Con: Why Timothy Stoltzfus Jost Thinks The Affordable Care Act Works

“They don’t like President Obama, and they don’t like this statute, and they’ve scored a lot of political points by creating the impression that this statue is unconstitutional.”

Jost: I don’t think it needs to be restructured. The rest of the statue stands on its own. If this provision is thrown out, it would make it somewhat more difficult for the insurers to cover people with preexisting conditions, insurance would be more costly, and fewer people would be covered. It’s an important provision, but the rest of the statue can stand on its own, and I think that’s demonstrated by the fact that there are several states in the United States that have adopted some of the same reforms that are found in this statute and they’re working without a minimum coverage requirement. So I don’t think that there’s a need to strike any other part of the statute is this part is stricken. If they do strike it down, it could be fixed very easily. All that would have to happen would be for Congress to say that the provision is a “tax” rather than a “penalty.” Congress has very broad power to tax, and if they simply said that everyone who does not have health insurance would have to pay a tax, that would be Constitutional, and I don’t think there would be much dispute about that. So that would be an easy fix. The problem is Congress is totally dysfunctional; it can’t tie its own shoes anymore. I think that getting any fix through Congress is going to be difficult, which is another reason why they should simply uphold the statue as written.

Loop21: What would be the immediate impact if the Supreme Court strikes down the provision?

Jost: There would be no immediate impact if the minimum coverage requirement was stricken, because it doesn’t go into effect for another year and a half. If the entire statue would be stricken, the immediate effects would be catastrophic. My son, who has serious health problems and is 22 years old and no longer in school would probably lose his health insurance, and probably many of your readers would as well. We have 2.5 million young people who are insured under the Affordable Care Act on their parents’ polices, and some of them would retain coverage under state law, but many of them would lose coverage. Many senior citizens who are on Medicare who are paying less for their prescription drugs would be paying more. People who are insured and now have access to preventative care without having to pay a copay for it would lose that protection. Cancer victims who have very expensive care and who otherwise would not receive payment because of lifetime limits would be subject to lifetime limits again. So there are a lot of parts of the Affordable Care Act that have already gone into effect that would presumably no longer be in effect if the statue were struck down as a whole. Not to mention provisions like at Washington and Lee we have a clinic that represents miners with black lung benefits and their widows, and there were important extensions of back lung benefits under the Affordable Care Act, and you would have people who would lose their benefits if the statue as a whole were declared unconstitutional, even though black lung benefits have absolutely no imaginable contact with the minimum coverage requirement.