Legal Analysis:
Surprise, Supreme Court upholds Affordable Care Act (aka ObamaCare)
On June 28, 2012, in a move that surprised legal scholars the Supreme Court of the United States (SCOTUS) in a five to four decision upheld the Affordable Care Act (ACA) passed by Congress and signed into law by President Barack Obama.
Contrary to what the general public and political pundits think, SCOTUS is not supposed to decide case based upon politics but rather interpret the law. In this case the SCOTUS reviewed only two provision of the ACA to determine whether Congress’s actions were permitted under the Constitution—the individual health insurance mandate and the Medicaid expansion. By way of quick review, the Constitution granted the Federal Government (Congress) enumerated powers to make laws but left the police power or reserved power to the individual states to make laws for their citizens. This long standing debate that originated with Alexander Hamilton and Thomas Jefferson has been before the Court often through Commerce Clause Jurisprudence.
First, SCOTUS reviewed whether the individual mandate of health insurance was a permissible exercise of Congress’s power. In doing so, the government argued that Congress had the power to do so under the Commerce Clause (power to regulate commerce between the states) and alternatively such power also was derived from its power to tax and spend for the general welfare. Ironically, the Government referred to the mandate as a “penalty” rather than a “tax” to avoid the Anti-Injunction Act which requires payment of the tax before bring suit and also to avoid the political ramification of such tax increase. In a 5-4 decision in which Chief Justice John Roberts was joined by the “liberal block,” the Court held that to the Commerce Clause did not allow Congress to “regulate” individuals not active in commerce. However, it upheld the ACA as a permissible exercise of Congress’s power to tax and spend.
Second, SCOTUS decided whether the proposed Medicaid expansion to the states, exceeded Congress’s power by compelling the states to take action. The ACA would require states to cover adults up to 133% about the poverty level, but if the states failed to comply they would lose current Medicaid funding. In a decision joined by Justice Breyer and Justice Kagan, Chief Justice Roberts said the threat of withholding current Medicaid funding to compel the states to adopt the expansion was unconstitutional but said it nevertheless does not strike down the entire law as it is capable of being severed.
In an unsigned dissent,the “conservative block” of justices, Justices Scalia, Kennedy, Alito, and Thomas, wrote that the individual mandate was unconstitutional under the Commerce Clause and Taxing and Spending Clause. The dissenters also said the Medicaid expansion was impermissible compulsion on the states. As both provisions were unconstitutional, the dissenters would have struck down the entire ACA.
It is interesting to note that Chief Justice Roberts attempted to clarify what exactly his role as a jurist and distance himself from the political implications by writing that “[T]he Framers created a Federal Government of limited powers, and assigned to this Court the duty of enforcing those limits. The Court does so today. But the Court does not express any opinion on the wisdom of the Affordable Care Act. Under the Constitution, that judgment is re¬served to the people.”