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Supreme Court Ruling of the Affordable Care Act: An Intern's Perspective

Tuesday, August 14, 2012   (0 Comments)
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One could feel the excitement in the air as I camped out all night on the sidewalk in front of the US Supreme Court for the next morning's showdown – the Supreme Court's ruling on the Affordable Care Act (ACA). Most of the other campers present were students or recent graduates, interns or nearby DC residents. Many campers didn't sleep that night, instead staying up all night sharing opinions and speculations on how the Court would rule. I finally succumbed to exhaustion and awoke at 5:00 a.m. in a sea of cameras. As the morning wore on, I found myself constantly mulling over what might happen inside that beautiful building later that day. This would be among the most important, far-reaching cases of my lifetime.

While we waited inside the building, I talked with a political science major from Johns Hopkins University. When I asked her how she would respond to someone who believes that the ACA violates the Constitution, she told me about her "Comparative Constitutions” class. "Under the US Constitution, the government would not be violating its duty if it just sat back and did nothing,” she said. ”Other countries' constitutions have specific provisions written in them that forbid the government from doing nothing. These countries have to provide certain services. Because of this, they are much more welcoming of big social changes like health care reform.”

Eventually we were escorted upstairs to a room with small lockers where we left all electronic devices and other personal items. Inside the courtroom we waited and whispered for nearly half an hour. Despite my profound lack of sleep, as soon as the Justices walked in, a surge of adrenaline flooded my body. Only this relatively small group of people I was sitting with would ever witness firsthand the words uttered from the mouths of out Justices Roberts, Ginsburg and Kennedy. It was an amazing feeling to witness history before anyone else. The mandate was found unconstitutional under the Commerce Clause, but constitutional under the taxing power, and the rest of the law stood with it. (The Court did overturn the expansion of Medicaid as coercive, but the only part removed was the threat of removing all Medicaid funding for states that choose to opt out of the expansion.) I don't think there was a person there who saw this ruling coming.

After the ruling outside the Court, Representative Michelle Bachman was on a loudspeaker in the middle of the Tea Party crowd, insisting that since the justices had failed and it now falls to the voters to repeal Obamacare. She was drowned out, at times, by boos and chants of "four more years” by people holding sign that read "We love Obamacare” and "Stand up for Women's Health.”

Instead of examining the ruling, the groups were too busy volleying taglines. When this type of one way discussion takes place and people disregard the details, they tend to talk past each other. The result is conflicting, often embarrassing messages.

ACA will continue to be a politicized as will speculations about Justice Roberts' reasoning. If we want to move forward with assuring healthy outcomes for all populations, we need to stop talking past one another, care enough to see what the other side has to offer, and build from our common ground. There are tough questions ahead involving the quality and cost of healthcare. Solving these problems will require meaningful dialogues and thoughtful consideration of the details. And by considering the details we might just discover, like I did, that solving problems doesn't have to be one-sided. We can find a middle-of-the-road solution that covers everyone's needs. That way, no one has to feel "left out in the open.”


by Mir Alikhan, a master of public health student at the University of Texas at Tyler. He completed his summer internship with DHPE through The Archer Center.


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