In a surprise ruling, the Supreme Court upheld Obamacare, maintaining the "individual mandate" as constitutional, not under the commerce clause, but under the taxing clause.

The only part of Obamacare the Court limited was the law's requirements on state Medicaid programs to expand or face a loss of all Medicaid funding.

So, here are the several pro-life and religious freedom problems that now stand with the Court's blessing, and other items of concern (section references are to PPACA, P.L. 111-148):

I. The abortion subsidies and funding scheme stand (see chart of Obamacare abortion scheme for more detail)

  1. Federal subsidies for health plans that include elective abortion in state exchanges will continue. (Section 1303)
  2. The abortion fee will require every person in a plan that has abortion coverage will pay at least $12 per year even if they do not want abortion services. (Section 1303)
  3. Allowing direct funding of abortion through direct spending in community health clinics (Section 10503), and high risk pools (Section 1101).
  4. Subsidies for the government run "multi-state" plans remains even if they include elective abortion (Section 1334).
  5. There are No conscience protections against government discrimination against businesses, providers, or health insurers who refuse abortion. The limited conscience protection is from insurers against providers, but the government can discriminate against anyone who refuses to offer or refer for abortion if they chose (Section 1303).

II. Religious Freedom infringement through HHS contraception/abortifacient mandate, which narrowly restricts religious liberties to churches (Section 1001). Penalties for failure to comply could be $100 per day per employee for the employer (and insurer) who fails to offer "preventive care services", including contraceptives, abortifacients and sterilizations free to the patient.

III. The Independent Payment Advisory Board (IPAB) remains in effect, an entity that will reduce Medicare costs through rationing health care (Section 3403).

IV. OTHER ISSUES:

  1. The "individual mandate" continues as a tax on people who do not buy health insurance, whether from an employer or in the individual market (Section 1501).
  2. The mandate remains on mid-size and large employers to offer "minimum essential coverage" --- which means plans that can't exceed 9.6% of salary, and plans cover 60% of total health care costs (they don't have to cover all the essential benefits). If employers don't offer these, they face penalties (Section 1511).
  3. States are required to establish exchanges or, if they chose not to, the Federal government will establish and run them in the state (Section 1311).