Opponents of the law say it marks a dramatic shift in the federal government’s posture toward the American people. Never before has the US government ordered citizens to purchase a private product or service under threat of government sanction.
If the federal government can order the purchase of a required level of health insurance, there is nothing to stop the federal government from ordering citizens to buy Ford cars to preserve jobs in the auto industry, join a private gym to keep health costs low, or buy and eat broccoli to boost nutrition, they say.
The health insurance reform measure is designed to expand coverage to those who can’t afford it or who have been refused coverage because they have been diagnosed with potentially expensive preexisting medical conditions.
The Affordable Care Act seeks to pay for this expanded coverage in part by requiring the purchase of insurance by young, healthy individuals who might otherwise skip coverage. The larger pool of younger, healthier (and cheaper) insurance customers is meant to spread the risk to health insurance companies and thus help cover the extra cost of insuring those with expensive preexisting medical conditions.
The key question is whether the means chosen by the Democratic Congress and Mr. Obama to accomplish this goal comport with constitutional requirements.
No Republican member of the House or Senate voted for the ACA.
Obama signed the reform measure into law in March 2010. It sparked immediate legal action. Twenty-six states, a church-run college, an association of small businesses, a public-interest law group, and a handful of citizens asked the federal courts to declare the ACA unconstitutional.
So far, four US appeals courts have ruled on the issue. Three have upheld the law; one, the 11th US Circuit Court of Appeals in Atlanta, struck it down.