The Supreme Court decision on the Affordable Care Act came down within the hour. Here is the bottom line on the decision:
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.
In addition, because the law as a whole is constitutional, the requirement for insurers to include children up to the age of 25 on their parents’ health plan is upheld.
In the state Medicaid matter, should Wisconsin fall out of compliance with the new law, Wisconsin would lose new funds for those provisions, not all Medicaid funding.
A more draconian issue surrounding the rejection of the Commerce Clause and Necessary and Proper Clause eventually may be interpreted 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 very hazardous in the current political climate.
The analysis will continue, but as the mandate was upheld, the law as a whole is Constitutional.