Striking Down the Affordable Care Act Would Be Unconscionable

About Ron Pollack:

Ron Pollack is the founding executive director of Families USA, a national organization for healthcare consumers.

For millions of Americans, the Affordable Care Act's promise of better healthcare is already a reality. Young adults can now maintain health coverage through their parents' policies until they turn 26. Children with conditions like autism or cerebral palsy can no longer be denied coverage by insurers for having pre-existing conditions. Insurance companies cannot cut off coverage if someone gets sick or reaches a lifetime limit. Seniors are paying less for prescription drugs and getting free preventive care. Small businesses are using tax credits to make coverage available for their workers.

Starting this summer, comprehensive preventive care for women, including mammograms and contraception, will be free. And in 2014, no insurance company will be allowed to discriminate against women (or men) with pre-existing conditions by charging higher premiums. Tax credits will make health coverage affordable for millions of middle-class families. And millions of low-income Americans will get coverage through an expanded Medicaid program.

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It would be unconscionable for the Supreme Court to take these gains away from the American people. It would also be a profound legal error. Most courts that have considered challenges to the Affordable Care Act have found the law to be soundly constitutional. Prominent conservative jurists, like Jeffrey Sutton of the Sixth Circuit Court of Appeals and Laurence Silberman of the D.C. Circuit, have upheld the law's individual responsibility provision. In his opinion, Judge Sutton concluded that it is up to the people through their elected representatives, not the courts, to decide what makes good policy. The Supreme Court should adopt this reasoning.

On the lesser-known, but vitally important, question of the Medicaid expansion, there should be even less controversy. Medicaid has been expanded many times in its 47-year history. No court has ever rejected any expansion. Even the 11th Circuit Court of Appeals that (erroneously, in my view) struck down the individual responsibility provision found that the Medicaid expansion was constitutional, stating that the states' complaints in this arena were more "rhetoric than fact."

For the American people, the stakes in this case are extraordinarily high. The health, and even the lives, of millions hang in the balance. Fortunately, the law is on the public's side. If the Supreme Court follows existing precedent, it should, and will, uphold the law.

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healthcare reform