Affordable Care Act is Victorious | LBJ School of Public Affairs | The University of Texas at Austin
BY:  Sherri Greenberg, Director of the LBJ School's Center for Politics and Governance

In the Olympic trial that was the June 28 Supreme Court ruling on the Affordable Care Act, health care reform won this heat. Just as sports enthusiasts have been waiting with eager anticipation for the 2012 Summer Olympics, many Americans have been waiting for this Supreme Court ruling. Crowds assembled in Washington and across the nation, as the Supreme Court ruled in a momentous 5-4 decision that the Affordable Care Act is constitutional.

How did this happen? In the 5-4 decision, with Chief Justice John Roberts siding with the majority, the Court ruled that the Act is constitutional because the mandate requiring individuals to have health insurance actually is a tax. The Court’s opinion states that the mandate is constitutional because the repercussion for someone not obtaining health insurance is paying a penalty to the Internal Revenue Service, along with the individual’s taxes.

Another very important aspect of the Court’s ruling regards the latitude states will have in complying with the Medicaid expansion portion of the Affordable Care Act. The Act requires the states to expand Medicaid coverage of individuals in their states up to 133% of poverty. However, the Supreme Court ruling says that the states cannot be forced to comply with Medicaid expansion, and most importantly, that if they do not, the federal government cannot reduce their current Medicaid dollars.

The Court’s decision is a big win for President Obama on his major domestic policy initiative, and the President has hailed the decision as a great victory for Americans. Meanwhile, Mitt Romney has vowed to repeal the Affordable Care Act if he wins the presidency. Clearly, health care reform will remain a major and contentious issue in the presidential election. Democrats will declare the Act an enormous policy and health care victory, and Republicans will focus on the Act as a tax and rally around repealing it in the future.

What does this mean for the State of Texas? For many individuals across the country, and in the State of Texas, the decision means access to health care. For instance, people with pre-existing conditions will be able to get insurance and kids will able to stay on their parents’ health insurance until they are 26. But, who knows what will happen in Texas regarding the Medicaid expansion? If Texas institutes the expansion, the State would receive many more dollars from the federal government than it puts up. However, Texas leaders, including Governor Perry and Attorney General Abbott, have not been fond of federal dollars with strings attached.

Whether you are in favor of or opposed to the Affordable Care Act, Chief Justice Roberts summed up the Court’s opinion when he said, “We do not consider whether the act embodied sound policies. That judgment is entrusted to the Nation’s elected leaders. We ask only whether Congress has the power under the Constitution to enact the challenge provisions.”