Last week, the U.S. Supreme Court spent three days hearing arguments regarding the constitutionality of the Patient Protection and Affordable Care Act. It’s unclear how the court will rule, but any decision will have massive national impacts. Of the three days of hearings, one was spent debating the legality of an individual mandate and another on whether or not the federal government can force states to raise Medicaid benefits. The Supreme Court should uphold President Barack Obama’s health care reform law due to the constitutionality of the individual mandate and the federal government’s ability to regulate Medicaid.

Each of the Supreme Court’s hearings debated one of the three elements of the Affordable Care Act. The first hearing on Monday, March 26 was focused on whether or not the court should debate the law now, or wait for it to take effect in 2014. Tuesday’s hearing contended the legality of the federal government’s ability to force states to raise the income level for collecting Medicaid benefits — a vital piece of the legislation that if upheld will provide healthcare coverage for an estimated 17 million Americans. Wednesday’s hearing was focused on the most controversial element of the Affordable Care Act: the mandate that would force those unwilling to purchase health insurance to pay a fine. After three days of debate, the court will deliberate and release its decision sometime in June.

The health care reform law would require states to offer Medicaid healthcare coverage to all legal residents whose income is less than 33 percent above the federal poverty level. This will cause states to incur significant costs, but the federal government will pay for any new costs that are associated with the law until 2019. After 2019, the federal government will still pay for 90 percent of any new Medicaid costs that states incur due to the Affordable Care Act. The 1987 Supreme Court case South Dakota v. Dole reaffirmed the federal government’s authority to pressure states to accept legislation as long as the new law “promoted general welfare” and the federal government paid for any additional costs. The coverage of 17 million low-income Americans is undoubtedly promoting the “general welfare” and is protected by the Constitution.

Mandating Americans to buy health insurance is not only necessary for driving the cost of insurance down in the United States, but it’s also entirely constitutional and should be upheld by the Supreme Court. If everyone bought health insurance, the overall pooled cost would go down, making it more affordable for all Americans to be covered. This cost-controlling mechanism is constitutional according to the 1942 Supreme Court decision in Wickard v. Filburn. This case states that the commerce clause of the Constitution grants the federal government the ability to regulate an individual’s choices if those choices, on an aggregate level, affect the national economy. By not purchasing health insurance, an individual is affecting the market of an interstate good. The federal government has the authority to regulate interstate commerce and is constitutionally granted the power of mandating individuals to purchase health insurance.

The Affordable Care Act is fully constitutional and should be upheld by the Supreme Court. According to the Organization for Economic Cooperation and Development, the United States currently spends approximately 16 percent of its gross domestic product on healthcare, more than any other developed nation. Yet in overall healthcare quality, the World Health Organization ranked America a dismal 37th out of about 191 nations. If the Supreme Court upholds the law, the Affordable Care Act has the potential to correct many of the inherent problems of the American healthcare system.

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