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Chewing Over the Affordable Care Act (With a Side of Broccoli)


Ronald Bayer, PhD
Professor of Sociomedical Sciences

After three days of Supreme Court arguments on the Affordable Care Act, the Mailman School community buzzed with questions and opinions on the legislation, the legal challenges, and what the future could bring for the American healthcare system.

To explore these issues, close to 100 students, faculty, and other members of the community gathered on March 29 for a lunchtime discussion. Health Policy and Management chair Michael S. Sparer, PhD, JD, and Sociomedical Sciences Professor Ronald Bayer, PhD, got the conversation started with their take on the week’s action in the high court.

Dr. Sparer mapped the complex terrain of the case, laying out the byzantine and sometimes bizarre arguments for and against the law’s major provisions. On the individual mandate—the requirement that all Americans have health insurance or face a penalty—lawyers representing the two sides battled over issues like the authority of the federal government to regulate interstate commerce and whether there can be limits on this authority. The question of which market was being regulated came into play, Dr. Sparer noted, when Justice Anthony Kennedy—widely seen as the swing vote—challenged the government position, suggesting it was trying to “create commerce in order to regulate it.”

Dr. Sparer also referenced Justice Antonin Scalia’s hypothetical question on whether the government, in mandating health behavior, could req