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Analysis: Supreme Court Upholds Obama Health Care Law

Updated: Saturday, August 3 2013, 04:08 PM CDT

One of the most closely watched legal sagas in recent memory ended Thursday with a twist few had expected and many are still parsing.

The political battle over the Affordable Care Act entered the judicial system the day President Obama signed it on March 23, 2010. Before the ink was dry, Florida and 12 other states filed a complaint in a federal court. The principle opposition to the law focused on the so-called individual mandate -- the requirement that all citizens be covered by some form of health insurance.

Supporters argued that the mandate is legal under Congress’ power to regulate interstate commerce as outlined in the Constitution. In writing his opinion in the 5-4 decision that upheld the law, Chief Justice John Roberts, who was appointed by former President George W. Bush, disagreed with that argument, but still arrived at the same ultimate conclusion. Instead of justifying the mandate under the Commerce Clause, Chief Justice Roberts instead ruled it constitutional under Congress’ power of taxation. The law states that people who don’t have the required coverage must pay a penalty, which Roberts says is tax (ironically, during the law’s rocky passage through Congress, its supporters – including President Obama – publically asserted the penalty was, in fact, not a tax).

While it upheld the mandate, the Court struck down another controversial provision in the law that would have allowed Congress to revoke Medicaid funding to states that didn’t expand the service to include to the entire non-elderly population with incomes below 133 percent of the poverty level (According to the federal government, that line is an individual income of $11,170 per year, so anyone making $14,856 would’ve qualified under the expansion).

Chief Justice Roberts wrote that the carrot-and-stick approach was unconstitutional but that therefore didn’t disqualify the entire law. He cited a legal precedent stating that his “touch¬stone for any decision about remedy is legislative intent, for a court cannot use its remedial powers to circumvent the intent of the legislature.” In other words, Congress would have intended the rest of the law to stand even without the punitive provision against states unwilling to expand services.

The fact that Chief Justice Roberts wrote the opinion upholding the ACA caught many observers off guard. But his written opinion is consistent with statements he made during his confirmation hearings in 2006 when he promised objectivity over ideology. In his conclusion, he writes, “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.”

President Obama, Democrats, and other supporters of the law largely welcomed the Court’s decision with praise but Mitt Romney, Republicans, and Tea Party activists have vowed to repeal the bill in Congress. That effort is likely to become a rallying cry heading into November’s elections. Indeed, the Romney campaign has already claimed it has raised $1 million ( in the hours after the decision was announced. That indicates the twisting, operatic saga of health care reform is far from over.

Read the Supreme Court decision:
Read the Affordable Health Care law: Supreme Court Upholds Obama Health Care Law

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