Texas Judge Rules ACA Unconstitutional

On Friday, December 14, a federal judge in Texas ruled the Affordable Care Act (ACA), also known as “Obamacare,” unconstitutional. But it’s not quite that cut and dried. The “unconstitutionality” of the ACA lies not in the entire piece of legislation, but in the individual mandate portion. Nevertheless, because of the way the ACA is written, declaring the individual mandate unconstitutional deems the entire ACA unconstitutional, according to District Judge Reed O’Connor, of Texas.

Congress’ 2017 tax reform bill included a change to the ACA’s individual mandate. Originally, the individual mandate required that every American purchase health insurance (if not covered by an employer’s policy) or face a tax penalty. The 2017 tax reform bill, however, eliminated the tax penalty.

Judge O’Connor ruled that when a tax penalty was attached to the individual mandate, Congress was exercising its Constitutional taxing power. Without the tax mandate, however, O’Connor ruled that Congress was overreaching its authority.

“Individual Mandate can no longer be fairly read as an exercise of Congress’s Tax Power and is still impermissible under the Interstate Commerce Clause—meaning the Individual Mandate is unconstitutional,” said O’Connor in his opinion, adding that the individual mandate is “essential to and inseverable from the remainder of the ACA.”

Judge O’Connor’s ruling goes further than the Trump administration originally asked. Invalidation of the individual mandate and the provision that protects those with pre-existing conditions were the only provisions the Trump administration had sought to overturn.

Tim Jost, a professor at Washington and Lee University, said that (in addition to the individual mandate and the pre-existing condition provision), “O’Connor’s order would invalidate many provisions of the Medicaid program, the Medicare program and other federal laws.”

Jost added, however, “Judge O’Connor has declared the individual mandate unconstitutional and the rest of the Affordable Care Act invalid, but he has not blocked its continued operation.”

“Today’s ruling is an assault on 133 million Americans with preexisting conditions, on the 20 million Americans who rely on the ACA’s consumer protections for healthcare, on America’s faithful progress toward affordable healthcare for all Americans,” said California Attorney General Xavier Becerra. “…The ACA has already survived more than 70 unsuccessful repeal attempts and withstood scrutiny in the Supreme Court.”

California and 16 additional blue states argue that the individual mandate is still constitutional, but that even without it, the ACA could stand. The Texas federal judge’s decision on the ACA will without question be appealed.

Texas Judge Rules Obamacare Unconstitutional | KPIX CBS SF Bay Area  [2018-12-04]

Federal judge strikes down Obamacare | Fox News [2018-12-14]

HHS Division of Conscience and Religious Freedom: A Slippery Slope

The Department of Health and Human Services (HHS), under Donald Trump, is creating a new enforcement division: The Division of Conscience and Religious Freedom. The new HHS division, supporters say, establishes protection (referred to as “conscience protections”) for health care workers who refuse to treat certain people (such as transgender people), or perform certain procedures (such as an abortion) due to religious or moral objections.

The Trump Administration’s creation of the new HHS division repeals an Obama policy that prohibited health care professionals from refusing to provide services on grounds of moral or religious beliefs. This reversal raises a number of issues with people who think beyond the doctrines that shape the world of any single group of people.

A source in Congress said, “It is expected that the HHS Civil Rights Office would devote resources and personnel to enforcing the new guidelines and ensuring compliance.”

A government agency with the name, Division of Conscience and Religious Freedom, sounds uncomfortably close to Committee for the Promotion of Virtue and the Prevention of Vice, the enforcer of Shariah law in Saudi Arabia. Should an agency of the United States, which is not a religious state, establish a division whose purpose is, essentially, to enforce compliance with the tenets of one religious ideology or moral stance over another? Should our government be supporting anyone’s religious or moral convictions over anyone else’s?

On the one hand, the Constitution guarantees freedom of religion in the United States. But freedom extends equally to all Americans. The principles of freedom of religion and other civil rights do not define freedom to the extent that one suppresses the freedom of someone else who is lawfully enjoying theirs.

One could argue that requiring health care workers to provide care or services that conflict with their religious beliefs or moral stance constitutes suppression of freedom for the health care worker. Which set of moral or religious beliefs should take precedence, then?

And how does one arrive at the idea that requiring a health care provider to administer health care (which it is their job to do) discriminates against the health care provider, if the health care service itself does not violate the law? Abortion, for example, is legal. Shouldn’t people who enter a profession perform the lawful duties and services that apply to their profession?

The establishment of the Division of Conscience and Religious Freedom raises additional questions:

  • Isn’t the refusal to provide health care services to certain groups the equivalent of saying that they don’t deserve health care?
  • Does this new division, established to protect religious freedom, really protect every health care worker to act in his or her conscience, or does it just protect them if their conscience conforms to certain ideologies?
  • Will the Division of Conscience and Religious Freedom also protect an objecting health care worker who refuses to even refer a person to a provider who won’t object to treating them?
  • Can the the U.S. government, in good conscience, really “devote resources and personnel” to the enforcement of compliance with this, while not addressing crucial issues such as affordable and accessible health care for Americans?
  • Will those who are opposed to a patient’s religious convictions (let’s say, “Christian,” for this example) be allowed to refuse to treat that person?

The HHS Division of Conscience and Religious Freedom perches on a slippery slope. The fact that it not only allows a health care worker to refuse to treat a patient based on personal beliefs, but enforces that stance, should scare us.

OCR New Conscience and Religious Freedom Division Announcement | U.S. Department of Health and Human Services [2018-01-18]

HHS Expected to Unveil ‘Conscience Protections’ | Hot Trending [2018-01-17]