Supreme Court Takes Up 'Obamacare'

Talib I. Karim | 3/30/2012, 2:29 p.m.

The final day of arguments focused on two questions, the first: whether the health reform law can stand even if the Court declares the individual mandate unconstitutional; the second whether the Affordable Care Act's expansion of Medicaid to cover everyone under 133 percent of the federal poverty line [individuals with yearly earnings of about $14,000] by 2014 is too onerous. The federal government argues that Medicaid is a voluntary grant program, thus states can opt-out if they object to the expanded coverage.

People of Color, Poor Caught in the Middle

While health reform was being debated by lawyers before the Supreme Court, the nation's top African-American physicians - members of the National Medical Association (NMA) - along with state legislators from across the country lobbied federal officials to ensure people of color are able to get their fair share of benefits.

NMA President, Dr. Cedric Bright, said people of color may likely feel the brunt of any decision. On the one hand, if the law stays intact, out of those unable or unwilling to get health insurance as mandated, Bright acknowledges that African Americans in particular may be those disproportionately required to pay the-lack-of-insurance fine [at least $695 per year by 2016]. Bright argues, that even this modest sum is a lot for "... folk with only a few dollars a month left over in their pockets." Bright said, "I believe an ounce of prevention is much better than a pound of cure." He also said that the mandate is a small cost for benefits provided by health reform: billions to build community health centers, funding to address ethnic health disparities, and increased minority participation in clinical trials.

Another historic dimension of this case is the record number of legal filings [at least 170, including more than 120 "friend-of-the-court" or amicus briefs]. These briefs, or written legal arguments, are known to have great weight on the Court's decisions, so much so that often justices quote directly from these submissions in writing their own decisions.

One such brief was filed by a coalition led by the NAACP Legal Defense Fund under the lead signature of John Payton who served as the organization's president until his death on March 22, days before the Supreme Court hearing. In their brief, the legendary civil rights attorney and his colleagues write, "[U]ninsured persons experience significant hardship that has a profound cumulative impact on our nation ...These burdens are disproportionately borne by racial and ethnic minorities, lower-income persons ... For many individuals, being uninsured is not a choice, but rather is a consequence that is imposed on them due to circumstances largely beyond their control."

For the nation, and the tens of millions who benefit from the health reform law, eyes are likely to stay glued on the Supreme Court until its ruling this summer.