Constitutionality of the Affordable Care Act

Abstract

Reforming health care is a complex debate revolving around accessible, cost-effective, accountable, and quality health care. In the National Federation of Independent Business versus Sebelius, the Supreme Court confirmed that individual mandate as well as expanding Medicaid falls under constitutional Affordable Care Acts (Musumeci, 2012). Policymakers have long-held that health care is a legal right that the constitution provides. It is on this basis that this report evaluates the right of citizens to health care and the constitutionality of resolving the Affordable Care Act (ACA).

Position of the Supreme Court in protecting public health and safety

According to Musumeci (2012), the act necessitates that American adults qualifying for healthcare keep a minimum level of insurance; also termed the individual mandate. Yet, the United States constitution does not explicitly cater to health care rights. Thus, courts have failed to deduce health care rights as a government mandate. After passing the act, Musumeci (2012) adds that the expanded Medicaid extended cover for those who could not get medical care, such as the disabled, the aged, and families with earnings below a certain income.

The court’s decision to expand Medicaid failed to invalidate the new eligibility group that existed as law since 2004 (Musumeci, 2012). Still, medical expansion remains optional for states after the Supreme Court’s decision. Nevertheless, the court’s decision provides that the secretary can hold back ACA Medicaid expansion funds for states, which fail to meet the requirements of Medicaid expansion.

Critiquing the court’s position in NFIB v. Sebelius

Plaintiffs in NFIB v. Sebelius contend that this was the ACA’s violation of particular fundamental liberty rights outlined in the Fifth Amendment (Teitelbaum, Riegelman & Wilensky, 2013). This includes the right to turn down medical treatment, the right to decline to pay for unwanted treatments, and the right to decline payment for insurance covering unwanted treatments. However, the appeal court concluded that individual mandate failed to implicate the essential right to decline unwanted medical care. This is because the court did not legally characterize the freedom to decline to pay for medical care they do not need or to stay uninsured as fundamental liberty interests.

Teitelbaum et al. (2013) assert that the legislature has to support and care for public health. Since the health and morality of people are part of their well-being, the Supreme Court ruling affirms its duty of promoting and protecting these vital interests. Additionally, this case affirms constitutional provisions that authorize governments to give health care services, although not a prerequisite. Therefore, from an ethical, legal, and public health perspective, the Supreme Court’s decision holds.

The case affirms the legal and ethical right to health care and the arising issue is the government’s obligation to provide health care for its citizens who are unable to afford it. This takes priority over whether one has a right to quality care that they are capable of paying.

While the constitution fails to set forth a right to health care, the Supreme Court’s decision in NFIB v. Sebelius suggests its failure to consider health care a fundamental right. Indeed, the constitution fails to discuss health care rights. On the other hand, the Supreme Court case holds that failing to give a minimum level of health to the poor goes against equal protection by health agencies that the constitution guarantees. While critics argued that the court’s decision is unconstitutionally coercive of states, it fails to guard against future coercion.

References

Musumeci, M. (2012). A guide to the Supreme Court’s Affordable Care Act decision. Web.

Teitelbaum, J. B., Riegelman, R., & Wilensky, S. E. (2013). 2013 annual health reform update [Supplemental material] (pp. 1–43). Burlington, MA: Jones & Bartlett Learning.