On Thursday, the Fourth Circuit Court of Appeals dismissed two constitutional challenges to the Affordable Care Act (ACA), finding that both plaintiffs lacked the requisite standing to challenge the law. Out of the other four other circuits have that have ruled on ACA challenges, only one other (the 11th Circuit) has decided (in a 2-1 opinion) that the individual responsibility provision is unconstitutional. Dozens of other cases have been dismissed because either they found the law constitutional or because they determined that the plaintiffs lacked standing.
Despite this victory for health reform advocates, it is clear that the Supreme Court will ultimately decide the constitutionality of the individual responsibility provision, which is the key provision of the ACA requiring all individuals who can afford insurance purchase coverage. The individual responsibility provision is an essential element of the ACA and it is simply good policy. It is fair to ask people to take responsibility for their health care. When someone chooses to be uninsured, unless that person has sufficient means to cover any possible medical expense or crisis, it is likely that they will incur a certain amount of medical care for which they cannot pay. Not only does this take a toll on the uninsured who may fall into medical bankruptcy and forgo other treatment. But the cost of that person’s care gets passed along to the rest of us who have health insurance. These costs put an unfair burden on hard-working taxpayers, as well as the efficiency of our health care system.
Health reform simply levels the playing field by saying that if you can afford to buy insurance, you should do so. The ACA makes that possible by coupling the individual responsibility provision with tax credits and other means to ensure that such a requirement is affordable.