The Supreme Court's narrow decision today that the Affordable Care Act is constitutional is a victory for all of us who defend the right of Americans to join together to impose new rules on the private health insurance industry—to require that they cover all applicants and not disqualify people with preexisting conditions. It is a victory for those who want to try to get the private insurance system to create state insurance pools —with subsidies for low income people—to make insurance available to all. The Affordable Care Act experiment in trying to get the insurance industry to cover everyone can now go forward.
In plain English: The Affordable Care Act, including its individual mandate that virtually all Americans can buy health insurance, is constitutional. There were not five votes to uphold the law on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the court did not need to decide what other parts of the statute were constitutional.
The many Republicans who are now disappointed that the court did not throw out the law— and who are campaigning to repeal the law that would extend affordable coverage to millions of Americans—are the same politicians who have recently voted to dismantle the two functioning parts of the health care system: Medicare and Social Security.
Almost every Republican in the House and Senate voted for the Ryan Republican budget. That budget would end Medicare’s pledge of guaranteed coverage for seniors; instead future seniors (today’s workers and youth) would get an inadequate voucher with which they would have to try to buy private health insurance in the confusing and inconsistent private insurance market.
By contrast, the Campaign for America’s Future was and is a strong proponent of including a "public option” as part of the Affordable Care Act. And CAF continues to urge Democrats to campaign (and win a new majority) as defenders of Medicare and Social Security – the two parts of our crazy-quilt health care system that guarantee health care and retirement security to all Americans who are eligible.