By Richard Asinof
(Updated, 11:04 a.m.)
WASHINGTON ‚Äď The U.S. Supreme Court issued its much-anticipated ruling this morning on the Patient Protection and Affordable Care Act, upholding the law, saying in a 5-4 decision that the law, with its mandate requiring health insurance coverage, was constitutional under the Congress‚Äôs taxing authority, not the Interstate Commerce clause.
The majority opinion, written by Chief Justice John G. Roberts, found that Congress had the constitutional authority because failure to comply with the individual mandate would be a tax penalty. As a result, people don‚Äôt have to get health insurance, but they will be required to pay a tax.
At the same time, the Supreme Court ruled that while the Medicaid expansion to broaden coverage was constitutional, it held that the ‚Äúall or nothing rule,‚ÄĚ which required states to participate in the expansion of coverage or lose their Medicaid funds, was not constitutional. The court ruled that states have the ability to opt out of the expanded coverage, which puts pressure on Congress to provide additional funds for the expansion.
The ruling upholds all the other reforms under the law.
‚ÄúBy upholding the law, the court validated the principle that all Americans should have access to health care,‚ÄĚ said Sen. Sheldon Whitehouse. ‚ÄúSeniors will continue receiving discounts on prescription drugs, children can continue to stay on their parents‚Äô health insurance policy after college, and individuals suffering from chronic illness won‚Äôt need to worry about running into lifetime caps.‚ÄĚ
‚ÄúToday the United States Supreme Court affirmed the legality of the Patient Protection and Affordable Care Act,‚ÄĚ said Edward Quinlan, president of the Hospital Association of Rhode Island. ‚ÄúThis is an important decision for our state‚Äôs hospitals and patients. More than 120,000 Rhode Islanders currently lack health insurance. Each day, nearly 150 patients seek care in our hospitals without the ability to pay. The cost of uncompensated care exceeded $160 million last year and has become a monumental fiscal burden for our struggling hospitals. The Affordable Care Act will help to alleviate these challenges and ensure that every Rhode Islander has access to quality health care.‚ÄĚ
R.I. Health Insurance Commissioner Christopher F. Koller, who was outside the Supreme Court in Washington, D.C., when the decision was announced today, described the scene as ‚Äúhistoric.‚ÄĚ As a result of the decision upholding the health care reform law, Koller said the ‚Äúcommercial health insurance market will function much better with an individual mandate, with healthy people as well as sick people in the market.‚ÄĚ Koller anticipated that there would be continuing discussions regarding what is the appropriate tax penalty for people who don‚Äôt buy health insurance.