Health care ruling a states’ rights victory
The government can’t force you to buy health insurance, but it can tax you if you don’t.
That’s the bottom line on the U.S. Supreme Court’s 5-4 decision regarding the individual mandate in the Affordable Care Act, often called Obamacare.
But the opinion, written by conservative Chief Justice John Roberts and joined by the four most liberal members of the court, is also the most significant victory in decades for those who seek more limitations on federal authority and more deference to states’ rights.
In the opinion, Roberts disposed of the Commerce Clause argument on behalf of the individual mandate. Instead, he took on the obvious — but often overlooked — question of whether the penalty for not buying health insurance amounts to a tax. The majority of justices concluded that it did, and it was therefore constitutional.
That was a definite victory for the president and supporters of Obamacare. But another important portion of Thursday’s decision — this time a 7-2 split — was a victory for states like Colorado that challenged the federal government’s ability to coerce states into expanding Medicaid by threatening to cut their existing Medicaid funds.
That portion of the ruling was a pointed limitation on the federal government’s use of its financial leverage to force states to do whatever federal authorities want. It may have far-reaching impacts on state challenges to other federal laws.
Political observers will spend a great deal of time over the next few months, analyzing the court’s decision and how it affects the election campaigns of President Barack Obama and GOP challenger Mitt Romney.
But legal observers will be parsing this ruling for decades to come. One reason is that Roberts went out of his way to reject most of the government’s arguments on the individual mandate, while still upholding it.
Most notably, Roberts’ opinion soundly rejected the idea that the individual mandate could be authorized under the Commerce Clause of the U.S. Constitution.
“The individual mandate forces individuals into commerce precisely because they elected to refrain from commercial activity,” Roberts wrote. “Such a law cannot be sustained under a clause authorizing Congress to ‘regulate commerce.’”
That part of Roberts’ ruling comports with arguments made by plaintiffs and conservative legal scholars. Many feared that if the Commerce Clause argument were allowed to stand, there would be no limit to what the government could compel its citizens to do, from eating broccoli to buying cars.
Even though the liberal justices who sided with him said there was no need to rule on the Commerce Clause issue since the mandate was upheld under congressional taxing authority, Roberts chose to specifically address those concerns. He made it clear the Commerce Clause doesn’t allow the government to force people to engage in activity they otherwise wouldn’t participate in.
But, much to conservatives’ dismay, Roberts also argued that it is the Supreme Court’s responsibility to uphold legislation legitimately passed by Congress if there is a valid constitutional means of doing so. Roberts and the four concurring justices concluded that can be accomplished under the taxing authority the Constitution gives Congress.
“The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax,” Roberts wrote. “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”
Health care costs represent one of every six dollars spent in this country, so the Supreme Court decision in this case was crucial, no matter how it came down.
Thursday’s ruling means that beginning in 2014, nearly all Americans will have to purchase health insurance — through their employers or on their own — or pay a tax for declining to do so. It also means that things like guaranteed insurance for those with pre-existing conditions will remain in effect.
Republicans, of course, have vowed to repeal the Affordable Care Act. But unless they win the White House and a filibuster-proof majority in Senate, that is unlikely to occur. The only way it might is if Republicans can offer a reasonable alternative to Obamacare, not simply a return to the unsustainable health care system that existed prior to 2010.