The Fifth Circuit Court of Appeals decision on Wednesday holding the Affordable Care Act’s individual mandate unconstitutional does two things.
First, it affirms the argument we’ve been making all along — that despite the promises and assurances all Americans received, Obamacare hurt families by taking away their insurance, taking away their doctors, limiting their choices and pricing them out of health care.
And second, the decision reinforces the principle that the federal government’s powers are limited. It cannot force Americans to purchase products they don’t want and don’t need, nor can it consign their welfare to a system — whether it’s Obamacare of Medicare-for-All— that fails to meet their needs and even puts them at risk.
What was in the decision
Let’s start with the decision itself. The only reason the U.S. Supreme Court upheld the ACA in the Sebelius decision was a charitable gesture on the part of Chief Justice John Roberts — he acknowledged that the individual mandate (the rule that everyone has to buy insurance) doesn’t work as an order from the government, but the penalty for not buying insurance does work as a tax. When President Trump’s Tax Reform and Jobs Act of 2017 set the penalty at zero, there was no longer any justification for it. The appellate judges agreed with this in their Wednesday ruling.
The Texas Public Policy Foundation represented the individual plaintiffs in the case, plaintiffs the appeals court found are injured by the law. Like millions of other Americans, our clients soon learned that instead of saving $2,500 per year on health insurance, their insurance premiums would skyrocket, the doctors of their choice were out-of-network, and the coverage they had before was replaced with a policy that didn’t meet their needs.
And because of ever-increasing deductibles, my clients (small business owners who buy their insurance off the exchange) found themselves making choices no parent wants to make — do we take our child into the doctor for that cough, or do we try to ride it out? Do we see a doctor now, or save our money in case one of the kids gets sicker later?
Those lauding the “success” of the ACA — measured by enrollment numbers alone — forgot that coverage does not equal care. Millions of Americans, like our clients, received less health care and suffered worse health outcomes because of the law, with its one-size-fits-all approach to every family.
If people are getting less care, what was the point of the ACA?
That’s the harm our clients have suffered. The Affordable Care Act failed them — as it has failed our nation. There’s no better proof of that than the fact that the top seven Democratic presidential candidates scheduled to be on stage at tonight’s debate are backing either Medicare-for-All, an expanded Medicare, or a “public option” that would do essentially the same thing — move people off private-sector insurance. It’s a clear indication that Obamacare didn’t work.
Indeed, U.S. Rep. Alexandria Ocasio-Cortez this week excoriated the ACA as being too complex, and reiterated her call for a simpler “let the government worry about that for you” Medicare-for-All scheme.
That’s the wrong approach. The Sebelius decision, though it upheld the ACA as a tax measure, made clear that the Commerce Clause of the U.S. Constitution has its limits. It can’t force Americans to purchase a product they don’t want and don’t need. The principle of federalism, in fact, is all about limits — the limits to the federal government’s powers.
This principle is more important now than ever before, because of the leftward swing of the Democratic Party. The ruling is a check on their expansive view of federal reach.
As for the issue the Court of Appeals didn’t decide — namely, whether the individual mandate is “severable” from the rest of the law, or whether parts can be salvaged — that’s something the lower court will now decide.
But Congress needn’t wait for that decision. We have a blueprint for success. Let’s move forward with policies that give Americans more power, not less.