In a 5-4 decision on Thursday, the Supreme Court of the United States ruled that the individual mandate in President Barack Obama’s health care law is constitutional.
The mandate required individuals to purchase health care coverage or face fines beginning in 2014. Supporters had insisted that the mandate was essential for controlling health care costs, a key goal of the law.
Protesters began to gather outside the Supreme Court this morning, both for and against the Affordable Care Act, which was signed into law on March 23, 2010. Critics have said that the law is an unacceptable incursion of government into the rights of health care providers and citizens. Supporters maintain that the law will make the U.S. health care system more just and less predatory.
(This post will be updated as more information becomes available.)
UPDATE: In what many consider a surprise ruling, Chief Justice John Roberts has ruled in favor of the mandate, whereas Justice Kennedy sided with the minority. Liberal justices issued concurring opinions, which means they did not dissent in the decision, but neither did they wholeheartedly accept it.
Roberts wrote the majority opinion. Dissenting justices argued that the entire act is unconstitutional.
UPDATE: Black conservatives with the Project 21 leadership network have issued a statement condemning the Supreme Court’s ruling. Octolaryngologist Dr. Elaina George wrote, “By upholding ObamaCare, the Supreme Court ignored the Constitution. It placed corporate interests and profits, along with government control, above the needs of doctors and patients. This decision virtually guarantees the destruction of the doctor-patient relationship, and — along with it — individualized health care, innovation and access while it perpetuates the worst aspects of our medical system.”
The group Catholics for Choice, however, supports the ruling, but also warned that the battle is far from over. “Catholics for Choice is pleased that the Supreme Court ruled that the Affordable Care Act is constitutional,” read a statement, “We are also aware, however, that the battle to ensure that individuals can make conscience-based decisions about their healthcare is not over. The United States Conference of Catholic Bishops has made clear that it will stop at nothing to block the ability of women and families to access contraception, even if it means derailing policies and programs that provide healthcare to those in need. CFC will continue to speak for the millions of Catholics whose views are not represented by the bishops, and who support increased access to comprehensive reproductive healthcare for all women and men as a matter of social justice and sound public policy.”
The full decision can be read here. (.pdf)
UPDATE:Editor Amy Howe wrote at the SCOTUS blog, “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.”
UPDATE: Watch video from 2009 of President Barack Obama explaining that the individual mandate is not a tax, embedded below.
UPDATE: Lyle Denniston at SCOTUS blog wrote: “The rejection of the Commerce Clause and Nec. and Proper Clause should be understood as a major blow to Congress’s authority to pass social welfare laws. Using the tax code — especially in the current political environment — to promote social welfare is going to be a very chancy proposition.”
UPDATE: The section of the ACA that was not upheld pertained to the expansion of medicare. At SCOTUS blog, Kevin Russell wrote, “The Court’s decision on the constitutionality of the Medicaid expansion is divided and complicated. The bottom line is that: (1) Congress acted constitutionally in offering states funds to expand coverage to millions of new individuals; (2) So states can agree to expand coverage in exchange for those new funds; (3) If the state accepts the expansion funds, it must obey by the new rules and expand coverage; (4) but a state can refuse to participate in the expansion without losing all of its Medicaid funds; instead the state will have the option of continue the its current, unexpanded plan as is.”
UPDATE: Sen. Bernie Sanders (I-VT) responded to the ruling by saying, “Today is a good day for millions of Americans who have pre-existing conditions who can no longer be rejected by insurance companies. It is a good day for families with children under 26 who can keep their children on their health insurance policies. It is a good day for women who can no longer be charged far higher premiums than men.
“It is a good day for 30 million uninsured Americans who will have access to healthcare. It is a good day for seniors who will continue to see their prescription drug costs go down as the so-called doughnut hole goes away. It is a good day for small businesses who simply cannot continue to afford the escalating costs of providing insurance for their employees. It is a good day for 20 million Americans who will soon be able to find access to community health centers.
“It is an especially good day for the state of Vermont, which stands to receive hundreds of millions of dollars in additional federal funds to help our state achieve universal health care.”
Senate Minority Leader Harry Reid (D-NV) said from the Senate floor, “I’m pleased to see the Supreme Court put the rule of law ahead of partisanship, and ruled the Affordable Care Act constitutional.
Sen. Chuck Schumer (D-NY) lauded the court ruling in a statement. “This decision preserves not only the health care law, but also the Supreme Court’s position as an institution above politics. Just as Speaker Boehner vowed not to spike the football if the law was overturned, Republicans should not carry on out of pique now that the law has been upheld. Democrats remain willing to cooperate on potential improvements to the law, but now that all three branches of government have ratified this law, the time for quarreling over its validity is over. Congress must now return its full-time focus to the issue that matters most to the public, and that is jobs.”
UPDATE: The Republican Attorneys General Association (RAGA) — a coalition of conservative state attorneys general who came together to attempt to block the Affordable Care Act — has issued a statement. Chairman Scott Pruitt (R-OK) said, “We disagree with the decision on the unconstitutionality of the health care act and find it disturbing that the Court did not place a limit on the power of the federal government to control the lives of Americans through the Commerce Clause. But, the battle isn’t over.”
“It now is up to the political process to repeal the act and replace it with measures that address the health care crisis within the confines of the Constitution. We must continue to oppose this act and multiple overreaching regulations proposed by the Obama Administration that cross the line of federal power.”
“This fall, the American people will have the opportunity to save the country from a disastrous future of similar intrusive policies and budget-busting costs by choosing their leaders wisely. Freedom and flexibility must remain with the states whose leaders know best how to care for the needs of their citizens.”
“Republican attorneys general will continue to serve as a firewall, taking every action to defend our states against this massive overreach from the federal government.”
UPDATE: Republican presidential candidate Gov. Mitt Romney (R-MA) has made a statement condemning the Supreme Court’s decision. “What the Court did today was say that Obama care did not violate the Constitution. They did not say that it is good law or good policy,” he said.
“This is now a time for the American People to make a choice. You can choose whether to have a larger and larger government making intrusions into your life… Or whether instead you want to return to a time where Americans have their own choice in health care.
“If we want to get rid of Obamacare then we have to get rid of President Obama.” (via SCOTUS blog)
UPDATE: House Minority Leader Rep. Nancy Pelosi said, “In passing health reform, we made history for our nation and progress for the American people. We completed the unfinished business of our society and strengthened the character of our country. We ensured health care would be a right for all, not a privilege for the few. Today, the Supreme Court affirmed our progress and protected that right, securing a future of health and economic security for the middle class and for every American.”
In live remarks, Pelosi said that the ruling should raise questions for every legislator, “Why are we here?” she asked, saying that elected officials have a duty to do everything they can to improve the lives of the American people.
UPDATE: ACLU legal director Steven R. Shapiro said that the ruling is “especially welcome” for women and minorities, “The ACLU welcomes today’s decision, which recognizes that Congress has the constitutional authority to fix a health care system that does not work for millions of Americans. The decision is especially welcome for disadvantaged minorities, who are more likely to be uninsured, and for women, who are more likely to suffer gaps and discrimination in their health care coverage. We trust that the states will recognize those needs and accept the additional funds that the federal government is offering under the new law to expand Medicaid coverage for needy individuals.”
UPDATE: The National Gay and Lesbian Task Force called the ruling “fair and humane,” and said that “it also reminds us of the work that remains to be done. People of color and economically impoverished people are disproportionately affected by health inequities. We have also long known that LGBT people — particularly LGBT people of color — suffer from higher rates of health disparities, and we continue to press for reform that addresses the stark realities that many of us face every day. This advocacy includes urging the Department of Health and Human Services to use its authority to make inroads in areas such as data collection and research on LGBT health disparities. We celebrate today, but also pledge to keep pressing forward.”
UPDATE: House Speaker Rep. John Boehner (R-OH) addressed reporters briefly in the wake of the ruling, followed by Rep. Eric Cantor (R-VA). Cantor has scheduled a vote to attempt to repeal the Affordable Care Act on July 11, when Congress returns from the July 4 holiday.