June 25, 2015

This morning, the United States Supreme Court upheld a key portion of the health insurance reform law known as the Affordable Care Act (ACA), often referred to as Obamacare. Chief Justice John Roberts wrote the 6-3 majority opinion allowing the federal government to provide subsidies in all 50 states, not just those states with independent exchanges. The subsidies help low- and moderate-income people purchase health insurance. The decision, a major victory for President Barack Obama’s administration, prevented millions of Americans from losing their health coverage. The court’s ruling was its second in defense of the ACA, which has been under constant Republican attack since Congress passed the law in 2010.

The Supreme Court Building in Washington, D.C. (© Joe Sohm, Photo Researchers)

The ruling ended the case of King v Burwell which challenged the legality of federal subsidies in the 34 states—nearly all Republican-led—without exchanges. In these states, political leaders have resisted or simply failed to create state-level insurance marketplaces, forcing people to purchase insurance independently or directly from the federal government. The case centered on the phrase “established by the state” within the ACA. Limousine driver David King—who did not qualify for a subsidy in Virginia—sued U.S. Secretary of Health and Human Services Sylvia Burwell, arguing that subsidies paid out to more people than the law intended raised his rates to an unfair and unacceptable level.

In the official Supreme Court opinion, Justice Roberts said the law clearly meant to make subsidies available to all Americans whether or not their local insurance exchange was “established by the state.” He wrote, “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them.” The ACA sought to improve Americans’ health coverage by expanding access to public health plans, by requiring individuals to purchase private insurance, and by reforming various practices in the insurance industry. President Obama, pleasantly reacting to the court’s decision, said that “the whole point of public service” is to look after each other and improve the lot of fellow Americans. “So this was a good day for America.”

Additional World Book articles:

• U.S. Supreme Court Upholds “Obamacare” (June 28, 2012, Behind the Headline article)
• Health 2010 (a Back in Time article)
• Supreme Court of the United States 2012 (a Back in Time article)
• Health 2013 (a Back in Time article)
• Health Care Reform–What’s In It for You? (a special report)

July 30, 2014

The United States House of Representatives passed a resolution yesterday to sue President Barack Obama for allegedly exceeding his constitutional powers. The vote–225 Republicans for and 196 Democrats joined by 5 Republicans against–authorized House lawyers to draft legal documents to launch a lawsuit in federal court.

Republicans in Congress have complained that the president has on numerous occasions exceeded his constitutional authority by issuing executive orders that purposely bypass the will of the legislative branch of government. In particular, House Republicans claim that President Obama exceeded his powers when he twice delayed requirements in the Affordable Care Act that businesses over a certain size provide workers with health insurance. They also object to presidential authorization of an exchange of Guantanamo detainees for Bowe Bergdahl, a U.S. soldier held captive for five years by the Taliban. Republicans also cite an executive order that eased deportations of some young illegal immigrants. Most recently, the president issued an executive order making it unlawful for businesses with government contracts to discriminate against members of the LGBT (Lesbian, Gay, Bisexual, and Transgender) community. “This isn’t about Republicans or Democrats. It’s about defending the Constitution we swore an oath to,” declared House Speaker John Boehner during the House debate.

President Barack Obama (The White House)

Speaker of the House John Boehner (United States House of Representatives)

President Obama has dismissed the law suite “as a political stunt” that will cost taxpayers million of dollars. He noted that he has been forced to issue executive orders to circumvent a gridlocked Congress. He cites the Republican-controlled House, under Speaker Boehner, for refusing to even to hold votes on such Senate-passed legislation as raising the minimum wage and much-needed immigration reform.

Democrats in Congress point out that every U.S. president since George Washington has issued executive orders and that President Obama has, in his six years in office, issued only 183. By comparison, George W. Bush issued 291 in his eight years in office; Bill Clinton issued 364; and Ronald Reagan issued 381.

Political experts note that the lawsuit–the first ever brought against a president by Congress–may be a maneuver by Speaker Boehner to tamp down a Tea Party move to impeach President Obama, an action that would likely prove highly unpopular with the electorate in the face of congressional elections in November. They also point to the irony of the House suing the president over not implementing parts of the Affordable Care Act after House Republicans voted 54 times in 4 years to repeal “Obamacare.”

Additional World Book articles:

• Tempest in a Tea Party (a special report)
• Health 2013 (a Back in Time article)

October 1, 2013

A central provision of the Affordable Care Act, popularly known as “Obamacare,” went into effect today amid a general shutdown of the U.S. government. Federal and state-run insurance exchanges opened for business this morning. As many as 7 million uninsured Americans are eligible to buy affordable health insurance on these exchanges.

Condemning the Affordable Care act as an unprecedented intrusion into Americans’ private lives, Congressional Republicans waged a years-long campaign to undermine it. The latest effort led to today’s government shutdown. A number of Republicans in the House of Representatives, in particular the Tea Party caucus, demanded that the law be repealed or stripped of funding as a condition for continuing to fund the government. The Senate refused to pass the House bill, and House leaders refused to even bring the Senate-approved budget up for a vote. (Political experts note that the Senate bill would have passed in the House, largely with Democratic votes, if it had been brought to the House floor by Speaker John Boehner. They suggest, however, that if Boehner had brought the Senate bill up for a vote in defiance of the Tea Party caucus, his action would have cost him his position as speaker of the House.)

With no new budget or budget extension in place, the U.S. government shut down this morning at 12:01 a.m. At least 800,000 federal employees will likely be sent home without pay as many government agencies prepared to close their doors. More than 1 million others will be asked to work without pay. President Barack Obama signed legislation late on September 30 ensuring that uniformed members of the military will be paid during the shutdown. The 533 current members of Congress will also receive their paychecks.

The shut down of the U.S federal government on October 1 led to the closing of national parks and monuments across the nation (c George Goodwin, Monkmeyer).

Republicans in Washington, D.C., and in state capitals across the country, have battled to repeal the health care law since its passage in 2010. The House of Representatives took 40-some symbolic votes to nullify it or eliminate its funding. Legal challenges led by Republican governors ended in June 2012 when the Supreme Court validated its most controversial provision: the individual mandate, which specifies that Americans not receiving health coverage from their employers or from the government must purchase individual plans or pay a fine.

Several provisions of “Obamacare” went into effect prior to today: children can now remain on their parents’ insurance plans up to age 26; children with pre-existing health conditions can no longer be denied coverage; senior citizens now enjoy prescription drug discounts; and insurance companies can no longer place lifetime limits on health coverage. Another major provision—the employer mandate—requires employers with at least 50 full-time workers to provide insurance or incur a $2,000 per employee penalty. Implementation of that provision has been delayed until 2015.

Additional World Book articles:

• Congress of the United States 2010 (a Back in Time article)
• Health Care Reform–What’s in it for You? (a special report)
• Medicaid in Distress (a special report)
• Tempest in a Tea Party (a special report)

September 30, 2013
A shutdown of the U.S. federal government looms, as Democratic and Republican lawmakers remain deadlocked over stopgap legislation to fund government operations. Without passage of a finance bill by both houses of Congress, the government will be forced to close all nonessential federal services at midnight on October 1.

Speaker of the House of Representatives, John Boehner (above), leads a Republican Party intent upon tying the U.S. budget bill to delaying or denying funding to the Affordable Healthcare Act, passed in 2010. Senate Majority leader Harry Reid (above left) has vowed that the Senate will not vote for the House's version of the finance bill (United States House of Representatives).

(U.S. Senate)

The key point of contention in the political stalemate is the Affordable Care Act, President Barack Obama’s landmark health care legislation. A number of Republicans in the House of Representatives—in particular the Tea Party caucus—demand that the law be repealed or stripped of funding as a condition for keeping the government running. The House passed its latest version of a stopgap funding measure on September 28. The bill included a year-long delay in the implementation of what has come to be called “Obamacare.” It also included a measure that would permanently eliminate a medical-device tax that was designed to partially fund the new health care system. Legal experts point out that eliminating the tax would essentially cripple the act. Senate Majority leader Harry Reid has vowed that his Democrat-led chamber will reject the House bill, and in fact, the Senate failed to go into session on September 29 despite the political crisis.

A government shutdown would place more than 700,000 federal employees on unpaid leave, with no guarantee of receiving back pay once the deadlock is over; Social Security, federal pension, and veterans’ benefit checks would be delayed; Medicare and Medicaid payments would be disrupted; and many government facilities, including immigration services  and passport and visa offices, would be shut down; the national parks and Smithsonian museums would also close.

President Obama emphasized today that the simple solution to the standoff is for House Republicans to pass the budget that was passed by the Senate on September 27. Of course, the Senate legislation does not gut the Affordable Care Act. Political experts note that the Senate bill, if brought to the House floor by Speaker John Boehner, would almost certainly pass, largely with Democratic votes. However, they suggest that if Boehner were to bring the Senate bill to a vote in defiance of the Tea Party caucus his action would likely cost him his position as speaker of the House.

Major portions of the Affordable Care Act, which a Democrat-controlled Congress passed in 2010, are due to go into effect tomorrow. The U.S. Supreme Court ruled that the act was constitutional in 2012.

Additional World Book articles:

• Congress of the United States 2010 (a Back in Time article)
• Health Care Reform–What’s in it for You? (a special report)
• Medicaid in Distress (a special report)
• Tempest in a Tea Party (a special report)

June 28, 2012

The U.S. Supreme Court, in one of the most far-reaching decisions in years, upheld much of the Patient Protection and Affordable Care Act, President Barack Obama’s landmark health care law. In a 5-to-4 decision, the court confirmed that the individual health-insurance mandate is constitutional under Congress’s authority to tax citizens. The mandate requires nearly all Americans to buy health insurance by 2014 or pay a fine if they refuse.

The Supreme Court Building in Washington, D.C. (© Joe Sohm, Photo Researchers)

Legal and health care experts considered the individual mandate to be the most crucial issue before the court. Striking it down would have made it financially difficult for insurance companies to comply with other, more popular elements of the law without drastically raising premiums: Under the Affordable Care Act, for example, insurance companies can no longer limit or deny benefits to children because of a preexisting condition; and insurance companies must expand coverage to young adults up to age 26 under their parents’ plan. The act also provides subsidies to some lower middle-income households to buy insurance and to some businesses for insuring their employees.

A major provision of the Affordable Care Act expanded Medicaid to cover a much wider range of lower income citizens. (Medicaid is a U.S. government program that works in cooperation with state governments to partly finance medical assistance to needy people.) On the question of Medicaid, the court ruled that the expansion could move forward. However, it struck down a provision that threatens states with the loss of Medicaid funding if the states refused to comply with the expansion.

Chief Justice John G. Roberts, Jr., joined Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan, and Sonia Sotomayor in voting to uphold the law. Associate justices Samuel Alito, Anthony Kennedy, Antonin Scalia, and Clarence Thomas voted against it.

The nine judges of the Supreme Court of the United States include Chief Justice John G. Roberts, Jr., (seated, center) and eight associate justices: Sonia Sotomayor, Stephen Breyer, Samuel Alito, and Elena Kagan (back row, left to right); and Clarence Thomas, Antonin Scalia, Anthony Kennedy, and Ruth Bader Ginsburg (seated, left to right). (AP Photo)

Popularly known as Obamacare, the law is expected to eventually extend health care coverage to more than 30 million Americans who currently lack it. It was also designed to help rein in health care costs, one of the largest and fastest-growing sectors of the economy.

Political experts note that the health care debate is far from over. Republicans–including the presumptive Republican presidential nominee, Mitt Romney–vow to overturn the act. Conservatives generally regard it as both unaffordable and an infringement on individual rights.

Additional World Book articles:

• Congress of the United States 2010 (a Back in Time article)
• Health 2010 (a Back in Time article)
• Entitlements–Benefit of Doubt (a special report)
• Health Care Reform–What’s In It for You? (a special report)
• Medicaid in Distress (a special report)