Yesterday, the Georgetown University Student Chapter of Academy Health held a panel entitled “Constitutional Challenges to the Affordable Care Act: Perspectives and Reactions” in the Leavey Center Program Room. The panelists tackled the constitutionality issue surrounding the Affordable Care Act, and took a largely liberal and supportive stance.
Rachel Piltch-Loeb (NHS ’12) opened the evening, and Professor John Kraemer gave the introduction. According to Kraemer, there are three ways to evaluate constitutionality: the “whatever the court says” is the constitutional outlook, the “interpretive,” based on reasoning and precedence sense, and the “normative” ideal of what should be constitutional. The panel announced its aim to speak with the “interpretive sense” regarding the act’s constitutionality.
Kraemer highlighted the two main facets of the legislation that usually surface in constitutionality debates—the individual mandate, which officially requires citizens to purchase health care, and the expansion of Medicaid. The act has been defended on the grounds that it falls under the Constitution’s “commerce clause,” that it could technically be considered a “tax,” or that it’s “necessary and proper.”
When asked why health care reform is such a “landmark decision” facing our government, Joseph Wender, the legislative director for Congressman Ed Markey, answered that Affordable Care is so monumental because, with its passing or overturn, we will witness “the extent to which the court will enter the political scene.” An overturn would mean “five unelected people reversing the will of two houses of Congress and the signature of the president,” Wender said.
Many questioned why conservatives are opposed to the Affordable Care Act when it seeks to foster the health of our nation. Kraemer said he believes such backlash exists because “there is something strange about the federal government ordering you to buy something.” Many conservatives believe that, if we allow the government to tell us what to do with health care, then it will be difficult to determine where the line will be drawn on what we allow the government to mandate of us.
“We’re going to get sick,” said panelist Professor Mark Rom, who recently wrote an essay about the “impossible inevitability” of health care reform. “We’re all going to die eventually. That’s what makes this issue different from others.”
Furthermore, people oppose the Affordable Care Act because it has become a symbol of party opposition. According to Wender, “this [issue] is different than all the others because it is the crowning achievement of President Obama,” and therefore “health care has become the quintessential vehicle to attack the presidential agenda.”
“We are such an angry country right now,” Kraemer said. “Liberals and conservatives are so fundamentally opposed to one another,” implying that polarization hurt the ACA’s prospects of survival.
Panelist Keavney F. Klein, a graduate of the School of Nursing and Health Studies and Georgetown Law who has studied the Affordable Care Act for years said, “you’re part of an economic system whether you like it or not. At some point, you’re going to need to see a doctor.” With that being the case, she said, the law’s constitutionality is not even a question, for its statutes fall under the commerce clause of our constitution.
Republicans claim that if the legislation is struck down, they will soon replace it with something else. Klein, however, is not convinced. “I have significant doubts that that would ever happen,” she said. “It’d be a really long time before anything this massive happens again.” And if the bill is overturned, Wendell says, “it’d be a sad state of affairs because that would say that it’s not even within Congress’s power to decide one of the [nation’s] biggest problems.”
But even in the event of a legislative overturn of the ACA, panelists insist that there is still hope for the future of the American health care system. “Even if it’s overturned, there are a lot of things in the Affordable Care Act that I think will carry on at a regulatory level,” Klein said. “Desperate times call for desperate measures.”
