Health Reform Prevails in Supreme Court

Health | 7/2/2012, 11:53 a.m.

Just One Step for People of Color and Poor

The Affordable Care Act or "Obamacare" (as described by critics) was designed by Congress to expand health insurance coverage to more than 30 million people in the United States and decrease health care costs. To achieve these goals, Congress included a provision in the law requiring taxpayers to obtain a "minimum" level of health insurance coverage. Those who failed to secure health coverage and were not exempt were mandated, by 2014, to begin paying a penalty to the IRS, similar to tax penalties.

In 2010, right after Obama signed the reforms into law, they were challenged by critics, including the National Federation of Independent Businesses. Earlier this year, the challenges made their way to the Supreme Court, which set aside an unprecedented three days of oral arguments to review the health law.

By a 5-4 decision, the Court made several findings in the case. First, the Court upheld its prerogative to review the individual mandate, bypassing a reconstruction-era requirement, the Anti-Injunction Act, which prevents a tax related issue from being reviewed by the Court until the tax is accessed. Next, Chief Justice John Roberts, joined by the Court's four traditionally conservative members (Justices Kennedy, Scalia, Thomas, and Alito), ruled that the individual mandate could not be sustained under the Constitution's Commerce Clause. Initially, this ruling caused some media outlets to incorrectly report that the entire law was struck down.

However, the chief justice and the liberal wing of the Court (Justices Ginsburg, Breyer, Sotomayor, and Kagan) sided in ruling that the individual mandate could be upheld, nonetheless under the long established Constitutional power of Congress to "lay and collect taxes."

Finally, the Court ruled that the Affordable Care Act could not penalize states who refused to expand Medicaid by cutting off all federal Medicaid funding. This, the Court's majority ruled, was an impermissible "threat" against the rights of states.

Brown vs Sebelius

In comparing the Brown and Sebelius cases, Hilary Shelton, director of advocacy for the District offices of the NAACP, sees distinctions and similarities. Shelton notes that "Brown concerned a fight over equal education, and whether segregated schools were legal so long as they were equal." Brown was argued by the late Chief Justice Thurgood Marshall, then the NAACP Legal Defense and Education president, who would go on to become the first African-American solicitor general and Supreme Court justice.

Shelton observed that "The thing Americans needed to be successful in the 1950s was good education...today...it's good health care." Further, Shelton pointed out that while Brown sought to protect mostly African Americans, the current ruling seeks to ensure working class and poor people of all races have the right to equal health care.

Impact on Doctors and Patients of Color

Congresswoman Donna Christian-Christensen of the U.S. Virgin Islands, a physician and chair of the Congressional Black Caucus's health reform task force, said the ruling "means a lot for people of color." Specifically, the Court's decision protects numerous programs and initiatives, such as placing minority health officers in each major health agency to ensure that the needs of people of color are being met, noted Christensen.