U.S. Supreme Court upholds Affordable Care Act, state leaders respond

Is it a tax or a penalty? That seemed to be the main question the U.S. Supreme Court was seeking to answer in regard to a challenged provision of the Affordable Care Act passed by Congress two years ago.

In a 5-4 vote, June 28, the U.S. Supreme Court upheld the Affordable Care Act, otherwise known throughout the country as "Obamacare," as constitutionally sound.

President Barack Obama calls the ruling a "victory for people" all over the United States, but many politicians in Alabama are calling it a devastating loss.

The bill, which Obama said would ensure more Americans are insured and insured at more affordable rates, had been widely criticized by many who said it was unconstitutional by requiring individuals to obtain health care or be subjected to a "tax penalty."

A provision in the act requires those who have not purchased health insurance through an employer, government program or private company by 2014 must make a "shared responsibility payment" to the federal government come tax season.

The flat dollar amount for individuals paying a "shared responsibility payment" will start at $95 per person beginning in 2014 and rise to a minimum of $325 the next year. Once fully phased in, the minimum amount per person will be $695 and rise each year with inflation. The minimum payment per family, no matter the size of the family, will go no higher than triple the per person payment.

However, the payment can never exceed the national average for the lowest cost insurance plans offered.

The payment can be higher for those with higher incomes and the law does provide for certain exemptions.

Twenty-six states, including Alabama, several individuals and the National Federation of Independent Business filed a suit in Federal District Court claiming the health care bill was unconstitutional.

The Commerce Clause, which defines the limits of Congress, does not allow Congress to demand people to buy insurance, though it is within Congress's power to "lay and collect taxes," which it does have the power to do under the Taxing Clause.

It all boils down to the bill's wording. The Affordable Care Act describes the "shared responsibility payment" as a "penalty" and not a "tax." But, according to the U.S. Supreme Court, it is, indeed, a tax.

Because it is within the power of the federal government to impose taxes, the law was upheld.

Alabama Attorney General Luther Strange said the individual mandate was sold to the American people as a penalty, but is now ruled constitutional as a tax.

"(It's) the very thing the Obama Administration and Congress insisted it was not," Strange said. "Now it is up to a new Congress and new president to repeal the act."

Several Alabama leaders have also expressed their thoughts on the court's ruling and general distaste that the law is a step away from market-based reforms. Alabama leaders continue to seek out appeal of the law.

"I am deeply disappointed by today's Supreme Court decision. The health care law is an outreach by the federal government that creates more regulation, bureaucracy, and a dramatic increase in costs to taxpayers. The ACA is the single worst piece of legislation to come out of Congress. This law must be repealed," said Alabama Governor Robert Bentley. "People need more choices, not fewer choices. Bigger government is not the answer. Market-based solutions are the best solutions to giving the public the most affordable options."

U.S. Rep. Martha Roby said she respectfully disagrees with the decision, calling the court's opinion "long and complicated."

"The president's health care reform has proven ineffective at reducing the cost of health care, has suffocated small businesses and has hampered job creation," Roby said. "Despite the court's ruling, I remain committed to working toward the repeal of this harmful law. We will again vote to repeal the law in the House of Representatives on July 9. We should immediately begin deliberate work toward the repeal of this harmful law with free market reforms that truly improve access to quality and affordable care."

Alabama U.S. Sen. Jeff Sessions, who is the ranking member of the Senate Budget Committee and a senior member of the Senate Judiciary Committee, said the bill is bad for health care, damaging to the economy and contrary to the country's free market heritage.

"Under this ruling, the big spenders have once again succeeded in surreptitiously imposing a tax on the American people while pretending they are not," he said. "The problem is that the mandate remains a mandate. It remains a demand that Americans purchase a product they do not wish to purchase. I do not believe the central government possesses such a broad power."

Sessions added that aside from whether it is constitutional or not, the bill still remains unaffordable at $2.6 trillion during the first 10 years, and will add $17 trillion in "unfunded long-term obligations," which he said will be "financially devastating to our Republic."

U.S. Sen. Richard Shelby agreed, saying though the ruling upheld the law it does not take away from "the fact that it is terrible policy."

In an official statement from the Medical Association of the State of Alabama, it opposed the law when it was passed two years ago and continues to oppose it after the court's ruling.

"If the American health care system is to remain the best health care system in the world, Congress must pass legislation that empowers patients and their physicians, not the government or any third party," the statement read. "Given there has not been adequate time for an in-depth analysis of the ruling, further examination is necessary to determine exactly what this ruling will mean for health care in Alabama."