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Red State or Blue State America? What's at Stake Over Healthcare at the Supreme Court

Republican leaders, including those in 11 states with the highest percentage of uninsured residents, don’t want to fix our broken healthcare system.

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Note that he did not answer the question—just as the red-state and libertarian-minded coalition that he and Clement represent do not want to acknowledge that there is a real crisis affecting the ability of tens of millions of Americans, especially including their states’ residents, to pay for the cost of healthcare when they need it.

Justice Ruth Bader Ginsburg was quiet throughout most of the hearing but asked the obvious question, comparing the coverage mandate to every worker paying for Social Security:

“It just seems very strange to me that there's no question we can have a Social Security system besides all the people who say: I'm being forced to pay for something I don't want. And this it seems to me, to try to get care for the ones who need it by having everyone in the pool, but is also trying to preserve a role for the private sector, for the private insurers. There's something very odd about that, that the government can take over the whole thing and we all say, oh, yes, that's fine, but if the government wants to get -- to preserve private insurers, it can't do that.”

The arguments and discussion before the Court suggested to some observers that the conservative majority would invalidate the individual mandate—though leave the rest of the law in place and let states decide how to proceed and implement it. Longtime court watchers seemed to suggest that the decision  lay in Justice Anthony Kennedy’s hands.

Earlier in the hearing, Kennedy raised the issue that the mandate could “change the relationship of the federal government to the individual in a very fundamental way.” However, later in the hearing, he seemed to be swayed by the government’s contention that people without insurance undeniably will get sick and everyone else will end up paying for their care—making this an economic issue that spans states’ borders and obviously falls under the U.S. Constitution’s Commerce Clause, allowing Congress to regulate interstate economic activity. “They are in the market in the sense that they are creating a risk that the market must accord for,” Kennedy said.

And with that ambiguous statement, court watchers are predicting it will be a very close call when the justices debate and decide the case. But one thing is not ambiguous at all from Tuesday’s hearing: much of red-state America’s political leaders do not care at all about improving healthcare for their residents. The party of no has reaffirmed its commitment to stonewalling and being part of the problem, not the solution.

Steven Rosenfeld covers democracy issues for AlterNet and is the author of "Count My Vote: A Citizen's Guide to Voting" (AlterNet Books, 2008).

 
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