A Supreme test for Affordable Care Act

Readers who lately have been paying little attention to the Affordable Care Act — frequently called Obamacare — may experience an overdose of health care policy and the Interstate Commerce Clause this week.

That’s because the U.S. Supreme Court begins hearing oral arguments Monday on constitutional challenges to the Affordable Care Act. A high court decision is expected this summer.

We make no predictions on how the court will rule. But we continue to see problems and promise in the law passed by Congress two years ago this month.

As columns and a letter on this page illustrate, there is a robust debate about the law and its consequences.

Many people argue — as lawyers representing 26 states will do this week — that the individual mandate of the health care law is unconstitutional. They maintain the requirement that all eligible Americans purchase health insurance violates the Commerce Clause of the U.S. Constitution. To these folks, the issue isn’t so much health care, but the limits of federal government authority. If the government can order citizens to purchase health insurance, they say, there is virtually nothing the government can’t compel us to do.

For others, the debate is entirely about health care and the inadequacies of the system that existed prior to 2010. They point to the many people already receiving health care coverage through the Affordable Care Act who didn’t have it before as evidence of the law’s benefits. The old system, where insurance companies held most of the cards on health care decisions, was unfair, inefficient and not cost-effective, they argue.

For still others, the debate over the health law is about money and the cost of the Affordable Care Act. New cost estimates released by the Congressional Budget Office — $1.7 trillion for the next decade — add ammunition for those who say it is too costly.

For a variety of reasons, The Daily Sentinel did not endorse the health care law when Congress was contemplating it. For one thing, we thought it was too much all at once. Incremental changes, whose effect could be evaluated before the next step was taken, made more sense to us.

We also had concerns about the cost estimates, which were much disputed even then. And we worried that some of the provisions would encourage businesses to drop health insurance for their employees, a concern that is already proving to be valid.

However, we also supported some of the provisions of the Affordable Care Act. Measures that encourage test programs in areas such as evaluating new technologies make a great deal of sense. So do provisions that prod health care professionals, from doctors and clinics to hospitals and insurance providers, to work together to control costs.

Because of the defects in the previous system, many people have long clamored for a government-operated health care system. That cry is likely to ring even louder if the Supreme Court were to invalidate the entire Affordable Care Act.

Regardless of how the Supreme Court rules on the legislation, we believe the search for a cure to the nation’s health care woes will have to continue.


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