Chief Justice John Roberts was the deciding vote in today's 5-4 Supreme Court decision to essentially uphold President Barack Obama's Affordable Care Act as constitutional.
The much-debated health insurance mandate was upheld, as well, with the court deciding that the penalty a citizen must pay for not buying insurance will be a tax.
In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding.
After some broadcast news confusion where outlets were reporting concurrently that the law had and had not been struck down, many following the case online stuck with the official source, and each other:
The media is completely useless. Everyone is just reading SCOTUSblog.
Dissenters were Justices Scalia, Kennedy, Thomas and Alito. The dissent reads, in part:
“The Act before us here exceeds federal power both in mandating the purchase of health insurance and in denying nonconsenting States all Medicaid funding. These parts of the Act are central to its design and operation, and all the Act’s other provisions would not have been enacted without them. In our view it must follow that the entire statute is inoperative.”
Caption: June 27, 2012 - Washington, District Of Columbia, U.S. - A view of the Supreme Court. The Supreme Court is expected to hand down its ruling on the constitutionality of the Affordable Care Act. PICTURED: March 28, 2012 - Washington, District Of Columbia, U.S. - Protestors questioning the constitutionality of the Patient Protection and Affordable Care Act demonstrate outside the United States Supreme Court Building. (Credit Image: © Ron Sachs/DPA/ZUMAPRESS.com)
Ezra Klein's Wonkblog piece about possible outcomes included an explanation from David G. Savage of the L.A. Times of making the mandate a tax:
If the mandate is really just a tax, that would be supported by the Constitution, which says Congress "shall have the power to lay and collect taxes … to provide for the common defense and general welfare."
So, in the end, the justices could agree the law's required tax payments are constitutional, while also making clear the government does not have broad power to mandate purchases.
Republicans vowed to work for repeal, with House Speaker John Boehner saying in a statement:
“The president’s health care law is hurting our economy by driving up health costs and making it harder for small businesses to hire. Today’s ruling underscores the urgency of repealing this harmful law in its entirety. What Americans want is a common-sense, step-by-step approach to health care reform that will protect Americans’ access to the care they need, from the doctor they choose, at a lower cost. Republicans stand ready to work with a president who will listen to the people and will not repeat the mistakes that gave our country ObamaCare.”
The hashtag #movingtocanada was also busy, although those considering heading north may want to consider that country's government-supplied healthcare as well.
CNN continues to update its liveblog continues to be updated with commentary from politicians, journalists, and representative of health care associations, among others.
Libertarian, lawyer, and all-around interesting political writer Emily Zanotti made some predictions yesterday on NakedDC for how things would go today. She was correct about at least one thing:
John Roberts writes, because that’s what John Roberts does. And he’s a smarty pants, and he hasn’t managed to eke out an opinion since May.
The effects of this intensely political and polarizing issue will, of course, be felt most profoundly in the personal and professional lives of patients and care providers across the country, long after this decision is in the books.
People like Jeneva, in Bethesda, Md., who cares for her son Robert, have a vested interest in affordable care that meets complex needs:
We need politicians who realize that critical investment must be made in our health infrastructure, that healthcare is part of our larger, job-creating economy, that we must, in fact, be proud of what our scientists and researchers are able to accomplish in this area, and that we need to figure out how to provide all of our citizens with access to all of these miraculous tools. If we start from the perspective of cost, assuming that our collective resources are puny (and they're not), we'll never get anywhere. If we point fingers of blame, we'll just self-destruct (sorry, Rep. Ryan, maybe you're not a literal executioner). We have to start from the perspective of investment, humanitarian investment and what this investment will yield for our country, its citizens, and even the world.
Have we become a country that looks to the future or a nation of Hobbits, content to spend our lives by our own home fires? What happened to us?
I think my kids may just have healthcare coverage when they need their next transplants when they're adults.
Stay tuned to BlogHer for more insights and personal reactions to the upholding of the ACA, and please share your thoughts in the comments. What does this ruling mean to you?
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