WASHINGTON — The Supreme Court refused Monday to bypass the lower courts and take up an immediate challenge to the constitutionality of the national healthcare reform law and its requirement that all those who can afford it have medical insurance by 2014.Now, even though this is simply the Court refusing to hear the case before it has a chance to work through the lower courts, this is an important victory for both health reform advocates and President Obama. First and foremost, it will let health reform be implemented unimpeded while it works through the court process. As time goes by, more and more of it are implemented and more and more benefits become part of everyday life, which, once instituted, people will not want to give up. Among the benefits already in place:
- No more pre-existing conditions discriminations against children.
- No more getting dropped when you get sick.
- No more "lifetime" limits on benefits, and annual limits being phased out too.
- No copays for preventive care in new plans. Free preventive care in Medicare.
- Insurers have to spend 80-85% of your premium on providing actual health care.
- Adult children up to age 26 can now be covered under their parents' plan.
- 35% tax credit for small businesses to cover their employees.
- Major expansion of drug discount programs in Medicare as well as community hospitals and health centers.
- High risk pools in all 50 states to last until exchanges become available in 2014.
- Establishment of a federal long term care insurance (CLASS) program.
- Grants to start establishing health insurance exchanges started being awarded a month ago.
There are a couple of other advantages of having it work through the court process also. By and large, the vast majority of federal courts looking at this case are outright throwing it away. Legally, this builds a stronger and stronger framework for the government and proponents of health reform. Practically, it dispirits opponents of health reform. As popular support for the opponents' efforts dry up at the same time its legal basis gets damaged, its financial support might start to crack as well. Especially now that President Obama is considering answering "Citizens United" with an Executive Order directing all federal contractors to disclose political donations (by the way, if you haven't already, go to WhiteHouse.gov and send the president an email asking him to sign the order). It should be noted here that Office of Federal Contract Compliance Programs (OFCCP) issued new guidelines in December that makes health insurers and health care providers that contract with the Federal Employee Health Benefits Plans are considered federal contractors and would be subject to that executive order.
In other words, at least some of the insurance and for-profit health services industry's efforts to fund politicians who carry their water to try to repeal health reform would be revealed. This may well dry up campaign coffers if not some of the funding for the challenges themselves. As time goes by and the challenge has to work up the courts, the expenses of the opposition (and unfortunately that of the government to defend the law) will increase.
All of these mean that while the Supreme Court did not pass down an judgment on the law itself, it made it a lot harder for opponents to win by refusing to skip the lower courts. This is a real setback for opponents of health reform, and likely a victory for the American people.