The Supreme Court has upheld the Affordable Care Act. Let’s briefly look at the specifics of their ruling.
The court looked at four issues regarding the legislation:
- The Anti-Injunction Act – This was basically the question of whether or not the law can be challenged considering many provisions have not been enacted yet.
- The Individual Mandate – This was the major issue over the constitutionality of the requirement that almost all Americans must have health insurance or pay a fine.
- Severability – If the individual mandate was struck down, would the entire law go down as well?
- Medicaid Expansion – The states argued that the new law’s expansion of Medicaid coverage was unconstitutional.
The primary issue was the individual mandate. Can the federal government require you to purchase health insurance? The court has decided that it can. However, the court did not use the justification that many expected. Most scholars predicted that, if the court did uphold the mandate, it would do so using the commerce clause, which gives Congress the right to regulate interstate commerce. However, the court actually upheld the law using Congress’s taxing authority, seemingly interpreting the fine that one would pay for not having insurance as a tax.
Another surprise came from the courts ruling on the Medicaid expansion. While it was not revoked, it was limited. Specifically, the court ruled that the federal government could not withhold current funding for Medicaid from states that choose to opt out of the expansion. The implications of this decision are still being analyzed (expect an article with my take on the issue later).
The full text of the Supreme Court’s ruling can be read here.