By Stephanie Wang
In a somewhat-surprising decision Thursday, the Supreme Court upheld nearly the entire Affordable Care Act—a huge blow to conservatives, libertarians and Republicans.
While it was not entirely surprising that the law was upheld, the way it was upheld was. Chief Justice John Roberts ended up being the deciding vote. Prior to Thursday, most thought Justice Anthony Kennedy would be the swing vote.
The Supreme Court also did not uphold the law using the Commerce Clause, which has been the point of focus for the right. The Commerce Clause, itself a point of contention among conservatives, essentially gives Congress the authority to regulate interstate commerce.
In the majority decision, Roberts wrote that the Congress has no authority to order individuals to engage in it. This idea is largely responsible for Fox News and CNN falsely reporting the news that the mandate was ruled unconstitutional.
Instead, Roberts said the Congress does have the power to tax, so the mandate and the penalty (now a tax) you have to pay for not purchasing health care is constitutional.
As Matt Lewis of the Daily Caller wrote, the number of conservatives arguing that this is a good thing is astounding. Some conservatives are praising his ruling, calling it a prime example of how conservatives are supposed to judge—not legislating from the bench, maintaining self-control, not ruling something unconstitutional just because you disagree with it—but they ignore the fact that Roberts absolutely changed the language in the ACA.
From day one, Democrats and proponents of the bill have argued that the mandate is not a tax. Back when he was trying to get the ACA passed, President Barack Obama told ABC’s George Stephanopolous the mandate is not a tax. In prior hearings of the health care law, judges who ruled on the law agreed it was not a tax. So conservatives dropped the idea too.
By deeming the mandate a tax (even the ACA bill doesn’t call it that), Roberts is absolutely legislating from the bench. He’s helping Congress out by twisting their unconstitutional bill into a constitutional one.
This newly named tax also means Obama has broken a campaign promise. In 2008, Obama promised no new taxes on individuals and families making less than $250,000 a year. The one good thing the ruling gave conservatives is another talking point. Now that the mandate is a tax, conservatives can point to Obama’s broken promise.
Seventy-five percent of the mandate penalty falls on Americans making less than $120,000 a year—making this the largest tax increase on the middle class in history.
Health care costs have been consistently rising. And the ACA isn’t going to make health care cheaper for most Americans, the Huffington Post reported. In fact, costs will continue rising just as they have been for years. A Bradley Woods analysis predicts premiums will rise 7.5 percent annually under the law.
As if rising costs weren’t enough to look forward, the ACA essentially screws young people over. Forbes writer Avik Roy explained:
Obamacare forces insurers to charge their eldest beneficiaries no more than 3 times what they charge their youngest ones: a policy known as “community rating.” This, despite the fact that these older beneficiaries typically have six times the health expenditures that younger people face. The net effect of this “community rating” provision is the redistribution of insurance costs from the old to the young.
All of this makes sense when you consider the price tag–$1.76 trillion by 2022 and compare it to the nation’s deficit which has surpassed $15 trillion.
And that’s if everything goes as planned (because that always happens).
Ezra Klein over at the Washington Post lays out some of the problems with the mandate. The $695 a year or 2.5 percent of your annual income is probably less than a decent insurance policy. And because a health insurer can’t charge you more for pre-existing conditions, it’s probably best to pay the penalty and wait until you actually need insurance. “In a way, paying the mandate is like buying an option to purchase insurance at some future date, when you need it more, for a price that you could never have gotten before the mandate,” wrote Klein.
To add insult to conservatives’ injury, the likely Republican presidential nominee, Mitt Romney, is probably the worst possible candidate conservatives could have chosen to argue against the ACA.
In summarizing the decision, New York University law professor Barry Friedman told the Washington Post, “They can’t make you eat broccoli, but they can tax you for not eating it.”