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The Affordable Care Act Survives

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Message Cris Brines
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The news cycle on June 28 2012 was a frantic hive of activity. It didn't matter if you watched television, listened to the radio, or checked aggregators online; journalists and pundits from worldwide sources scrambled to produce content at a rate that seemed almost cartoonish. Serious newspapers and fun viral websites all got in on the action -- but what caused such a fervor? In short, the Supreme Court of the United States finally announced their ruling on the constitutionality of the Patient Protection and Affordable Care Act (PPACA).

The United States has long lagged behind other developed nations when it comes to health care. It is one of the only developed countries without a form of universal coverage; more than 30 million citizens do not have insurance, and the government spends up to twice its GDP on health costs compared to Canada. The PPACA , signed into law in March 2010, sought to reform health care policy on virtually every level; insurance companies could no longer deny coverage for people with pre-existing conditions, and plans would be more affordable for everyone. The PPACA included a provision called the individual mandate, which required that all Americans buy insurance if they could afford it, or else pay a yearly penalty fee.

This Will Not Stand

This mandate was one of the most controversial aspects about the PPACA, splitting the country along political party lines. Twelve states filed lawsuits within hours of the PPACA being signed, protesting that the government was seriously overstepping its regulatory bounds by forcing American citizens to engage in commerce. Eventually, twenty-six states got involved in the challenge, along with the National Federation of Independent Businesses. After conflicting decisions from multiple federal judges, it became clear that the constitutionality of the mandate was only one part of the problem. Another question was whether the PPACA could survive without the mandate; it provided a majority of the funding for the rest of the bill's helpful provisions. The decision eventually came to the bench of the Supreme Court.

Proponents of the PPACA insisted that the individual mandate was a necessary first step towards a form of universal health care. It would actually bring health care premiums down when it worked with the new insurer regulations. Most citizens could agree that the current health care system was patently unfair; the mandate was the way to fund real change and make sure that the uninsured had coverage. But opponents were just as convincing; they saw the mandate as a violation of individual rights. It was a first step towards complete government control, and unfairly crippled the insurance industry. They argued that the mandate was a violation of the Commerce Clause, which gives Congress the power to " regulate commerce...among the several states" but cannot actively require Americans to buy anything.

The Supreme Court heard arguments for three days in March 2012, and debated several questions. First: did Congress have the right to enact the individual mandate under the Commerce Clause? Second: did the individual mandate exceed Congressional powers, and if so, could the mandate be severed from the PPACA without the entire bill collapsing? Third: did Congress have the right to force states to accept new Medicaid provisions, under threat of losing all funding?

After months of debate, the Court ruled on June 28 2012: the individual mandate was constitutional, if it was considered a tax. Rather than collecting federal taxes for health care revenue (which is how a single-payer health system works), the mandate directly funded the insurance companies that were already in place. Chief Justice John Roberts, a conservative, ended up breaking the tie; he ruled in favor of the mandate, shocking his Republican supporters. Crowds outside of the D.C. courthouse erupted in celebration; news channels scrambled to get their stories straight. Republicans vowed to get the bill overturned, and Democrats cheered their successful health care reform. Both parties prepped to discuss the PPACA at length on the election campaign trail.

No matter your stance, it's clear that health care in the U.S is going to change. By 2014, the mandate will be fully in place, and millions of Americans will have access to affordable health insurance -- some for the very first time in their lives.

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As an experienced finance professional at a premier investment bank I was able to successfully transfer my skills into leading a national online insurance brokerage and provide advice to thousands of Medicare recipients regarding their health (more...)
 
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