Supreme Court Upholds Affordable Care Act

"The Supreme Court did the right thing by upholding the Affordable Care Act. APHA is overjoyed by today's ruling," APHA Executive Director Dr. Georges C. Benjamin said.

The Obama administration won a narrow but important victory as the U.S. Supreme Court on June 28 upheld the Affordable Care Act as constitutional in a 5-4 decision. Chief Justice John Roberts sided with the majority in holding that the health care reform law's key provision, the individual mandate requiring most U.S. citizens to have health insurance or pay a penalty for not having it, is a tax that is within Congress' power.

This finding is crucial because on page 44 of the majority opinion in National Federation of Independent Business, et al. v. Sibelius, No. 11-393, in which the law was upheld, Roberts writes that the federal government does not have the power to order people to buy health insurance, but it does have the power to impose a tax on those who do not have it.

The majority opinion did hold one part of the law, the Medicaid expansion, is unconstitutional insofar as financially penalizing states that choose not to expand their programs.

Justices Scalia, Kennedy, Thomas, and Alito dissented, saying the law exceeded Congress' powers.

"The Supreme Court did the right thing by upholding the Affordable Care Act. APHA is overjoyed by today's ruling," American Public Health Association Executive Director Georges C. Benjamin, M.D., FACP, said in a statement following the announcement. "Today's historic ruling by the nation’s highest court marks a significant milestone in our national efforts to improve the delivery and financing of health services in the U.S. and to promote health and wellness rather than disease treatment," he said. "The Supreme Court's decision allows for long-overdue changes made possible by the law to move forward without question or further delay. The law will bring relief to millions of Americans in addition to those who are already receiving life-saving benefits, including:

  • 31 million Americans are projected to gain health coverage by 2019 due to critical upcoming reforms, including the exchanges, exchange subsidies, minimum coverage provision, and Medicaid expansion;
  • 54 million U.S. families have additional benefits, including greater access to preventive health care services recommended by the U.S. Preventive Services Task Force, such as vaccines and preventive care and screenings for women;
  • 2.5 million young adults up to age 26 are able to stay on their parents' health insurance plans;
  • nearly 18 million children with pre-existing conditions are protected from insurance coverage denials;
  • 3.6 million seniors received 50 percent discounts on their drugs in 2011 as an initial step in closing the "donut hole"; and
  • nearly 33 million seniors accessed preventive services now available without cost-sharing through Medicare.

"In upholding these essential reforms, today's decision marks tremendous progress towards reshaping our health system into one that saves the lives of at least 44,000 people who die annually simply because they do not have health insurance that could keep them healthy," he concluded.

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