‘Obamacare’ Prevails: Supreme Court Upholds Healthcare Law

In a 5-4 vote, the U.S. Supreme Court upheld the Patient Protection and Affordable Care Act today, including the controversial individual mandate that requires all Americans to buy health insurance beginning in 2014. However, the ruling limited the federal government’s power to punish states for not expanding Medicaid coverage, as the ACA required.

“The Court did not sustain it as a command for Americans to buy insurance, but as a tax if they don’t. That is the way Chief Justice John G. Roberts, Jr., was willing to vote for it, and his view prevailed. The other Justices split 4-4, with four wanting to uphold it as a mandate, and four opposed to it in any form,” Lyle Denniston, the 81-year-old reporter, wrote on SCOTUS blog today.

The immediate sense is that this is a major victory for President Barack Obama and the signature legislation from his first term in office. “Whatever the politics,” the president said after the ruling, “today’s decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court’s decision to uphold it.”

But the decision also was an indication that the Supreme Court perhaps isn’t as predictably partisan as many believed prior to the announcement. Breaking with the court’s other conservative justices, Chief Justice Roberts announced the judgment that allows the law to go forward with its mission of covering more than 30 million uninsured Americans. Many observers speculate that Roberts’s ruling reflected his attempt to avoid going down in history as an activist chief justice on what might be the most important decision of his tenure.

UrbanFaith spoke to a variety of legal and medical experts about what the implications of today’s decision may be.

BERNARD JAMES: “An extraordinarily important substantive issue about the power of Congress under the Commerce Clause.”

Bernard James, professor of law at Pepperdine University in Malibu, California, along with three other sources UrbanFaith talked to earlier this week, expected the individual mandate to be struck down, but said the ruling has the potential to answer “an extraordinarily important substantive issue about the power of Congress under the Commerce Clause.”

The Commerce Clause refers to Article 1, Section 8, Clause 3 of the U.S. Constitution. It gives Congress the power to regulate commerce with foreign nations and among the states.

“Once it’s clear what the Commerce Clause permits and what it requires, not just health care, but all other subjects on the current agenda for this Congress will be more easily pondered and legislated,” said James.

“There were not five votes to uphold [the individual mandate] on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power,” editor Amy Howe wrote on the SCOTUS blog. “Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose,” she wrote in her summary of the ruling.

JAMES A. DAVIDS: “This is like federalism on steroids.”

James A. Davids, former president of the Christian Legal Society and a joint professor at the Robertson School of Government and the School of Law at Regent University in Virginia Beach, Virginia, said that ever since the New Deal was implemented in the 1930s, the Supreme Court has viewed federal power “expansively.” That vision of federal power was “tweaked” under the Renquist court, Davids said, in its rulings on two bills, the Violence Against Women Act of 1994 and the Gun-Free School Zones Act of 1990. As with today’s ruling, the court said then that there may be good reasons to enact these laws, but not under the Commerce Clause. “There were exceptions going into the power of the government under the Renquist court, under federalism issues, and this is like federalism on steroids,” said Davids.

Davids also said the Rehnquist court ruled that it was constitutional for the federal government to withhold highway funding from South Dakota when the state refused to comply with the National Minimum Drinking Age Act. In this case, the Court said current Medicaid funding cannot be revoked, but new funding can be withheld.

“Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding,” Chief Justice Roberts wrote in his opinion. Roberts, who was appointed by President George W. Bush, cast the deciding vote to uphold the ACA.

DR. BEN CARSON:“We got what could be expected” from politicians.

For Dr. Ben Carson, the world-famous neurosurgeon and director of pediatric neurosurgery at Johns Hopkins Children’s Center in Baltimore, Maryland, the outcome of today’s decision doesn’t change much. “The impetus behind the bill was the fact that we had these escalating costs and people who weren’t adequately covered … even though we spend twice as much per capita on healthcare as anybody else in the world,” said Carson.

He supports the concept of health-care reform, but doesn’t think the ACA was done right and compared the effort to hiring pundits to rebuild a bridge instead of hiring structural engineers. “It was done by politicians and special interest groups as opposed to by people who actually know what the problem is and know how to deal with it,” said Carson. “We got what could be expected in that situation.”

Escalating beaurocracy and a lack of comprehensive electronic medical records make the practice of medicine more difficult than it once was, Carson said. In his new book, America the Beautiful: Rediscovering What Made This Nation Great, he includes a chapter on health-care reform. He suggests using “health stamps” to incentivize the uninsured to use  clinics rather than emergency rooms for their primary care. This would lead not only to cost savings, but to better care for patients with chronic illnesses, Carson said.

He also advocates Tort reform to rein in the costs of medical malpractice suits. “We’re the country in the world that has the biggest problem with that. Is it because we have the worst doctors? Of course not. It’s because of special interest groups. The Trial Lawyers Association. We will not deal with them. Every time it has come up before Congress, the House has passed it, but the Senate will not vote on it, because there are some filibustering senators who are in the hip pocket of the Trial Lawyers Association,” said Carson.

Finally, Carson said we have to come to grips with the fact that insurers make money by denying people care. “That’s a basic inherent conflict of interest. We have to find a way to deal with that,” he said.

TONY MEGGS: “We’re grateful that congress, both left and right, saw healthcare sharing ministries like ours … as being part of the solution.”

Some Christians, especially the self-employed and small business workers, are participating in medical cost sharing ministries like Medi-Share because they can’t afford the high cost of individual health insurance plans. Today’s ruling won’t have a direct impact on them, said Tony Meggs, the president and CEO of Medi-Share’s parent organization, Christian Care Ministry.

As part of an alliance of three cost sharing organizations, Medi-Share lobbied for and won an exemption from the individual mandate for its members. “We’re grateful that Congress, both left and right, saw healthcare sharing ministries like ours and the other two ministries as being part of the solution,” said Meggs.

His organization’s 19-year history of paying every eligible bill (approaching $700 million to date) and its focus on wellness and preventative care helped convince legislators that cost-sharing ministry members deserved an exemption, he said.

“They understand that they need to bend the cost curve in some way in getting people to make better choices in terms of how they live their lives. From a diet and exercise perspective, those are things that Congress was interested in, and so I think it was a combination of [that and] the fact that we’ve been here for a long time. This is how we help people. It’s credible. We’re not scamming people,” said Meggs.

Medi-Share’s steady growth “accelerated” after the ACA was enacted, Meggs said, and he expects that growth to continue because he says there is about a 40 percent cost difference between an individual health insurance plan and a monthly Medi-Share contribution.

There are differences, however. Medi-Share participants must sign a statement of faith and agree not to abuse drugs or alcohol or engage in extra-marital sex, Meggs said. Medical problems resulting from violations of these agreements are not generally “shared,” nor are mental health problems or some pre-existing conditions. Additionally, insurance companies are contractually obligated to pay for eligible services, but “sharing” medical expenses is voluntary for Medi-Share members. “There’s no guarantee. There’s no contract. Our program is strictly voluntary, but what I can tell you is that over a 19 year history, a 100 percent of every eligible bill that we’ve ever published has been shared,” said Meggs

What about you?

How will today’s ruling impact your family’s health decisions?

Everyone Wins (and Loses): The Supreme Court’s Immigration Ruling

The U.S. Supreme Court upheld a key component of Arizona’s controversial immigration law Monday, allowing local police to request documentation from people they suspect to be in the country illegally. It struck down “two provisions that made it a crime for an illegal immigrant to seek work or fail to register with the federal government,” NPR reported. It also ruled against “a portion of the law that allowed state and local law enforcement officers to arrest anyone based solely on the suspicion that the individual was in the country illegally.”

Governor Jan Brewer declared the ruling a victory, according to Politico. “Today is the day when the key components of our efforts to protect the citizens of Arizona, to take up the fight against illegal immigration in a balanced and constitutional way, has unanimously been vindicated by the highest court in the land,” she said. “Arizona’s and every other state’s inherent authority to protect and defend its people has been upheld.”

But the ruling “reignited concerns that the law could lead to widespread racial profiling and civil-rights violations by overzealous police targeting Hispanics, including U.S. citizens or those who are here legally,” The Arizona Republic reported. Writing at The Grio, Judith Browne Dianis said the decision is also “a mixed bag and a cautionary note for black folks” because anti-immigration laws “intrinsically include us in their broad sweep, as civil rights violations always do. ”

“I am pleased that the Supreme Court has struck down key provisions of Arizona’s immigration law,” President Obama said in a statement. “What this decision makes unmistakably clear is that Congress must act on comprehensive immigration reform. A patchwork of state laws is not a solution to our broken immigration system – it’s part of the problem.”

His administration went further. “Just hours after the Supreme Court issued its decision on  SB1070, federal officials said they would immediately rescind a controversial federal-state partnership that uses local cops in Arizona to detain immigrants,” Colorlines reported.

Rival Mitt Romney took the opposite approach, according to The Washington Post. “I would have preferred to see the Supreme Court give more latitude to states, not less. And the states, now under this decision, have less authority, less latitude, to enforce immigration law,” he reportedly said at a fundraiser in Scottsdale.

The ruling could be a “boon” to the president, but Romney loses no matter what, said Howard Fineman at The Huffington Post. “Praise the court and [Romney] offends Latinos; fault it and he offends social conservatives who have made a crackdown on the undocumented a key Tea Party plank. … Since possession of a valid driver’s license is, under the Arizona law, sufficient proof of citizenship, the ruling will force legal residents and citizens to get them if they don’t have them. There’s no better place to run a registration drive than at or near a DMV. Most of those voters are likely to be Democrats, or at least Obama supporters,” Fineman wrote.

Either way, “Many politicians – and Americans in general – don’t understand the complex contours of Hispanic voters in America,” The Christian Science Monitor reported. The problem begins with the term Hispanic, which was reportedly “manufactured by Congress in 1976 to be an umbrella term that applies to all Americans of Spanish descent.”

Speaking of Hispanics, the National Hispanic Christian Leadership Conference issued a statement stating, in part, that the Court “initiated the process of establishing a legal firewall against draconian measures as it pertains to immigration” and conveyed “a clear message that 21st century jurisprudence will not tolerate measures that polarize and segregate our communities.”

Christians for Comprehensive Immigration Reform also issued a statement, from Jim Wallis, that said, in part, “The decision to strike down key provisions of this legislation is a victory for everyone in the faith community who seeks to follow the Bible’s call for concern for the vulnerable and ‘stranger’ among us. Arizona’s immoral legislation threatened families, harmed children, and made it difficult for law enforcement to safeguard the communities they swore to protect; it remains important to ensure that any remaining parts of the legislation are never used to justify racial profiling by local police.”

The American Civil Liberties Union will devote $8.7 million to fight expansion of “show me your papers” laws in other states, its Executive Director Anthony D. Romero announced Monday. The ACLU will “aggressively battle any state’s attempts to enact copycat legislation while also fighting the ‘corrosive effects’ of existing anti-immigrant laws in Arizona and five other states,” its statement said.

It may be an uphill battle. The latest Rasmussen Reports national telephone survey found that 55% of likely voters wanted SB1070 upheld, while only 26% wanted it overturned. Nineteen percent were undecided about the law.

What do you think?

Did the U.S. Supreme Court make the right decision?

Asian Americans Object to Pew Survey

“Asian Americans are the highest-income, best-educated and fastest-growing racial group in the United States,” according to a new Pew Research Center report, which is curiously titled, “The Rise of Asian Americans.” Members of this community are “more satisfied than the general public with their lives, finances and the direction of the country, and they place more value than other Americans do on marriage, parenthood, hard work and career success,” the report said.

Asian-American groups quickly pounced on the research, however, saying the community is hardly monolithic. The National Council of Asian Pacific Americans issued a statement saying the survey “could lead some to draw conclusions that reflect inaccurate stereotypes about Asian Americans being a community with high levels of achievement and few challenges.”

“Pacific Islander women experience myriad health disparities, discrimination, long-term unemployment, domestic violence, foreclosure and more, but reports like this make it hard for those in need to have their voices heard,” echoed the National Asian Pacific American Women’s Forum.

The Japanese American Citizens League also expressed dissatisfaction: “Asian Americans make up 5.6% of the U.S. population and include over 45 different ethnicities speaking over 100 different dialects. While our community reflects diversity, this research does not; instead, it sweeps Asian Americans into one broad group and paints our community as exceptionally successful without any challenges. This study perpetuates false stereotypes and the model minority. The JACL strongly advocates for further research and analysis specifically regarding disaggregated data collection.”

Colorlines reported similar sentiments from the Asian American Center for Advancing Justice. “More than a third of all Hmong, Cambodian and Laotian Americans over the age of 25 don’t have a high school degree,” the article. And, “while some Asians may report incomes at or higher than whites, Cambodian and Laotian Americans report poverty rates as high as, and higher than, the poverty rate of African Americans, according to the 2010 census.”

Pew Senior Researcher Cary Funk responded to Colorlines, saying the survey is “a detailed analysis of the census data combined with a nationally representative survey of all Asian Americans. …If you are going to talk about Asian Americans as a whole then the facts are what the facts are.”

The Rise of Asian Americans was based on “a nationally representative sample of 3,511 Asian Americans” who were interviewed in English and seven Asian languages by telephone from January 3 to March 27, 2012, the report said.

This being a presidential election year, there is, of course, a political angle. “Even though Asian Americans are slightly less than 6 percent of the U.S. population, they have become much-coveted voters. Both President Obama’s re-election campaign and the Republican Party have launched efforts to reach Asian-American voters and encourage members of the community to run for elective office,” The Seattle Times reported.

What do you think?

Does this survey reinforce stereotypes about Asian Americans?

Rev. Fred Luter Elected to SBC Presidency

HISTORIC ELECTION: Rev. Fred Luter has been elected as president of Southern Baptist Convention.

This afternoon, in a move that has been anticipated for at least a year, the Southern Baptist Convention elected the Rev. Fred Luter Jr. as its new president. Luter, the 55-year-old pastor of Franklin Avenue Baptist Church in New Orleans and first vice president of the SBC, will be the first African American to head the denomination, which was founded in defense of slavery in 1845.

In a rousing nomination speech, the Rev. Dr. David Crosby, senior pastor of First Baptist Church of New Orleans, said Luter is “qualified in every way to hold this office.” Crosby described Luter as a “man of integrity” who has a “loving family” and an “unblemished, untarnished reputation” in his community. Crosby also said Luter “would likely be a candidate for sainthood one day if he were a Catholic.” The men got to know each other after Hurricane Katrina when they shared worship space and did ministry together, he said.

Because Luter ran unopposed and because of the historic nature of his election, all convention “messengers” were asked to rise to affirm his nomination, which they did. Wiping away tears, Luter simply said, “To God be the glory for the things he has done. God Bless you. I love you.”

The New York Times reported that there are “51,000 congregations with 16 million members” in the SBC. “Luter shares the Baptists’ firm rejection of abortion and same-sex marriage, but he preaches more about personal salvation than politics. Though he never completed seminary training, he is renowned for his rapid-fire sermons filled with wordplay and hypnotic repetition,” the article said. Luter told The Times that his first priorities will be “the traditional Baptist goals of evangelizing, serving believers and providing disaster relief,” but that he would “use his power of appointments to get more minorities on the governing boards.”

The Rev. Dr. Dwight McKissic, senior pastor Cornerstone Baptist Church in Arlington, Texas, first advanced Luter for the presidency in 2010, according to an Associated Baptist Press article published earlier this year. Today, McKissic told UrbanFaith he thinks Luter’s election signals that the SBC wants to send a message that the denomination is ready to welcome African Americans.

“The next step I believe will be a real position of power in the Southern Baptist Convention. Unfortunately the president of the convention controls no budget, no personnel. It has influence, but it has no real inherent authority or power. … The jury is still out, but we’ll see when they get ready to hire an entity head whether or not they’re serious,” said McKissic.

“Symbolism has the capacity to make folks feel good about themselves without actually doing anything,” Robert Parham, executive director of Baptist Center for Ethics and EthicsDaily.com told USA Today.

“It is symbolism, but it’s major symbolism in the right direction that will open the door for full inclusion and empowerment of African Americans in the Southern Baptist Convention,” countered McKissic. Last year McKissic published two blog posts about egregious racism in SBC churches. UrbanFaith asked him if there has been any improvement in the situation since then. “The jury is out. Only time will tell. I don’t take this move to say that there is,” he said.

“This is not some tokenism. It’s symbolism with substance,” said Dr. Robert Smith, professor of divinity and Christian preaching at Beeson Divinity School in Birmingham, Alabama. Smith spoke to UrbanFaith this morning. “Fred Luter pastors Franklin Avenue Baptist Church, which is the largest Southern Baptist Church in terms of membership in the entire state of Louisiana. … He is greatly beloved and appreciated—the keyword is respected—by the convention. Otherwise he wouldn’t be elected,” added Smith.

After Luter’s election, UrbanFaith talked to Parham about Smith and McKissic’s responses to his USA Today quote. “Southern Baptists sought for decades to address the issue of racism with symbolic acts, such as pulpit swaps with African-American Baptist pastors. That symbolism of racial reconciliation was encouraging and positive,” Parham said. “When the white power structure in those pews sought to maintain economic privilege and maintain racial inequality, then the symbolism of pulpit swaps was often of little earthly good. … A lot of folks, including those in the national media, are reacting to the election as if it represented immediate, substantive transformation. Casting a single ballot is not the same thing as denominational reformation.” Still, Parham, like many others, tweeted his congratulations to Luter.

Quoting French author Victor Hugo, Smith said, “There’s nothing so powerful as an idea whose time has come. [Luter’s] time has come. It’s the right time. … He’s a middle of the way kind of person, aggressive with tenderness and mercy and patience. Things will not be changed overnight. …. I think he is the kind of person who is willing to see it through and waiting to see it through.”

“He will not be a black president. He will be a president black. What I mean by that is that if you say ‘black president,’ that means black is the adjective, which, in a way, modifies his presidency. No, he will be a president who just happens to be black. So it’s the presidency that is crucial and blackness happens to be who he is ethnically, but he’s been called to be president of the entire convention,” said Smith.

He also said it should be noted that “Fred really is not Fred without [his wife] Elizabeth.” “He has such great love for her and she has great love for him that they have a duel ministry and she will bolster his ministry in a tremendous way, because she has the same ideals.” Elizabeth Luter has spoken to “many of the great Southern Baptist churches” with white congregations, Smith said. “She is a mediating presence as well and has the ability to mix and mingle with different people and to love them as people and to not have a prejducial regard.”

Smith and McKissic were in New Orleans for the SBC annual meeting. Smith described the atmosphere this morning as “placid, peaceful, and anticipatory.” He said he overheard white men and women talking about “how wonderful it is” that Luter would be elected. “Everyone is standing on tip-toe anticipation, expecting it, and many are saying it’s a long time coming and should have been sooner,” said Smith.

It seemed few African Americans were tweeting with the convention hashtags #SBC12 and #SBC2012 throughout the day, and Dr. Nathan Finn, associate professor of historical theology and Baptist studies at Southeastern Baptist Theological Seminary, tweeted that “The #SBC12 is still a sea of white faces.” However, Smith said he saw “pockets of African Americans” at the convention, including a large contingent from the National African American Fellowship. This group will host a banquet tonight in honor of Luter’s election, he said.

McKissic may be cautiously optimistic about the significance of Luter’s ascendency, but he put forward three race-related resolutions that he said will be voted on tomorrow. One opposes connecting same sex marriage to the civil rights movement; another denounces racism in Mormon source documents; the third seeks recognition of Baptist minister George Liele as America’s first missionary.

The “skuttlebut” is that the first and third resolutions will pass, but that the Mormon one will not, McKissic said. “For some reason, the Southern Baptist Convention is declining to carry that resolution forward. I’m amazed by that,” he said.

He put forth the resolution regarding George Liele, a former slave who became a missionary to Jamaica, to “correct historical error,” he said. “They were not telling us the truth to say [Adoniram and Ann Judson] were the first missionaries.” Leile embarked in 1782, while the Judsons left for Burma in 1812, his resolution says. “I thought it would also be great in the year of Fred Luter that they are bookends, so to speak,” McKissic said.

“We need to look back and recognize the George Lieles … and other people like that who’ve paved the way so that we can rejoice over what God is doing and not forget about the individuals who have gone through the struggles and walked the stony road and shed the tears that we might enjoy what [has happened] today,” said Smith.

Obama Grants Young Immigrants Reprieve

IMMIGRATION SHIFT: President Barack Obama delivers remarks on the Department of Homeland Security’s immigration announcement in the Rose Garden of the White House, June 15, 2012. (Official White House Photo by Sonya N. Hebert)

President Obama announced June 15 that the Department of Homeland Security will stop targeting young undocumented immigrants for deportation under certain circumstances.

Deferrals for Immigrant Children

“Under the new policy, people younger than 30 who came to the United States before the age of 16, pose no criminal or security threat, and were successful students or served in the military can get a two-year deferral from deportation,” CNN reported. It also allows these immigrants to apply for work permits if they are currently in the United States and can prove that they have been for at least five years, the article said.

Renewed Support from Evangelicals

The president’s announcement follows a June 12 announcement that more than 100 Evangelical leaders have signed a Statement of Principles for Immigration Reform. The statement calls for “a bipartisan solution on immigration” that respects human dignity and the rule of law, protects family unity, guarantees secure borders, ensures fairness to taxpayers, and establishes a “path toward legal status and/or citizenship for those who qualify and who wish to become permanent residents.”

‘Path to Citizenship’ Controversial

Christianity Today reported that only the path to citizenship point “is likely to touch on anything controversial,” because “the other five principles represent values that the vast majority of Americans believe should drive immigration reform.”

Focus on the Family Joins the Fight

The Los Angeles Times reported that although evangelical leaders like Southern Baptist Ethics and Religious Liberty Commission president Richard Land and National Association of Evangelicals president Leith Anderson have supported immigration reform for several years, this is the first time that Focus on the Family has affirmed support for the issue.

‘Political Cover’ for President Obama

At The Daily Beast, David Sessions opined that “thanks to an emerging coalition of religious leaders, [immigration reform] might be the only issue where there is plausible common ground to be shared between the White House and the GOP base.” Perhaps he is correct. CNN described Evangelical and Catholic support for reform as “political cover” for the president.

Whether Obama’s political move will win him votes or backfires is the subject of a roundup at The Week, should you care about such things.

Gov. Romney’s ‘Tricky Balancing Act’

On Sunday, Presidential hopeful Mitt Romney told “Face the Nation’s” Bob Schieffer that  “if [Obama] really wanted to make a solution that dealt with these kids or with illegal immigration in America, than this is something he would have taken up in his first three and a half years, not in his last few months,” The Washington Post reported.

Today, CBS described Romney’s position on the issue as “a tricky balancing act”  of “aggressively courting the Hispanic vote, which could be decisive in the election” while holding on to his “conservative base that wants tough immigration policies.”

Impacted Immigrants Have Questions

Meanwhile, the young undocumented immigrants that the law directly impacts have questions, according to the Associated Press. They want to know: “Is it too good to be true? How will it actually work? What are the risks or pitfalls?”

 What Do You Think?

Should young people whose parents brought them to the United States illegally be eligible for a path to citizenship?