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How SCOTUS Rulings On Marriage, Health Care Could Affect Hoosiers

Obergefell v. Hodges could establish a national standard on marriage equality.

Within two days, the U.S. Supreme Court handed down two landmark decisions. In a 5-4 vote announced Friday morning, the court recognized marriage equality for same-sex couples in all 50 states.

The decision came one day after the court’s 6-3 ruling upholding nationwide federal health care subsidies under the Affordable Care Act.

Brian Powell, a professor in the Indiana University Department of Sociology, says he wasn’t surprised with the court’s decision on marriage equality.

“To me the question was, simply, is it going to be a 5-4 decision or a 6-3 decision,” Powell says. “I think for most Americans, it’s maybe a surprise, but it’s not inconsistent with where Americans are right now.

He says between 58 and 60 percent of Americans support same-sex marriage. 

But Ryan Scott, associate professor in the IU Maurer School of Law, says the task of the court is not to decide based on what popular opinion demands, but to interpret the Constitution. He says many legal experts, including the dissenting Supreme Court justices, claim the court overstepped its boundaries by ruling on this issue.

“All four dissenters wrote separate opinions expressing their dissatisfaction with the outcome in this case,” Scott says. “The major charge that comes through is this is judicial activism, this is taking away a subject that’s properly a matter for public debate and democratic process.” 

In his principal dissent, Chief Justice John Roberts wrote:

“Celebrate the achievement of a desired goal. Celebrate the opportunity for a new expression of commitment to a partner. Celebrate the availability of new benefits. But do not celebrate the Constitution. It had nothing to do with it.”

Similar claims of “judicial activism” have been posited about the court’s ruling on the Affordable Care Act’s federal subsidies as well. Beth Cate, constitutional law expert and associate professor in the IU School of Public and Environmental Affairs, says that label doesn’t apply.

“Judicial activism has an understanding among lawyers as meaning judges go in and they strike down statutes, which are passed by legislatures, or they’re overturning established precedent,” Cate says.

In the Affordable Care Act case, the justices upheld the statute passed by Congress, meaning people in the 34 states relying on the federal exchange for health insurance will continue to receive monthly subsidies. That includes 160,000 Hoosiers, or 89 percent of Indiana residents who purchased their insurance on the federal exchange.

Had the court decided to overturn the federal subsidies, Kosali Simon, health economist and SPEA professor, says there would have been a severe impact.

The immediate impact, she says, would have been premiums rising significantly and people having to drop their health care coverage. 

She says the Affordable Care Act intended to insure the uninsured and reduce the rising cost of care, while improving the quality. The two primary ways to insure the uninsured are expanding Medicaid or providing subsidies through exchange marketplaces.

“There are other secondary impacts that would have happened because as people would have left the insurance market, it would have been the healthier people that would have left, and then insurers would have had to raise premiums further,” Simon says. “Some insurers would have dropped out of the market; that would have led to fewer insurers competing and premiums rising further.”

The court will release its decisions on the remaining three cases on Monday.

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