Now that the Supreme Court has ruled on the individual mandate, what’s next for both conservatives and the Republican party on health-care reform?
Thursday’s ruling means that the November elections are a referendum not just on President Obama’s poor handling of the economy, but now also on the fate of his signature piece of legislation, including, not insignificantly, his assault on religious liberty.
There’s a lot of talk about the insurance mandate, but in upholding the Affordable Care Act, the Court also preserved the other mandate — the one imposed by Kathleen Sebelius and personally signed by President Obama. That’s the HHS mandate, which would bury virtually every Catholic hospital, school, and charity in an avalanche of fines unless they provide health services that directly violate their church’s teachings.
Only one man in the last 40 years has been elected president without a majority of the Catholic vote. Even those Catholics who oppose elements of Church teaching don’t want the federal government forcing their Catholic school to provide sterilizations and abortion pills, which the HHS mandate would require. That’s why a majority of Catholics favor a clear exemption to the HHS mandate.
But President Obama has refused to grant a workable exemption to Catholic institutions and instead has sought to define the very criteria for what constitutes a religious group. And that’s why states with significant Catholic populations, such as Michigan, Wisconsin, and Pennsylvania, have suddenly become swing states. If Romney were to win just one of these states, it’s hard to imagine a scenario where Obama wins reelection.
The Catholic vote is very much in play. Governor Romney must make the case that the only way to start fresh and reform health care in a way rooted in moral principles and sound economics is to elect him president on November 6.
Brian Burch is president of CatholicVote.org
VERONIQUE DE RUGY
In the aftermath of the Supreme Court ruling, emotions run high on both sides of the political spectrum. I think it will take some time to figure out what the consequences of this ruling will be. One thing is sure: The government isn’t shrinking.
First, I am not a legal scholar, but I certainly hope that Randy Barnett (effectively the intellectual father of the legal challenge to the constitutionality of the health-care law) is correct when he writes:
Today, the Roberts Court reaffirmed the “first principle” announced by Chief Justice Rehnquist some 17 years ago in Lopez: “The federal government is one of limited and enumerated powers.” It accepted all of our arguments about why the individual insurance mandate exceeded the commerce power: “The individual mandate cannot be upheld as an exercise of Congress’s power under the Commerce Clause,” wrote Chief Justice Roberts. “That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage in it.”
According to Barnett, what we got today is a victory for federalism — granted, a weird one — or, as others have said, the president won the policy battle, but Justice Roberts won the war. One kept his very unpopular but signature law, and the other established limits on the Commerce Clause. I guess we will see about that.
However, even if this is true, it looks as if what we gained on the Commerce Clause side we may have lost on the tax side. Doesn’t this ruling effectively expand the power of Congress to regulate whatever it wants once it slaps a “penalty” on it and then defends it on the ground that it is actually a “tax”? Isn’t the distinction between tax and regulation a pure fiction, given that, in the end, we get a severe encroachment on our freedom either way? The government is already overreaching at every turn, and this ruling adds insult to injury.
Second, the fiscal impact of the decision is unclear. On the spending side, our financial outlook is dark, because the ruling keeps in place a health-care law that will increase spending dramatically. As my colleague Chuck Blahous has shown, once we look past the budget gimmick and double counting, “over the years 2012–21, the ACA is expected to add at least $340 billion and as much as $530 billion to federal deficits while increasing federal spending by more than $1.15 trillion over the same period and by increasing amounts thereafter.”
That’s not surprising. Unlike the claims made by advocates of the law, the government can’t create a system that will reduce costs while increasing access and services. As libertarian presidential candidate Gary Johnson explains, “Only competition and the price transparency that competition will bring can accomplish the imperatives of affordability and availability. Whether it is the president’s plan, or the Republican prescription drug benefit, the idea that anyone in Washington can somehow manage one of the most essential and substantial parts of both our quality of life and the economy is, and always has been, fundamentally wrong.”
However, it is clear that since this is a tax, the president has now officially broken his promise not to raise taxes on the middle class. According to previous CBO data, roughly 75 percent of the penalties will fall on the middle class.
Now there is also another uncertainty: What will be the impact of the Court’s ruling that states can opt out of the health-care law’s Medicaid expansion? In principle I see the limitation imposed by the Court as a good thing, but it could have some serious fiscal implications. As Avik Roy explains at Forbes, by allowing states to opt out, SCOTUS may have paved the way to dramatically increased deficits. Individuals who would have received coverage through Medicaid, but who won’t if their states opt out, may now be eligible for subsidies under the exchange, which is more expensive. Under this scenario, taxpayers will pick up the tab.
In the end, however you look at it, this ruling leaves us with a bloated government, too much spending, too much debt, less freedom, and a system that doesn’t even take care of poor people that well.