What everyone (and we mean everyone) should know about the recent Supreme Court rulings

The Constitution guarantees a right to same-sex marriage and Obamacare is here to stay. The Supreme Court had quite a Term, and the last week of June produced two tremendously important rulings. We all have our opinions on universal healthcare and same-sex marriage, and the Constitution guarantees that we are entitled to voice them, however these rulings must be understood before supported or criticized. Supreme Court of the United States (“SCOTUS”) opinions are lengthy, complex and smattered with legal nuances, which complicate the general idea behind the decision. So we’ll dispose of (most of) the complexities for now and get down to the basics, because a basic understanding is better than no understanding at all.

Patient Protection & Affordable Care Act (“ACA” or “ObamaCare”)

Often referred to as “ObamaCare,” the Patient Protection and Affordable Care Act was signed into law by President Obama in 2010 and has been recognized as the most significant overhaul to the U.S. healthcare system since Medicare and Medicaid. As would be expected, the constitutionality of this federal statute was challenged, and in 2012 SCOTUS upheld the law as a valid exercise of Congress’s taxing power (the subsidies were declared “tax credits”). There is a limitation, though:  the ACA provides for a Medicaid expansion, which casts a wider net of coverage to lower income individuals and families. States cannot be forced to participate in the Medicaid expansion – it is elective; approximately half the country has adopted this expansion.

Not to be discouraged, opponents of the ACA then challenged the language of the law, claiming that, as written, the obtainment of healthcare via the federal exchange program (HealthCare.gov) was illegal. The specific language debated was this:  “enrolled in through an Exchange established by the State under 1311.” Opponents of the law argued the legislative intent clearly allowed for subsidies under state exchange programs only, while proponents urged that a “plain meaning reading” of the statute would eviscerate its overall purpose and intent, which was to provide quality and affordable healthcare to lawful permanent residents of the United States.

“Under the Constitution, same-sex couples seek in marriage the same legal treatment as opposite-sex couples, and it would disparage their choices and diminish their personhood to deny them this right.”

On June 25, 2015, the Supreme Court agreed with the proponents. In a 6-3 decision, SCOTUS held that government-issued subsidies were legal on a state and federal level. This is really interesting, guys!  The Court essentially deviated from the “plain meaning reading” of the statute and went a step further in interpreting what Congress meant when it drafted ObamaCare; this is rarely done. Courts do not generally “read into” or infer what the author intended. But here’s the logic: if the language of the text was interpreted literally, and those federally-issued healthcare subsidies were declared illegal, millions of individuals would lose their healthcare tax subsidies and the (most likely healthier) people would opt not to purchase individual insurance, which would send insurance premiums through the roof (since there are less healthy people in the pool). This is the oft quoted “death spiral” Congress intended to avoid: “Congress passed the Affordable Care Act to improve health insurance markets, not to destroy them,” Chief Justice Roberts wrote in the long and complex majority opinion. “If at all possible, we must interpret the Act in a way that is consistent with the former, and avoids the latter…. In this instance,” he wrote, “the context and structure of the act compel us to depart from what would otherwise be the most natural reading of the pertinent statutory phrase.” (Life Lesson: a few words can create a whole mess of legal problems!  Hire a good lawyer to prevent said messes.  Trust.)

Let’s break down some key points of ObamaCare:

  1. Americans Getting Health Care Through Their Employer: Under the Affordable Care Act, all Americans are required to have insurance. Companies must either provide their workers with health insurance or deem that it would be cheaper to subsidize them and let them get health insurance through the state. There are some additional protections such as no limits or restrictions on benefits and no annual limits, to name a few. 
  2. Americans Receiving Health Care Coverage Through Medicare: The ACA will continue to provide protections and benefits to seniors who receive coverage through Medicare.
  3. Individual Policy Holders: ObamaCare requires all U.S. citizens to have healthcare insurance. Of course, if you already have private insurance, the healthcare reform will have little impact on you. Your rates may shift slightly, and your coverage will have added protections.
  4. Uninsured Americans: All uninsured Americans will still have the option to buy health insurance through the state or federal exchanges. Those Americans who cannot afford coverage can get a federal subsidy. Additionally, insurance companies may not turn people away for preexisting conditions.
  5. Small Business Owners: Due to their income bracket, truly-small businesses have always been in a bad space when it comes to providing health insurance for their employees. While health care reform will not solve this problem, it does offer more options for employers wishing to provide coverage to their employees. It’s worth noting that ObamaCare does not tax businesses making under $250k, but does guarantee coverage to business owners and their employees.1

And voila, like it or not, we are one step closer to universal healthcare. Now, this is certainly not a utopian circumstance. Congress has a lot of work to do. Since its enactment, the ACA has undergone 51 significant changes, according to the Galen Institute. And remember that Medicaid expansion? Well, it’s a bit problematic. Since states are able to reject the Medicaid expansion, it has created a coverage gap, which could include up to 6 million Americans. And then there’s that employer mandate, which requires large employers to provide healthcare for its employees. This provision is unpopular in general, and has caused many layoffs so businesses can avoid falling within the purview of the mandate. 

Currently, the campaign trail is hot and heavy and the ACA is sure to be a huge ticket item for debate. Efforts to repeal the law have been thwarted so far (in late July, the Senate voted down a GOP attempt), with each party remaining loyal to its position on the matter.  Senator Ted Cruz has called it “an exercise in meaningless political theater”. Regardless, as we’ve all learned from House of Cards, drastic measures will undoubtedly create enemies, but are ultimately rather effective. 

Phew. The next one is a little less complicated…

Same-Sex Marriages are Declared Constitutional

On June 26, 2015, the Supreme Court held that same-sex couples can legally marry no matter where they live. This one was close!  In a 5-4 decision, Justice Anthony M. Kennedy, who has authored all SCOTUS’s decisions expanding gay rights, declared the ban on gay marriage a violation of due process and that the fundamental right to marry applied to same-sex couples. “Under the Constitution, same-sex couples seek in marriage the same legal treatment as opposite-sex couples, and it would disparage their choices and diminish their personhood to deny them this right.”

The story is this: two men married in Maryland, but resided in Ohio. They obtained their marriage license in Maryland, but the Ohio State Registry would not recognize it.  The couple filed a lawsuit, alleging that the state was discriminating against same-sex couples who lawfully married out-of-state, and that the Ohio law provided “a marriage solemnized outside of Ohio is valid in Ohio if it is valid where solemnized.” The case found its way to the Supreme Court, who hinged its ruling on the fundamental right to marry by way of the 14th Amendment, which requires a State to license a marriage between two people of the same sex and to recognize a marriage between two people of the same sex when their marriage was lawfully licensed and performed out-of-State.

Four key principles were discussed as to why the fundamental right to marry applies to same-sex couples:

  1. The right to personal choice regarding marriage is inherent in the concept of individual autonomy.
  2. Same-sex couples have the right to intimate association. This intimate association includes marriage, not just sexual activity.
  3. Same-sex couples have children and families and are entitled to rights relating to child rearing, procreation, and education.
  4. Finally, marriage was declared a keystone of America’s social order. The Court found that to prevent same-sex couples from marrying stigmatized them and put them at odds with society, denied them countless benefits of marriage and introduced instability. 

These key factors have everything to do with constitutional rights and very little to do with religious freedom.  In fact, SCOTUS reaffirms the protection of the First Amendment, stating that religious groups are free to continue to advocate for their traditional beliefs. You see, the courts are forbidden from interpreting religious doctrine; this is a concept known as the “evangelical abstention doctrine.” SCOTUS leaves the interpretation of marriage itself alone, and focuses on extending the fundamental right to marry by relying on well-known legal precedent. The dissenting Justices remain nervous, calling the decision a “threat to American democracy” which “usurps the constitutional right of people to decide whether to keep or alter traditional marriage”; the issue dances closely around religious interpretation, a danger zone for social conservatives. 

So that wraps up our learning session for this month. It’s a mouthful, I know, but this will be in textbooks (ebooks?) long past our time here. These cases truly exhibit why our Constitution is a living, breathing document.  Perhaps proof that it can evolve after all…

1www.obamacarefacts.com