The Affordable Care Act has come to the forefront of the news with the confirmation of its Constitutionality by none other than Justice Roberts, much the the chagrin of many Republican politicians.

Whatever his motives, Justice Roberts has given the thumbs up to this law and undoubtedly has had his name removed from many a Christmas card/party list.

The Republicans are nearly apoplectic:

Brent Bozell, conservative activist said, “His reputation is forever stained in the eyes of conservatives, and there will be no rehabilitating of it. He will be seen as a traitor to his philosophy.”

Steve King, (R-IA) recently opined that, “Every provision of Obamacare must be repealed, not selective parts of it. Obamacare must be ripped out completely, lock, stock and barrel, root and branch — no vestige left behind, not a DNA particle of Obamacare retained.”

Matthew Davis, attorney and former spokesman for the Michigan GOP suggested it might now be time for armed rebellion, “If government can mandate that I pay for something I don’t want, then what is beyond its power? If the Supreme Court’s decision Thursday paves the way for unprecedented intrusion into personal decisions, then has the Republic all but ceased to exist? If so, then is armed rebellion today justified?”

Phil Gingrey (R-GA) : I think this is one of the worst decisions in Supreme Court history. I still respect the Supreme Court justices, I’m just disappointed bitterly and vehemently disagree with the decision, just like I was in 1973 when Chief Justice Warren Burger sided with the majority on that bone-headed ruling to destroy human life.

Louis Gohmert (R-TX): We still have the issue of Justice Kagan. Either she was totally derelict and negligent in her duties as Solicitor General and had absolutely nothing to do with the most important bill to the president, her boss, or she did have something to do with it, she has violated federal law, and as such she needs to be removed from the Supreme Court. […] I think it’s important to look at Justice Kagan for potential impeachment. […]

And, of course, let us not forget Rush Limbaugh’s pledge to move to Costa Rica “if this thing passes…” I’m guessing he didn’t know Coasta Rica has universal health care. And, sadly, someone has probably informed him by now, so I doubt he’ll go.

And now the GOP is enraged that SCOTUS made the decision on the basis that the mandate is a TAX!!

Mitt Romney’s spokesman Eric Fehrnstrom disagrees – he termed in a “penalty” not a “tax. That would probably be because the only time payment is required is when one fails to buy insurance — an then the penalty is unenforceable in that the IRS (who is supposed to collect it), cannot prosecute the offender or file a lien against their property in an attempt to collect. The method of collect may be withholding the payment from any tax refund, however.

While some of you may know ACA’s history, others may not. So, briefly, the various components of the bill came together over the years primarily from members of the Republican Party. The Heritage Foundation came up with the mandate, Bob Dole submitted much of it as his response to Hillarycare, and even Senator “pull the plug on grandma” Grassley supported the end of life counseling for the terminally ill in the 2008 Medicare prescription drug bill that ACA expanded to allow those not terminally ill to make those decisions before they became ill. And, finally, it came together in the form of Romneycare, Mitt Romney’s signature legislation – that included the mandate and he an numerous occasions defended. I’m certain YouTube is repleat with clips of the former Governor speaking to the necessity of the mandate.

In 1986 Ronald Reagan signed into law one of the most expensive mandates in the history of the nation, the Emergency Medical Treatment and Active Labor Act. This act mandated that hospitals provide emergency room care (the most expensive care there is) to the uninsured. The results of this mandate have been expensive. Uninsured care makes up about 55% of hospital costs, and those costs are passed on to insurance companies, who in turn pass them on to their insureds in the form of higher premiums. In addition, the government – federal and state – reimburse hospitals about 50% of those costs using our tax dollars.

Mandating that everyone have insurance would relieve that problem. And the mandate will only effect about 2% of the currently uninsured population – many of whom could afford to pay the premiums. Maybe they can skip one latte a day?

Under the ACA not everyone will be required to have insurance. The Kaiser Foundation explains it:

All individuals will be required to have health insurance, with some exceptions, beginning in 2014. Those who do not have coverage will be required to pay a yearly financial penalty of the greater of $695 per person (up to a maximum of $2,085 per family), or 2.5% of household income, which will be phased-in from 2014-2016. Exceptions will be given for financial hardship and religious objections; and to American Indians; people who have been uninsured for less than three months; those for whom the lowest cost health plan exceeds 8% of income; and if the individual has income below the tax filing threshold ($9,350 for an individual and $18,700 for a married couple in 2009)

There are plenty of exceptions and much in place to get those of us who don’t have insurance on the roles:

Insuring 18-26 year olds on their parents plans.

Insuring those with pre-existing conditions.

No lifetime cap on the amount of insurance available

Ends the discriminatory practice of charging women more for insurance.

Permit states to form health care choice compacts and allow insurers to sell policies in any stateparticipating in the compact. (Yes, the GOP has been lying about this one repeatedly.)

Create (private insurer run) exchanges (or cooperatives or single payer plans) offering various levels of insurance, including a catastrophe plan for those under 30 or those exempt from the mandate. Yes, Bobby Jindal, there is no one size fits all plan, regardless of how much you complain — please GO READ THE BILL – after all you demanded the Democrats do so, don’t you think you should as well? Vermont is working on a single payer plan, in case you haven’t heard.

and much, much more.

There will be many who are still not covered and, if those GOP controlled states decline the now optional expansion of Medicaid, there will be a lot more who could have been covered who won’t be. And, since the GOP threw a complete hissy fit about not allowing the undocumented some of whom could afford to buy their own coverage under some of these plans, they won’t be able to buy in; they are prohibited.

But what about those who can afford to pay or who don’t have religious objections? You know those that the GOP has been screaming about the mandate over?

Let me get this straight – the party of “responsibility” now doesn’t want the freeloaders that could pay to pay? In this upside down through the looking glass world that the GOP now lives in, that’s their complaint? Seriously? Hypocrites!

I could cover all the other reasons laid out previously – McConnell’s “one-term President” remark. The obvious racially charged rhetoric dangling the red meat to the party faithful.

But I think it goes deeper than that – I think the GOP began with the idea that they didn’t want to give Obama a win, but before long they realized if Obama got it passed, the Democrats would rule once again, as they did for years after FDR. Yes, there were Republican Presidents, but the House and Senate were dominated for decades by the Democratic Party. And when the GOP finally took control they did nothing at all to reform health care – instead they wasted billions of dollars on the prescription drug act to enrich the pharmaceuticals. So they had no choice – they went on the campaign trail and told lie after lie after lie confusing the public in an attempt to turn them against the bill.

And they did…except as more and more people learn what is really in the bill (without the words Obamacare) they like it. At this point we must make sure that more and more people learn about what is in the bill and how it could benefit them or members of their family.

This is a small set back for single payer, but inevitably a single payer system — Medicare for All — will be enacted. There is no way to control the delivery of health care with 50 states making those decisions and with insurer’s forced to live within their means at 80-85% – they will demand the health care industry start living within theirs.