Supreme Court upholds healthcare law as advocates continue call for single payer system

The Supreme Court ruled today that the President’s Affordable Care Act can go forward almost unchanged, except that state Medicaid expansion is now optional instead of mandatory. Though Democrats, women’s health advocates and progressive groups celebrated the decision, others say defending the Health Care Reform bill isn’t enough, and are calling for a universal, single payer system. FSRN's Alice Ollstein was outside the Supreme Court this morning, and files this report.

(Transcript of FSRN broadcast story)

AMBI/CHANTING: “WOOOOOO! The Mandate survived!”

As word that the Supreme Court voted 5 to 4 to uphold the Affordable Care Act filtered out to the street, hundreds of demonstrators began cheering and booing the decision.

AMBI/CHANTING: “We love Obamacare!” “We hate Obamacare!”

Some cried with joy while others shed tears of sadness. Shouting matches broke out across the marble steps of the Court as Tea Party and progressive activists confronted each other’s positions on everything from birth control to the Constitution. Some, including Lela [LEE-luh] Klein of Dayton, Ohio came from across the country to be at the Court as the decision came down. She told FSRN what it means for her.

KLEIN: “I’m a survivor of childhood cancer. I had Hodgkin’s lymphoma when I was 17.  As a result of that I have trouble getting health insurance because of the pre-existing conditions of the current regime. I was radiated in my chest, and because of that I’m supposed to get a breast mammogram and radiation test every year. With the prohibitive costs, I couldn’t afford it without this.”

But not everyone outside the Court was celebrating. Louisiana Republican Jeff Landry told the crowd he and his supporters will work to fully repeal the health care reform law, and failing that…

LANDRY: To engage in non-compliance, and if necessary, respectful, peaceful disobedience. We will not cooperate with this law no matter the consequences.

In the ruling, Chief Justice Roberts joined the Court’s four left-leaning Justices to uphold the constitutionality of the central piece of the law—the “individual mandate” that requires most Americans to either purchase insurance by 2014 or pay a penalty. Though most Justices rejected the Administration’s argument that it was entitled to regulate health care under the Commerce Clause, they said the mandate fell under the government’s legal power to levy a tax to influence behavior. Justice Anthony Kennedy joined the Court’s conservative wing in dissenting, saying both the mandate and the rest of the law should be struck down.

Counsel Emily Martin with the National Women’s Law Center explained what would have been at stake had those Justices prevailed.

MARTIN: We were worried that if the mandate fell, that the pieces of the Affordable Care Act that require insurers to charge women and men the same for the same health insurance might also fall. We were concerned about all the provisions that require insurers to provide preventative care without any sort of cost-sharing, so free mammograms, free pap smears, and free birth control for women with insurance. And we were very concerned that if insurers could revert to the practice of denying people insurance because of pre-existing conditions, that would have a terrible impact on women, who are being denied insurance because they’ve had a Cesarean section in the past, or been victims of domestic violence. [<--CK: CLIP IS REALLY LONG]

The other key piece of the ruling dealt with the bill’s provision that expands Medicaid to million of Americans not currently covered. The complex and divided opinion essentially held that Congress can offer states money for expanding Medicaid coverage to more low-income individuals, but can’t dock their funds if they refuse to participate.

Martin says she’s concerned some states will refuse, despite what she called “compelling reasons” for them to comply.

MARTIN: The federal government provides almost all the funding for the Medicaid expansion, all of it for the first several years, and then 90 percent after five years, so they’re picking up the great majority of the tab. And of course there are major public health reasons to expand Medicaid and make sure their citizens have access to affordable health coverage.  

But some remain skeptical of the Affordable Care Act’s ability to provide truly affordable care, and criticize the mandate for forcing individuals to pay private companies for health insurance. Many progressives are promising build on the momentum of the Court’s ruling to demand a single-payer system.

EVANS: We will continue to demand our right to access to affordable health care in this country.

That’s Reverend Anthony Evans with the National Black Church Initiative. He said Medicaid should be open to anyone, especially the people in the US most vulnerable to illness and accidents.

EVANS: We are tired and sick and tired of being sick all the time.  To be the last ethnic group on the worst statistical health indicators ever recorded.  It is time they provide adequate, comprehensive, universal healthcare for every African American in this country.

One pro-single payer group even petitioned the Supreme Court to strike down the individual mandate. Dr. Margaret Flowers with Physicians for a National Health Program explained why.

FLOWER: We cannot force people to purchase a private product.  We do not want our public dollars, hundreds of billions of dollars, going to the private insurance industry to subsidize this defective product, and health insurance is not protective. We cannot create a universal health system in this country based on a market model based on private insurance.

Though some members of the Congressional Progressive Caucus introduced a “Medicare for All” bill last year, they say it has little chance of passing the deeply polarized House and Senate.

Alice Ollstein, FSRN, Washington.


ANCHOR OUTRO: Nearly lost in the chaos of the health care ruling, the Court also struck down the Stolen Valor Act as unconstitutional. The bill made it a federal crime to lie about having received a military medal, punishable by up to a year in prison. Six of the Justices ruled that even knowingly false statements are a protected form of free speech.