it for care instead of profits covers everyone.
Comparable state plans failed. Residents were betrayed. So-called reforms
"founder(ed) on the shoals of skyrocketing costs, even as the private
insurers have continued to amass vast fortunes."
Medicare for all offers real reform. Everyone in. No one out. Healthcare
is a universal right. Commodifying it has no place in free societies.
It's always been that way in America.
Reform efforts never worked. Lobby power blocked them. In 1917, 15 states
introduced a standard health insurance bill. Eight others established
commissions to study the issue. Proposals were weak and confusing. They
were dead on arrival.
In the 1930 and 1940s, government-sponsored health insurance resurfaced.
The issue remained contentious. Industry giants again blocked change.
Post-war, employer-provided coverage increased. Retirees, the disabled,
unemployed, and others were uninsured. After years of debate, Medicare
and Medicare included them.
Nonetheless, efforts to cover everyone affordably failed. PPACA is the
latest example. It's a rationing scheme to enrich insurers, drug companies
and large hospital chains.
PNHP speaks for millions saying:
"What is truly unrealistic is believing that we can provide universal
and affordable health care in a system dominated by private insurers
and Big Pharma."
"The American people desperately need a universal health system that
delivers comprehensive, equitable, compassionate and high-quality care,
with free choice of provider and no financial barriers to access."
Convoluted arguments upheld PPACA's controversial individual mandate
provision. It requires purchasing coverage from private insurers.
Ruling with the majority, Chief Justice John Roberts said:
"The Affordable Care Act’s requirement that certain individuals pay
a financial penalty for not obtaining health insurance may reasonably
be characterized as a tax."
"The federal government does have the power to impose a tax on those
without health insurance."
"Because the Constitution permits such a tax, it is not our role to
forbid it, or to pass upon its wisdom or fairness."
He added that he and other majority justices abstained on judging whether
passing PPACA was right or wrong.
"Those decisions are entrusted to our nation’s elected leaders, who
can be thrown out of office if the people disagree with them," he said.
"It is not our job to protect the people from the consequences of their
Anthony Kennedy disagreed. He called the law an affront to individual
liberty and should have been entirely rejected.
"The values that should have determined our course today are caution,
minimalism and the understanding that the federal government is one
of limited powers," he said. "The court’s ruling undermines those values
at every turn."
"The act requires the purchase of health insurance and punishes violation
of that mandate with a penalty," he added.
"But what Congress called a ‘penalty,’ the court calls a tax. What Congress
called a ‘requirement,’ the court calls an option....In short, the court
imposes a tax when Congress deliberately rejected a tax."
At the same time, majority justices rejected the administration's main
argument about congressional authorization to regulate interstate commerce.
The Commerce Clause doesn't give legislators the right to require people
buy health insurance, they said.
It's "not a general license to regulate an individual from cradle to
grave, simply because he will predictably engage in particular transactions,"
In a separate opinion, Justice Ruth Bader Ginsburg called arguments
against the Commerce Clause "stunningly retrogressive."
It represents pre-New Deal rulings "in which the Court routinely thwarted
Congress' efforts to regulate the national economy in the interest of
those who labor to sustain it."
In other words, the Court restricted congressional authority to pass
social welfare laws. Doing so makes planned cuts easier.
The ruling also limited Medicaid's expansion. Seven justices said Congress
exceeded its constitutional authority to coerce states to participate
by threatening to cut off federal funds. They can opt out of Medicaid's
expansion if they wish.
Doing so undermines efforts to cover individuals under age 65 with incomes
of 133% above poverty or less. Around 11 million Medicaid recipients
are affected. They already receive minimal care.
Experts say America's poorest are left in "no-man's land." They'll be
uncovered by federal benefits and ineligible for subsidized insurance.
PPACA provides 100% of funds to expand Medicaid until 2016. Thereafter,
it's 90%. Until now, federal funding required state participation. No
longer. Millions will be harmed. Many will be left out entirely.
Medicaid expansion provided coverage for around 17 million Americans
by 2019. States now can opt out at their discretion.
Matt Solo, executive director of the National Association of Medicaid
Directors said states have a major decision to make.
"There is a real debate here where states are going to have to weigh
leaving huge amounts of federal dollars on the table versus accepting
potential exposure in the future. Before, you just had to just hold
your nose and do it," he said.
He's not sure what states will do. He called the Court decision "a total
surprise." It will greatly impact PPACA's future, he believes.
According to Professor Sara Rosenbaum:
"The practical effect....will make the Medicaid expansions go more slowly."
Future court decisions may have to distinguish between new programs
or additions to existing ones. Budget strapped states seek new ways
to cut costs. This ruling adds leverage. It lets them do it on the backs
of residents most needing help.
Professor Adam Winkler said:
"It will be interesting to see what happens in the 26 states that challenged
Obamacare. Will they go through with their threats of not expanding
their own Medicaid coverage? Or will the promise of federal money persuade
them to expand coverage?"
Opting in assures full federal coverage for three years. At the same
time, Congress plans major Medicare, Medicaid, Social Security, disability,
education, and other social benefits cuts post-election.
Both parties agree. It's part of an earlier struck "grand bargain" no
matter which party controls the White House and/or Congress.
Regardless of how the High Court ruled, expect bipartisan congressional
support to inflict the most harm. Social America is fast eroding. Party
leaders plan ending it entirely.
Stephen Lendman lives in Chicago and can be reached at email@example.com.
His new book is titled "How Wall Street Fleeces America: Privatized
Banking, Government Collusion and Class War"
Visit his blog site at sjlendman.blogspot.com and listen to cutting-edge
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