The landmark Supreme Court ruling Thursday upholding key tenets of the federal health-care overhaul was a victory for common sense. It offers hope to so many Americans who thought health insurance was beyond their reach.
Even as both parties jockey for advantage in November, the five justices who upheld the Patient Protection and Affordable Care Act (ACA) pulled the nation back from a disastrous U-turn on reform efforts soon to reach full stride.
At stake was not only the future aim of providing for almost two-thirds of the 50 million uninsured, but also major structural reforms under way in a sprawling sector of the U.S. economy that accounts for $2.7 trillion in spending, or $1 in every $6.
Already, people are benefiting from popular provisions of the 2010 law, which fully kicks in 18 months from now: Retirees, and all women, now have access to preventive care like mammograms and wellness visits. Nearly seven million young adults remain on their parents' health plans. An additional 5.3 million Medicare recipients reaped $3.7 billion in savings on medicine. With old lifetime limits of private insurance gone, you can no longer run out of coverage.
Meanwhile, the business of medicine is being transformed by mergers like the just-announced linkage of the Abington and Holy Redeemer health systems, the digitizing of patient records, and the expansion of best practices that are more affordable and, therefore, accessible.
Now the court has made it possible to look to 2014, when individuals will be able to shop for coverage on new insurance exchanges — their premiums reduced by subsidies based upon income.
It's hard to imagine that Republicans once disparaged "Obamacare" as little more than a mandate to eat your vegetables. Conservative Justice Antonin Scalia was the one who tossed out the GOP talking point, asking when the case was argued whether Congress could also require everyone to eat broccoli because it's healthy.
With Chief Justice John G. Roberts Jr. joining the liberal wing to cast the deciding vote, the court rightly rejected such trivialization. While the justices brushed back a heavy-handed expansion of state Medicaid programs for the poor — in effect, making that optional — they ruled that Congress was well within its rights to impose a tax penalty on those who don't acquire insurance by 2015.
As Roberts wrote of the penalty, "It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without insurance."
Although as unpopular as broccoli, taxes are legal — even if abhorred by the no-new-taxes ideology that drove GOP attorneys general in 26 states to challenge the ACA.