Political Implications in the United States
Political implications in the United States
resulting from Judge John Roberts and the U.S. Supreme Court ruling
regarding the
Patient Protection and Affordable Care Act
[pic]
Collaborative Authors:
Gentry Hill ( Brian Kingsbury ( Henry Singletary ( Jessica Hawkins ( Catherine Alqallaf
Stetson University
August 15, 2012
Contents
Contents i Abstract ii Introduction 1 Implications of Rejecting the ACA on Grounds of the Commerce Clause 3 Implications Of Upholding The Individual Mandate As A Tax 4 Implications of Rejecting the Medicaid Mandate, as Undue Coercion 9 Conclusion 14 Bibliography 16 Weekly Agendas a
Abstract
In June 2012, the Supreme Court issued a mixed ruling on the Patient Protection and Affordable Care Act. The key mandates contained in the new law were: 1) states were required to expand Medicaid coverage to more low income and disabled people, and 2) individuals were required to purchase health insurance. The Supreme Court ruled that the individual mandate could not be enacted within the scope of Congress’ authority under the Commerce Clause. Ultimately, the Court decided that Congress had the authority to enact the individual mandate as a tax imposed only on those who do not purchase health care insurance. The Supreme Court ruling on the individual mandate of the ACA has opened a wide door for Congress to impose a tax on pretty much anything at all, so long as it can be demonstrated to have an impact on the general welfare of the country. Although the Supreme Court upheld the constitutionality of the controversial individual mandate portion of the ACA, it concluded that the Medicaid expansion violates the Constitution.
Political implications in the Unites States resulting from Judge John Roberts and the U.S. Supreme Court ruling regarding the Patient Protection and Affordable Care Act
Introduction
On June 28, 2012, the Supreme Court issued a mixed ruling on the Patient Protection and Affordable Care Act (hereafter referred to as the “Affordable Care Act” or “ACA”). The ACA was passed by Congress in March 2010, and was intended to expand health insurance coverage to nearly all Americans. The key mandates contained in the new law to achieve its purpose were twofold: 1) states were required to expand Medicaid coverage to more low income and disabled people, and 2) individuals were required to purchase health insurance. The law enacted provisions to make compliance easier, such as requiring health insurance companies to provide coverage for individuals with pre-existing conditions. It also enacted penalties for those who failed to comply: withholding of federal funding for states, and a fine for individuals. Stiff opposition to the requirements and penalties imposed by the ACA were manifest in the Courts, where the constitutionality of the law was called into question.
In the Supreme Court’s ruling on the Medicaid expansion mandate, seven of the nine justices agreed that Congress had exceeded its constitutional authority when it threatened states with the loss of existing federal payments in order to coerce them into participating in Medicaid expansion. (Liptak, Supreme Court upholds health care law, 5-4, in victory for Obama, 2012).
The remainder of the Court’s attention focused largely on the “individual mandate,” the requirement that all Americans obtain minimum health insurance or pay a penalty. Republicans challenged it as an unconstitutional extension of Congressional authority (Andrews, 2012). The Obama administration contended that it “fell within Congress’ power to regulate interstate commerce” (Chapman, et al., 2012), and was central to the ACA’s effectiveness and feasibility.
Ultimately, the Supreme Court rejected the notion that the Commerce Clause extended to Congress the authority to impose a mandate to purchase health insurance. Nevertheless, the individual mandate was upheld by the Supreme Court, which ruled that the penalty for failing to purchase health insurance could be constitutionally imposed under Congress’ authority to tax. This ruling passed by a slim majority when Justice John Roberts (a "conservative"), together with the four liberal justices currently serving on the Supreme Court, ruled that, “a financial penalty for not obtaining health insurance may reasonably be characterized as a tax” (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 44).
This decision judicially expanded the federal government 's taxing authority. Four of the nine Supreme Court judges dissented from the opinion that the individual mandate was constitutional, stating:
We have never held that any exaction imposed for violation of the law is an exercise of Congress’ taxing power… Congress imposed a regulatory penalty … to say that the Individual Mandate merely imposes a tax is not to interpret the statute but to rewrite it… (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, pp. 24, 18)
Implications of Rejecting the ACA on Grounds of the Commerce Clause
The Supreme Court ruled that the individual mandate could not be enacted within the scope of Congress’ authority under the Commerce Clause. One of the primary implications of the ruling is, interestingly, why Justice John Roberts disagreed with the previously accepted view of the Commerce Clause. In the widely accepted interpretation of the Commerce Clause there are few limits on the extent to which legislation can be passed. Even whilst upholding the general purpose of the ACA for other reasons, Judge Roberts rejected the this broad interpretation of the Commerce Clause.
He rejected the widely held expansive view of the Commerce Clause of the United States Constitution, ruling that it doesn’t give Congress the power to make people buy health insurance — or, for that matter, healthy green vegetables like broccoli. (Stewart, 2012)
The purpose of specifically mentioning the Commerce Clause and the justification for it, by which the judges did not support the more expansive perspective, was to keep the government’s ability to regulate commerce from expanding into the realm of specifically creating markets in order to attain the authority to regulate commerce within those markets.
Although Chief Justice John Roberts joined his liberal colleagues in upholding the law, he joined his conservative colleagues in rejecting a key argument on the law’s behalf. In particular, he said that the mandate was not a legitimate way for the government to regulate interstate commerce. (Cohn, 2012)
Although it may seem like semantics, the specific wording in relation to the Commerce Clause has some people thinking that the ruling, without striking anything down, could provide important support for limiting Congressional powers under the Commerce Clause.
If the mandate had been upheld under the Commerce Clause, the Court would have decisively construed this clause so permissively as to give Congress an essentially unlimited police power — the power to mandate, proscribe and regulate behavior for whatever Congress deems a public benefit. (Will, 2012)
So it’s not that Judge Roberts had a philosophical difference with the root of the regulations, but instead opted to attempt a preventative measure to make sure that a more broad interpretation, and potentially dangerous situation involving further manipulation of free market systems, could be avoided in the future. The measure was apparently intended to prevent the ACA from becoming a precedent for future legislation used in times of economic recession, depression, or stagnation. Perhaps not as significant as the other implications of his vote, there may be further ramifications that have yet to be discovered.
And that’s where the roadmap shows up. Congress, if it wants to shield its future laws from the Commerce Clause problem that the Court spotted here, can simply make sure that it doesn’t regulate “inactivity.” (Allen, 2012)
Implications Of Upholding The Individual Mandate As A Tax
One political implication of the Supreme Court ruling is that this decision judicially – rather than legislatively – expanded the federal government’s taxing authority. Several steps were taken to before the Court could make this ruling. First, the Supreme Court Justices determined that the Anti-Injunction Act would not proscribe its immediate consideration of the case. Under the 1867 Anti-Injunction Act, “no suit for the purpose of restraining the assessment or collection of any tax shall be maintained in any Court by any person…” (USC Title 26 §7421(a)). “In other words, people who object to taxes must pay first and litigate later” (Liptak, Justices hear argument that health case is premature, 2012). “Lawyers for both the Obama administration and challengers to the law took the same side on this question, [and argued] that the Court could hear the case now” (The New York Times, 2012). Arguments against imposing the Anti-Injunction Act ranged in nature from the idea that the penalty was not a tax, and therefore not subject to the act, to the concept that state litigation was not subject to the Anti-Injunction Act in the same manner as individual litigation.
Next, the Supreme Court Justices had to review Article I, Section 8 of the Constitution, which lists the powers granted to Congress. The central question in the Supreme Court case was whether those powers authorized the enactment of the health care law, and particularly the individual mandate. The relevant text reads:
The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States; …
To regulate commerce with foreign nations, and among the several states, and with the Indian tribes. (US Const, Art I, §8, 1787)
In essence, the legal question for the justices was whether Congress had exceeded its constitutional authority by requiring most Americans either obtain insurance or pay a penalty. The two sides of the argument were represented as follows:
1. “The law’s challengers – 26 states led by Florida, the National Federation of Independent Business and several individuals – present the central question as one of individual liberty” (Liptak, Health ruling hinges on how justices frame the core issue, 2012); and
2. The law’s supporters – The Obama administration presented the issue as one of “fashioning a comprehensive response to a national crisis in the health care market, to regulate how people pay for the health care they will almost inevitably need” (Liptak, Health ruling hinges on how justices frame the core issue, 2012).
Ultimately, the Court decided that Congress had the authority to enact the individual mandate of the ACA. However, the Court was closely divided over this controversial decision. Four of the nine Supreme Court Justices dissented from the opinion that the ACA was constitutional because there were no constitutional grounds for imposing a requirement on individuals to purchase a particular product, in this case, health insurance. Chief Justice Roberts and the majority decided that the ACA could be constitutionally imposed as a tax. Since this new tax on individuals is not on “income from whatever source derived” (USC Title 26 §61(a)), but rather is a tax imposed only on those who do not purchase health care insurance, it has gone beyond the bounds of an income tax. It also does not fit into any other previously known tax category: for example, it is not an excise tax, employment tax, sales tax, ad valorem tax, etc. Instead, of being imposed on people who take a particular action – for example, earn, give, die, work or employ, buy, own, etc. – this new tax is imposed for a failure to take an action mandated by the ACA legislation. Thus, the dissenting justices spoke out strongly stating:
[W]e have never held—never—that a penalty imposed for violation of the law was so trivial as to be in effect a tax. We have never held that any exaction imposed for violation of the law is an exercise of Congress’ taxing power—even when the statute calls it a tax, much less when (as here) the statute repeatedly calls it a penalty. (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 18)
Justice Roberts’ effort to find substantial grounds to uphold the ACA may not have come as a surprise for everyone. He has been described as “committed to the notion that courts should not overturn the actions of democratically elected legislatures” (Oliphant, 2012). In another opinion issued just days before the Supreme Court ruling on the ACA, Roberts wrote,
[C]ourts must presume an Act of Congress is constitutional … the Court does not rely on the Eighth Amendment’s text… its analysis of precedent alone must bear the ‘heavy burden [that] rests on those who would attack the judgment of the representatives of the people’ (Miller v. Alabama, 2012, p. 7).
For Roberts, this presumption may have been a driving factor in how he approached the ACA decision, causing him to embrace any “reasonable” reading of the legislation which could be construed as constitutional. When the Court issued its opinion on the ACA, Chief Justice John Roberts, writing for the majority, stated that the question before the Court was to determine “whether the Government’s alternative reading of the statute – that it imposes a tax on individuals without insurance – is a reasonable one” (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 32). Explaining the Court’s reasoning for deciding that it was, Roberts continued:
Under the mandate, if an individual does not maintain health insurance, the only consequence is that he must make an additional payment to the IRS … That, according to the Government, means the mandate can be regarded as establishing a condition—not owning health insurance—that triggers a tax—the required payment to the IRS. Under that theory, the mandate is not a legal command to buy insurance. Rather, it makes going without insurance just another thing the Government taxes, like buying gasoline or earning income. (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 32)
Roberts concluded, “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon the wisdom or fairness” (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 44).
What, then, are the expected implications of this ruling? First, contrary to Justice Roberts’ opinion, a distinction exists between taxing individuals for failure to take a particular action (e.g., purchase health insurance) and taxing individuals based on their actions (e.g., buying gasoline, or generating income). In granting Congress the authority to tax inactivity – rather than just activity – this ruling empowers Congress to use its taxing authority to regulate every personal and individual decision which it can reasonably claim to have some impact on the general welfare of the United States. Congress now effectively has the power to tax individuals for failure to purchase broccoli (we might be less healthy if we don’t eat broccoli, thus increasing the overall economic health care burden). In addition to taxing people on the income they generate, under its new authority to tax inactivity Congress can now tax people for failing to generate income. Instead of receiving tax breaks for making energy conscious consumer decisions, in the future we may expect to be taxed for making decisions not to spend money to upgrade to more energy efficient cars, roofs, windows, etc. In essence, the Supreme Court ruling on the individual mandate of the ACA has opened a wide door for Congress to impose a tax on pretty much anything at all, so long as it can be demonstrated to have an impact on the general welfare of the country; and taken in aggregate, nearly every consumer decision can be found to have an economic effect impacting the country’s overall general welfare.
There may also be implications resulting from this ruling’s effective circumvention of the Commerce Clause, under which the individual mandate did not pass. It could reasonably be expected that future legislation will take advantage of this freshly developed hole in the constitution.
Overall, the political implications of this decision can be expected to weaken constitutional limits imposed on government actions, further deteriorate individual rights, exponentially expand the government’s authority over individual choice, and increase the tax burden on individuals.
Implications of Rejecting the Medicaid Mandate, as Undue Coercion
Although the Supreme Court upheld the constitutionality of the controversial individual mandate portion of the ACA, it concluded, “that the Medicaid expansion violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion” (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 4). The Supreme Court of the United States (2012, p. 5) added, “The legitimacy of [spending legislation] depends on whether a State voluntarily and knowingly accepts the terms of a [program]” and that, under the Constitution, states are not required to regulate a program. This conclusion by the Supreme Court emboldened states that are opposed to the ACA. Since the federal government cannot coerce states into complying with the ACA by withholding funds for programs, the resulting political implication will be that opposing states will seek to nullify the healthcare law simply by not implementing its provisions. Meanwhile, current funding levels for established programs will remain virtually unaffected. States which oppose the law still face delicate political decisions. A relatable political implication is that by refusing to implement the Medicaid expansion, state politicians may face the ire of hospitals, small businesses, and uninsured constituents and their empathizers at the polls.
Twenty-six states took part in the lawsuit challenging the constitutionality of the ACA (The Heritage Foundation, 2012). Several governors of these states have been adamant in their defiance of all aspects of the ACA. According to Epstein (2012), Bobby Jindal of Louisiana and Bob McDonnell of Virginia, are among several governors who have refused to proceed with implementing the state-based health insurance exchanges, which by law are required to be in effect by 2014. Governor Jindal issued a vehement statement of hostility, arguably as a provocation for the Obama administration, stating, “Here in Louisiana … we refused to set up the exchange. We’re not going to start implementing Obamacare,” (Epstein, 2012). However, instead of becoming incensed, the Obama administration is actually willing to create health insurance exchanges in the states whose governors refuse to create them. If the Obama administration proceeds with this plan, the governors of the opposing states stand to lose little, if any, political capital by refusing to implement the state-based health insurance exchanges. Residents in these states who oppose the individual mandate of the ACA will applaud the governors’ contumacy, and residents choosing to participate in health insurance exchanges can do so through a federal exchange operating within their state.
The Obama administration would prefer the opposing governors to accept the Supreme Court’s decision and move forward on implementing the law. Secretary of Health and Human Services, Kathleen Sebelius, echoed the sentiment stating, “What we can’t afford to do is spend any more time refighting political battles …” (Epstein, 2012). However, opposing governors, like Nikki Haley of South Carolina, are anxiously awaiting the 2012 presidential election, and placing their hopes on a Mitt Romney win. Immediately following the Supreme Court’s ruling, Romney stated, “What the Court did not do on its last day in session, I will do on my first day if elected President of the United States. And that is I will act to repeal Obamacare" (LoGuirato, 2012). The key phrase in Romney’s statement is, “I will act to repeal Obamacare.”
While many Americans would like to see some form of health care reform, the ACA itself is a very unpopular law. According to Bastasch (2012), 46 percent of Americans want the ACA repealed. Nevertheless, a Kaiser Family Foundation poll (Bastasch, 2012) found that 19 percent of Americans who are currently opposed to the ACA remain persuadable and could change their opinion and support the law in its current form. In addition, the same poll discovered that a majority of those who support repealing the law did not approve of eliminating the funding for the ACA as a method of preventing its implementation. Furthermore, 50 percent of poll participants who support repealing the law simply desire a Republican alternative to healthcare reform (Bastasch, 2012). This complicates the issue even more for politicos who oppose the ACA. Since one can deduce from the polls that a majority of Americans support some form of healthcare reform, it is possible that the public may discover some aspects of the law appealing, thus making a complete repeal unlikely.
By stating that he will “act to repeal Obamacare,” Romney provided himself the opportunity to place blame for a failed repeal of the law on Congress’ inability to get a repeal bill to his desk, if elected president. If the majority of American voters have shifted to a favorable opinion of the law at this time, his previous opposition will not matter because his administration will be able to make popular expansions to the law to regain any lost political capital. State governors who refuse to implement provisions of the ACA may have to capitulate and comply if public opinion shifts in favor of the law, despite putative fiscal consequences.
By refusing to implement the ACA, opposing governors shifted the fight to nullify the law to the states. While federally operated state health insurance exchanges will allow state politicians to oppose the healthcare law without significantly affecting residents who wish to participate via the exchanges, the states still maintain the right not to expand their Medicaid programs. However, refusing to expand the program may be detrimental to these state governors’ political careers. Support for Medicaid expansion is rising among Americans. A poll from the Kaiser Family Foundation (Culp-Ressler, 2012) found 67 percent of Americans favor a nationwide expansion of Medicaid. Under the ACA, Medicaid expansion will provide health care to over 16 million uninsured Americans whose income is below 133 percent of the federal poverty level (Morgan, 2012). According to Covert (2012), the governors of Florida, South Carolina, and Louisiana have firmly stated that they will reject federal funding for Medicaid expansion under the ACA. The percentages of uninsured residents in these states are amongst the highest in the nation; the current rates are 21 percent, 19 percent, and 17 percent respectively (State Health Facts, 2010). Since there are programs available to cover the majority of children in the country, most of the uninsured are likely to be voting age adults. According to Martin and Holan (2012), Florida has 3.8 million uninsured residents and Medicaid expansion under the ACA would allow more than one million of them to qualify for coverage. Florida’s governor, Rick Scott, has a 31 percent approval rating (Bender, 2012), and refusing to expand Medicaid to cover such a large number of uninsured voters may cost him re-election in 2014.
There appears to be a consensus among Americans in support of Medicaid funding. In a Bloomberg News National Poll (2011), only 21 percent of the respondents supported making cuts to Medicaid in order to reduce the deficit. “[G]overnors in states that refuse federal dollars will find themselves up against a coalition of powerful interests that include hospitals and small business groups. … [U]nder the [ACA], hospitals will gradually lose the federal funds they currently receive to defray the costs of treating uninsured patients. If a state refuses to extend coverage to [uninsured] residents, hospitals are still [required] to admit them, but they [will not receive any] funding to pay the costs” (Whitman, 2012).
Refusal of funds will be a detriment to small businesses because they will have to pay the costs of covering the uninsured that Medicaid would have covered under the expansion program. Regardless of whether the governors accept federal funding for Medicaid expansion or not, residents of their states will still have to pay for expansion of the program with their tax dollars. The federal government covers the first three years of Medicaid expansion costs and then the federal share of the cost drops to no lower than 90 percent (Alonso-Zaldivar, 2012). This may be the catalyst to force opposing governors accept Medicaid expansion funds. Residents of their states will be subsidizing Medicaid expansion programs of the states that implemented the program, while not receiving any of the expanded program benefits or funding. Many believe the refusal to accept funding for Medicaid expansion is just election year “posturing and that eventually [states] will succumb to the lure of federal dollars” (Vestal, 2012). Vestal (2012) adds, that many of those skeptical of the governors’ refusal to accept funding “note that several … governors initially refused stimulus money on political principle, but eventually accepted it because their states were desperate for help.” Politicians who do not accept Medicaid expansion funding on political and fiscal conservative principles may suffer backlash at the polls in 2014. Residents in states with a high percentage of uninsured may force politicians to accept funding and expand Medicaid when the residents of cooperating states start enjoying the benefits of a program subsidized by their tax dollars, while their own residents continue to go uninsured.
Conclusion
In summary, the majority opinion of the Supreme Court held that Congress did exceed its constitutional authority by threatening to take away existing federal payments to ensure compliance with the mandate to expand Medicaid. It further held that the Commerce Clause of the U.S. Constitution does not give government the power to mandate that individuals purchase health insurance. However, it found that the individual mandate is constitutional under Congress’ authority to impose taxes to “provide for the common defense and general welfare of the United States” (US Const, Art I, §8).
Popular aspects of the ACA are that it is expected to increase access to health care, end insurance abuses, and lower medical costs. Children can stay on the family health insurance plan until the age of 26, coverage cannot be denied because of a pre-existing condition, and preventive services are covered without a co-pay or deductible. These popular aspects are likely to ensure that the ACA is not completely overturned by any future administration.
The Court’s ruling established definitive limits on the Commerce Clause. Nevertheless, apprehension persists due to concern that there may be future attempts to manipulate the choices and behavior of individual citizens through the use of Congress’ expanded taxing authority.
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The Heritage Foundation. (2012, June 29). The Plaintiffs ' perspective on the ObamaCare ruling. Retrieved August 1, 2012, from The Heritage Foundation: http://www.heritage.org/events/2012/06/obamacare-plaintiffs
The New York Times. (2012, March 26). Justices hear argument that it 's too soon to rule on health care. Retrieved August 14, 2012, from Herald-Tribune: http://politics.heraldtribune.com/2012/03/26/justices-hear-argument-that-its-too-soon-to-rule-on-health-care/
Tomasky, M. (2012, June 21). Michael Tomasky on America’s Robed Radicals on the Supreme Court. Retrieved July 31, 2012, from The Daily Beast: http://www.thedailybeast.com/articles/2012/06/21/michael-tomasky-on-america-s-robed-radicals-on-the-supreme-court.html
United States Constitution, Article I, §8. (1787, September 17). Retrieved from http://www.archives.gov/exhibits/charters/constitution_transcript.html
Vestal, C. (2012, July 11). For some states, Medicaid expansion may be a tough fiscal call. Retrieved August 2, 2012, from Stateline: The Daily News Service of The Pew Center on the States: http://www.pewstates.org/projects/stateline/headlines/for-some-states-medicaid-expansion-may-be-a-tough-fiscal-call-85899404110
Whitman, G. (2012, July 24). Governors who refuse Medicaid expansion put politics ahead of people. Retrieved Augusst 2, 2012, from Huffington Post: http://www.huffingtonpost.com/gordon-whitman/politics-ahead-of-people_b_1695396.html
Will, G. (2012, June 29). Chief Justice Roberts ' health-care ruling is a victory for conservatives. Retrieved August 1, 2012, from The Seattle Times: http://seattletimes.nwsource.com/html/opinion/2018563800_will01.html
Wolf, R., Heath, B., & Raasch, C. (2012, June 29). How health care law survived, and what 's next. Retrieved July 24, 2012, from USA Today: http://www.usatoday.com/NEWS/usaedition/2012-06-29-still2_CV_U.htm
Weekly Agendas
Due to scheduling incompatibility among group members, no “live” meetings were scheduled. Communication between group members was maintained using the Virtual Café forum and email.
Week 1
Join the group
Share contact info
Determine the best method(s) of group communication
Set up a group discussion forum
Determine how the work will be divided among group participants
Share strengths/preferences for group participant’s contributions to the project
Week 2
Share ideas about the main points to cover in our project
Share preliminary research links
Determine what each group participant will do
Establish a schedule / agenda
Week 3
Research the main points
Write the body of the paper
Write the background portion of the introduction
Create a cover page
Prepare a draft for submission to Dr. Stryker by Wednesday evening
Week 4
Finish the introduction
Discuss group participants’ opinions regarding the Supreme Court’s decision
Write the conclusion
Make any necessary revisions to the body of the paper
Edit the paper
Week 5
Write an abstract
Create the bibliography
Participants review the paper and make suggestions for improvement
Make any revisions
Final edit
Submit the paper
Bibliography: Andrews, P. S. (2012, July 30). Health care reform. Retrieved August 1, 2012, from The New York Times: http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html Bastasch, M Bender, M. C. (2012, July 26). The GOP 's Rick Scott problem. Retrieved August 2, 2012, from Bloomberg Businessweek: http://www.businessweek.com/articles/2012-07-26/the-gops-rick-scott-problem CCH Cohn, J. (2012, June 28). Did Roberts gut the Commerce Clause? Retrieved August 1, 2012, from The New Republic: http://www.tnr.com/blog/plank/104455/did-roberts-gut-the-commerce-clause Covert, B Effects of the Supreme Court 's health care decision. (2012, July 24). Retrieved July 31, 2012, from The New York Times: http://www.nytimes.com/interactive/2012/07/25/us/effects-of-health-care-decision.html Epstein, R Fisher, D. (2012, June 28). Inside the Obamacare ruling: How Roberts got a majority. Retrieved July 24, 2012, from Forbes: http://www.forbes.com/sites/danielfisher/2012/06/28/inside-the-obamacare-ruling-how-roberts-got-a-majority/ Fisher, D Hoffman Jr, W. H., Maloney, D. M., Raabe, W. A., & Young, J. C. (Eds.). (2013). South-Western Federal Taxation Comprehensive Volume (2013 Professional ed.). Mason, OH, USA: South-Western, Cengage Learning. Isaacson, J. (2012, June 28). Supreme Court backs Obamacare. Retrieved July 18, 2012, from Global Data: http://www.globaldata.com/ExpertsInsightDetails.aspx?PRID=222&Type=Industry&Title=Pharmaceuticals+and+Healthcare Liptak, A Liptak, A. (2012, March 26). Justices hear argument that health case is premature. Retrieved August 14, 2012, from The New York Times: http://www.nytimes.com/2012/03/27/us/health-law-hearings-open-in-supreme-court.html?pagewanted=all Liptak, A LoGuirato, B. (2012, June 28). Mitt Romney: 'I will repeal Obamacare '. Retrieved August 1, 2012, from Business Insider: http://www.businessinsider.com/mitt-romney-reaction-to-supreme-court-decision-i-will-repeal-obamacare-2012-6 Martin, M Martin, R., & Holan, A. D. (2012, July 22). Can Florida afford to say no to Medicaid expansion? Retrieved August 2, 2012, from Tampa Bay Times: http://www.tampabay.com/news/health/can-florida-afford-to-say-no-to-medicaid-expansion/1241313 Miller v Office of the Legislative Council. (2010, May 1). Compilation of Patient Protection and Affordable Care Act. Washington, DC, USA. Retrieved 22 2012, July, from http://housedocs.house.gov/energycommerce/ppacacon.pdf Oliphant, J Supreme Court decisions. (2012, June 29). (KCTS9) Retrieved July 24, 2012, from KCTS9: http://kcts9.org/kcts-9-connects/supreme-court-decisions-june-29-2012 The Heritage Foundation United States Constitution, Article I, §8. (1787, September 17). Retrieved from http://www.archives.gov/exhibits/charters/constitution_transcript.html Vestal, C Whitman, G. (2012, July 24). Governors who refuse Medicaid expansion put politics ahead of people. Retrieved Augusst 2, 2012, from Huffington Post: http://www.huffingtonpost.com/gordon-whitman/politics-ahead-of-people_b_1695396.html Will, G Wolf, R., Heath, B., & Raasch, C. (2012, June 29). How health care law survived, and what 's next. Retrieved July 24, 2012, from USA Today: http://www.usatoday.com/NEWS/usaedition/2012-06-29-still2_CV_U.htm Weekly Agendas
resulting from Judge John Roberts and the U.S. Supreme Court ruling
regarding the
Patient Protection and Affordable Care Act
[pic]
Collaborative Authors:
Gentry Hill ( Brian Kingsbury ( Henry Singletary ( Jessica Hawkins ( Catherine Alqallaf
Stetson University
August 15, 2012
Contents
Contents i Abstract ii Introduction 1 Implications of Rejecting the ACA on Grounds of the Commerce Clause 3 Implications Of Upholding The Individual Mandate As A Tax 4 Implications of Rejecting the Medicaid Mandate, as Undue Coercion 9 Conclusion 14 Bibliography 16 Weekly Agendas a
Abstract
In June 2012, the Supreme Court issued a mixed ruling on the Patient Protection and Affordable Care Act. The key mandates contained in the new law were: 1) states were required to expand Medicaid coverage to more low income and disabled people, and 2) individuals were required to purchase health insurance. The Supreme Court ruled that the individual mandate could not be enacted within the scope of Congress’ authority under the Commerce Clause. Ultimately, the Court decided that Congress had the authority to enact the individual mandate as a tax imposed only on those who do not purchase health care insurance. The Supreme Court ruling on the individual mandate of the ACA has opened a wide door for Congress to impose a tax on pretty much anything at all, so long as it can be demonstrated to have an impact on the general welfare of the country. Although the Supreme Court upheld the constitutionality of the controversial individual mandate portion of the ACA, it concluded that the Medicaid expansion violates the Constitution.
Political implications in the Unites States resulting from Judge John Roberts and the U.S. Supreme Court ruling regarding the Patient Protection and Affordable Care Act
Introduction
On June 28, 2012, the Supreme Court issued a mixed ruling on the Patient Protection and Affordable Care Act (hereafter referred to as the “Affordable Care Act” or “ACA”). The ACA was passed by Congress in March 2010, and was intended to expand health insurance coverage to nearly all Americans. The key mandates contained in the new law to achieve its purpose were twofold: 1) states were required to expand Medicaid coverage to more low income and disabled people, and 2) individuals were required to purchase health insurance. The law enacted provisions to make compliance easier, such as requiring health insurance companies to provide coverage for individuals with pre-existing conditions. It also enacted penalties for those who failed to comply: withholding of federal funding for states, and a fine for individuals. Stiff opposition to the requirements and penalties imposed by the ACA were manifest in the Courts, where the constitutionality of the law was called into question.
In the Supreme Court’s ruling on the Medicaid expansion mandate, seven of the nine justices agreed that Congress had exceeded its constitutional authority when it threatened states with the loss of existing federal payments in order to coerce them into participating in Medicaid expansion. (Liptak, Supreme Court upholds health care law, 5-4, in victory for Obama, 2012).
The remainder of the Court’s attention focused largely on the “individual mandate,” the requirement that all Americans obtain minimum health insurance or pay a penalty. Republicans challenged it as an unconstitutional extension of Congressional authority (Andrews, 2012). The Obama administration contended that it “fell within Congress’ power to regulate interstate commerce” (Chapman, et al., 2012), and was central to the ACA’s effectiveness and feasibility.
Ultimately, the Supreme Court rejected the notion that the Commerce Clause extended to Congress the authority to impose a mandate to purchase health insurance. Nevertheless, the individual mandate was upheld by the Supreme Court, which ruled that the penalty for failing to purchase health insurance could be constitutionally imposed under Congress’ authority to tax. This ruling passed by a slim majority when Justice John Roberts (a "conservative"), together with the four liberal justices currently serving on the Supreme Court, ruled that, “a financial penalty for not obtaining health insurance may reasonably be characterized as a tax” (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 44).
This decision judicially expanded the federal government 's taxing authority. Four of the nine Supreme Court judges dissented from the opinion that the individual mandate was constitutional, stating:
We have never held that any exaction imposed for violation of the law is an exercise of Congress’ taxing power… Congress imposed a regulatory penalty … to say that the Individual Mandate merely imposes a tax is not to interpret the statute but to rewrite it… (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, pp. 24, 18)
Implications of Rejecting the ACA on Grounds of the Commerce Clause
The Supreme Court ruled that the individual mandate could not be enacted within the scope of Congress’ authority under the Commerce Clause. One of the primary implications of the ruling is, interestingly, why Justice John Roberts disagreed with the previously accepted view of the Commerce Clause. In the widely accepted interpretation of the Commerce Clause there are few limits on the extent to which legislation can be passed. Even whilst upholding the general purpose of the ACA for other reasons, Judge Roberts rejected the this broad interpretation of the Commerce Clause.
He rejected the widely held expansive view of the Commerce Clause of the United States Constitution, ruling that it doesn’t give Congress the power to make people buy health insurance — or, for that matter, healthy green vegetables like broccoli. (Stewart, 2012)
The purpose of specifically mentioning the Commerce Clause and the justification for it, by which the judges did not support the more expansive perspective, was to keep the government’s ability to regulate commerce from expanding into the realm of specifically creating markets in order to attain the authority to regulate commerce within those markets.
Although Chief Justice John Roberts joined his liberal colleagues in upholding the law, he joined his conservative colleagues in rejecting a key argument on the law’s behalf. In particular, he said that the mandate was not a legitimate way for the government to regulate interstate commerce. (Cohn, 2012)
Although it may seem like semantics, the specific wording in relation to the Commerce Clause has some people thinking that the ruling, without striking anything down, could provide important support for limiting Congressional powers under the Commerce Clause.
If the mandate had been upheld under the Commerce Clause, the Court would have decisively construed this clause so permissively as to give Congress an essentially unlimited police power — the power to mandate, proscribe and regulate behavior for whatever Congress deems a public benefit. (Will, 2012)
So it’s not that Judge Roberts had a philosophical difference with the root of the regulations, but instead opted to attempt a preventative measure to make sure that a more broad interpretation, and potentially dangerous situation involving further manipulation of free market systems, could be avoided in the future. The measure was apparently intended to prevent the ACA from becoming a precedent for future legislation used in times of economic recession, depression, or stagnation. Perhaps not as significant as the other implications of his vote, there may be further ramifications that have yet to be discovered.
And that’s where the roadmap shows up. Congress, if it wants to shield its future laws from the Commerce Clause problem that the Court spotted here, can simply make sure that it doesn’t regulate “inactivity.” (Allen, 2012)
Implications Of Upholding The Individual Mandate As A Tax
One political implication of the Supreme Court ruling is that this decision judicially – rather than legislatively – expanded the federal government’s taxing authority. Several steps were taken to before the Court could make this ruling. First, the Supreme Court Justices determined that the Anti-Injunction Act would not proscribe its immediate consideration of the case. Under the 1867 Anti-Injunction Act, “no suit for the purpose of restraining the assessment or collection of any tax shall be maintained in any Court by any person…” (USC Title 26 §7421(a)). “In other words, people who object to taxes must pay first and litigate later” (Liptak, Justices hear argument that health case is premature, 2012). “Lawyers for both the Obama administration and challengers to the law took the same side on this question, [and argued] that the Court could hear the case now” (The New York Times, 2012). Arguments against imposing the Anti-Injunction Act ranged in nature from the idea that the penalty was not a tax, and therefore not subject to the act, to the concept that state litigation was not subject to the Anti-Injunction Act in the same manner as individual litigation.
Next, the Supreme Court Justices had to review Article I, Section 8 of the Constitution, which lists the powers granted to Congress. The central question in the Supreme Court case was whether those powers authorized the enactment of the health care law, and particularly the individual mandate. The relevant text reads:
The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States; …
To regulate commerce with foreign nations, and among the several states, and with the Indian tribes. (US Const, Art I, §8, 1787)
In essence, the legal question for the justices was whether Congress had exceeded its constitutional authority by requiring most Americans either obtain insurance or pay a penalty. The two sides of the argument were represented as follows:
1. “The law’s challengers – 26 states led by Florida, the National Federation of Independent Business and several individuals – present the central question as one of individual liberty” (Liptak, Health ruling hinges on how justices frame the core issue, 2012); and
2. The law’s supporters – The Obama administration presented the issue as one of “fashioning a comprehensive response to a national crisis in the health care market, to regulate how people pay for the health care they will almost inevitably need” (Liptak, Health ruling hinges on how justices frame the core issue, 2012).
Ultimately, the Court decided that Congress had the authority to enact the individual mandate of the ACA. However, the Court was closely divided over this controversial decision. Four of the nine Supreme Court Justices dissented from the opinion that the ACA was constitutional because there were no constitutional grounds for imposing a requirement on individuals to purchase a particular product, in this case, health insurance. Chief Justice Roberts and the majority decided that the ACA could be constitutionally imposed as a tax. Since this new tax on individuals is not on “income from whatever source derived” (USC Title 26 §61(a)), but rather is a tax imposed only on those who do not purchase health care insurance, it has gone beyond the bounds of an income tax. It also does not fit into any other previously known tax category: for example, it is not an excise tax, employment tax, sales tax, ad valorem tax, etc. Instead, of being imposed on people who take a particular action – for example, earn, give, die, work or employ, buy, own, etc. – this new tax is imposed for a failure to take an action mandated by the ACA legislation. Thus, the dissenting justices spoke out strongly stating:
[W]e have never held—never—that a penalty imposed for violation of the law was so trivial as to be in effect a tax. We have never held that any exaction imposed for violation of the law is an exercise of Congress’ taxing power—even when the statute calls it a tax, much less when (as here) the statute repeatedly calls it a penalty. (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 18)
Justice Roberts’ effort to find substantial grounds to uphold the ACA may not have come as a surprise for everyone. He has been described as “committed to the notion that courts should not overturn the actions of democratically elected legislatures” (Oliphant, 2012). In another opinion issued just days before the Supreme Court ruling on the ACA, Roberts wrote,
[C]ourts must presume an Act of Congress is constitutional … the Court does not rely on the Eighth Amendment’s text… its analysis of precedent alone must bear the ‘heavy burden [that] rests on those who would attack the judgment of the representatives of the people’ (Miller v. Alabama, 2012, p. 7).
For Roberts, this presumption may have been a driving factor in how he approached the ACA decision, causing him to embrace any “reasonable” reading of the legislation which could be construed as constitutional. When the Court issued its opinion on the ACA, Chief Justice John Roberts, writing for the majority, stated that the question before the Court was to determine “whether the Government’s alternative reading of the statute – that it imposes a tax on individuals without insurance – is a reasonable one” (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 32). Explaining the Court’s reasoning for deciding that it was, Roberts continued:
Under the mandate, if an individual does not maintain health insurance, the only consequence is that he must make an additional payment to the IRS … That, according to the Government, means the mandate can be regarded as establishing a condition—not owning health insurance—that triggers a tax—the required payment to the IRS. Under that theory, the mandate is not a legal command to buy insurance. Rather, it makes going without insurance just another thing the Government taxes, like buying gasoline or earning income. (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 32)
Roberts concluded, “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon the wisdom or fairness” (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 44).
What, then, are the expected implications of this ruling? First, contrary to Justice Roberts’ opinion, a distinction exists between taxing individuals for failure to take a particular action (e.g., purchase health insurance) and taxing individuals based on their actions (e.g., buying gasoline, or generating income). In granting Congress the authority to tax inactivity – rather than just activity – this ruling empowers Congress to use its taxing authority to regulate every personal and individual decision which it can reasonably claim to have some impact on the general welfare of the United States. Congress now effectively has the power to tax individuals for failure to purchase broccoli (we might be less healthy if we don’t eat broccoli, thus increasing the overall economic health care burden). In addition to taxing people on the income they generate, under its new authority to tax inactivity Congress can now tax people for failing to generate income. Instead of receiving tax breaks for making energy conscious consumer decisions, in the future we may expect to be taxed for making decisions not to spend money to upgrade to more energy efficient cars, roofs, windows, etc. In essence, the Supreme Court ruling on the individual mandate of the ACA has opened a wide door for Congress to impose a tax on pretty much anything at all, so long as it can be demonstrated to have an impact on the general welfare of the country; and taken in aggregate, nearly every consumer decision can be found to have an economic effect impacting the country’s overall general welfare.
There may also be implications resulting from this ruling’s effective circumvention of the Commerce Clause, under which the individual mandate did not pass. It could reasonably be expected that future legislation will take advantage of this freshly developed hole in the constitution.
Overall, the political implications of this decision can be expected to weaken constitutional limits imposed on government actions, further deteriorate individual rights, exponentially expand the government’s authority over individual choice, and increase the tax burden on individuals.
Implications of Rejecting the Medicaid Mandate, as Undue Coercion
Although the Supreme Court upheld the constitutionality of the controversial individual mandate portion of the ACA, it concluded, “that the Medicaid expansion violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion” (National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 2012, p. 4). The Supreme Court of the United States (2012, p. 5) added, “The legitimacy of [spending legislation] depends on whether a State voluntarily and knowingly accepts the terms of a [program]” and that, under the Constitution, states are not required to regulate a program. This conclusion by the Supreme Court emboldened states that are opposed to the ACA. Since the federal government cannot coerce states into complying with the ACA by withholding funds for programs, the resulting political implication will be that opposing states will seek to nullify the healthcare law simply by not implementing its provisions. Meanwhile, current funding levels for established programs will remain virtually unaffected. States which oppose the law still face delicate political decisions. A relatable political implication is that by refusing to implement the Medicaid expansion, state politicians may face the ire of hospitals, small businesses, and uninsured constituents and their empathizers at the polls.
Twenty-six states took part in the lawsuit challenging the constitutionality of the ACA (The Heritage Foundation, 2012). Several governors of these states have been adamant in their defiance of all aspects of the ACA. According to Epstein (2012), Bobby Jindal of Louisiana and Bob McDonnell of Virginia, are among several governors who have refused to proceed with implementing the state-based health insurance exchanges, which by law are required to be in effect by 2014. Governor Jindal issued a vehement statement of hostility, arguably as a provocation for the Obama administration, stating, “Here in Louisiana … we refused to set up the exchange. We’re not going to start implementing Obamacare,” (Epstein, 2012). However, instead of becoming incensed, the Obama administration is actually willing to create health insurance exchanges in the states whose governors refuse to create them. If the Obama administration proceeds with this plan, the governors of the opposing states stand to lose little, if any, political capital by refusing to implement the state-based health insurance exchanges. Residents in these states who oppose the individual mandate of the ACA will applaud the governors’ contumacy, and residents choosing to participate in health insurance exchanges can do so through a federal exchange operating within their state.
The Obama administration would prefer the opposing governors to accept the Supreme Court’s decision and move forward on implementing the law. Secretary of Health and Human Services, Kathleen Sebelius, echoed the sentiment stating, “What we can’t afford to do is spend any more time refighting political battles …” (Epstein, 2012). However, opposing governors, like Nikki Haley of South Carolina, are anxiously awaiting the 2012 presidential election, and placing their hopes on a Mitt Romney win. Immediately following the Supreme Court’s ruling, Romney stated, “What the Court did not do on its last day in session, I will do on my first day if elected President of the United States. And that is I will act to repeal Obamacare" (LoGuirato, 2012). The key phrase in Romney’s statement is, “I will act to repeal Obamacare.”
While many Americans would like to see some form of health care reform, the ACA itself is a very unpopular law. According to Bastasch (2012), 46 percent of Americans want the ACA repealed. Nevertheless, a Kaiser Family Foundation poll (Bastasch, 2012) found that 19 percent of Americans who are currently opposed to the ACA remain persuadable and could change their opinion and support the law in its current form. In addition, the same poll discovered that a majority of those who support repealing the law did not approve of eliminating the funding for the ACA as a method of preventing its implementation. Furthermore, 50 percent of poll participants who support repealing the law simply desire a Republican alternative to healthcare reform (Bastasch, 2012). This complicates the issue even more for politicos who oppose the ACA. Since one can deduce from the polls that a majority of Americans support some form of healthcare reform, it is possible that the public may discover some aspects of the law appealing, thus making a complete repeal unlikely.
By stating that he will “act to repeal Obamacare,” Romney provided himself the opportunity to place blame for a failed repeal of the law on Congress’ inability to get a repeal bill to his desk, if elected president. If the majority of American voters have shifted to a favorable opinion of the law at this time, his previous opposition will not matter because his administration will be able to make popular expansions to the law to regain any lost political capital. State governors who refuse to implement provisions of the ACA may have to capitulate and comply if public opinion shifts in favor of the law, despite putative fiscal consequences.
By refusing to implement the ACA, opposing governors shifted the fight to nullify the law to the states. While federally operated state health insurance exchanges will allow state politicians to oppose the healthcare law without significantly affecting residents who wish to participate via the exchanges, the states still maintain the right not to expand their Medicaid programs. However, refusing to expand the program may be detrimental to these state governors’ political careers. Support for Medicaid expansion is rising among Americans. A poll from the Kaiser Family Foundation (Culp-Ressler, 2012) found 67 percent of Americans favor a nationwide expansion of Medicaid. Under the ACA, Medicaid expansion will provide health care to over 16 million uninsured Americans whose income is below 133 percent of the federal poverty level (Morgan, 2012). According to Covert (2012), the governors of Florida, South Carolina, and Louisiana have firmly stated that they will reject federal funding for Medicaid expansion under the ACA. The percentages of uninsured residents in these states are amongst the highest in the nation; the current rates are 21 percent, 19 percent, and 17 percent respectively (State Health Facts, 2010). Since there are programs available to cover the majority of children in the country, most of the uninsured are likely to be voting age adults. According to Martin and Holan (2012), Florida has 3.8 million uninsured residents and Medicaid expansion under the ACA would allow more than one million of them to qualify for coverage. Florida’s governor, Rick Scott, has a 31 percent approval rating (Bender, 2012), and refusing to expand Medicaid to cover such a large number of uninsured voters may cost him re-election in 2014.
There appears to be a consensus among Americans in support of Medicaid funding. In a Bloomberg News National Poll (2011), only 21 percent of the respondents supported making cuts to Medicaid in order to reduce the deficit. “[G]overnors in states that refuse federal dollars will find themselves up against a coalition of powerful interests that include hospitals and small business groups. … [U]nder the [ACA], hospitals will gradually lose the federal funds they currently receive to defray the costs of treating uninsured patients. If a state refuses to extend coverage to [uninsured] residents, hospitals are still [required] to admit them, but they [will not receive any] funding to pay the costs” (Whitman, 2012).
Refusal of funds will be a detriment to small businesses because they will have to pay the costs of covering the uninsured that Medicaid would have covered under the expansion program. Regardless of whether the governors accept federal funding for Medicaid expansion or not, residents of their states will still have to pay for expansion of the program with their tax dollars. The federal government covers the first three years of Medicaid expansion costs and then the federal share of the cost drops to no lower than 90 percent (Alonso-Zaldivar, 2012). This may be the catalyst to force opposing governors accept Medicaid expansion funds. Residents of their states will be subsidizing Medicaid expansion programs of the states that implemented the program, while not receiving any of the expanded program benefits or funding. Many believe the refusal to accept funding for Medicaid expansion is just election year “posturing and that eventually [states] will succumb to the lure of federal dollars” (Vestal, 2012). Vestal (2012) adds, that many of those skeptical of the governors’ refusal to accept funding “note that several … governors initially refused stimulus money on political principle, but eventually accepted it because their states were desperate for help.” Politicians who do not accept Medicaid expansion funding on political and fiscal conservative principles may suffer backlash at the polls in 2014. Residents in states with a high percentage of uninsured may force politicians to accept funding and expand Medicaid when the residents of cooperating states start enjoying the benefits of a program subsidized by their tax dollars, while their own residents continue to go uninsured.
Conclusion
In summary, the majority opinion of the Supreme Court held that Congress did exceed its constitutional authority by threatening to take away existing federal payments to ensure compliance with the mandate to expand Medicaid. It further held that the Commerce Clause of the U.S. Constitution does not give government the power to mandate that individuals purchase health insurance. However, it found that the individual mandate is constitutional under Congress’ authority to impose taxes to “provide for the common defense and general welfare of the United States” (US Const, Art I, §8).
Popular aspects of the ACA are that it is expected to increase access to health care, end insurance abuses, and lower medical costs. Children can stay on the family health insurance plan until the age of 26, coverage cannot be denied because of a pre-existing condition, and preventive services are covered without a co-pay or deductible. These popular aspects are likely to ensure that the ACA is not completely overturned by any future administration.
The Court’s ruling established definitive limits on the Commerce Clause. Nevertheless, apprehension persists due to concern that there may be future attempts to manipulate the choices and behavior of individual citizens through the use of Congress’ expanded taxing authority.
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CCH. (2012, June 30). CCH provides expert analysis of Supreme Court health care ruling in new tax briefing. Retrieved July 18, 2012, from CCH Group: http://www.cchgroup.com/wordpress/index.php/press-release/cch-provides-expert-analysis-of-supreme-court-health-care-ruling-in-new-tax-briefing/
CCH. (2012, June 29). Supreme Court upholds health care law: June 29, 2012 special report. Riverwoods: Commerce Clearing House (CCH). Retrieved July 16, 2012, from http://tax.cchgroup.com/downloads/files/pdfs/legislation/health-care-law-upholds.pdf
Chapman, R., Friedman, S., Hoffman, S., Jackson, A., Kastrinsky, S., Reid-Eriksen, E., . . . Wethall, J. (2012, June 28). Health care reform stands & employers must now take action. Retrieved August 1, 2012, from Littler: http://www.littler.com/publication-press/publication/health-care-reform-stands-employers-must-now-take-action
Cohn, J. (2012, June 28). Did Roberts gut the Commerce Clause? Retrieved August 1, 2012, from The New Republic: http://www.tnr.com/blog/plank/104455/did-roberts-gut-the-commerce-clause
Covert, B. (2012, July 5). GOP’s rejection of Medicaid funds is one more ideologically driven bad idea. Retrieved August 2, 2012, from The Nation: http://www.thenation.com/blog/168736/gops-rejection-medicaid-funds-one-more-ideologically-driven-bad-idea#
Crowley, S. (2012, June 29). Health care reform and the Supreme Court (Affordable Care Act). Retrieved July 24, 2012, from The New York Times: http://topics.nytimes.com/top/reference/timestopics/organizations/s/supreme_court/affordable_care_act/index.html
Culp-Ressler, T. (2012, July 31). POLL: Majority of Americans favor expanding Medicaid under Obamacare. Retrieved August 2, 2012, from Think Progress: http://thinkprogress.org/health/2012/07/31/612741/poll-majority-of-americans-favor-expanding-medicaid-under-obamacare/?mobile=nc
Effects of the Supreme Court 's health care decision. (2012, July 24). Retrieved July 31, 2012, from The New York Times: http://www.nytimes.com/interactive/2012/07/25/us/effects-of-health-care-decision.html
Epstein, R. J. (2012, June 29). GOP governors aim for health care slowdown. Retrieved August 1, 2012, from Politico: http://www.politico.com/news/stories/0612/78024.html
Fisher, D. (2012, June 28). Inside the Obamacare ruling: How Roberts got a majority. Retrieved July 24, 2012, from Forbes: http://www.forbes.com/sites/danielfisher/2012/06/28/inside-the-obamacare-ruling-how-roberts-got-a-majority/
Fisher, D. (2012, June 28). Supreme Court upholds Obamacare: What it means, what happens next. Retrieved July 24, 2012, from Forbes: http://www.forbes.com/sites/danielfisher/2012/06/28/supreme-court-upholds-healthcare-law-what-it-means/
Hoffman Jr, W. H., Maloney, D. M., Raabe, W. A., & Young, J. C. (Eds.). (2013). South-Western Federal Taxation Comprehensive Volume (2013 Professional ed.). Mason, OH, USA: South-Western, Cengage Learning.
Internal Revenue Code. (n.d.). United States Code Title 26 §61(a). Gross income defined.
Internal Revenue Code. (n.d.). United States Code Title 26 §7421(a). Prohibition of suits to restrain assessment or collection.
Isaacson, J. (2012, June 28). Supreme Court backs Obamacare. Retrieved July 18, 2012, from Global Data: http://www.globaldata.com/ExpertsInsightDetails.aspx?PRID=222&Type=Industry&Title=Pharmaceuticals+and+Healthcare
Liptak, A. (2012, March 27). Health ruling hinges on how justices frame the core issue. Retrieved March 27, 2012, from The New York Times: http://www.nytimes.com/2012/03/28/us/supreme-court-hears-arguments-to-health-care-law.html
Liptak, A. (2012, March 26). Justices hear argument that health case is premature. Retrieved August 14, 2012, from The New York Times: http://www.nytimes.com/2012/03/27/us/health-law-hearings-open-in-supreme-court.html?pagewanted=all
Liptak, A. (2012, June 28). Supreme Court upholds health care law, 5-4, in victory for Obama. Retrieved July 24, 2012, from The New York Times: http://www.nytimes.com/2012/06/29/us/supreme-court-lets-health-law-largely-stand.html?_r=1&pagewanted=all
LoGuirato, B. (2012, June 28). Mitt Romney: 'I will repeal Obamacare '. Retrieved August 1, 2012, from Business Insider: http://www.businessinsider.com/mitt-romney-reaction-to-supreme-court-decision-i-will-repeal-obamacare-2012-6
Martin, M. (2012, August 8). Supreme Court decision creates unprecedented expansion of federal powers. Retrieved August 9, 2012, from Heartlander: http://news.heartland.org/newspaper-article/2012/08/08/supreme-court-decision-creates-unprecedented-expansion-federal-powers
Martin, R., & Holan, A. D. (2012, July 22). Can Florida afford to say no to Medicaid expansion? Retrieved August 2, 2012, from Tampa Bay Times: http://www.tampabay.com/news/health/can-florida-afford-to-say-no-to-medicaid-expansion/1241313
Miller v. Alabama, 10-9646 (Supreme Court of the United States june 25, 2012). Retrieved August 14, 2012, from http://www.supremecourt.gov/opinions/11pdf/10-9646.pdf
Morgan, D. (2012, July 30). Obama administration says states will join Medicaid expansion. Retrieved August 2, 2012, from Reuters: http://www.reuters.com/article/2012/07/30/us-bc-usa-healthcare-medicaid-idUSBRE86T14G20120730
National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al., 11-393 (Supreme Court of the United States June 28, 2012). Retrieved July 24, 2012, from http://www.supremecourt.gov/opinions/11pdf/11-393c3a2.pdf
Office of the Legislative Council. (2010, May 1). Compilation of Patient Protection and Affordable Care Act. Washington, DC, USA. Retrieved 22 2012, July, from http://housedocs.house.gov/energycommerce/ppacacon.pdf
Oliphant, J. (2012, June 29). Daring to defer. Retrieved July 24, 2012, from National Journal: http://www.nationaljournal.com/magazine/roberts-daring-to-defer-20120629
Plumer, B. (2012, July 27). How the Supreme Court’s health care ruling could weaken the Clean Air Act. Retrieved July 31, 2012, from The Washington Post: http://www.washingtonpost.com/blogs/ezra-klein/wp/2012/07/27/how-the-supreme-courts-health-care-ruling-could-weaken-the-clean-air-act/
Selzer & Company. (2011, September 12). Bloomberg News National Poll Study #2026. Retrieved August 2, 2012, from http://media.bloomberg.com/bb/avfile/rcBTdobXyUWg
State Health Facts. (2010). Health insurance coverage of the total population, states (2009-2010), U.S. (2010). Retrieved August 2, 2012, from State Health Facts: http://www.statehealthfacts.org/comparemaptable.jsp?typ=2&ind=125&cat=3&sub=39&sortc=6&o=a
Stewart, J. B. (2012, June 29). In Obama 's victory, a loss for Congress. Retrieved August 1, 2012, from The New York Times: http://www.nytimes.com/2012/06/30/us/conservatives-see-silver-lining-in-health-ruling.html?_r=1
Supreme Court decisions. (2012, June 29). (KCTS9) Retrieved July 24, 2012, from KCTS9: http://kcts9.org/kcts-9-connects/supreme-court-decisions-june-29-2012
The Heritage Foundation. (2012, June 29). The Plaintiffs ' perspective on the ObamaCare ruling. Retrieved August 1, 2012, from The Heritage Foundation: http://www.heritage.org/events/2012/06/obamacare-plaintiffs
The New York Times. (2012, March 26). Justices hear argument that it 's too soon to rule on health care. Retrieved August 14, 2012, from Herald-Tribune: http://politics.heraldtribune.com/2012/03/26/justices-hear-argument-that-its-too-soon-to-rule-on-health-care/
Tomasky, M. (2012, June 21). Michael Tomasky on America’s Robed Radicals on the Supreme Court. Retrieved July 31, 2012, from The Daily Beast: http://www.thedailybeast.com/articles/2012/06/21/michael-tomasky-on-america-s-robed-radicals-on-the-supreme-court.html
United States Constitution, Article I, §8. (1787, September 17). Retrieved from http://www.archives.gov/exhibits/charters/constitution_transcript.html
Vestal, C. (2012, July 11). For some states, Medicaid expansion may be a tough fiscal call. Retrieved August 2, 2012, from Stateline: The Daily News Service of The Pew Center on the States: http://www.pewstates.org/projects/stateline/headlines/for-some-states-medicaid-expansion-may-be-a-tough-fiscal-call-85899404110
Whitman, G. (2012, July 24). Governors who refuse Medicaid expansion put politics ahead of people. Retrieved Augusst 2, 2012, from Huffington Post: http://www.huffingtonpost.com/gordon-whitman/politics-ahead-of-people_b_1695396.html
Will, G. (2012, June 29). Chief Justice Roberts ' health-care ruling is a victory for conservatives. Retrieved August 1, 2012, from The Seattle Times: http://seattletimes.nwsource.com/html/opinion/2018563800_will01.html
Wolf, R., Heath, B., & Raasch, C. (2012, June 29). How health care law survived, and what 's next. Retrieved July 24, 2012, from USA Today: http://www.usatoday.com/NEWS/usaedition/2012-06-29-still2_CV_U.htm
Weekly Agendas
Due to scheduling incompatibility among group members, no “live” meetings were scheduled. Communication between group members was maintained using the Virtual Café forum and email.
Week 1
Join the group
Share contact info
Determine the best method(s) of group communication
Set up a group discussion forum
Determine how the work will be divided among group participants
Share strengths/preferences for group participant’s contributions to the project
Week 2
Share ideas about the main points to cover in our project
Share preliminary research links
Determine what each group participant will do
Establish a schedule / agenda
Week 3
Research the main points
Write the body of the paper
Write the background portion of the introduction
Create a cover page
Prepare a draft for submission to Dr. Stryker by Wednesday evening
Week 4
Finish the introduction
Discuss group participants’ opinions regarding the Supreme Court’s decision
Write the conclusion
Make any necessary revisions to the body of the paper
Edit the paper
Week 5
Write an abstract
Create the bibliography
Participants review the paper and make suggestions for improvement
Make any revisions
Final edit
Submit the paper
Bibliography: Andrews, P. S. (2012, July 30). Health care reform. Retrieved August 1, 2012, from The New York Times: http://topics.nytimes.com/top/news/health/diseasesconditionsandhealthtopics/health_insurance_and_managed_care/health_care_reform/index.html Bastasch, M Bender, M. C. (2012, July 26). The GOP 's Rick Scott problem. Retrieved August 2, 2012, from Bloomberg Businessweek: http://www.businessweek.com/articles/2012-07-26/the-gops-rick-scott-problem CCH Cohn, J. (2012, June 28). Did Roberts gut the Commerce Clause? Retrieved August 1, 2012, from The New Republic: http://www.tnr.com/blog/plank/104455/did-roberts-gut-the-commerce-clause Covert, B Effects of the Supreme Court 's health care decision. (2012, July 24). Retrieved July 31, 2012, from The New York Times: http://www.nytimes.com/interactive/2012/07/25/us/effects-of-health-care-decision.html Epstein, R Fisher, D. (2012, June 28). Inside the Obamacare ruling: How Roberts got a majority. Retrieved July 24, 2012, from Forbes: http://www.forbes.com/sites/danielfisher/2012/06/28/inside-the-obamacare-ruling-how-roberts-got-a-majority/ Fisher, D Hoffman Jr, W. H., Maloney, D. M., Raabe, W. A., & Young, J. C. (Eds.). (2013). South-Western Federal Taxation Comprehensive Volume (2013 Professional ed.). Mason, OH, USA: South-Western, Cengage Learning. Isaacson, J. (2012, June 28). Supreme Court backs Obamacare. Retrieved July 18, 2012, from Global Data: http://www.globaldata.com/ExpertsInsightDetails.aspx?PRID=222&Type=Industry&Title=Pharmaceuticals+and+Healthcare Liptak, A Liptak, A. (2012, March 26). Justices hear argument that health case is premature. Retrieved August 14, 2012, from The New York Times: http://www.nytimes.com/2012/03/27/us/health-law-hearings-open-in-supreme-court.html?pagewanted=all Liptak, A LoGuirato, B. (2012, June 28). Mitt Romney: 'I will repeal Obamacare '. Retrieved August 1, 2012, from Business Insider: http://www.businessinsider.com/mitt-romney-reaction-to-supreme-court-decision-i-will-repeal-obamacare-2012-6 Martin, M Martin, R., & Holan, A. D. (2012, July 22). Can Florida afford to say no to Medicaid expansion? Retrieved August 2, 2012, from Tampa Bay Times: http://www.tampabay.com/news/health/can-florida-afford-to-say-no-to-medicaid-expansion/1241313 Miller v Office of the Legislative Council. (2010, May 1). Compilation of Patient Protection and Affordable Care Act. Washington, DC, USA. Retrieved 22 2012, July, from http://housedocs.house.gov/energycommerce/ppacacon.pdf Oliphant, J Supreme Court decisions. (2012, June 29). (KCTS9) Retrieved July 24, 2012, from KCTS9: http://kcts9.org/kcts-9-connects/supreme-court-decisions-june-29-2012 The Heritage Foundation United States Constitution, Article I, §8. (1787, September 17). Retrieved from http://www.archives.gov/exhibits/charters/constitution_transcript.html Vestal, C Whitman, G. (2012, July 24). Governors who refuse Medicaid expansion put politics ahead of people. Retrieved Augusst 2, 2012, from Huffington Post: http://www.huffingtonpost.com/gordon-whitman/politics-ahead-of-people_b_1695396.html Will, G Wolf, R., Heath, B., & Raasch, C. (2012, June 29). How health care law survived, and what 's next. Retrieved July 24, 2012, from USA Today: http://www.usatoday.com/NEWS/usaedition/2012-06-29-still2_CV_U.htm Weekly Agendas
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