Affordable Care Act's Constitutionality Confirmed

Over the next few weeks, we'll be exploring the details and impact of the Supreme Court's decision to uphold the Affordable Care Act.  Here is a summary of what was decided:

Individual Mandate

In a split 5-4 decision today, the Supreme Court has confirmed the constitutionality of the Affordable Care Act.  Sallvaging the idea that Congress did have the power to try to expand health care to virtually all Americans, the Supreme Court upheld the constitutionality of the crucial – and most controversial — feature of the Affordable Care Act.  By a vote of 5-4, however, the Court did not sustain it as a command for Americans to buy insurance, but as a tax if they don’t.  That is the way Chief Justice John G. Roberts, Jr., was willing to vote for it, and his view prevailed.  The other Justices split 4-4, with four wanting to uphold it as a mandate, and four opposed to it in any form.

Since the mandate survives, the Court did not have to rule on the other parts of the law aside from the Medicaid expansion (which was argued separately) – the remainder of the law survives with the individual mandate ruling.

Medicaid Expansion

The Medicaid expansion provision requires states to comply with new eligibility rules or risk losing total Federal funding. The court holds that this expansion is constitutional but limited: the Federal Government may only withhold new Medicaid funding in the event of non-compliance. As a result, states will have the ability to opt out of the Medicaid expansion.

It is entirely too early to guage whether the result will be a large number of states opting out of Medicaid expansion in an effort to limit their own financial liability.

More to come.