Published June 28, 2012
The Supreme Court upheld President Barack Obama's Affordable Care Act, including its individual mandate requiring nearly all Americans to buy health insurance. The 5-4 decision, with Chief John Roberts writing the decision for the majority, means Obama's Affordable Care Act will go into effect over the next several years.
The decision is a big win for President Barack Obama who invested much of the political capital of his first term in passage of the health care measure. This is the second major court victory by the Obama Administration. Earlier this week, the court agreed with the federal government and struck down three of four provisions of Arizona's immigration law.
On health care, possibly the most anticipated court decision since Bush vs. Gore in 2000, which decided a presidential election, the Supreme Court fully upheld the health care measure.
The individual mandate will not be upheld under the Constitution's Commerce Clause, but will be upheld as a tax, according to the majority opinion written by Roberts.
The Supreme Court disagreed with the government’s argument that it has the authority, due to its role in regulating commerce, to penalize people for failing to buy health insurance.
“Every day individuals do not do an infinite number of things,” Justice Roberts wrote in the Court’s majority opinion. “Indeed, the Government’s logic would justify a mandatory purchase to solve almost any problem.”
But the Court upheld the individual mandate by reframing it as a tax, rather than a penalty—a second line of reasoning advanced before the Court by the Obama administration.
The individual mandate “makes going without insurance just another thing the Government taxes, like buying gasoline or earning income,” Roberts wrote.
Those required to buy health insurance under the new law but who choose not to must begin paying the new tax in 2014.
The Court also supported the health care law’s expansion of Medicaid, which is jointly funded by the federal government and the states, but narrowed the law’s interpretation.
The health care law required states to expand Medicaid, facing the loss of federal funds for the program as a penalty for declining. Under the ruling, the government may still penalize states for failing to expand Medicaid under the Obama health care law, but the federal government may only withhold new funds, rather than all federal funds for Medicaid destined to a particular state.
The court's four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the majority view.
Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.
Opponents of the bill had strongly criticized the health care bill as an overreach by the federal government.
The dissenting justices struck a theme about legal over-reach that Republicans have often pushed against the Obama administration, accusing it of going for shortcuts around the normal channels of law to get its way.
“The Court regards its strained statutory interpretation as judicial modesty,” the dissenting opinion by the four dissenting justices said. “It is not. It amounts instead to a vast judicial overreaching. It creates a debilitated, inoperable version of health-care regulation. . .In the name of cooperative federalism, it undermines state sovereignty.”
Republicans immediately cast the Supreme Court decision as a wake-up call for Americans. In what is surely to be a campaign theme for Romney going forward, the Republican National committee chairman Reince Priebus said: "We need market-based solutions that give patients more choice, not less. The answer to rising health care costs is not, and will never be, Big Government.”
Democrats heralded the decision as a much needed extension of basic health care to millions of Americans without access to medical attention.
The matter is immensely important to Latinos, who number some 50 million in the United States and who are twice as likely as the general population to be uninsured.
Nearly a third of Latinos, or slightly more than 15 million of them, are uninsured. They are three times as likely as non-Hispanic whites to be uninsured.
That rate may be much higher given that many more Latinos are undocumented.
To fill the void for lack of healthcare, many immigrants in the Latino community often rely on a patchwork of remedies that includes getting medicine from their native countries that sometimes have been outlawed in the United States because they are considered unsafe.
Health Care Timeline
The Supreme Court's ruling on President Barack Obama's health care overhaul law follows a century of debate over what role the government should play in helping people in the United States afford medical care. A look at the issue through the years:
1912: Former President Theodore Roosevelt champions national health insurance as he unsuccessfully tries to ride his progressive Bull Moose Party back to the White House.
1929: Baylor Hospital in Texas originates group health insurance. Dallas teachers pay 50 cents a month to cover up to 21 days of hospital care per year.
1935: President Franklin D. Roosevelt favors creating national health insurance amid the Great Depression but decides to push for Social Security first.
1942: Roosevelt establishes wage and price controls during World War II. Businesses can't attract workers with higher pay so they compete through added benefits, including health insurance, which grows into a workplace perk.
1945: President Harry Truman calls on Congress to create a national insurance program for those who pay voluntary fees. The American Medical Association denounces the idea as "socialized medicine" and it goes nowhere.
1960: John F. Kennedy makes health care a major campaign issue but as president can't get a plan for the elderly through Congress.
1965: President Lyndon B. Johnson's legendary arm-twisting and a Congress dominated by his fellow Democrats lead to creation of two landmark government health programs: Medicare for the elderly and Medicaid for the poor.
1974: President Richard Nixon wants to require employers to cover their workers and create federal subsidies to help everyone else buy private insurance. The Watergate scandal intervenes.
1976: President Jimmy Carter pushes a mandatory national health plan, but economic recession helps push it aside.
1986: President Ronald Reagan signs COBRA, a requirement that employers let former workers stay on the company health plan for 18 months after leaving a job, with workers bearing the cost.
1988: Congress expands Medicare by adding a prescription drug benefit and catastrophic care coverage. It doesn't last long. Barraged by protests from older Americans upset about paying a tax to finance the additional coverage, Congress repeals the law the next year.
1993: President Bill Clinton puts first lady Hillary Rodham Clinton in charge of developing what becomes a 1,300-page plan for universal coverage. It requires businesses to cover their workers and mandates that everyone have health insurance. The plan meets Republican opposition, divides Democrats and comes under a firestorm of lobbying from businesses and the health care industry. It dies in the Senate.
1997: Clinton signs bipartisan legislation creating a state-federal program to provide coverage for millions of children in families of modest means whose incomes are too high to qualify for Medicaid.
2003: President George W. Bush persuades Congress to add prescription drug coverage to Medicare in a major expansion of the program for older people.
2008: Hillary Rodham Clinton promotes a sweeping health care plan in her bid for the Democratic presidential nomination. She loses to Obama, who has a less comprehensive plan.
2009: Obama and the Democratic-controlled Congress spend an intense year ironing out legislation to require most companies to cover their workers; mandate that everyone have coverage or pay a fine; require insurance companies to accept all comers, regardless of any pre-existing conditions; and assist people who can't afford insurance.
2010: With no Republican support, Congress passes the measure, designed to extend health care coverage to more than 30 million uninsured people. Republican opponents scorned the law as "Obamacare."
2012: On a campaign tour in the Midwest, Obama himself embraces the term "Obamacare" and says the law shows "I do care."