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Obama health care law survives Supreme Court review


David Goldman / AP

Supporters of President Barack Obama’s health care law celebrate outside the Supreme Court in Washington, Thursday, June 28, 2012, after the court’s ruling.

Updated Thursday, June 28, 2012 | 8:38 a.m.

Health Care Law Ruling

Supporters of President Barack Obama's health care law celebrate outside the Supreme Court in Washington, Thursday, June 28, 2012, after the court's ruling was announced. Launch slideshow »
Harry Reid

Harry Reid

Dean Heller

Dean Heller

President Barack Obama’s health care law has survived all legal challenges unscathed, with the Supreme Court ruling this morning that the individual mandate and all other parts of it are constitutional.

But it happened in a way few expected.

Chief Justice John Roberts carried the 5-4 decision, which hung on the rationalization that the mandate to carry insurance is constitutional under Congress’ authority to levy taxes.

It is an ironic outcome, considering the lengths the president and other supporters of the law initially went to characterize the mandate as anything but a tax.

The government had argued primarily the mandate was constitutional under the Commerce Clause, which gives Congress the power “to regulate commerce...among the several States.”

Health care, it argued, was a form of interstate commerce.

Justices Ruth Bader Ginsbrug, Stephen Breyer, Sonia Sotomayor, and Elena Kagan were convinced by that argument; Roberts wasn’t.

Instead, he relied on the government’s backup argument — that the mandate was a tax — in joining the majority to uphold the mandate, which in the bill comes under Section 5000A.

“Our precedent demonstrates that Congress had the power to impose the exaction in Section 5000A under the taxing power, and that Section 5000A need not be read to do more than impose a tax,” Roberts wrote. “This is sufficient to sustain it.”

The only penalty for not complying with the mandate, Roberts wrote, is a charge that effectively is a tax. The other four justices in the majority agreed.

The court also ruled that the expansion of Medicaid under the Affordable Care Act was legitimate — so long as the government doesn’t pull the entire Medicaid plug on states that resist fully complying.

“Nothing in our opinion precludes Congress from offering funds under the Affordable Care Act to expand the availability of health care and requiring that states accepting such funds comply with the conditions on their use,” Roberts wrote. “What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding.”

The court did not consider the question of whether the mandate was severable from the rest of the bill, as they upheld the mandate.

That means people with preexisting conditions and individuals under the age of 26 will continue to be eligible for health care coverage uninterrupted.

With almost all parts of the law he spent more than a year carefully shepherding through Congress preserved, Senate Majority Leader Harry Reid of Nevada took a reserved victory lap Thursday morning, congratulating the court for eschewing politics and supporting the law.

“Our Supreme Court has spoken,” Reid said, a few minutes after the decision was announced. “The matter is settled.”

Republicans, however, don’t think so.

“This law has now been affirmed as a colossal tax increase on the middle class,” Nevada Sen. Dean Heller said in a statement. “This onerous law needs to be repealed and replaced with market-based reforms.”

But in the short term at least, repeal seems unlikely.

Even if Mitt Romney wins the presidency and Republicans gain a majority in the House and Senate, they are not poised to gain enough Senate seats to overcome the potential threat of filibuster to any repeal efforts. And if they try, Reid, who orchestrated the bill’s passage, will be leading the counter-offensive.

Reid, safe in the shadow of the Supreme Court’s ruling, is ignoring the sabre-rattling for now.

“It’s time, though, for Republicans to stop refighting yesterday’s battles,” he said. “Now that this matter is settled, let’s move on to other things, like jobs.”

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