The U.S. Supreme Court is about to consider what may be the most important civil rights case since Brown v. Board of Education.
I’m referring to the pending challenge to the Affordable Care Act, the health care reform law signed by President Obama in 2010.
To call this a civil rights issue may be surprising, until you look closely.
First, more than half of the millions of Americans who will be newly able to obtain health insurance under the law will be people of color. Latinos and African-Americans, in particular, are disproportionately uninsured today, often because they work in jobs that don’t provide health coverage or because they simply can’t afford it.
The expansion of coverage under the Affordable Care Act will help millions who are poor or near-poor but don’t qualify for Medicaid, as well as those deemed uninsurable due to pre-existing conditions.
The key to making this work is to bring more healthy people into the system. That’s the reason for the “individual mandate” — actually a series of fairly mild tax penalties for those who don’t obtain health coverage —that is now being challenged.
This mandate, opponents argue, is an extraordinary and unprecedented extension of federal authority into areas that are traditionally ruled by individual choice or left to the states.
When have we heard these arguments before?
Just like the Affordable Care Act, congressional authority to enact the Civil Rights Act of 1964 was based on its constitutional power to regulate interstate commerce. And just like today, opponents argued back then that it was an outrageous overreach for the federal government to prohibit private discrimination in employment or public accommodations.
Then-Sen. Strom Thurmond, D-S.C., denounced the Civil Rights Act as “unconstitutional, unnecessary, unwise and ... beyond the realm of reason.” For people of color who urgently need the access to healthcare that the Affordable Care Act will provide, the echoes of Thurmond are not comforting.
In the 1960s, the Supreme Court rejected the arguments that Thurmond and his ilk made. Now we’re hearing them all over again, in a context that makes little sense.
The federal government is already deeply involved in regulating healthcare, not just through Medicare and Medicaid but also through a variety of regulations covering private plans — such as COBRA, which provides continued coverage for employees who leave a job. Much existing federal regulation of health coverage seeks to control the tens of billions of dollars a year that uninsured patients cost the system — costs we all pay through taxes and our own higher insurance premiums.
The Affordable Care Act is simply another way of doing what the government already does. It makes sound financial sense to make sure everyone has insurance, because one way or another we end up paying for those who don’t.
The Affordable Care Act is a wise step forward for our health care system — and for all Americans.
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