WASHINGTON (BP) -- The U.S. Supreme Court has narrowly upheld the 2010 health-care law, dealing a disheartening setback to pro-life and religious liberty advocates who fervently oppose the controversial measure.
With Chief Justice John Roberts casting the deciding vote in a 5-4 opinion, the high court Thursday (June 28) announced its support for what critics often label "Obamacare." Four associate justices -- Anthony Kennedy, Antonin Scalia, Clarence Thomas and Samuel Alito -- said in a dissenting opinion they would have struck down the entire law.
Writing for the majority, Roberts said the "individual mandate," which requires almost all Americans to buy health insurance, is a valid exercise by Congress of its power to tax. Although Congress does not have the power under the Commerce Clause of the U.S. Constitution to require the purchase of health insurance, it does have the authority to tax those who do not have such coverage, the court said.
The Patient Protection and Affordable Care Act -- in combination with subsequent federal rules -- not only has elicited widespread opposition because of the "individual mandate" but because of other provisions, such as its federal subsidies for abortion, an abortion/contraceptive mandate that critics say violates religious liberty and a requirement that insurance plans in state exchanges not disclose their abortion coverage until people are enrolled.
The abortion-contraceptive mandate, which requires all plans to cover contraceptives and sterilizations as preventive services without cost to employees, has been in the spotlight of criticism since a federal rule to that effect was announced in January. The mandate includes coverage of contraceptives that can cause abortions of tiny embryos. The rule regarding that mandate has a religious exemption critics find woefully inadequate and has elicited ardent opposition from church groups and religious freedom advocates.
The Southern Baptist Convention's Ethics & Religious Liberty Commission (ERLC) and GuideStone Financial Resources have protested those provisions and others. The U.S. Conference of Catholic Bishops has led a charge against the abortion/contraceptive mandate and the failure to protect freedom of conscience and have been joined by pro-life and religious liberty organizations. Multiple lawsuits challenging the mandate have been filed in federal court.
Southern Baptist leaders expressed deep disappointment with the opinion.
"It is astonishing that the majority of the justices did not see the bill for what it really is: a blatant violation of the personal freedoms guaranteed by our Constitution and perhaps a mortal blow to the concept of federalism," ERLC President Richard Land said in a written statement.
In addition to continuing to protest the "abortion/contraceptive mandate" and its insufficient religious exemption, Land said, "Greater government involvement in medical care also means that the sick, elderly and terminally ill will suffer." He suggested many patients will have to wait longer to receive treatment as the government determines how to allocate resources.
"With its far-reaching effects," Land said, the health care law "will destroy much of what Americans hold dear."
O.S. Hawkins, president of GuideStone Financial Resources, said in a written release, "As I told messengers at the Southern Baptist Convention in New Orleans last week, we will never allow this Administration, or any other, to tell us that we have to provide abortive drugs like morning-after pills. ... We will maintain our advocacy on behalf of ministers we are privileged to serve."
The Supreme Court's decision quickly turned attention to the other two branches of government, especially the White House.
The Republican leadership of the House of Representatives announced it would hold a vote July 11 to repeal the health care law. The House is likely to approve the proposal, but the Democrat-led Senate undoubtedly will reject it.
Mitt Romney, the presumptive Republican nominee for president in November's election, said in a written statement, "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.
"Let's make clear that we understand what the Court did and did not do," he said. "What the Court did today was say that Obamacare does not violate the Constitution. What they did not do was say that Obamacare is good law or that it's good policy."
President Obama said, "Whatever the politics, today's decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court's decision to uphold it."
The high court "upheld the principle that people who can afford health insurance should take the responsibility to buy health insurance," he said. Obama added he is "as confident as ever that when we look back five years from now or 10 years from now or 20 years from now, we'll be better off because we had the courage to pass this law and keep moving forward."
Foes of the law undoubtedly grieved the fact Kennedy, the normal swing vote between the high court's liberal and conservative wings, agreed to invalidate the entire law, but Roberts, considered a staunch originalist when it comes to interpreting the Constitution, sided with the nominees of Presidents Clinton and Obama.
In the court's opinion, Roberts explained why the majority decided Congress could not require the purchase of health insurance as part of its authority to regulate interstate commerce but accepted the Obama administration's legal argument that the "individual mandate" acts as a tax.
As an alternative to its Commerce Clause argument, the administration contended the requirement that a person who refuses to buy insurance must make a payment to the Internal Revenue Service serves as a tax, Roberts said.
That theory "makes going without insurance just another thing the Government taxes, like buying gasoline or earning income," Roberts wrote. "And if the mandate is in effect just a tax hike on certain taxpayers who do not have health insurance, it may be within Congress's constitutional power to tax."
That may not be the "most natural interpretation of the mandate," but it is a "fairly possible one" under the high court's precedent and the law should be granted the "full measure of deference owed to federal statutes."
In deferring to elected leaders, Roberts said for the majority, "It is not our job to protect the people from the consequences of their political choices."
Joining Roberts in the majority were Associate Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan.
If the justices had invalidated the "individual mandate," they would have addressed whether any of the law could survive minus a provision that appeared so integral to its existence.
The four dissenting justices charged the majority with saving a law Congress did not craft.
"The Court regards its strained statutory interpretation as judicial modesty," they said in dissent. "It is not. It amounts instead to a vast judicial overreaching. It creates a debilitated, inoperable version of health-care regulation that Congress did not enact and the public does not expect. It makes enactment of sensible health-care regulation more difficult. . . ."
The court did provide a restriction on the health care law, ruling the section expanding Medicaid is unconstitutional in its threat to take away states' current funding if they refuse to participate.
GuideStone said the ruling has no immediate effect on the rates, benefits or eligibility of its health-plan participants. The benefits already have been established for 2013, and the rate-setting process for 2013 "is ongoing," according to GuideStone.
Tom Strode is Washington bureau chief for Baptist Press. Get Baptist Press headlines and breaking news on Twitter (@BaptistPress), Facebook (Facebook.com/BaptistPress) and in your email (baptistpress.com/SubscribeBP.asp).
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