Supreme Court rules on health care law; bishops say needs 'repair'

A woman opposed to the administration's health care reform law speaks shortly after a Supreme Court ruling in front of the court building in Washington June 28. The nation's high court upheld the Patient Protection and Affordable Care Act as constitutional but placed some limits on the federal government's ability to terminate states' Medicaid funding. (CNS photo/Bob Roller)

By Nancy Frazier O'Brien
And CFP staff

WASHINGTON (CNS) – Although the individual mandate in the 2010 health reform law does not pass constitutional muster under the Commerce Clause of the Constitution, it can be upheld as an acceptable exercise of Congress' taxing powers, the U.S. Supreme Court ruled Thursday. (Link to the decision)
The U.S. bishops are calling for repair of the Affordable Care Act after the Court issued its decision.
Bishop McManus said, “ The Catholic Church in the United States has consistently supported better access to healthcare as a fundamental human right. I join with my brother bishops in noting that today’s Supreme Court decision does not diminish the moral imperative to ensure decent health care for all. However, the Court’s decision does not correct the fundamental flaws in the law, including the protection of conscience and respect for religious liberty. The Church must continue to urge Congress and the Administration to fix those flaws.”
In a 65-page opinion written by Chief Justice John Roberts, five members of the court upheld the Patient Protection and Affordable Care Act in full but limited the federal government's right to withhold its share of Medicaid funding from states that do not expand the health program for the low-income and disabled as mandated by the law.
Joining Roberts in the majority opinion were Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor and Elena Kagan, although Ginsburg differed from the other four on whether the mandate was constitutional under the Commerce Clause.
"The federal government does not have the power to order people to buy health insurance ... (but) does have the power to impose a tax on those without health insurance," the Roberts opinion says. The mandate "is therefore constitutional, because it can reasonably be read as a tax."
Dissenting were Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito, who would have overturned the entire law as an unconstitutional violation of the Commerce Clause.
By forcing those who are young and healthy to purchase health insurance, the law compels those who do not wish to participate in a particular marketplace to do so, the dissenters said.
"If Congress can reach out and command even those furthest removed from an interstate market to participate in the market, then the Commerce Clause becomes a font of unlimited power, or in (Alexander) Hamilton's words, 'the hideous monster whose devouring jaws ... spare neither sex nor age, nor high nor low, nor sacred nor profane,'" said the dissenting opinion, written by Scalia.
“For nearly a century, the Catholic bishops of the United States have been and continue to be consistent advocates for comprehensive health care reform to ensure access to life-affirming health care for all, especially the poorest and the most vulnerable,” they said in a press release after the ruling was announced Thursday.
The United States Conference of Catholic Bishops did not participate in these cases and took no position on the specific questions presented to the Court. However, the USCCB’s position on health care reform generally and on ACA particularly is a matter of public record, they said.  The bishops ultimately opposed final passage of ACA for the following reasons.
“First, ACA allows use of federal funds to pay for elective abortions and for plans that cover such abortions, contradicting longstanding federal policy.  The risk we identified in this area has already materialized, particularly in the initial approval by the Department of Health and Human Services (HHS) of “high risk” insurance pools that would have covered abortion.
“Second, the Act fails to include necessary language to provide essential conscience protection, both within and beyond the abortion context.  We have provided extensive analyses of ACA’s defects with respect to both abortion and conscience.  The lack of statutory conscience protections applicable to ACA’s new mandates has been illustrated in dramatic fashion by HHS’s “preventive services” mandate, which forces religious and other employers to cover sterilization and contraception, including abortifacient drugs.
“Third, ACA fails to treat immigrant workers and their families fairly.  ACA leaves them worse off by not allowing them to purchase health coverage in the new exchanges created under the law, even if they use their own money.  This undermines the Act’s stated goal of promoting access to basic life-affirming health care for everyone, especially for those most in need.”
The bishops have not joined in efforts to repeal the law in its entirety, and “do not do so today,” the release states.
“The decision of the Supreme Court neither diminishes the moral imperative to ensure decent health care for all, nor eliminates the need to correct the fundamental flaws described above.  We therefore continue to urge Congress to pass, and the Administration to sign, legislation to fix those flaws,” it concluded.
Thursday’s decision does not affect the recent Department of Health and Human Services definition of “preventative services” which called for free contraception for women, including abortion-inducing drugs, and sterilization to their employees at no cost.
In a press release to members of “Women Speak for Themselves,” a group headed by Helen Alvare, a law professor at George Mason University who has worked on life issues for the USCCB and is a consultor to the Pontifical Council for the Laity, she said, “This means, for the time being, that the HHS mandate stands as is, and we can and must continue our fight against it!”
She said lawsuits challenging the “preventive services” mandate on the grounds it violates religious freedom are in their early stages and are continuing.Those cases are still in lower courts and have not yet reached the Supreme Court.
Judie Brown, president of American Life League, said in a statement, “This is indeed a sad day for the people of this once great nation where liberty has always been equated with freedom of religion, freedom from oppression, and freedom of speech. The government's draconian healthcare law denies so many rights that the true result is yet unknown, but surely liberty has been trounced in unbelievable fashion.”