The U.S. Supreme Court affirmed the core of President Barack Obama’s health-care overhaul in an opinion that held two surprises: Chief Justice John Roberts was the deciding vote, and his legal reasoning was unanticipated.
The 5-4 ruling yesterday gave Obama an election-year triumph by declaring that Congress had the power to make Americans obtain insurance or pay a penalty. That requirement is at the center of the measure and of a political debate over the appropriate role of government in health care that showed no signs of abating with the court’s decision.
Republicans, including presidential candidate Mitt Romney, vowed to redouble their efforts to repeal “Obamacare,” while the president sought to portray the fight as over.
“The highest court in the land has now spoken,” he said from the White House.
Briefs and oral arguments had focused primarily on whether Congress overreached its authority to regulate interstate commerce when it approved the insurance mandate as part of the Patient Protection and Affordable Care Act. Roberts, who wrote the majority opinion, declared that it did and then upheld the provision on the administration’s fallback argument: that the penalty was within congressional power to tax.
It was the first time Roberts had joined with the court’s four Democratic appointees in a 5-4 majority.
Along with the mandate and its accompanying penalty, the court left intact features that force insurers to cover people with pre-existing medical conditions, keep adult children on their parents’ health plans until age 26 and remove lifetime caps from policies. The justices limited the law’s extension of the Medicaid program for the poor by saying the federal government can’t threaten to withhold existing funds from states that don’t fully comply.
Speculation before the decision had focused on Justice Anthony Kennedy as the likely deciding vote on a court divided between four Democratic appointees and five justices named by Republican presidents, including Roberts.
“Justice Kennedy is the axis around which the court spins in a case like this,” Tom Goldstein, an appellate lawyer, said two weeks ago. Goldstein’s Scotusblog website is sponsored by Bloomberg Law.
Barry Friedman, a New York University Law professor, said he was surprised that Kennedy wound up in the minority. “To the extent they were going to uphold the law, I always believed the chief justice would be a vote to do so,” Friedman said. “But I thought Justice Kennedy would also be in that group.”
Focus on Commerce
The administration’s legal brief in support of the law devoted three times as much space to discussing the commerce power as it did to the tax issue. Yet it was the secondary argument that carried the day.
While the federal government “does not have the power to order people to buy health insurance,” Roberts wrote, “the federal government does have the power to impose a tax on those without health insurance.” The law “is therefore constitutional because it can reasonably be read as a tax.”
Roberts said that, for most Americans, the amount of the penalty will be far less than the cost of insurance.
“It may often be a reasonable financial decision to make the payment rather than purchase insurance,” he wrote. “Although the payment will raise considerable revenue, it is plainly designed to expand health-insurance coverage. But taxes that seek to influence conduct are nothing new.”
That line of reasoning gave Republicans what they portrayed as a powerful new argument against the health plan: that it is a tax increase.
“Now we will let the American people decide if they want this huge tax burden,” said Representative Joe Walsh, of Illinois, one of 87 Republican freshmen elected in 2010.
“The president’s health-care law is hurting our economy by driving up health costs and making it harder for small businesses to hire,” House Speaker John Boehner, an Ohio Republican, said in a statement.
The president pledged that, “we will continue to implement this law” and search for improvements. “What we won’t do, and what the country can’t afford to do, is re-fight the political battles of two years ago or go back to the way things were,” he said in his televised statement.
Republicans vowed to do just that, with House leaders saying they would hold a vote to repeal the act on July 11, though there’s no chance they can succeed as long as Democrats control the Senate and the president is there to veto a bill.
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