Your Voice: The Supreme Court Upholds The Affordable Care Act

By a 5-4 vote, President Obama's health care legislation survived a constitutional challenge. Tell us what you think about the decision.

9:15 a.m. Update

Multiple news outlets are reporting that the United States Supreme Court has upheld the Affordable Care Act.

Chief Justice John Roberts authored the majority opinion and wrote in part,

"The Affordable Care Act is constitutional in part and unconstitutional in part  The individual mandate cannot be upheld as an exercise of Congress's power under the Commerce Clause. That Clause authorizes Congress to regulate interstate commerce, not to order individuals to engage it. In this case, however, it is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without health insurance. Such legislation is within Congress's power to tax."

Read the entire opinion here, courtesy of the Supreme Court's website.

Check out Reuters' live Supreme Court Blog

Tell us what you think about the Court's 5-4 decision upholding the individual mandate.

10:20 a.m. Mercy Hospital St. Louis used a


Original Story

After years of controversy over universal healthcare, and months since the historic healthcare legislation that both ends of the political spectrum have now called "Obamacare" became the subject of a legal challenge, the U.S. Supreme Court is expected to announce a decision Thursday morning.

Check out Reuters' live Supreme Court Blog

Predicting an outcome of the case surrounding the Affordable Care Act has been a parlor game among Supreme Court watchers. The Huffington Post has a roundup of some last-minute possibilities laying out what could happen.

We want to hear from you...how do you think the court will rule? How will the ruling impact your life or of the people you know? If you're an employer, what will it mean for your business? Tell us in the comment section, or if you'd like some more space to do it, try a Patch blog.

Maria Jansen July 03, 2012 at 12:43 PM
I agree that we are a bit insane if we think the government can run the healthcare industry more efficiently or effectively or economically than the private sector. It is broken, for sure, but this just changes (and enlarges) the scope of the problem, it doesn't fix it.
Sonny Pondrom July 03, 2012 at 12:58 PM
Devin - What is your source for "a $500,000,000,000 tax, again, the largest tax increase ever". You should be suspicious about such big claims. A history of tax increases shows the Affordable Care Act as 6th highest (similar to Clinton's rescue of our economy and only 1/2 that of Reagan's rescue). In addition, the tax will NOT be imposed on 93% of our citizens, so it won't hurt the economy, it will help.
Elizabeth July 03, 2012 at 03:35 PM
Sonny - You are naive if you believe that 93% of citizens will not be affected by the taxes in the ACA. Even if they are not taxed directly they will end up footing the bill as the increased costs will be ultimately passed down. Ironically, undocumented workers are exempt from the penalty for not having insurance. So in essence, 100% of those affected by taxes and / or penalties called for in the ACA will be citizens. Just out of curiosity, what source did your 93% statement come from?
Sonny Pondrom July 03, 2012 at 05:10 PM
Elisabeth - I don't remember the organization that produced the figure. They said only 7% of the country would have to pay tax. I'm not sure if which tax they were talking about - the tax that pays for ACA or the tax penalty for not buying insurance.
Sonny Pondrom July 03, 2012 at 05:26 PM
I won't have to pay the 3.8% surtax on "investment income" because my adjusted gross income is not more than $200,000 ($250,000 for joint-filers) where investment income is dividends, interest, rent, capital gains, annuities, house sales, partnerships, etc. Also this income limit of 1/4 million dollar means I don't have to pay 0.9% surtax on Medicare taxes. I don't plan to put more than $2,500 in a Flexible Spending Account, so no change for me. I don't meet the Itemized-deduction limit now, so raising it from $7,500 to $10,000 does not effect me either. I don't pay the 10% penalty on non-medical withdrawals now, so the 20% penalty does not effect me.
Robin Tidwell July 03, 2012 at 05:42 PM
Until the healthcare industry is regulated to keep costs down, it doesn't matter in the least if insurance is "mandated" or not. The problem is not uninsured individuals, the problem is that we seem to think we MUST have insurance - and the healthcare industry feeds into that. It's a system of fear. I spoke with a radiologist in another country recently, and there they charge approx. 10% for an equivalent US procedure - he was appalled at our prices. Only in America can different folks be charged different prices by the same doctor/hospital/company. We wouldn't put up with that in any other industry, would we? If you were in line at the pump, and you had to pay 3.15 per gallon but the next person got gas for $2.15, wouldn't you protest? Wouldn't you call it a racket? As long as we tacitly agree to pay $20 for a pill that costs 5 cents to manufacture - yes, even taking into account R&D, we exacerbate the problem.
Sonny Pondrom July 03, 2012 at 05:50 PM
Elisabeth - There is no penalty for not buying healthcare insurance if you make less than $9,500. Incomes lower than $37,000 have to pay $695 per person; below $50,000 its $1000; and below $75,000 its $1600 or $134/month. However, if you are exempt from Social Security, employer's plan greater than 8% of your pay, member of Indian tribe, or suffer hardship, then there is no tax. I just found out that the 2.3% medical device tax is only for items costing over $100. I don't remember paying that much for anything.
Elizabeth July 03, 2012 at 06:00 PM
Sonny - Do you purchase branded prescription drugs? Those manufacturers are looking at a tax based on the sales they make of those drugs. Medical equipment manufacturers are facing a 2.3% tax. Additionally, if you have a healthcare plan considered a cadillac plan, you can look forward to an excise tax beginning in 2018 that is figured at 40% over the threshold. Check out this site for a better explanation....http://www.seiu.org/a/healthcare/frequently-asked-questions-excise-tax-on-high-cost-health-plans.php. Even if you don't use the things I mentioned, your premiums will be adjusted (passed on) to compensate for the increased costs. You can pretend it is free all you want, that doesn't make it real. If this were the land of sunshine & kittens & you happen to miraculously fall into some magic bubble that shields you from any negative affects from the ACA there are still PLENTY of middle class Americans who DO use the HSA, who will be affected by the decrease in medical claims credits, who ARE small business owners who will be hit for capital gains (gains on paper don't always mean cash in hand. sometimes it is simply based on the increase in property value at a manufacturing plant). Personally, there are things about the ACA that will benefit me, but I wouldn't have voted for a law that hurts someone else for my own gain. Especially when the people most likely to get hurt are average people like myself. Nothing is free....someone is paying for it.
Sonny Pondrom July 03, 2012 at 06:05 PM
Elizabeth - I didn't mention that you can no longer pay for over-the-counter medicines from a pre-tax Flexible Spending Account. And there is a 10% tax on indoor tanning services. WOW. No wonder this law took so many pages.
Elizabeth July 03, 2012 at 06:09 PM
Sonny - I gave you those numbers several posts ago. As far as the medical device tax...tell that to people who use scooters, wheelchairs, heart monitors, portable oxygen machines, dialysis, insulin pump, etc. Just because it doesn't affect YOU personally doesn't mean it won't affect millions of other Americans. Try to think outside yourself for a few minutes and realize that it may not affect you today...but down the road could be a different story. And for lots of people the costs is direct and very real.
Elizabeth July 03, 2012 at 06:14 PM
Well put, Robin. The ACA isn't tackling the root of the problems...it simply makes it more complicated. Love the analogy!
Sonny Pondrom July 03, 2012 at 06:22 PM
Robin - You are correct when you say, "Until the healthcare industry is regulated to keep costs down, it doesn't matter in the least if insurance is "mandated" or not." When the US mandates that emergency rooms must care for anyone regardless of insurance or not, then we already have "universal healthcare". The difference with other parts of the world is their people do not have to deal with 'profit driven' insurance companies. The other thing we lack is tighter control on healthcare fraud. You are right to question how the rest of the world gets their healthcare so much cheaper.
Robin Tidwell July 03, 2012 at 07:57 PM
Exactly! If everyone is "entitled" to healthcare, then profits shouldn't enter into it. We've all heard the same tired arguments that R&D drives costs. Bull. Salaries drive costs - but those are somehow deemed "necessary." Furthermore, if I can go to a walk-in doc and pay $30, which I have done, how can another doc possibly justify billing me $150 without health insurance OR billing my insurance company $200 and charging me a $50 co-pay? Fix this garbage, healthcare is fixed.
D. Walker July 04, 2012 at 01:42 AM
Sonny Pondrom, so nice reading your comments without all the political rhetoric, sound bites and misinformation some are passing on here.
Sonny Pondrom July 04, 2012 at 02:02 AM
Thanks. That is the inspiration that we all need to find the truth. I wish our legislatures would compromise more. The "its my way or the highway" attitude never leads to a good solution. I am hoping that both parties read this blog.
reg July 04, 2012 at 02:24 AM
The hype is balony. This is not the largest tax increase in US history. Not close. It is the largest one since 1993, but that is hardly the same thing. http://news.yahoo.com/fact-check-looming-tax-hike-not-biggest-ever-073809320.html
reg July 04, 2012 at 02:26 AM
In case you haven't noticed, the Supreme Court says that it is constitutional, and they are the final arbiters in such matters. I assume what you meant is that you don't like it, but that is not the same thing.
reg July 04, 2012 at 02:27 AM
Unconstitutional. I don't think you know what the word means.
reg July 04, 2012 at 02:39 AM
And what abuse of executive power would you be referring to? If that was really happening, don't you think that Democratic House would be writing up Articles of Impeachment?
Sonny Pondrom July 04, 2012 at 12:23 PM
Elizabeth - I just found out that it is not so Ironic that undocumented workers are exempt from the penalty for not having insurance. The insurance does not cover them. However, they can go to the emergency room. Hmmm. Universal healthcare is looking better in that case. It looks like the tax mandate is a result of the emergency care mandate.
John Doe July 07, 2012 at 09:07 PM
How do you like these taxes? There is more to come. Taxes that took effect in 2010: 1. Excise Tax on Charitable Hospitals (Min$/immediate): $50,000 per hospital if they fail to meet new "community health assessment needs," "financial assistance," and "billing and collection" rules set by HHS. Bill: PPACA; Page: 1,961-1,971 2. Codification of the “economic substance doctrine” (Tax hike of $4.5 billion). This provision allows the IRS to disallow completely-legal tax deductions and other legal tax-minimizing plans just because the IRS deems that the action lacks “substance” and is merely intended to reduce taxes owed. Bill: Reconciliation Act; Page: 108-113 3. “Black liquor” tax hike (Tax hike of $23.6 billion). This is a tax increase on a type of bio-fuel. Bill: Reconciliation Act; Page: 105 4. Tax on Innovator Drug Companies ($22.2 bil/Jan 2010): $2.3 billion annual tax on the industry imposed relative to share of sales made that year. Bill: PPACA; Page: 1,971-1,980 5. Blue Cross/Blue Shield Tax Hike ($0.4 bil/Jan 2010): The special tax deduction in current law for Blue Cross/Blue Shield companies would only be allowed if 85 percent or more of premium revenues are spent on clinical services. Bill: PPACA; Page: 2,004 6. Tax on Indoor Tanning Services ($2.7 billion/July 1, 2010): New 10 percent excise tax on Americans using indoor tanning salons. Bill: PPACA; Page: 2,397-2,399
Sonny Pondrom July 07, 2012 at 10:11 PM
I love these taxes. Especially those that: harm people's skin; spend more the 15% of premiums on bonuses, lobbying, and advertisements; lobbying drug companies; big oil companies; invent tax loop holes and unmerciful billing practices. Thank you President Obama. Thank you for bring down the deficit while stimulating the economy and helping the middle class.
Devon Seddon July 10, 2012 at 05:46 PM
I have spoken with politicians from both sides, that number came from them. How much money do you think is involved in healthcare per year? It's well more than that number I gave you. I would like to know how you think that 7% of the people can foot this whole bill. I would also like to know how you think that 7% react, will it be by ADDING jobs in their industries, or maybe cutting jobs to pay for this nonsense? You don't seem to understand that the top incomes are the countries employers, not just a pool of money that the government can tap into whenever they've irresponsibly spent too much. Adding burdens to them will only create more unemployed dependents upon the system. THAT'S what this is about, creating dependents upon a system that is already broke. How do you expect that to work? Different than you & your co-horts, I'm not OK with something just because someone else is paying for it. Those who will pay for it will be FORCED to do so, and that's also wrong in a 'free country'. Funny how you don't hear anyone call America that anymore, and you can thank this kind of Federal interference for that.
Devon Seddon July 10, 2012 at 05:50 PM
You forgot to add in the tax part again. This isn't going to fix any of those issues, it's only going to move it to our taxes so that you all can act like it's free.
Devon Seddon July 10, 2012 at 05:57 PM
Obama has not lowered the deficit OR stimulated the economy, and his policies do not help the middle-class no matter how many times he tells you they do. He will never tell you how he's doing it, either. He always says what he supports, and always tells you that his opponents don't, but he never tells you how. I wonder why that is. Truth is, he continues to attack employers, which whether you like it or not, attacks employees -> the middle-class. You're buying the rhetoric because you are somehow emotionally tied to it, but facts don't have emotions.
Sonny Pondrom July 10, 2012 at 07:29 PM
Devon, Why don't you give us facts, like John Doe did above? Saying the "truth is" is really saying, "my opinion is". I believe the ACA will cost me nothing because I already have insurance and plan to use the Missouri exchange next year. I'm expecting to reduce my healthcare cost next year instead of the annual increase. I'm also happy that the insurance companies will have more business when almost 1 million additional Missourians will be covered next year.
Elizabeth July 11, 2012 at 02:47 AM
"A government big enough to give you everything you want is a government big enough to take from you everything you have." Gerald Ford, 1974
Devon Seddon July 11, 2012 at 06:17 PM
The truth is Sonny, there are thousands of examples. Drive down Mexico Rd in St Peters, drive down St Charles Rock Road in St Ann, etc. Even you can't say the industry has picked-up. Unemployment has been at 8+% for how long? It never got over 5.5% during the previous administration. We now have the highest corporate tax-rate in the world as of April, do you think that creates jobs or do you think businesses are leaving the country because of it? I'm sorry for not pointing out the obvious, but it doesn't matter, your mind is already made-up. You don't "believe" you have to see the largest tax increase ever to cover the cost of this program as a healthcare expense. Well, believe it or not, it is. As long as you don't count it, you "believe" it isn't there. It is. What about the price increases of every product created by those you claim will carry your burden for you, will that not count either? What about the unemployment increase that will result from placing further burdens on those job-providers, does that not count?. You have a short-sighted outlook on this (first it's a TAX increase, not an ACA), constantly talking only about your own healthcare, and dismissing where this will cost all of us more, including you. I'll now need you to give an example of when government involvement has cost less than before. It's not possible, no matter what you "believe". As long as you don't want to look at some very real effects of this tax, it doesn't matter what facts I give you.
Devon Seddon July 11, 2012 at 06:38 PM
Thank you Elizabeth, that's what this is... bigger government taking, in the name of giving. It's the "enlightened" & "tolerant" forcing their will upon those who have different beliefs & opinions (ironic isn't it), and using misdirection to fool the rest with "gifts", while hiding the fact that we will all pay more for it via tax-increases & the resulting economic effects. ps- No one on here has even addressed my repeated request for an example of when getting the government involved in anything has ever cost the people less in the long run.
Devon Seddon July 12, 2012 at 07:30 AM
I'm guessing you got your satisfactory response from an insurance company or government employee. Someone who maybe profits from the staus quo? What if crossing state lines would actually create COMPETITION instead? Competition that afforded customers with more choices? That would make insurance prices go down, right? Yeah, but I'm sorry, we only have a couple-hundred years of evidence that prove it, unlike what you have your faith in. Clever managers, that's my exact point and you still missed it. The repeated burdens on business have already caused these 'clever managers' to cut corners. Somehow you missed that part, and that part where the economy is in shambles, and unemployment is at a 70 year high, but somehow you found the part where it says that your premiums dictate the quality of your care. Look, ample competition is the only thing proven to eliminate corner-cutting, because it results in a loss of customers (when they have options), boundries & limits (regulations & record tax-rates) promote the opposite. Social medicine is only a "bad word" if you need people to look at this as something else. "You can't me sell a definition vacant the word it defines." That's how they trained you. It's the same thing you keep trying to do with the word: "tax", like if you cover your eyes, it's not there. Well, Peek-a-boo. It is.


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