What Do the Affordable Care Act and Arizona’s Immigration Laws Have in Common?

By Ruth Flower on 06/25/2012 @ 07:30 PM

Tags: immigration, health care

Is it just that the Supreme Court is releasing decisions on both cases this week? (See our analysis of the immigration decision here.)

Is it that both cases challenge concepts of fundamental fairness and governing for the common good?

It may be more basic than that. Maybe it’s about states’ rights and the role of government overall.

In the immigration case, Arizona adopted laws to strengthen enforcement of federal immigration laws by requiring Arizona police check the legal status of people who are stopped for some other reason. Questions and protests rose immediately about harassment of citizens of Hispanic descent, implied requirements that people of Hispanic descent “carry papers,” degrading treatment of immigrant detainees by a particularly brash and aggressive sheriff, and racial profiling leading to questioning drivers who gave no legitimate cause for a traffic stop.

But the Supreme Court is not looking just at the over-enthusiastic character of the state’s enforcement program; the question for the court is whether a state can opt to enforce federal law on its own.

States don’t usually go out of their way to enforce federal laws. At a traffic stop, for example, citizens are not asked whether they paid their federal taxes, even though those taxes might arguably have helped to pay for the roads and highways on which a traffic violation might have taken place. However, in the last decade or so, many states have decided to deny higher education benefits to young men who did not comply with the federal draft registration law. Are states overstepping their bounds in enforcing the draft laws? Possibly so.

In the Affordable Care Act cases, it is the states (as well as employers and individuals) who are arguing that the federal government has overstepped its authority. States argue that the parts of the ACA that expand Medicaid eligibility “coerce” the states into complying with the requirements of a federal program. No state is required to participate in Medicaid (although they all do), and the states and the federal government share the cost of the program. But the states argue that they need the federal contribution to the program so much, that it is “coercive” for the federal government to attach conditions – such as the coverage of more people. (The federal government will carry 100% of the cost of the expansion for two years, and then 90% of the cost after that.)

Individuals and employers argue that the federal government oversteps its authority in requiring almost everyone to obtain health care insurance or pay a penalty. Basing its authority on the Commerce Clause, the government argues that the current structure of the health care marketplace places a burden on commerce, by passing along the hidden costs of treating uninsured individuals to hospitals, providers, and ultimately other insured consumers. To make this whole area of commerce work better, the federal government argues that it needs to create a structure in which everyone pays into the system, and everyone has access to care.

The Supreme Court’s decisions will look at large questions and structures of law, rather than at the lives of immigrant families or of people who cannot pay for health care. As people of faith, we look at the lives affected. As a public policy organization, FCNL looks at how our federal and state governments can best be structured to create and support the world we seek – one with commitment to fundamental fairness and the common good, and attention to the potential of every person.

Congress hasn’t finished immigration reform – that’s partly why some states have created their own laws in frustration. The Affordable Care Act isn’t the last chapter in health care reform – there’s more to be done to ensure that health care is organized to keep people, rather than an industry, healthy. The rough drafts on these policies and others need more work.

As we in this nation ask ourselves some of the big questions about the best role of government and our hope for the common good – and answer those questions, for this season anyway, in the elections – we’ll see what opportunities we have ahead for finishing the rough edges of these critical social policies, these arrangements we make with each other for our lives together.

Read more about the background of the Affordable Health Care Act cases in the Supreme Court.

Read more about the background of the Arizona Immigration Law case in the Supreme Court and FCNL's analysis of the Supreme Court's decision.