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Can the Supreme Court sabotage Obama's health reform?

by Camilo Smith | September 30, 2011 at 2:35 PM
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The Supreme Court is expected to rule on whether or not a provision in President Barack Obama’s health care reform law is constitutional in their upcoming term which begins next week. The segment of the Patient Protection and Affordable Care Act that’s come under fire by conservatives and challenged by over two dozen states is one that requires all individuals to maintain some level of health insurance, or pay a penalty. The legislation could potentially help the 30 million people who are currently without health coverage in the U.S.

African-Americans are one of the largest populations of uninsured and could be among the most affected if the high court strikes down the provision.

According to a 2010 study that appeared in the journal Demography, blacks spend more of their lives uninsured than whites. For blacks from ages 20 to 24, 43 percent of their time is spent uninsured compared with whites at 36 percent, according to the study titled, Unhealthy and uninsured: Exploring racial differences in health and health insurance coverage using a life table approach. Older African-Americans are affected the most, time spent being uninsured is highest between 55 and 59.

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“If you think of coverage in general, it’s a civil right’s issue. For minorities, the price for that coverage will spiral up,” said Dave Chandra of the Center on Budget and Policy Priorities in Washington, D.C.

Chandra, who supports the Affordable Care Act, says that the individual mandate works in conjunction with other requirements in the law. A recent New York Times article explains “Congress had found the [minimum coverage] requirement essential to the operation of two other provisions — one forbidding insurers to turn away applicants, the other barring them from taking account of pre-existing conditions.”

One of the main things at issue, especially within the insurance industry is whether the government’s commerce clause limits the ability to require the minimum health coverage provision.

“This health care law is an affront on Americans’ individual liberty and we will not allow the federal government to violate our constitutional rights,” Florida Attorney General Pam Bondi told Reuters. Bondi is part of a group whose states are opposing the law.Clarence Thomas’ opposition came to the forefront after it was revealed that his wife belongs to a conservative think-tank that’s challenging the health care law. Legal analysts expect him to recuse himself from making opinions in the matter.

“The have interpreted the commerce clause very, very broadly in the past,” said Timothy S. Jost, a professor at the Washington and Lee University School of Law. “The Supreme Court can sort of do what it likes. They’ve expanded the commerce clause before and then contracted it, and then expanded it again,” he said.

According to Jost, who specializes in health law, “If they hold that the minimum coverage requirement is unconstitutional, I think the effect is that insurance is going to be a lot more expensive for people who are unhealthy and that the costs of insuring people for the federal government will go up,” he said.

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Despite the fact conservatives are against the health law, Jost points out that it’s partially the result of a group effort in Washington. “A lot of [the anti-fraud provisions] were suggested by Republican senators, I think there’s a lot of bipartisan material in the statue.” He definitely believes Justice Clarence Thomas should recuse himself.

“My feeling is that you shouldn’t rule on a case if you’ve already decided it before the case even gets to you,” said Jost. “He’d rule against it even if his wife wasn’t involved in it.”

Jost and many who support the health care law find it a necessity because it provides a promise of health care to millions and millions of Americans who don’t have access. Even if the minimum coverage provision is struck down however, some say, there are still many benefits, according to experts. Changes to how Medicaid pays for services, provisions for public health and prevention, and workforce training for doctors are also included in the statute.

Still, the decision to implement the Affordable Health Care Act may not rest solely with the high court according to Jost.

“The fact of whether or not the statue fully goes into effect or not, probably depends a whole lot more on who wins the next election, than on what the Supreme Court decides in this particular case,” he said.

Filed in: Health, Politics, Top Stories, Video | Related Topics: Barack Obama, Clarence Thomas, Health Care, Health Care Reform, Supreme Court
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