Hey, everybody.
Welcome to module three.
the Patient Protection and Affordable Care Act,
the ACA or Obamacare as some will call it,
was signed by President Obama in 2010.
The law really changed the healthcare system
in the US monumentally
in a way we really hadn't seen since Medicare
and Medicaid in 1965.
The goal of Obamacare was to reduce the amount
of individuals and families without health insurance
and provide a better path
to health insurance for those without insurance
through work or through government insurance systems,
like Medicare and Medicaid.
What is the ACA?
Most of you have discussed the ACA in other classes already.
You'll discuss it in other classes
that you haven't taken yet.
The ACA was really just a bunch of ideas put together
in an effort to have everyone on healthcare insurance,
and in doing so,
the idea was to make coverage more affordable
because everyone was basically paying in.
Parts of the ACA were pretty successful.
You'll see in the optional readings I'll put in this week
the success of some of it.
Other pieces have not been so successful.
Parts like the CLASS Act,
which I encourage you to read about,
which was meant to deal with kind
of long-term care insurance were completely eliminated.
So one of the things that we'll discuss this week
are the numerous actions
in courts to challenge the constitutionality
of the Affordable Care Act.
These are numerous and ongoing.
As you probably know,
the Supreme Court upheld the ACA initially
and then for a third time again in 2021.
Is this the end of the story? No.
There are current lawsuits trying to undo parts
or the total of the ACA right now.
The first major attack on the ACA,
probably the most significant was on the commerce clause.
So Congress has the power to regulate how states deal
with one another.
Plaintiffs in that case argued
that Congress did not have the power
under the commerce clause to enact the Affordable Care Act
and therefore, the whole thing should be unconstitutional
and thrown out.
However, the Supreme Court declared instead
that this was a valid exercise of Congress's power
to tax because we had that initial provision
that taxed individuals who did not have health insurance.
So that individual mandate that was originally part
of the Affordable Care Act was the reason
why the Supreme Court upheld the ACA initially.
Another challenge that followed that one,
plaintiffs argued that the plain language
of the Affordable Care Act provided was not plain enough
and therefore, folks who would be eligible
for tax credits would only be those
who were receiving their insurance
through state-operated exchanges.
It would've basically hollowed out the Affordable Care Act
and made it, you know, not effective.
The Supreme Court rejected that one
and that was the second big challenge
to the Affordable Care Act.
In 2018, in a suit brought in Texas,
the plaintiff said that because the individual mandate,
the tax had been reduced
to zero under the Trump administration,
plaintiffs argued that the tax was unlawful.
It was no longer a viable use of power.
However, rather than ruling on the merits of that 2018 case,
the court said that there was not standing
to challenge the individual mandate to begin with.
Standing is basically, if you're a plaintiff in a case,
you have to show that you either have an injury
or threat of injury to be able to bring a case.
Otherwise, you know, you don't have a standing to come
to court and complain about something.
So if you don't have this harm element
or potential harm element,
you don't have standing to challenge in court.
And basically, the court said, you know,
if there's a tax that is amount of zero,
you're not harmed or you do not have potential to be harmed.
So the third big try also failed.
There's another lawsuit pending right now,
Kelley versus Becerra, where plaintiffs are arguing
that the preventative care requirements
under the Affordable Care Act
for insurers and health plans is unconstitutional
and they make arguments,
such as the PrEP, pre-exposure prophylaxis
to prevent HIV violates the Religious Freedom Act.
So probably this will be the fourth big Supreme Court case.
So this week is kind of about
the landmark Affordable Care Act
and how law and litigation goes back and forth
as we try to carve out parts of the law
that some folks don't like.
Underlying this complex legal drama,
there's some questions
at play that you'll see in the module.
You know, should healthcare be a right?
Can we get access to healthcare if we can't pay?
Did the ACA expand healthcare for insurance?
Did the ACA expand healthcare insurance or healthcare?
I think these are all kind
of these philosophical questions
that are underlying the Affordable Care Act
and the results thereof.
So I'll see you in the discussion forum
and we can talk through some of these important matters.