• What the Supreme Court didn’t do

    That’s a screenshot from SCOTUSblog‘s live blogging of the decision.

    Though the Supreme Court’s ruling on the ACA has many implications, what its focus on the law doesn’t do by itself is make progress on the problems of cost, quality, and access in our health care system. Those problems remain in approximately the same state they were in when the ACA was passed in 2010. That law is an attempt to begin to address each of them, to various degrees and over time. But even its strongest advocates know it is only a first step. If health reform is to be further advanced, it will be through legislation, not litigation.

    In short and in my view, the Supreme Court’s attention to the ACA did nothing to promote a health and health system improvement agenda, despite what it may have done for the Court’s constitutional agenda or the political ambitions of some of the litigants.


    • Cost, quality and access more pliable with ACA in tact. Change is hard work that takes time, forces and fortitude. It’s a beginning, consider:

      No more preexisting conditions for patients. Reduces costs (in the long run), improves quality and increases access.

      My take.

    • It’s not the Court’s responsibility or mission to “promote a health and health system improvement agenda”. They are supposed to determine if laws are constitutional, and indeed they found that they justification for the individual mandate to be lacking, along with the compulsion to accept the Medicaid expansion. Those were perfectly legitimate issues to be raised, and in fact from a narrow technical point of view the plaintiffs won (obviously not from a broader political view). If you’re frustrated with what you perceive to be a waste of time here, your quarrel is really with the Obama administration: they could have all the fuss and bother in the first place by framing the mandate as a tax increase but chose not to do so because of purely political reasons.

      • Theodore,

        Although you have a valid point, one cannot over look the unconstitutionality of ACA. The contents of ACA could/should be debated at length, the Judicial Branch has the responsibility of judicial review (granted from the Judiciary Act of 1789) to challenge the unconstitutionality of any state or federal law. (See, Marbury v. Madison, 1 Cr. 137 (1803))
        The individual mandate is what was called into question with the Supreme Court. The Obama Administration is using the “Commerce Clause” of the Constitution as a means to regulate intestate commerce (this being healthcare). (See, U.S. Const. Art I Sec. 8 § 3) The debate lies in if healthcare can be regulated since it is not a tangible item, although Obama claims it to be. The Supreme Court ruled the way it did because it classified this mandate as a tax, which can be regulated under U.S. Const. Amend XVI. So in quick closing, the basis for ACA lay within this mandate, which why the Supreme Court played such a pivotal role in the decision. Advocates of ACA knew if the Supreme Court struck down the mandate, the core objectives of ACA could not be met.