For too long, our health care system left millions of Americans out in the cold. Many people didn’t have access to insurance and others lacked security. For example, those with a pre-existing condition were not able to get insurance at any cost, and those who lost their jobs lost their insurance.
Even those with coverage have struggled with rising costs and high co-pays and deductibles. Those with insurance have also been paying higher premiums to cover the cost of those who show up at the emergency room without insurance — an average of an extra $1,017 to a family policy every year for this uncompensated care. In 2010, after almost a century of trying to reform health care and improve access, Congress passed and President Obama signed into law the Affordable Care Act, which will make health coverage affordable and accessible for all Americans.
The real benefits of the law are not speculative. The Vernon J. Harris and Daily Planet health clinics in Richmond received millions of dollars to expand their health care services. A recent VCU graduate who has not yet found employment now has peace of mind knowing that he can stay on a parent’s policy until age 26. A senior citizen in Church Hill who is forced to spend out of pocket for prescription drugs when she falls into the “doughnut hole” now receives $600 in assistance. A small-business owner in Carytown struggling to provide health insurance now receives a tax credit to make it more affordable for her to provide the coverage for her employees. A child with diabetes in Henrico County cannot be denied coverage because of a pre-existing condition.
Because of the law, plans must now offer free preventive care for services like mammograms, so that illnesses can be detected and treated early. For instance, when breast cancer is detected early, the five-year relative survival rate is 98 percent, but declines to 23 percent when cancer has spread to other parts of the body. No woman should ever have to forgo a life-saving screening because she lacks money or insurance. The bottom line is that thousands in my congressional district and millions nationwide are now better off because of the Affordable Care Act.
After enactment, several lawsuits were filed challenging the law’s constitutionality. Many of those cases were dismissed, though in late 2011, the Supreme Court agreed to review the law.
A great deal of the publicity and controversy surrounding these challenges has focused on the so-called “individual mandate,” the provision requiring individuals to purchase insurance or pay a penalty. While the administration proffered several arguments to support this provision’s constitutionality, including Congress’ authority under the Commerce Clause, the court ultimately upheld the law based on Congress’ power to lay and collect taxes to provide for the general welfare — the same authority under which Social Security and Medicare are constitutional.
I have always maintained that the “individual mandate” is in fact simply a tax — equivalent to receiving a tax credit for having insurance. In February 2011, when Republicans invited Virginia’s Attorney General Ken Cuccinelli to testify on the mandate’s constitutionality at a House Judiciary Committee hearing, I asserted that there was in fact no mandate. Rather, if you don’t have insurance, you pay the extra tax. Chief Justice John Roberts reached the same conclusion by writing that “Congress’ use of the Taxing Clause to encourage buying something is … not new. Tax incentives already promote, for example, purchasing homes and professional educations. There is little distinction between a credit for purchasing health insurance and the variety of tax credits currently offered by the federal government.
The practical implication of the court’s decision is that states can continue to implement the law — health insurance exchanges will be up and running in 2014 and Americans will continue to enjoy the law’s benefits. For example, individuals will not lose their insurance when they get sick, and seniors will no longer fall into the “doughnut hole.” While many have opposed health reform for a variety of ideological reasons, the fact remains that the law has always stood on firm constitutional ground. While the debate has been divisive and health reform has been riddled with misinformation, Americans will quickly begin to see how this new law helps them, their families, and their neighbors.
The vote I cast on the Affordable Care Act will remain one of the highlights of my legislative career. In 20 years, Obamacare will no longer be a derogatory term. It will be on par with Medicare and Social Security as a vital function of government that enhances the lives of every American.
Congressman Robert C. “Bobby” Scott is the U.S. Congressman representing Virginia’s Third Congressional district. He has seerved in Congress since 1993.