The U.S. Supreme Court today upheld the constitutionality of the 2010 Affordable Care and Patient Protection Act, better known as health care reform. I am shocked not only by the decision, but by the 5-4 breakdown with Chief Justice John Roberts (not Justice Anthony Kennedy) being the swing vote in favor of upholding the law. Most commentators and the betting site Intrade thought the court would strike down at least the individual mandate to purchase health insurance, if not the whole law. To her credit, Linda Greenhouse of the New York Times consistently predicted that Roberts would vote to uphold the law.

Any comments related to health care reform are welcome in this thread. I will update this post frequently during the day as Iowa elected officials, candidates, and activist groups weigh in on the decision.  

Roberts wrote the majority opinion, joined by Justices Sonia Sotomayor, Elena Kagan, Ruth Bader Ginsburg, and Stephen Breyer. He rejected the Obama administration’s argument that the Commerce clause gives the federal government the right to force individuals to purchase health insurance. However, he found that the individual mandate (enforced by a financial penalty) was consistent with the federal government’s taxing power.

The lawsuit brought by many states also had challenged the Medicaid expansion provision in the 2010 law, saying it denied states’ rights. Governor Terry Branstad signed Iowa onto this lawsuit in January 2011, against the advice of Attorney General Tom miller. I haven’t seen yet whether any of the justices accepted the argument against the Medicaid expansion, which seemed absurd on its face. For decades, the federal government has attached strings to federal funding to the states. For instance, many states raised the legal drinking age to 21 in order to avoid losing federal highway funds.

Later today Ross Daniels and Amy Ward are scheduled to appear at a press conference discussing today’s ruling. They have personally benefited from the 2010 law’s ban on lifetime limits for private health insurance coverage.

UPDATE: This pdf file contains the court rulings in the health care cases: the majority ruling, Justice Ginsburg concurring in part, and the dissent signed by Justices Samuel Alito, Clarence Thomas, Antonin Scalia, and Anthony Kennedy.

CNN just reported on the portion of the ruling dealing with the Medicaid expansion. Apparently the court held that the federal government cannot withdraw existing Medicaid funding from states that decline to implement the Medicaid expansion. However, the federal government can make additional Medicaid funding contingent on states accepting the broader eligibility rules for Medicaid. Two justices (Sotomayor and Ginsburg) disagreed with Roberts on that point, finding the Medicaid expansion fully constitutional. Ginsburg’s decision discusses these points on pages 38 through 61.

Lyle Denniston wrote on the SCOTUS blog’s liveblog this morning,

The rejection of the Commerce Clause and [Necessary] and Proper Clause should be understood as a major blow to Congress’s authority to pass social welfare laws. Using the tax code — especially in the current political environment — to promote social welfare is going to be a very chancy proposition.

SECOND UPDATE: Representative Bruce Braley (D, IA-01) was the first member of Iowa’s Congressional delegation to get his statement out:

“The Supreme Court got it right today.  This decision is good news for the middle class and affordable healthcare.  It makes me think of thousands of Iowans like my nephew, Tucker.  Tucker survived a fight with liver cancer at age 2 because his family had health insurance.  But his parents lived in constant fear of losing their jobs because Tucker would be denied new insurance due to his pre-existing condition.  The healthcare reform law ended those fears — and this decision means many other critical reforms will stay in place.

“From allowing 18,000 Iowans to stay on their parents’ insurance up to age 26, to requiring insurance companies cover screenings for diseases like breast cancer, to saving Iowa seniors hundreds of dollars per year on their Medicare prescription drugs, the law’s positive impact on Iowa is just beginning to be felt.

“It’s not a perfect law.  That’s why I’ll be working to bring Republicans and Democrats together to improve it and make it better.”

Governor Terry Branstad and Lieutenant Governor Kim Reynolds released these statements “on the United States Supreme Court ruling of Obamacare.”

Gov. Branstad:

“Today, the Supreme Court handed down a disastrous decision to uphold President Obama’s destructive health care law, which means a future of higher costs, higher taxes, and increasing debt for Iowans.  The current health care system is nothing but a federal takeover and continues to exceed its budgeted amount every day.  But, as Governor Romney has said many times, no matter what may happen in Court, the American people must remain vigilant in their fight to repeal the law. Our goal is for Iowa to become the healthiest state in the country and to do so Iowans will need to take ownership of their own health to reduce health care costs and lead healthier lives.”

Lt. Gov. Reynolds:

“America needs real health care reform and we need Governor Romney in Washington. Gov. Romney will enact real reforms to ensure that the future of Iowa and America as a whole can replace Obamacare with solutions that put Iowans in control of their own health care and preserve the economic future of Iowa’s next generation.”

THIRD UPDATE: The four dissenting justices basically accepted all of the arguments against the law’s constitutionality. The mandate to purchase health insurance is unconstitutional, the rest of the law can’t stand without the mandate because it can’t be severed from the mandate, and the Medicaid expansion is an affront to states’ rights. Excerpt:

The Court today decides to save a statute Congress did not write. It rules that what the statute declares to be a requirement with a penalty is instead an option subject to a tax. And it changes the intentionally coercive sanction of a total cut-off of Medicaid funds to a supposedly noncoercive cut-off of only the incremental funds that the Act makes available.

The Court regards its strained statutory interpretation as judicial modesty. It is not. It amounts instead to a vast judicial overreaching. It creates a debilitated, inoperable version of health-care regulation that Congress did not enact and the public does not expect. It makes enactment of sensible health-care regulation more difficult, since Congress cannot start afresh but must take as its point of departure a jumble of now senseless provisions, provisions that certain interests favored under the Court’s new design will struggle to retain. And it leaves the public and the States to expend vast sums of money on requirements that may or may not survive the necessary congressional revision.

The Court’s disposition, invented and atextual as it is, does not even have the merit of avoiding constitutional difficulties. It creates them. The holding that the Individual Mandate is a tax raises a difficult constitutional question (what is a direct tax?) that the Court resolves with inadequate deliberation. And the judgment on the Medicaid Expansion issue ushers in new federalism concerns and places an unaccustomed strain upon the Union. Those States that decline the Medicaid Expansion must subsidize, by the federal tax dollars taken from their citizens, vast grants to the States that accept the Medicaid Expansion. If that destabilizing political dynamic, so antagonistic to a harmonious Union, is to be introduced at all, it should be by Congress, not by the Judiciary.

The values that should have determined our course today are caution, minimalism, and the understanding that the Federal Government is one of limited powers. But the Court’s ruling undermines those values at every turn. In the name of restraint, it overreaches. In the name of constitutional avoidance, it creates new constitutional questions. In the name of cooperative federalism, it undermines state sovereignty.

FOURTH UPDATE: Justices Sotomayor, Ginsburg, Breyer, and Kagan supported upholding the constitutionality of the mandate, period. Only Roberts drew the distinction that the mandate is constitutional under the taxing power, not under the power to regulate inter-state Commerce.

FIFTH UPDATE: Statement from Iowa Senate Health and Human Services Committee Chair Jack Hatch, a Democrat and former leader of the national Working Group of State Legislators for Health Care Reform.

“The U.S. Supreme Court’s decision today is a major victory for all Iowans, both those with health insurance and those without.  Now, thanks to the Affordable Care Act, the health care of every Iowan will improve and become more secure while costs for consumers and businesses are reduced.

“Iowa’s nonpartisan, forward-looking approach to health care made us the top state in the nation with regard to children’s health care.  We should now take full advantage of the new opportunities presented by this decision to make Iowa the best state in the nation when it comes to health care for every Iowan.

“I’m confident that most elected officials in our state are ready to work closely with consumers, health care providers, insurers, business leaders and others to do just that.”

–end–

At 2:00 pm on Thursday, June 28, in Room 116 at the Iowa State Capitol, Senator Jack Hatch of Des Moines and Dr. Steve Eckstat, Vice President of Primary Care Services at Mercy Hospital and the President of Free Clinics of Iowa, will provide more details on how the decision impacts the health care of Iowa families.

SIXTH UPDATE: Republican State Senator Kent Sorenson had this to say on twitter:

Our supreme court chose to walk and urinate on our constitutional freedoms today. It is time to control-alt-delete the judicial system.

In the past, Sorenson has called for impeaching Iowa Supreme Court justices who concurred in the Varnum v Brien decision on marriage. He also sought to bring back Iowa Supreme Court elections.

Within an hour of the Supreme Court’s announcement today, John Roberts’ wikipedia page had been updated to label him a “coward.”

SEVENTH UPDATE: At the Volokh Conspiracy blog, David Bernstein points to hints that Scalia’s dissent “was originally written as a majority opinion (in particular, he consistently refers to Justice Ginsburg’s opinion as “The Dissent”).” If that’s the case, then Roberts most likely flipped his vote. LATER UPDATE: Brad DeLong fleshes out this theory with excerpts from Scalia’s opinion.

Nine times Scalia refers to Ginsburg’s opinion on the mandate not as a concurrence–agreeing with the result, but for different reasons–but as a “dissent”. […] Is this deliberate–that Scalia wants us to know that his opinion was originally written to be the opinion of the Court? Or is this simply sloppy draftsmanship–chronic laziness at revision?

And what made Roberts peel off?

Mitt Romney spoke on live television shortly before 11 am and vowed to seek repeal of Obamacare. He emphasized that the court ruled Obamacare is constitutional, but didn’t imply that it is good law. He promised that he would work to replace Obamacare with something that empowers consumers and helps lower the cost of health care and health insurance. He expressed support for banning insurance companies from discriminating against people with pre-existing medical conditions. “If we want to get rid of Obamacare, we’re going to have to replace President Obama.”

EIGHTH UPDATE: Senator Tom Harkin’s office released this statement.

WASHINGTON-Today, Senator Tom Harkin (D-IA), Chairman of the Senate Committee on Health, Education, Labor and Pensions, released the following statement in response to the Supreme Court’s ruling on the Affordable Care Act:

“Today’s decision by the Supreme Court is a rigorous, resounding confirmation of the constitutionality of the Affordable Care Act.  It is great news for America’s families and businesses, and for our economy.  This decision keeps consumers, rather than insurance companies, in the driver’s seat, and protects the more than $1 trillion in deficit reduction included in the ACA. Today’s decision allows us to continue our work replacing the current sick care system with a genuine health care system – one focused on wellness, prevention, and public health, keeping people out of the hospital in the first place.

“I am heartened to see that the hundreds of millions of corporate dollars poured into the effort to kill the Affordable Care Act did not win. This law is a critical step in the right direction;I have likened it to a starter home, suitable for improvement.  I look forward to working with my colleagues to make sensible changes as we continue to implement the law.  I invite them to bring their tool kits, rather than their sledgehammers, so we can work together to improve the law.

“The choice is to go forward, or be dragged backward.  I believe the great majority of Americans want to go forward – and today the Supreme Court made clear what we have long known: that the opposition is standing on the wrong side of history.  Now let’s get back to work building a health care system that works not only for the healthy and wealthy, but for all Americans.”

Under the Affordable Care Act:

More than 3.1 million young adults who would have gone uninsured are now covered by their parents’ health care plans

The Patients’ Bill of Rights puts Americans back in charge of their health care decisions, protects those with pre-existing conditions, eliminates lifetime coverage limits, ends arbitrary policy cancellations by insurers, and improves accountability and transparency

45.1 million women have access to breast and cervical cancer screenings, prenatal care, and well-child visits with no out-of-pocket costs

Over 5.1 million people on Medicare saved over $3.2 billion on prescription drugs thanks to discounts on both name brand and generic drugs donut hole over the past two years

86 million Americans have already received one or more preventive services, like cancer screenings and check-ups, at no cost

360,000 small businesses have used the Small Business Health Care Tax Credit to help insure 2 million workers

For a list of Iowa benefits under the new law, please click here: http://www.healthcare.gov/law/…

###

Senator Chuck Grassley spoke to reporters by conference call.

Republican Senator Chuck Grassley says the ruling “throws the issue into the arms of the American people” in this fall’s presidential election.

“The legislation, as you know, was sold to congress and to the people of this country under the false pretense because the president said that he wasn’t going to raise taxes and that this bill didn’t raise taxes,” Grassley said this morning.

The Supreme Court has ruled the law’s “mandate” that Americans buy health insurance is constitutional under the power congress has to levy taxes. Grassley said that means Barack Obama has “fought for and signed one of the biggest taxes ever” – a motivating factor for Republican and Republican-leaning voters in the fall election. […]

“That’s going to mean that taxes are going to be highlighted to a greater extent during the presidential election,” Grassley said.

Today’s decision ensures the power of the government is “just as strong as ever,” according to Grassley.

“If the power to tax can make you buy insurance, can they make you buy Chevrolets because the government owns 27 percent of General Motors and if you don’t buy a Chevrolet you’re going to pay a tax?” Grassley asked rhetorically during a telephone conference call with reporters.

NINTH UPDATE: President Barack Obama just addressed the country on live television. He said he didn’t pass health care reform because it was “good politics.” Thought it was good for the country. He said the country can’t afford to re-fight battles of two years ago, and it’s time to move forward, to implement and, where necessary, improve on this law. He said people will be able to keep their health insurance but will also be protected from the whims of insurance companies.

Meanwhile, Representative Dave Loebsack (D, IA-02) released this statement:

“Today’s decision will bring stability and certainty to Iowans as they make critical health care choices for themselves and their families.  It maintains protections for those who have pre-existing conditions, ensures no Iowan will be denied coverage, and that young Iowans can stay on their parents’ health care plans until they are 26.  Additionally, this ruling affirms that preventative care will be provided without a co-payment, and that those who lose their jobs will not lose their coverage.  It also prevents women from being charged higher premiums simply because they are female, and prohibits pregnancy from being treated as a pre-existing condition.  Further, the Medicare prescription drug donut hole will be completely closed by 2020, through reforms that are already saving our seniors $650 each this year.

“As we move forward, the bill is not perfect and I will continue to work with my colleagues on both sides of the aisle to ensure that the Affordable Care Act is enacted in a way that will reduce health care costs and help bring stability to Iowans during these difficult economic times.”

Representative Steve King (R, IA-05) will speak to reporters by conference call later today. His office sent out this statement:

King: The Fate of ObamaCare is Not Yet Set

Washington, DC- Congressman Steve King released the following statement today in response to the Supreme Court declaring the individual mandate to be Constitutional under Congress’s taxing power.

“Leading up to today, the lower courts were split on a handful of issues,” said King. “One issue they were nearly unanimous on was that the individual mandate was not a tax therefore could not be upheld under Congress’s power to tax. Today the Supreme Court disagrees with the vast majority of lower court decisions and contradicts President Obama himself, who vehemently denied that the individual mandate was a tax.

The fate of ObamaCare is not yet set. The House has voted to pass my language to repeal 100% of ObamaCare. Every Republican Senator has voted to do the same. On the other hand, President Obama and Democrats in Congress remain as committed as ever to forcing the unconstitutional law that bears the President’s name upon an unwilling and disapproving public. The choice could not be clearer. The American people should be reminded that there is no force more powerful than their voice. After the passage of ObamaCare, the American people made their disapproval known in a powerful way. Today’s decision should renew that call and spirit.

The Constitution lays out a government of limited, enumerated powers, and the size and scope of our current government, and specifically ObamaCare, are well beyond what our Founding Fathers ever intended. The American people will decide the fate of ObamaCare.”

Iowa House Minority Leader Kevin McCarthy, a Democrat, released this statement:

“Today’s ruling is a win for the middle class and will reduce the overall cost of health care in the long term.  It means insurance companies can’t deny health care to Iowans with pre-existing conditions, charge women more to get health care, or impose lifetime limits on care for Iowans.  It means over 18,000 young Iowans can stay on their parents health care plan until 26.  It means over 42,000 seniors in Iowa will save an average of $615 every year on their prescription drugs.  It also means small businesses can get help to offer health care for their employees.”

The SCOTUS blog has posted more pieces on the ruling. Amy Howe summarizes the ruling in plain English. Richard Epstein finds Roberts’ analysis on taxation and regulation “intellectually shabby.” Adam Winkler argues that “The Roberts Court is Born”:

With this deft ruling, Roberts avoided what was certain to be a cascade of criticism of the high court. No Supreme Court has struck down a president’s signature piece of legislation in over 75 years. Had Obamacare been voided, it would have inevitably led to charges of aggressive judicial activism.  Roberts peered over the abyss and decided he didn’t want to go there.

Roberts’ decision was consistent with his confirmation hearings pledge to respect the co-equal branches of government, push for consensus, and reach narrow rulings designed to build broad coalitions on the Court. He promised to respect precedent. His jurisprudence, he said, would be marked by “modesty and humility” and protection of the precious institutional legitimacy of the Court.

Today, the institutional legitimacy of the Court was buttressed. President Obama wasn’t the only winner at the Supreme Court today. So was the Supreme Court itself.

TENTH UPDATE: Representative Leonard Boswell (D, IA-03) released this statement.

“The highest court in the land spoke today and found the Affordable Care Act constitutional. Millions of Americans, including children, seniors, and health care providers, have won today. No one will ever be denied coverage for having a pre-existing condition. If you’re a young adult, you can be covered under your parent’s plan until your 26 years old. Seniors will continue seeing the gap in their prescription drug coverage close and will be able to take advantage of preventative care, like cancer screenings, without having a co-pay or deductible.

“This decision reaffirms a major victory for the middle class and I will be working to make sure the health care law continues to serve Americans’ health care needs and provides families with the necessary security and stability for the future. Now that this law has been reaffirmed, it is time for opponents to stop spreading misinformation in their attempts to confuse the American people on this law.  Enrolling approximately 30 million additional Americans in health insurance is an achievement we can be proud of as we act to fulfill our responsibility to those in need. It’s time for ALL to work together to make sure the law is enacted fairly and properly. “

Senator Chuck Grassley’s office released a video statement. Click here to listen. The text is here:

I respect the Supreme Court but strongly disagree with this decision.

The court has upheld the law saying that the President’s health care law is a tax on every American – regardless of income – unless that American takes an action the government demands.

The only way the law is constitutional is by doing what the President denied, that the penalty was a tax.  The legislation was sold in Congress and to the country under false pretenses.

With this decision, the court said that while Congress’ ability to regulate is limited, its ability to tax is unlimited.

In addition, the court saying the Medicaid enforcement mechanism was unconstitutional means that President Obama cannot deliver on his promise to poor people needing Medicaid.  Here, there was no way out for the unconstitutional approach of the President.

Now, it’s up to the American people.  The majority of Americans don’t like this law, and health care will be a major issue in the presidential election, including its impact on the economy and jobs, which should have been the first priority all along.

The goal has got to be on growing the economy and creating jobs, not making government bigger, but including health care solutions that use free-market principles, don’t get between patients and their doctors, and succeed in driving down health care costs.

Republican Congressional candidate Ben Lange, who is running against Braley in IA-01, released this statement:

Lange on Obamacare Ruling: Vote Out Incumbent Politicians

INDEPENDENCE, IA — Iowa congressional candidate Ben Lange (IA-01) issued the following statement today in response to the Supreme Court’s ruling on Obamacare:

“The issue before the Supreme Court today was not about the wisdom of Obamacare, it was about the legal foundations of our constitutional Republic and the role of federal politicians in the lives of states and individuals.

Our founders constructed the Constitution on the pillars of federalism, separation of powers, and enumerated powers in order to divide and limit the power of the federal government. Why? Because history has shown that well-meaning politicians armed with concentrated power in pursuit of desirable ends tend to trample the rights of citizens.

Obamacare is the quintessential example. In pursuing more affordable and accessible health care, no doubt a desirable end, Congressman Bruce Braley and other federal politicians sought to establish the legal principle that the federal government can force Iowans to purchase a good or service against our will.

By upholding this legal principle today, the Supreme Court has ruled that there are no longer any meaningful limits on what federal politicians can do to the American people under the auspices of the taxing power. Individual and states’ rights have been permanently compromised in our constitutional system.  

While I disagree with the legal conclusion of the Supreme Court, I respect their judgment.  

Chief Justice Roberts is correct in stating: “Members of this Court are vested with the authority to interpret the law; we possess neither the expertise nor the prerogative to make policy judgments. Those decisions are entrusted to our Nation’s elected leaders, who can be thrown out of office if the people disagree with them. It is not our job to protect the people from the consequences of their political choices.”    

Iowans now have only one option for taking back control of their most intimate health care decisions from divisive federal politicians and bureaucrats: Iowans must vote out politicians like Congressman Bruce Braley in November.  

Loebsack’s Republican challenger in IA-02, John Archer, highlighted the Supreme Court ruling in this fundraising e-mail blast.

We Need You

Now, more than ever, we need to send our values to D.C.

Today, the Supreme Court passed down its decision on the Patient Protection and Affordable Care bill more commonly known as ObamaCare. The Supreme Court has created a precedent giving the Federal Government the right to mandate your healthcare, the right to wedge themselves between your doctor and you, and the Supreme Court can be bullied into making excuses for the liberal political machine.

President Barack Obama and his rubber stamp in Congress, Dave Loebsack, have made a fatal mistake. They have given all Americans another excuse to get involved. If ever you have considered volunteering, donating or making your voice heard then now is the time. Each day the Democrats in Washington make this election more and more important. The fate of this country rests solely on the shoulders of the American people and to be prosperous we must act now. I need your help to defeat Dave Loebsack, bring your voice to Washington and steer this country off the path of socialism and certain economic doom.

President Obama claimed over and over again that this bill was not a tax and yet calling it a tax is what saved the bill from being struck down.  As always, Democrats continue to raise taxes and implement burdensome regulations that stifle job growth as well as create an environment that increases dependency on the federal government.   This vicious cycle must stop and it must stop now. I need your time and your donations to fix what is broken, rebuild and then prosper. Please make a generous donation of $25, $50, $100 or $200 to our campaign.

I have taken up this cause because I know what America needs. We need conservative, common sense ideals in Washington and that is exactly what I bring to the table. This week, I was honored to receive the endorsement of  former Senator Rick Santorum.  In his statement, Rick Senatorum so graciously said, “His business background working through the regulatory and legal hurdles facing manufacturing makes him uniquely qualified to come to Washington and stop the attacks on our economy.”  Further, Santorum said, “We look forward to working to help elect John Archer as the next congressman for southeast Iowa.”

I ask you now to please support our campaign financially so that we can bring the fight to Dave Loebsack and send a message that the people of Iowa are no longer going to stand by and allow America to have a Greece-like demise. That is why we need you to make a contribution to the campaign now, before our very important June 30th FEC reporting deadline.

Thank you in advance,

John Archer

Candidate for Congress

Republican Party of Iowa Chair A.J. Spiker also sent out a fundraising e-mail today in response to the Supreme Court ruling. Excerpt:

Friend,

Right now Barack Obama is grinning ear to ear.

But he has no idea the sleeping giant he’s awakened.

This morning the Supreme Court upheld the main parts of “Obamacare” and dealt a blow to freedom and liberty throughout the nation.

And while Obama and his liberal establishment minions are celebrating, Republicans have already begun to make sure this law never sees the light of day.

Here in Iowa we plan on doubling our efforts to keep our majority in the State House, take back the State Senate and ensure Obama becomes a one term President.

We can do it, but we need your help.

As Mitt Romney comes to Iowa and builds his campaign structure it is vital we give him the ground support he needs.

This election will be a close one and It is imperative we turn Iowa red this Fall and deliver our electoral votes to Governor Romney.

This morning I have spoken at length with state and national Republican leaders on how to reverse Obama’s dangerous liberal agenda.

We all agree, the best way to effectively fight back is to elect Republicans at all levels of government and ensure we have the votes in place to defeat Obamacare once and for all.

The Des Moines-based Child and Family Policy Center released this comment:

Affordable Care Act will improve health care for Iowa children and families

Child and Family Policy Center executive director Charles Bruner issued the following statement regarding the U.S. Supreme Court’s decision upholding the Affordable Care Act:

“Today is a good day for Iowa families. When fully implemented, the ACA will assure health coverage for tens of millions of the uninsured, make insurance more affordable for those who already have it and boost consumer protections for Americans of all ages.

“But Iowa still has work to do to achieve these reform goals, which are ones Iowans truly want. Key will be affirming the expansion of Medicaid and assuring the state creates an exchange that meets the needs of health-care consumers.”

The Child and Family Policy Center is a Des Moines-based research and advocacy organization dedicated to promoting outcome-based policies that improve child well-being.

I asked Amy Ward for a comment on the Supreme Court ruling, because the White House and other supporters of the Affordable Care Act have told her story. She sent me this reply:

I’m thrilled by the Supreme Court’s ruling today.  Right at this very moment, in intensive care units across the country, other families wait and pray for the health and well-being of loved ones facing serious health crises.  I hope these loved ones will have the same chance to heal as I did – without having to worry about lifetime maximums, pre-existing conditions clauses, and the fear of health insurance coverage terminated in the midst of major illnesses.

I am disappointed that Americans in some states won’t benefit from the Medicaid expansion. Millions of the people who were supposed to be covered under the law would have been added to Medicaid rolls. Roberts’ ruling opened the door for states to refuse to expand eligibility. I expect this to become a major battle in Iowa, because Governor Branstad has said he doesn’t think the Medicaid expansion is affordable. Democrats in the Iowa House and Senate will want to implement the Medicaid expansion.

ELEVENTH UPDATE and CORRECTION: According to this statement released by Iowa Senate Health and Human Services Committee Chair Jack Hatch, the Medicaid provision is not as crucial for Iowa, because we already cover people at income levels beyond the requirements of the 2010 federal law.

Statement on the U.S. Supreme Court Decision

Affirming the Affordable Care Act

Sen. Jack Hatch (D-Des Moines)

I have been working with Iowa legislators and three different Governors on health care reform for more years than I care to remember, and this is the most significant and happiest day of that effort.

The U.S. Supreme Court’s decision today on the Affordable Care Act, or Obamacare (because, Obama does care) is a major victory for all Americans – those with health insurance and those without.  We are now on a path to expand access, lower costs for businesses, large and small, individual consumers and taxpayers, and increase preventative care for all Iowans.

This decision is a historic milestone in the creation of an American social safety net.  It is not hyperbole to suggest it is one of the most important Court decisions of the past 50 years.

The Court has affirmed President Obama’s bold approach to health care reform.

I’m proud of the members of the Supreme Court who put differences aside and did the right thing for our country.  What they preserved is an effective, reasonable health care law that does some important things for Iowans including:

·        Helping thousands of Iowans with pre-existing conditions get coverage after being denied it for years;

·        611,000 Iowans already have received common-sense preventative health services – including well-child visits, cancer screenings and immunizations – without co-pays;

·        18,012 young adults, up to the age of 26, will be allowed to stay on their parents’ health insurance policy;

·        42,015 Iowa seniors saved an average of $1,384 on prescription durgs on Medicare;

·        Thousands of Iowans no longer have lifetime dollar caps in health insurance policies;

And there is much more.

But we know this decision is far from the last word in the health care debate.

Suddenly, there are political concerns that somehow Obamacare will be the largest tax increase in history.  The reality is the tax only kicks in for those who choose not to have health insurance, and our goal is to have no Iowan ever have to pay that tax.

The Medicaid provisions of the decision have less impact on Iowa because of a forward thinking program called IowaCare which allows childless adults to get health care up to 200 percent of the poverty level.  We are ahead of the federal government.  And I don’t believe we are going to move backward on that.    

There apparently is an effort in the U.S. House to repeal the law entirely.  I am confident that repeal will not get 60 votes in the Senate and that President Obama won’t sign it, so that bill is DOA.

Those who want to play out the politics of this issue are free to do so.  I believe it is now more urgent than ever that state leaders step in and provide bipartisan direction to implement the Affordable Care Act.  I am more interested in implementing Obamacare.  

Make no mistake, there remains room for mischief in the implementation of the ACA.  But in Iowa, our work on health care has been marked by cooperation, not sabotage, and I remain very confident we can work out a bipartisan implementation plan.

Two weeks ago, I called on Governor Branstad and legislative leaders to convene an Iowa health care “summit” to chart a path forward for Iowa and fully implement the ACA.  Yesterday, I met with the Governor’s Chief of Staff and was encouraged by what I heard about the summit.  I proposed that a non-partisan third parties host the event and invite the stakeholders.

My hope is to convene Iowa’s health care summit within a matter of weeks.

The summit is important because the health reform process is too important to be left to just the politicians, industry and the usual stakeholders.  We need to hear what’s best for Iowans.

And when it comes to getting Iowans the health care they need in the highest-quality, most affordable way, there is no room for delay.

We must seize this opportunity to build on the bipartisan success of the past five years in health care reform and truly become “The Healthiest State.”

TWELFTH UPDATE: Kevin Russell wrote a good post on how the court arrived at its decision on the Medicaid expansion. George Zornick provides some useful numbers:

Healthcare reform aimed to expand coverage, in part, by expanding Medicaid to cover people up to 133 percent above the poverty line (as compared to 63 percent now)-that is, at or below income of $30,700 for a family of four. This expansion would extend coverage to 16 million additional people by 2019. […]

The stakes here are not small. A ProPublica analysis of an Urban Institute study found the twenty-six states that sued the federal government contain 8.5 million uninsured people who would be covered under the expansion-more than half of the total number expected to benefit.

The decision is only hours old, and as yet, no Republican governor has announced that he or she will reject the Medicaid expansion. But if anyone does it will have real impacts on many uninsured in that state-in Texas, for example, Rick Perry could yank Medicaid away from 1.8 million people who would get it under an expansion. The biggest question for healthcare reformers and the uninsured going forward is whether Perry and his cohorts will actually pull the trigger.

This news is very discouraging. There’s no doubt in my mind that lots of red-state governors will “pull the trigger.” The low-income uninsured who will be forced to keep relying on emergency room care aren’t as important as taking a stand against the so-called “federal takeover.”

THIRTEENTH UPDATE: Representative Tom Latham (R, IA-04) released this statement:

“While the Supreme Court has the duty to determine the constitutionality of the health care law, it does not have the authority to determine if it is good or bad policy for hardworking Americans. Thankfully, it is still the American people who ultimately have the power and the right to make that final judgment.

“I opposed and voted against the health care law because it is bad policy that ignored the voices of the people. Congress must set its sights on completely replacing this bad law with measures that truly will lower health care costs for hardworking taxpayers. I have offered a solution made up of better ideas that offer better solutions that will produce the best results for everyone.  My patient-centered approach empowers the American people, not Washington bureaucrats, to choose the best health care plan for themselves, and it puts them in control of their health care, not the government.

“As we move forward, I continue to stand ready to work with any of my colleagues in Congress, regardless of political affiliation, who are willing to enact real solutions for the benefit of the American people.”

In this YouTube video, Steve King called today’s ruling the most momentous Supreme Court decision since Roe v Wade.

King’s challenger Christie Vilsack sounded less excited than most Democrats today.

“Now that the Supreme Court has made their decision, Congress must reform the Affordable Care Act to control the skyrocketing costs of health care in America,” said Christie Vilsack.

“This law did little to address the rapidly increasing cost of health care. I believe we must control costs and provide stability to families and small businesses in Iowa.

“With the legal battle over health care reform behind us, Democrats and Republicans must focus on having a real conversation about how we can create jobs and economic opportunity in this country.”

That take contrasts sharply with Iowa Democratic Party Chair Sue Dvorsky’s statement:

“Today was an unequivocal victory for the American people. Health care has been protected for 34 million Americans, including the 12 percent of Iowans living without health insurance.

“By virtue of President Obama’s bold leadership, 18,000 Iowans under 26 can now stay on their parent’s insurance and two million Iowans no longer have to worry about lifetime caps or losing insurance when they get sick. Soon, no American will ever again be denied care or charged more due to a pre-existing condition. President Obama believes quality affordable health insurance you can rely on is at the heart of middle class security. The Iowa Democratic Party agrees with this 100 percent.

“We move forward today knowing that this law makes us a stronger and healthier nation. We can now return to the mission of getting Iowans back to work in this recovering economy.”

The Cedar Rapids Gazette reports,

Hatch said the governor’s staff was open to the summit but the “House leadership has to take a deep breath and find out how they want to proceed.”

In an email response, Albrecht wrote, “We are always interested in discussing significant policy issues of this nature with all parties, but that it would be premature to commit to any specific event until the decision had been rendered and we had adequate time to review its implications for Iowa.”

House Speaker Kraig Paulsen, R-Hiawatha, also seemed skeptical of the idea.

“I, we, don’t want to help Jack Hatch and President Obama in their government takeover of health care,” he said.

Paulsen released this comment on the Supreme Court’s ruling:

“The federal health care law is plain and simple, the government takeover of health care and a massive tax increase on all Iowans. The Supreme Court’s decision today makes it harder for Iowa’s small businesses to hire workers, operate their businesses and grow our state. A full repeal of the law is needed and it’s up to Iowa voters to end the government takeover of health care.”

Iowa House Majority Leader Linda Upmeyer had this to say:

“Iowans are perfectly capable of making health care decisions on their own; they don’t need Washington, D.C. telling them what to do. This law creates trillions in new government spending that we cannot afford and it ensures Iowans will have limited choices and freedoms. Iowans want an end to bureaucracy and regulations handed down from the federal government. I am confident that as president, Gov. Mitt Romney will enact commonsense reforms based on the free market, not dictated by government bureaucrats.”

Iowa Senate Minority Leader Jerry Behn wants us to believe health care reform is not just a tax increase, but the largest tax increase in U.S. history.

“Today’s disastrous Supreme Court decision allows the largest tax increase in American history to go into effect, thus guaranteeing more uncertainty and unpredictability for Iowa small businesses and employers. This destructive health care law means a future of higher costs, higher taxes and increasing debt for Iowans and it underscores the need to elect a new president that will put our economy first.”

I saved the best for last. State Senator Sorenson sent out this e-mail blast to supporters today (I think it was sent out missing the first part of the first sentence).

from time to time with the blood of patriots and tyrants” said Thomas Jefferson.

Friend, almost 200 years ago on August 24, 1814, the British  government captured and destroyed the  American capital, and burned the White House and Capitol to the ground. Today reminds me  of that day.

The British troops marched up Pennsylvania Avenue and set fire to the White House, but not before, as the story goes, they ate the dinner and drank the wine that was set for a party President Madison was hosting that evening.

So too today the symbolism of American freedom has taken a beating by tyrants occupuying the White House, Supreme Court Building and Capitol buildings in Washington, D.C.

The Supreme Court today decided to uphold tyrant Barack Obama’s “signature legislation” of his first term in office, commonly known as Obamacare.

Obamacare was passed as a law that would mandate individuals to purchase health care  insurance, and the hope that was that the Republican appointed “majority” on the United  States Supreme Court would rule that Obamacare was unconstitutional.

They did rule that it was unconsitutional, but only under the Commerce Clause. America’s new Benedict Arnold, President Bush-appointed Chief Justice John Roberts, betrayed  the Constitution he swore to uphold by allowing Obamacare to live on, insisting that it has legitimate existence in the form of a tax, even though the tax or fine is based on a law that is unconstitutional.

The window to drain the swamp is drawing to a close. For several hundred years now we have taught our children that the patriots who stormed onto the tea ships in Boston Harbor were heroes, and that the forefathers who valued liberty above the “chains and slavery” of Europe’s tyrants were forced to forge our country of freedom in the fires of war against  the world’s biggest superpower.

Today, the world’s superpower has once again become the tyrant, but who is standing in the gap ready to fight it?

The European socialist, communist and whatever other dictatorial type of government you’d like to call it has come home to roost. It’s here, it’s in our back yard, and it’s  knocking angrily at the back door.

But America’s cherished Founding Fathers foresaw the possibility that tyranny might rear his ugly head here in these United States, and made provisions for that possibility.

First of all, they re-affirmed our God given right to Keep and Bear arms. No, the Second  Amendment wasn’t given to us to ensure that we could go out and shoot a rabbit if need be. It was given to us as a measure of last resort against tyranny, for an armed citizenry is the best defense against tyranny.

Second, they gave us a Constitutional Republic form of representative government. Each  branch of government has checks and balances on it, and, luckily for us, the states are also  a check and balance on a federal government that has clearly overstepped its boundaries.

It has never been more incumbent upon the state of Iowa to remove our own dictators in charge of the Iowa Senate. In the elections this November, we need to remember how the  Supreme Court ruled today. We need to remember that the tyrant knocking at the back door wants to come into our house and run our lives, our checkbooks and tell us what we can and  can’t believe or think.

Federal Government is more than just “out of control.” It has reached the point of no return,  and it won’t be “reformed” or “reworked.”

State and local government, along with nullification, are the last peaceful resort against this tyranny.

And because there is so much at stake, we need to make sure that we do everything humanly possible to drag our friends, our neighbors, and the disaffected to the polling locations  and replace these despots who want to destroy the fabric of our state and nation.

You see Friend, I’ve known for some time that there was a chance the courts could try to sneak unconstitutional mandates in on us as a tax or fine. That’s why my bill, Senate File 94,  explicitly states that “no law shall interfere with the right of a person or entity to pay for lawful medical services, or impose any type of penalty, tax, fee, or fine on a person who declines or fails to contract for health care coverage or declines or fails to participate in any particular health care system or plan.”

And that’s also why I authored Senate File 2198, a bill establishing and Iowa Freedom and Sovereignty Act. As a sovereign state, we should never be under an obligation to uphold treacherous and unconstitutional federal mandates.

I was elected to go to Des Moines to fight for my consitutents, and I was elected to go to Des Moines to fight for our rights. In 2011 and 2012, I had 23 cosponsors to my bills dealing specifically with this issue, and in 2013, Lord willing, we’ll have the numbers we need to take this fight back to them and pass these bills.

This fight is coming at us full steam, right here in Iowa. The fight is coming, and if we end up with a conservative majority in the Senate in 2013, you can rest assured I stand ready, willing and able to come out swinging on our behalf.

Thomas Jefferson said that the tree of liberty needed to be watered occasionally with the blood of patriots and tyrants. Before it comes to that point once again, we need to exhaust every single other option, much like our forefathers did before the American Revolutionary War.

The US Supreme Court issued their ruling today.

In the November general elections, you and I will issue our ruling as well.

Go find out who your conservative, principled candidate is, and throw everything you’ve got into helping them get elected.

Sincerely,

Kent Sorenson

Republican State Senator

Warren, Madison and SE Dallas Counties

———————————————————————————————————————-

Kent Sorenson lives in Milo, IA with his wife of 20 years, Shawnee, and their six children.

Sorenson is noted for his staunch conservative positions and his insistence that the rights he fights for are endowed on us by our Creator.

Paid for by Sorenson for Statehouse. Not paid for at taxpayer or government expense.

Mail can be sent to:

Sorenson for Statehouse

PO Box 633

Indianola, IA 50125

LATE UPDATE: Attorney General Tom Miller released this statement on June 28.

Statement on Supreme Court Ruling

For 90 years, as a nation we have tried to secure health coverage for all Americans.  For many years, the United States has been the only industrialized country without coverage for all.  Congress spent much of two years working intensely on this legislation and finally passed it.  It would have been wrong for an unelected court to strike it down with the issues presented.  This is a matter for the political process.

The decision today means that —-

* Tens of millions of Americans without health care can secure it.

* Hundreds of millions of Americans who have or get in the future a pre-existing condition will not lose their health care.

* Millions of young people under 26 now covered by their parents’ policies will not lose coverage.

Chief Justice John Roberts showed great wisdom and courage in leading and writing today’s decision.  He found a basis (the tax power) he was comfortable with to uphold the law.  He changed constitutional law from a conservative perspective by limiting the ability of Congress to condition federal grants.  Because he believed it was the right thing to do, he broke with the beliefs and ideology of his usual allies.  I worked with Chief Justice Roberts when he was a lawyer on the Microsoft case.  I came to know him and became a big believer in his great character and other high personal qualities.  But never more so than today.