With a key vote by Chief Justice John Robert, the U.S. Supreme Court has upheld the constitutionality of the Affordable Care Act and the individual mandate under President Obama’s health care law.
The court’s four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the majority vote. They argued for a more sweeping approval based on the commerce clause, but the end result was the same.
In 2010, Congress enacted the Patient Protection and Affordable Care Act in order to increase the number of Americans covered by health insurance and decrease the cost of health care. One key provision is the individual mandate, which requires most Americans to maintain “minimum essential” health insurance coverage. For individuals who are not exempt, and who do not receive health insurance through an employer or government program, the means of satisfying the requirement is to purchase insurance from a private company. Beginning in 2014, those who do not comply with the mandate must make a shared responsibility payment to the federal government. The Act provides that this “penalty” will be paid to the Internal Revenue Service with an individual’s taxes.
Twenty-six States, several individuals, and the National Federation of Independent Business brought suit challenging the constitutionality of the individual mandate and the Medicaid expansion.
They key issue in the case was the interpretation of the Commerce Clause in the U.S. Constitution. The U.S. Constitution grants Congress the power to “ regulate Commerce” under Article I, section 8, clause 3.
Chief Justice John Robert joined the more liberal members of the court, Justices Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, in the majority opinion. The decision by Roberts comes somewhat as a surprise. Roberts often joins fellow conservatives Samuel Alito, Antonin Scalia and Clarence Thomas with Justice Anthony Kennedy as the key swing vote on many cases.
Justice Roberts and the other justices in the majority viewed the individual mandate as a tax. Justice Roberts wrote in the majority opinion “In our federal system, the National Government possesses only limited powers; the States and the people retain the remainder. Congress may also ‘lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defence and general Welfare of the United States.’ U.S. Const., Art. I, § 8, cl. 1. Put simply, Congress may tax and spend.”
Kennedy, often a swing vote on many matters before the court, delivered a scathing denunciation from the bench. “The majority rewrites the statute Congress wrote. . . What Congress called a penalty, the court calls a tax,” Kennedy said. “The Affordable Care Act now must operate as the court has revised it, not as Congress designed it.”
The dissenting opinion observed “What is absolutely clear, affirmed by the text of the 1789 Constitution, by the Tenth Amendment ratified in 1791, and by innumerable cases of ours in the 220 years since, is that there are structural limits upon federal power—upon what it can prescribe with respect to private conduct, and upon what it can impose upon the sovereign States. Whatever may be the conceptual limits upon the Commerce Clause and upon the power to tax and spend, they cannot be such as will enable the Federal Government to regulate all private conduct and to compel the States to function as administrators of federal programs.”
Justice Scalia was a guest speaker in my federal courts class in law school at the University of Idaho and I asked him which U.S. Supreme Court decision he had written was the most important. Justice Scalia replied that those opinions that involve structure and shifts in powers are the most important. It comes as no shock that the dissenting opinion uses the term “structural limits upon federal power.”
The political ramifications of the ruling are noteworthy. President Barack Obama will tout the decision as a major victory for his reelection. Republican challenger Mitt Romney has criticized the Obama health care plan and has supported a repeal of the act if he is elected. If Romney is successful in winning the White House, to repeal the Affordable Health Care Act, he will also need to have the support of Congress.
The decision by the U.S. Supreme Court also reaffirms the power of Congress to enact other legislation affecting all types of commerce under the Commerce Clause. The decision reaffirms a shift in power to the federal government from state governments.
A few questions remain in the aftermath of the decision. Will Congress amend the health care after the 2012 elections? What powers are reserved to the states under the Tenth Amendment? What are the limits of Congressional power, if any, under the Commerce Clause?
For now, the individual mandate and provisions in the Affordable Care Act survived constitutional scrutiny.