The U.S. Supreme Court upheld the central provision of health care reform legislation on Thursday, keeping intact the law that improves access for LGBT Americans who disproportionately lack affordable care.
In a 5-4 decision issued on the final day of the court’s term, the justices voted to uphold the individual mandate, and thus preserve the entire law, known as the Affordable Care Act, under Congress’s authority to tax.
“The high court rejected the argument, advanced by the Obama administration, that the individual mandate was constitutional under the commerce clause of the Constitution,” reported The Washington Post. “But Chief Justice John G. Roberts Jr. joined the court’s four liberal justices – Ruth Bader Ginsburg, Sonia Sotomayor, Stephen G. Breyer and Elena Kagan – in voting to uphold the mandate, ruling that a penalty for refusing to buy health insurance amounts to a tax.”
Justices Anthony Kennedy, Antonin Scalia, Clarence Thomas, and Samuel Alito said that the entire law should have been struck down on the basis of its key component parts. In their dissent, they wrote, “The Act before us here exceeds federal power both in mandating the purchase of health insurance and in denying nonconsenting states all Medicaid funding.”
The 2010 law promised to improve conditions for LGBT Americans, who are underserved by the nation’s health care system. Secretary of Health and Human Services Kathleen Sebelius has said the law “may represent the strongest foundation we have ever created to begin closing LGBT health disparities.” Key provisions, according to the Center for American Progress, include nondiscrimination provisions in accessing care, data collection on LGBT health disparities, an end to limits on lifetime coverage and the practice of denying coverage because of pre-existing conditions such as HIV and cancer, and the expansion of Medicaid eligibility, which boosts protections for LGBT people with incomes limited by workplace and relationship discrimination.
While legal experts continued to analyze the full impact of the high court’s opinion, leading LGBT advocacy organizations issued words of praise for the decision.
"This ruling is a victory for millions of people - including LGBT people and our families - who don't have access to adequate, affordable health care,” said National Gay and Lesbian Task Force executive director Rea Carey. “Health care reform is about revamping a severely broken system to help everyone get a fair shake when it comes to keeping themselves and their families healthy and out of harm's way. It is about making sure everyone has access to affordable health care when faced with injury and illness. It is based on the premise that no one get hung out to dry - to literally die in some cases - because they were denied affordable health care in one of the richest countries in the world.”
“The Supreme Court’s decision means millions of Americans – including many lesbian, gay, bisexual and transgender people and their families – will be better served by our nation’s healthcare system,” said Chad Griffin, president of the Human Rights Campaign. “The Affordable Care Act addresses a number of the barriers LGBT people face in obtaining health insurance, from financial barriers to obtaining affordable coverage to discrimination by insurance carriers and health care providers. While there is a great deal more that must be done to ensure that the health needs of all LGBT people are fully met throughout the healthcare system, today’s decision is an important victory in the fight for healthcare equality.”
The decision also handed a political victory to President Barack Obama, who made the Affordable Care Act a centerpiece of his first term. The president was scheduled to speak on the decision in the early afternoon, but it appeared to ensure that law would remain a hot-button issue throughout the reelection campaign. House Republicans announced after the decision that they would schedule another vote on repeal of the law the week of July 9.
"Mitt Romney and the GOP have been adamant that this law is unconstitutional and they were wrong,” said Jerame Davis, executive director of the National Stonewall Democrats. “The individual mandate, which was the centerpiece of the GOP's faux outrage, was originally a Republican idea and now a conservative-leaning court has just upheld it in its entirety. In fact, Mitt Romney himself signed such a provision into law as governor of Massachusetts. This is one Etch-a-Sketch moment Mitt Romney cannot shake away."
Republican LGBT groups criticized the court’s decision. GOProud, the group for gay conservatives and their allies that endorsed Romney last week, called Thursday “a good day for big government and a bad day for individual liberty.”
“Free market health care reform would expand access to domestic partner benefits and put gay people in charge of their healthcare decisions,” said executive director Jimmy LaSalvia. “By upholding Obamacare, the Supreme Court has upheld legislation that hurts all Americans, but especially hurts gay and lesbian families.”
The Log Cabin Republicans, which has not yet endorsed a presidential candidate, said the Supreme Court’s decision “has enabled Washington’s addiction to big government and coercive taxes.”
“The individual mandate forced through Congress was an unprecedented expansion of federal power in blatant disregard of the will of the American people,” said deputy executive director Christian Berle. “Log Cabin looks forward to working with our Republican allies in Congress to repeal and replace Obamacare with real, market-driven reforms that will lower costs while preserving the standard of care Americans deserve.”