“Obamacare,” Its Benefits, And Why Its Critics Are Wrong

March 23, 2012 marked the second anniversary of President Obama signing into law his landmark health care reform initiative, the Patient Protection and Affordable Care Act. While the legislation is far from perfect, it includes numerous historic provisions that will greatly benefit the American people and our health care system. In celebration, below are links to a number of the posts that Winning Progressive has featured about health care reform. Also, if you want a year-by-year listing of all of the benefits from health car reform, this page by the Kaiser Family Foundation is a great resource.

ObamaCare is, of course, under attack with conservative activists having taken a constitutional challenge to the law all the way to the Supreme Court. That challenge focuses on the individual mandate or shared responsibility provision of ObamaCare, which requires individuals to purchase insurance, which critics claim exceeds the federal government’s power under the Commerce Clause of the Constitution.  As we’ve previously explained, leading conservative federal appellate court judges have already rejected that argument, explaining that the “substantial effects” of millions of people not purchasing insurance until they are sick would undermine the health insurance market that Congress indisputably has the authority to regulate. Winning Progressive believes that the Supreme Court will follow suit, either 5-4 or 6-3.

ObamaCare critics, however, have argued that the individual mandate must be reversed because there is no possible limiting principle to a decision upholding the mandate. For example, in the Supreme Court argument yesterday, Justice Roberts asked whether the government could mandate the purchase of cell phones to ensure that people are able to access emergency services when needed, while Justice Alito offered a hypothetical about requiring the purchase of burial plots because everyone will eventually need them. Similarly, in the New York Times, Ross Douthat suggested that if Congress can require the purchase of health insurance, it could also require individuals to obtain food vouchers or join a grocery club presumably to make food more affordable.

The conservative “lack of a limiting principle” argument, however, fails because it ignores the fact that the underlying regulatory goal that the government is attempting to achieve through a mandate must itself be a proper government goal. In the context of health insurance, there is no reasonable dispute that the government can, under the Commerce Clause, require private insurance companies to provide insurance to anyone who can afford it, regardless of pre-existing conditions. But the only way a system free of pre-existing condition exclusions can work is to require individuals to purchase insurance, because otherwise everyone would wait to purchase insurance until they are sick, which is unworkable.

With regards to purchasing groceries or burial plots, however, requiring grocery store owners or burial plot owners to sell their products to anyone who can afford them does not require a mandate to require everyone to purchase those products. That is because an individual’s refusal to purchase groceries or a burial plot does not threaten a system that requires grocery stores or burial plot owners to sell to anyone who can afford the product. The only way that an individual mandate to purchase groceries or burial plots they can afford could be necessary to achieve a regulatory goal is if that regulatory goal was to require grocery stores or burial plot owners to provide groceries for free to those who cannot afford them. But the government cannot require that (instead, the government would have to provide such products if it wanted to) and, therefore, a grocery mandate or burial plot mandate would never pass muster.

In short, the conservative claim that upholding ObamaCare would open the door to the government requiring individuals to purchase all sorts of products is grounded in fearmongering, not fact.


Some Winning Progressive posts on health care reform:

Reforming the Broken Health Care System

Protecting Consumers From Abusive Health Insurance Industry Practices

Expanding Health Insurance Coverage to 32 Million Americans

Health Care Reform Benefits That Went Into Effect on January 2, 2011

Closing the Medicare Doughnut Hole

Health Care Reform Benefits for Small Businesses

ACA’s Free Birth Control Won’t Be Enacted Without a Fight

Let’s Rationalize Health Care Spending, Rather Than Rationing Health Care