Supreme Court Upholds Affordable Care Act on 5-4 Vote

The Supreme Court voted 5-4 to uphold the Affordable Care Act, including the controversial mandate. Chief Justice John Roberts joined the court’s four liberals and became the deciding vote, the justices ruled that the so-called individual mandate is a tax that Congress can impose on Americans. That undercut the challenge to that provision’s constitutionality for allegedly violating the Commerce Clause. Chief Justice Roberts wrote: “It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without insurance. Such legislation is within Congress’ power to tax.” NCPR is providing special coverage now. We’ll also air a special edition of NPR’s Talk of the Nation call-in program at 2 to 3pm today.

Were you surprised by the Supreme Court’s decision?  What do you think will happen now?

43 Comments on “Supreme Court Upholds Affordable Care Act on 5-4 Vote”

  1. Peter Hahn says:

    I, personally, am grateful that Roberts joined that majority (maybe he switched with Kennedy). Otherwise his court would be known forever as a partisan Republican vs Democrat court.

  2. JDM says:

    However, a 5-4 decision in favor of the Democrat vs Republican position isn’t partisan?

  3. Peter Hahn says:

    JDM – no its not.

  4. JDM says:

    Peter Hahn: Actually, I agree, it is not. Not when good ‘old Chief Justice Roberts crosses over to join the liberals.

    However, we now have the biggest tax increase on the middle and lower class in the history of the world!

  5. Ken Hall says:

    By dint of accepting that 4 of the current supreme court justices are liberal and 5 are conservative any 5/4 decisions rendered by this court certainly have the appearance of partisanship when they split along the liberal conservative divide.

  6. mervel says:

    Judges sometimes actually rule on the legal arguments and not the political arguments. Even if Robert by nature disagreed with the concept of the act, the fact is legally the government already requires us to buy insurance.

  7. Pete Klein says:

    Three cheers for Roberts.

  8. mervel says:

    The supreme court is not supposed to be about purely liberal or conservative politics although of course they play a role, it is supposed to be about interpreting the constitution in light of the laws we pass. Sometimes political bents play a part, but this idea that if you are a conservative judge or a Republican Judge you always rule one way and vice versa for a Democratic Judge, is not the intention of how the supreme court should operate.

  9. I know the mainstream media are more comfortable with the easy dichotomy of “if you oppose Obama/Democrats, you oppose the decision” and “if you oppose the Tea Party/Republicans, you support the decision”… but I’ll deviate from that simplistic narrative. I oppose the Tea Party/Republicans and oppose the decision and the ACA (“Obamacare”).

    The ACA is akin to solving the problem of hunger by mandating people eat three meals a day.

    Health insurance (the ACA has nothing to do with health care) is now the only *private* commodity that *all* Americans are required by law to purchase as a condition of citizenship, as a condition of being.

    (A smack in the head to anyone ignorant enough to cite auto insurance)

    If all Americans are required by law to pay for it, then it should be a public commodity. We should have single payer in this country (for everyone, not just for seniors).

  10. This is what passes for “choice” in America. Mitt Romney and Republicans are running against a health insurance (not care) plan he inspired. Pres. Obama and Democrats are defending a health insurance plan their opponent inspired. Now you know why I’m a Green. I can’t think of a more perfect illustration of why we need real multipartyism in this country.

  11. Larry says:

    I will try one more time: insurance is not the problem and requiring people to purchase it while also prohibiting companies from properly underwriting it will cause costs to rise for all and eventually, the system to collapse. We will all be forced into a single payer system and those of us who already have affordable insurance will lose it. Thanks a lot. Many of us have worked hard and made a lot of hard choices to provide for ourselves and our families and now we are being forced, against our will, to participate in this half-assed scheme to provide insurance (not health care) for people who really need affordable care. Who pays? As always, those of us who don’t need any of this nonsense. This is socialism and not even effective socialism, if there is such a thing.

  12. Larry says:

    Roberts now joins the pantheon of idiots who brought us decisions like Dred Scott v. Sanford and Plessy v. Ferguson and who turned Gideon v. Wainwright and Miranda into a free-for-all mockery of the Constitution. And before someone tells you not to believe anything I write, look it up. All true.

  13. zeke says:

    How much are you paying for your health insurance Larry?

  14. Larry says:

    Approx. 20% of the total cost based on years of service at my job. No complaints, it’s affordable.

  15. jeff says:

    So my healthcare premium is now a tax. Or is the tax the penalty for not having a policy? Tell me how that will reduce my premium?

    Why can’t I have what Congress has?

    There is no limit to our government laying taxes to force behavior.

  16. knuckleheadedliberal says:

    For all of you who believe this is just the camel’s nose under the tent of universal healthcare…I sure hope it is.

    I wouldn’t count this ruling by Roberts as any sign that he has gone socialist. I’m sure he has thought through the repercussions of his decision and that his opinion is to the long term benefit of the constituency he serves. But it is just possible that his own health problems with epilepsy may have some bearing on his thinking. Even Supreme Court Justice can have a health problem that was no fault of his own. He is relatively young, fit, wealthy, and good looking – but he could have an epileptic episode, fall off his dock and drown. Just like any ordinary poor person. Except the dock part.

  17. Captain Marvel says:

    A sad day for liberty. Not that many on this blog would care.

    Roberts’ ruling seems a bit schizophrenic, especially in the portion of the majority opinion on the Anti-Injunction Act not being applicable since this is a penalty and not a tax, but wait, it is a tax…ugh.

    The only silver lining is that this ruling should prevent, or at least give Congress pause, if it considers shoving any ol’ mandate down our throats by virtue of paying a tax as a penalty for non-compliance.

    The dissenting got it right. Our Government and its laws do not simply require “taxes” for violations of law or statute. The logic used for rejection of Anti-Injunction is flawed, illogical, and does not have precedent (to my knowledge). As such, one must go back to the original opinion that Obamacare is legal under the Commerce Clause, which Roberts and Co soundly and properly rejected.

    Partisanship aside, the ruling today just took Federal power to a new level. Statists should be overjoyed. I am dismayed.

  18. Captain Marvel says:

    Of course, this also presents good News, bad News.

    Good News: The decision now makes it easy to argue that Democraps (and President Obama) have placed a new, sizable tax on most Americans. Easy fodder for Mittens Romney, possibly leading to Obama loss in Nov.

    Bad News: It will now be easier for Mittens and Repugnicans to attack Obama, possibly leading to Romney victory in Nov.

    We lost today and we’ll lose in November.

  19. Pete Klein says:

    If the Republicans want to repeal the health care act, before they do this they should get rid of their tax payer paid for health insurance and pension plans.
    I am sick of people who don’t want other people to have what they have.

  20. Larry says:

    Opposition to the ACA is not about not wanting people to have things. Anyone who wants to have what I have is free to get it the same way I did. It is about not wanting to be forced to do things and about not agreeing with the way of doing what needs to be done.

  21. zeke says:

    Larry, I’m forced to do things I don’t want to all the time. Like; pay for wars in countries far far away from here and pay 80% of your health care.

  22. Larry says:

    First of all, zeke, you are not paying for any of my health care or any of my health insurance premiums. That’s a benefit I earned in the private sector. As for your objection to paying for wars, you should do the same thing those of us who oppose the ACA are going to do: seek change through the political and legal systems.

  23. mervel says:

    Everyone’s health care is more expensive because of uninsured people, that is why we require everyone to get automobile insurance, it reduces the costs of the uninsured on everyone. Like vouchers for carbon, this was a conservative idea that originally came out of either the Heritage Foundation or the Cato institute I can’t remember.

    We already have government health care in the US, we don’t have a free market system now, we have the worst of all worlds, so this could not make things worse. We operate our health care like a developing nation, well not really because health care in many developing nations is BETTER than it is in the US.

    The big issue is cost, until that is solved I don’t know how this will work. You have to go in and tell the drug companies they are going to take about a 40% cut in the prices of most of their drugs, if that means they can’t role out the next worthless permutation of a sleep aid or a anti-anxiety drug or the next generation of vicodin, oh well. Most of the drugs that modern drug companies make are not curing disease or making us healthier, that is the big myth.

  24. Walker says:

    “The big issue is cost.”

    Right. Ever read The China Study? If we could get big Pharma out of medical education and research, and Big Agribiz out of nutrition education, we could save absolutely staggering amounts of money nationwide.

  25. knuckleheadedliberal says:

    Larry,
    “Anyone who wants to have what I have is free to get it the same way I did.”

    And I suspect the way you got what you have is by everyone else helping to pay for your education and the road system and police protection…

  26. Larry says:

    And I thought this was a forum for serious commentary and debate.

  27. knuckleheadedliberal says:

    Are you accusing me of not being serious or are you not understanding my point?

  28. Captain Marvel says:

    I believe that Larry is merely making the point that success/acquisition/attainment has an awful lot to do with the individual and what he does with his opportunities. The points about access to education, roads, and police seem like irrelevant smokescreen.

    If Larry was able to earn a job that provided benefits such as affordable health insurance, then why can’t others? Why does it have to go back to he was given things like education, roads, and police? So were all of the others. There is not a disparity on roadway systems and police protection so stark in this country that makes your point relevant.

    and i’d be willing to bet that a large chunk of the currently uninsured had similar opportunities to Larry in the realm of education. In the USA of the past 20-30 years (maybe longer), it would probably be tough to demonstrate an individual who was never given any educational opportunities at all. The question is what did they do with them?

    Apparently Larry made the most of his, the uninsured may or may not have (they may be voluntary uninsured).

    Our individual destiny is wide, we control the direction of it. Every situation has a choice. Every single one. Even if the choices are ugly, you can choose between ugly and uglier.

  29. mervel says:

    I guess I am having a hard time finding this that big of a deal. Until someone tells me where to go sign up for free government provided health insurance and where I can go get that, or tell me that my taxes are going up by some huge amount to pay for others to get that; I will pretty much keep doing what I am doing now as will most people. It still seems pretty removed from real life.

  30. mervel says:

    I see all these people screaming about it on tv it seems surreal, why do they care so much, I just don’t get it?

  31. Captain Marvel says:

    it may only matter to you if some of the predicted outcomes prove prescient, especially in the arguments of rising costs from mandating coverage of people who certainly will use the insurance (preexisting conditions) and forcing companies to cover preventative care “at no cost” to the consumer. these will drive premiums up and you will not be allowed to opt out of the “deal”.

    it matters to me because of these possible outcomes but mainly matters because liberty has been stripped away again, but this time in a dangerous way. The Government is now free to mandate any activity as long as it provides that the penalty for non-participation is a tax.

    imagine if uber conservatives take over Congress and they may mandate you purchase a firearm to protect yourself and help offset rising police costs. otherwise, pay a tax. this an extreme example, but highlights the dangerous precedent before us. Congress now has vastly expanded power with the only real check being the votes of the people…this is populism, not the representative republic as we are supposed to be.

    but i could go on and on and i know…i do. sorry.

  32. zeke says:

    I see no difference between the health care law and the gov’t giving people a tax break if you do X. For example; if you choose to buy an on demand hot water heater you pay less tax . if you choose to NOT buy a on demand hot water heater you pay a higher amount in tax. The government has had a hand in picking winners and losers for years

  33. knuckleheadedliberal says:

    I think that too many people believe that they somehow made it on their own, that everything they have they got though their own effort alone. My point is that nobody really does it on their own. They have a larger society around them that works to provide a system that allows individuals to attain whatever it is they attain.

    The most important thing a society can do to help people achieve any goal they set for the self is to make sure they are healthy enough to do it. Health may be more important than education in that regard.

    In fact, the health of the populace may turn out to be the most important factor in the continued strength and security of our nation. If you love your country you should also love and care for its people.

  34. mervel says:

    Well I understand the philosophical argument about the power of government in this case Marvel. But in the world of health care right now; if you go to the ER with a heart attack or severe injury uninsured you will get some form of care and essentially the rest of society will pick up the tab. In addition if you are uninsured you won’t go to the doctor and probably have a lifetime of bad health outcomes, also expensive.

    I think instead of a small token tax you should have all adults that don’t want to buy health insurance sign off that they fully acknowledge that they will be denied health care services in the future. In fact you could simply put them on a black list that they cannot receive services or even an appointment until they get health care insurance. I think this would actually motivate people to buy some health insurance. The problem will be with this law in my mind is once again the cost. What if people can’t get medicaid and can’t afford private health insurance? This is a real possibility and will largely stick it to working lower income Americans, just as it does now. Right now if you have a full time job even at minimum wage you won’t qualify for medicaid, however a lower wage job is nowhere near enough to afford private health insurance which for a family of say 3 is going to run over $1000.00 per month. What if that number goes up?

    We will see, to me this is all about cost control, I could see this program being one giant mess.

  35. mervel says:

    But it might also work. I say try it, I don’t see things getting any worse than they are now.

  36. Captain Marvel says:

    these are extremely fair points, mervel. truly.

    there is no doubt that the current state of health care is broken. and i do have an appreciation for some taking a look at a problem and brainstorming up solutions to the matters. however, the application is the problem. there are plenty of solutions that just shouldn’t be implemented in a truly free society.

    the unpopular solution to people uninsured entering facilities for health care is ugly but effective…they pick up the tab themselves or are refused service.

    this is “heartless” and lacks compassion, but it is the correct move for a free society.

    now, this does not mean that i think the uninsured are disgusting and deserve injury or death…quite the contrary, they deserve help and we as decent human beings (and, as some of us believe, people made in the image of a compassionate God) should do all we can to help them while in need.

    the difference in my opinion is that this help should be voluntary. mandatory to us as decent people, but ultimately a voluntary decision by ourselves.

    the tab for health care for the unfortunate and uninsured should be picked up by churches, private donations, pro-bono from medically trained personnel, and even by a set aside of overhead by responsible insurance companies, pharma companies, and medical service companies.

    if these companies do not offer set asides, the people should demonstrate their disapproval by using a company that does.

    people say this is too pie in the sky, too idealistic, which i freely admit i am guilty of being…but when did it become so wrong to have ideals? why can we not do these things from our own hearts and minds, rather than just hand them off to Big Brother to be done by force and coercion? our entire societal mindset is completely backwards.

  37. zeke says:

    I’m not sure what you mean by a “free society” maybe we are, maybe we are not. However, I do not believe by any definition that we are a free market economy. I repeat; the gov’t has a hand in picking winners and losers.

  38. Walker says:

    “the difference in my opinion is that this help should be voluntary. mandatory to us as decent people, but ultimately a voluntary decision by ourselves.”

    Let’s take that same approach to defense.

  39. Captain Marvel says:

    “Let’s take that same approach to defense.”

    Couldn’t agree more, Walker.

  40. Larry says:

    Knucklehead, the answer is both. I do not think you are serious nor do I understand the point about roads and police.

    For the record, I have been paying my own way since high school, without any sort of public assistance or government program. That includes college tuition. I’ve worked hard and I’ve worked a lot, often at jobs that I did only because the money was good or benefits were available and sometimes, at low-end jobs just because that was all that was available. I also went where the jobs were, not that I didn’t wish to be elsewhere.

    I don’t think anything I’ve done was exceptional, unusual or out of the ordinary and I am sure many, many other people have done as much as I did and more. I’ve always felt that I was just doing what I needed to do. Some tuition assistance or a need-based scholarship or a government financed job training program or Medicaid or some EEO help might have been nice, but none of that was available to me.

    It’s no big deal, but I am happy with the choices I made, happy with what I have and would also be happy to be left alone. I’m tired of hearing all that 1% crap and tired of the jealousy of those who want what I have without doing what I did. I’m also tired of armchair liberals who talk a good game but don’t want anyone messing with their public sector pensions or 401K plans. Excuse me if I also don’t care much about able-bodied people who would rather cry about inequity than get busy making a life for themselves and their families. All the bullshit philosophy and share-the-wealth rhetoric will never replace the essential formula: if you want something you have to work for it.

  41. knuckleheadedliberal says:

    Larry, I’m right there with you. Most of my life I’ve worked with my hands, and I’ve paid my way by the sweat of my brow. I don’t have a 401k or an IRA. I have a savings account with about $120 in it. I fully expect to work until the day I die.
    And there are days when I can hardly stand because my back is sore, and my shoulder hurts but I have work that needs to be done so I do it. I work for myself so I don’t have a 40 hour week and collect a paycheck. I went 8 years without health insurance because I couldn’t afford it.

    But I also recognize that there were people who went before me who fought for a 40 hour work week, and a minimum wage, and they paid taxes to provide good roads that helped our economy grow, and they paid for police protect our homes and property, and they paid for my elementary and high school education, and they paid for the airports and train stations that helped me travel, and they built water and sewer systems that helped our communities grow.

    I’ll put my work ethic up against pretty much anyone’s (though I know a few old guys who at 80 can outwork most 30 year olds) and I’ve had it just as hard as many but not as hard as a lot of others. And I’ve done okay. I’ve mostly put 2 kids through college and paid all my bills and built a business from nothing.

    But I recognize that I didn’t do it on my own. There were people along the way that took me under their wing and helped me out. I always knew I could count on my family if something went terribly wrong. And we have good people in our communities who are supportive and willing to lend a hand when needed, even if it is just to hold an umbrella over your head when you’re changing a flat tire in the rain.

    My support for universal health care is based on a nuts and bolts, practical knowledge of dealing with purchasing health insurance for my own very small company. I have dealt with the insurance brokers who get a cut of all of my health insurance payments even though they have never done a thing for me. I have looked through various plans from Blue Cross/Blue Shield, MVP, CDPHP and tried to compare costs and coverage. They don’t make it easy to compare; in fact they make it impossible. Because they don’t want you to know what the best thing to do is. If they want you to stay in their plan they give you a 6% or 8% increase, if they don’t care either way they give you a 12% – 15% increase, and if they want to get rid of you they give you a 25% increase. Over the last 8 years or so that I’ve had health insurance my average yearly increase was about 12% per year. My premiums have more than doubled and at that rate of increase they will have tripled in 3 more years and quadrupled in about 6 years. I can’t afford the private insurance system for too much longer.

    But it isn’t about me, nobody else can either. Ask people who deal with it.

    And I am firmly convinced that as a Nation we will all do better if everyone has health insurance. People will be more productive. They wont be trapped in jobs they don’t like because they will lose insurance if they change their job. I know a DOCTOR who told me he can’t leave his job because his wife has a pre-existing condition. People will work harder and better at jobs they want to do. People will start new businesses. They’ll work for themselves. We will create a stronger and better economy if we are not trapped in the system that virtually everyone you ask will tell you is a failed system.

  42. tootightmike says:

    Amen. I too have been self employed almost forever. I have been healthy, and most of all, I have been lucky. Being uninsured for 35 years gives you a different perspective on health and healthcare, and probably means that I’ve skipped having this or that ailment treated…and I was the boss. What about those young fellows who worked for 12 or 18 dollars per hour…they certainly didn’t have money to spend on insurance. We will all be better off when everyone has access to care.

  43. oa says:

    Well-said, Knuck.
    Larry, you said: “Some tuition assistance or a need-based scholarship or a government financed job training program or Medicaid or some EEO help might have been nice, but none of that was available to me.”
    That’s interesting if you were, as you seem to imply in your comment, completely supporting yourself. Pell Grant money and Work Study programs have been readily available to students who claimed independence from their parents, for decades, though I understand Pell money restrictions have grown recently.
    Students in the last 10 years have had fewer resources, as much of the student-loan program was privatized, so maybe you’re in that demographic. (Obama’s changing that, as I understand it.)
    I applaud your work ethic, but maybe you didn’t research what was available to help make things more manageable? Just asking, seriously.

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