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Explaining the Obamacare Decision

Thursday, June 28th, 2012

After weeks of anticipation that the Supreme Court would find “Obamacare” unconstitutional, the opposite has just happened. The entire law has been upheld by the Court, except for a few tweaks.

Whether you are young and healthy or challenged by catastrophic illness such as mesothelioma, this ruling will impact you, sooner or later. And while it leaves the Affordable Care Act (ACA), known as “Obamacare,” standing, it did so in a way that is likely to keep the law controversial.

The chief part of the ACA that had been challenged was the individual mandate. This means that, beginning in 2014, most Americans will be mandated to obtain health insurance. Those who don’t comply with the law will have to pay a fine.

If you are getting your health insurance through your job, or if you are on Medicare or Medicaid, you don’t need to do anything else to comply with the law. If you don’t get health care benefits, you will have to get insurance on your own. However, the ACA sets up all kinds of ways that make it easier for people without benefits to find affordable policies. It also expands the Medicaid program so that more low-income people will be eligible.

The mandate is important mostly because another part of the ACA declares that, after 2014, insurance companies will no longer be able to deny coverage to anyone because of pre-existing conditions. The mandate will prevent people from waiting until they get sick to buy insurance. If everyone did that, it could devastate the health insurance industry.

Challenges to the law said that the federal government doesn’t have the constitutional authority to make people buy something. The Obama Administration defended the law by saying the mandate, and its penalty, come under Congress’s power to regulate interstate commerce. This was so because when people choose not to buy health insurance it affects the cost of health care and premiums for everyone. That in turn has a big impact on the nation’s economy, which means it affects interstate commerce.

In today’s ruling, four justices agreed that the mandate was constitutional under the commerce clause. Four others disagreed, saying the mandate is unconstitutional and the commerce clause doesn’t apply.

Chief Justice John Roberts cast the deciding vote, and split the difference. He said that the commerce clause does not apply to the mandate. However, he said the penalty amounts to a tax, and so the mandate is constitutional because it falls under the power of Congress to levy taxes.

Already Republicans are seizing on the “tax” decision to say that the mandate is a huge tax increase. However, it is a tax most Americans won’t have to pay, because most Americans have insurance. Indeed, the way the law currently is written, the government has given itself little power to collect the penalty.

Beginning in 2016, individuals without insurance will be fined $695, or 2.5 percent of income, whichever is greater.  However, the law provides for no criminal sanctions if you don’t pay the penalty. You can’t be charged with a crime, and there will be no liens or levies on your property. Obviously, that could change, but that’s how the law stands now.