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What the Supreme Court Did not Decide


Location: Washington, DC

At the very end of Chief Justice John Roberts' majority opinion on the health care law is a message for American citizens. He writes, "… the Court does not express any opinion on the wisdom of the Affordable Care Act. Under the Constitution, that judgment is reserved to the people."

And judged they have. While the Supreme Court judged the health care law's constitutionality, the American people and actuarial experts have already judged its quality and determined that it is a disaster for patients, small businesses and future generations of Americans.

The law is a debt-driver. The Congressional Budget Office (CBO) now estimates that it will cost nearly $1.8 trillion from the years 2013-2022. However, that projection only takes into account nine years of the Affordable Care Act's (ACA) full implementation -- most of the law's provisions do not take effect until 2014 -- so only next year will we see a projection with a true "ten-year" price tag. A $2 trillion figure is likely.

The law will deprive many Americans of their current health plans. According to the CBO, the ACA will likely cost three to five million Americans their employer-provided coverage. Some scenarios project that twenty million Americans could have to find new health coverage.

The law was partially "paid for" with over half a billion dollars in cuts to Medicare, including drastic Medicare Advantage cuts that are estimated to halve enrollment by 2017 and decrease plan options by two-thirds. This will affect care for seniors throughout the country.

The takeaway: young or old, the health care law accomplishes little to ensure affordable coverage for all Americans.

It does accomplish a lot of taxing, however. ACA is fraught with new taxes, including taxes on medical device and drug manufacturers, taxes on medical savings and spending accounts, taxes on health insurance providers, taxes on certain health plans, taxes on the sale of some homes -- taxes on practically everything under the sun. The health care law even taxes tanning beds.

In all, twenty-one tax increases from the ACA, twelve of which target families earning less than $250,000, are intact after last week's Supreme Court ruling. They amount to more than $800 billion, according to a just-released estimate from the nonpartisan Joint Committee on Taxation.

One of these taxes is the health care law's individual mandate. This provision, which requires everyone to obtain health insurance or pay a new tax, could penalize Americans an estimated $17 billion over ten years.

The President has routinely tried to convince the public that the individual mandate is not a tax increase. "I absolutely reject that notion," he said in a 2009 interview. Flash forward three years, however, and the Supreme Court reached a different conclusion. Chief Justice Roberts wrote that the Supreme Court interpreted the individual mandate "as increasing taxes on those who … choose to go without health insurance."

If the American public wants to repeal the Affordable Care Act, they must put in place a Congress and a President committed to achieving that result. Until that time, the House will continue working to make headway on this issue, with a vote to repeal the law in full July 11th so we can then start anew on reforms that will increase patient access and quality of care while reducing costs.

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