Within hours of the announcement of the Supreme Court’s decision in favor of the Affordable Care Act, my e-mail had filled with commentary and questions from friends, colleagues, students and citizens around the nation all asking the same thing: “What now? How should we think about this?”
Pundits are talking non-stop about what this decision means for the Supreme Court, the upcoming election and the finances of already-strapped state governments. These are important issues, but for Christians busy with their everyday lives who want to be faithful citizens yet do not live for politics, what does this decision mean?
I think Christians, no matter what their politics, should be OK with this Supreme Court decision and we should resist the temptation to make this the lynchpin on which we base our upcoming election decisions.
The good thing about American politics is that nothing is ever a done deal. This court decision is complex, but its most simple communication is that the federal government has the right to tax. Under this analysis, the national health care program as defined by the Affordable Care Act is constitutional. We are at the beginning of what is going to be years of discussion about how we think about health care. Here are some things that we have to keep in mind as we continue to talk about how we take care of the sick.
First, Christians are clearly directed by both the Old and New Testaments to put the care of the sick and the poor at the top of their concerns. If we believe that God is sovereign over all of life we have to accept the challenge that our concern for the sick and the poor is an individual concern and it is a concern of government, churches and businesses. The interplay of these different responsibilities can be difficult to figure out. Democrats tend to stress the responsibility of government; Republicans tend to stress the responsibility of the church. But all of these institutions are responsive to God and all of them have an obligation in this area.
Second, those that advocate for a national program are not communists and those that advocate for less government oversight, or oversight at the state level, are not abandoning the poor. However, our state programs have not stepped up to the plate in helping the uninsured get coverage. In good economic times, states like Washington did a good job of covering the working poor in a state health insurance program. As soon as times got tough, though, the program was reduced. All states are facing very difficult economic realities. At this point the federal government’s requirements are the only way those most in need are going to be covered. And, when we look at other countries around the world we see that our situation is quite typical. The United States is one of only a few developed countries that has not had universal health coverage shaped by a system of legislation, regulations and taxes. While the U.S. medical system is excellent for those with resources, those with fewer resources suffer greatly. Our life expectancy ranks us around 50th in the world. Our infant mortality rate is high (6.7 deaths per 1000 live births), ranking us 29th. This isn’t because we can’t care for our citizens but because we don’t.
Third, much of the national program still has to be implemented, especially at the state level, and Christians should be prepared to think through difficult questions. Smaller businesses will have a harder time complying with the law, so states might want to further increase tax and other incentives to encourage them. Individual states have to decide if they will increase Medicaid coverage in order to receive more federal funding. Nationally, we also to be attentive to the religious freedom arguments of institutions that say coverage of certain drugs or procedures violate their conscience.
Universal health care will continue to be debated. It isn’t a panacea but is also isn’t an outrage. As long as we keep our responsibility to care for those in need front and center, there are many ways to achieve just policy.
What Do You Think?
- Where do you find your information when trying to learn about the Affordable Care Act?
- From your understanding, how does the act support a Christian approach to just health care and how does it restrict such an approach?
- What influence should Supreme Court decisions have on Christians?