On Thursday the Supreme Court largely upheld the Affordable Care Act, including the controversial individual mandate portion that requires all Americans to purchase health insurance. The ruling is a major victory for the Obama administration, as the 2010 law is one of the president's largest accomplishments while in office.
The court declared the law constitutional because the Constitution grants Congress the power to tax, and the penalty for not purchasing health insurance will be collected as a tax. In writing the 193-page majority opinion, Chief Justice John Roberts did not rule that the individual mandate was constitutional because it fell under the commerce clause, as the administration had argued:
Congress already possesses expansive power to regulate what people do. Upholding the Affordable Care Act under the Commerce Clause would give Congress the same license to regulate what people do not do. The Framers knew the difference between doing something and doing nothing. They gave Congress the power to regulate commerce, not to compel it. Ignoring that distinction would undermine the principle that the Federal Government is a government of limited and enumerated powers. The individual mandate thus cannot be sustained under Congress's power to “regulate Commerce.”
The Affordable Care Act requires all Americans to purchase health insurance, which opponents argued was unconstitutional on the grounds that the government can't legally require the purchase of something. Other provisions include allowing parents to keep children on their parents' insurance policies up until age 26, a benefit 2.5 million young adults have taken advantage of since that part of the law took effect in 2010. It also provides coverage to those previously excluded by insurance companies due to pre-existing conditions. Polls showed Americans overwhelmingly supporting these provisions, while opposing the individual mandate portion which requires them to purchase coverage by 2014 or pay a penalty.
Although the individual mandate portion of the law was upheld, the justices did restrict the Medicaid portion, which expands the amount of people able to receive healthcare under the program. They ruled that the federal government could not penalize states who refused to comply with this part of the law by cutting off all funding for Medicaid.
In a surprising move, Roberts joined the liberal wing of the court (Justices Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan, and Sonia Sotomayor) in upholding the individual mandate. Justices Samuel Alito, Anthony Kennedy, Antonin Scalia, and Clarence Thomas dissented.
President Obama praised the court's decision, calling it "a victory for people all over this country whose lives will be more secure because of this law." He went on to reject the claim that he passed the law for political reasons.
"It should be clear by now that I didn't do this because it was good politics. I did it because I believed it was good for the American people," Obama said. "Because of this law [sick] Americans... will not have to hang their fortunes on chance. These are the Americans for whom we passed this law."
Presumptive Republican presidential nominee Mitt Romney does not support the law, and would instead allow each state to regulate insurance markets on their own. "What the court did not do on the last day of session, I will do on my first day as president of the United States, that is to repeal Obamacare," Romney said Thursday. "Our vision is clear, if we want to get rid of Obamacare, we are going to have to get rid of President Obama."
While he was governor of Massachusetts, Romney passed a similar state-wide healthcare bill. He has downplayed this accomplishment in the election in attempt to cater to Republican voters, as many oppose Obama's legislation and see it as massive federal overreach.
In reaction to Thursday's decision, Republican House Speaker John Boehner of Ohio said, "The president's healthcare 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."
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