March 26, 2012

No these numbers are not the combination to a safety deposit box or to your high school kid’s locker. They are some of the key numbers that drive the Affordable Care Act, better known as Obamacare. 50 stands for the 50 million Americans who do not have health insurance, 30 represents the 30 million new customers that the insurance companies will get if the law is upheld by the Supreme Court and 47 is the percentage of the American people who disapprove of the legislation.

All these numbers tell a story about the state of health care in this country – the scandal of the uninsured, the windfall for the insurance companies and the continued refusal of the American people to support this landmark law. But the real story, the story that matters is not in the numbers, but in the wording and interpretation of the commerce clause in Article 1 Section 8 of the Constitution.

The Founding Fathers gave Congress the power to ” regulate interstate commerce” and with those words hang the fate of the Affordable Care Act. Supporters of the law can cite the injustice of 50 million people without health insurance, while opponents will complain that the individual mandate requiring the purchase of insurance by all Americans is an inherent violation of personal liberty.

Both arguments have merit, but the nine justices of the Supreme Court will in the end look at the commerce clause and determine whether the Affordable Care Act went too far in expanding their interpretation of the commerce clause. Right now it is tea leaf reading time as those in the know or claim they are in the know try to predict how the nine will vote. There is conflicting evidence on both sides regarding the intepretation of the commerce clause by the justices. Some signs point to the conservative justices who hold the majority unwilling to buck precedent and will thus come down in favor of the Act as a legitimate exercise of congressional power, while others point to signs that the conservatives will see this law as an unlawful expansion of federal power.

No one really knows how the nine will vote, but one thing is certain, the future of health care policy is on the line. Uphold the law and this country moves to mandated health care with all its benefits for the uninsured, those with pre-existing conditions and those who lose their protection when they are unemployed. Strike the law down and the proponents of big government, intrusive government and impersonal government win a big victory for personal rights.

For all the drama at the Supreme Court, Americans will likely have to wait until the end of June to find out how this constitutional debate plays out. Whatever the decision, American health care will never be the same again.