Live Blogging The Supreme Court Healthcare Decision

Ken AshfordConstitution, Health Care, Supreme CourtLeave a Comment

0327-mandate-Supreme-Court-Health-Care_full_6009:46 am: Here is the question before the court, in plain English:

Does it violate the Constitution for Congress to require virtually all Americans to obtain health insurance by 2014 or pay a penalty? If the Court's answer is yes, then it has to decide whether just the requirement — the so-called "individual mandate" — is invalid, or whether part or all of the rest of the health care law must go with it.

The Commerce Clause allows the Congress to "regulate commerce… within the several states".  This is known as the "Interstate Commerce Clause".  The question has come before the court many times: What constitutes "commerce"?  Historically, the Supreme Court has taken a broad view of "commerce", saying that the Interstate Commerce Clause even allows Congress to pass laws on things that effect commerce, even if it is not "commerce" itself.

The issue with the Affordable Care Act (the ACA, or "Obamacare") is the provision which requires all Americans to buy health insurance.  Those opposed to the ACA say that the Commerce Clause isn't so broad that it can force people to engage in commerce.  

And those who support ACA characterize it differently.  They say that everybody, at some point in their lives, is going to engage in healthcare "commerce".  All that the mandate does is change the WAY we all engage in that commerce, i.e., through the health insurance industry.

9:54 am:  The Supreme Court starts at 10:00, and they usually are punctual.  But expect a few small decisions on other matters before they get to the good stuff.  They'll probably get to the decision around 10:15.

9:55 am:  There is no live video or audio in the courtroom.  The first place to get the result is probably SCOTUSBLOG, who has embedded reporters.  They are likely to get the news first, and probably interpret the most accurately.  

10:05 am:  REading from the Alverez case, a First Amendment case.  Court holds that the Stolen Valor Act is unconstitutional.  The Stolen Valor Act was a law which made it illegal (well, MORE illegal than prior law) to manufacture fake war medals and replicas.

10:07 am:  Healthcare opinion released.

10:09 am:  Individual mandate survives!!!!

Apparently as a "tax".  Congress has the power to tax (aside from its commerce power)

10:10 am:  Roberts joined the lefties on the court.

10:13 am: The bottom line: the entire ACA is upheld, with the exception that the federal government's power to terminate states' Medicaid funds is narrowly read.

 10:17 am:  Opinion still not public.  My guess is that if Obamacare went down, history would paint the court as being "activist".  Chief Justice Roberts (a conservative) didn't want that to happen under his watch. 

10:19 am:  Money quote from the opinion: "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. This is sufficient to sustain it."

Section 5000A is the part of the health care act which is the individual mandate.

So basically, the Court said that the individual mandate does NOT fall within the Commerce Clause powers of Congress.  But Congress also has the power to TAX.  And the individual mandate is essentially a tax.  And like a tax, individuals can choose not to comply and face a penalty.

10:23 am  Below is a picture of a younger Chief Justice John Roberts who is not gay.  (He's sitting on the left)


10:26 am:  The part that is unconstitutional deals with Medicaid expansion.  A majority of the Court holds that the Medicaid expansion is constitutional but that it would be unconstitutional for the federal government to withhold Medicaid funds for non-compliance with the expansion provisions. The Constitution requires that states have a choice about whether to participate in the expansion of eligibility, and the ACA denies them that choice.  So now, if states decide not to comply, they still can continue to receive funds for the rest of the program.

10:28 am:  The court is still reading the opinions.  The four lefties on the Court take the position (not surprising) that the individual mandate is valid under the Commerce Clause.  But since that is not a majority, their view on that particular issue is not controlling.

10:30 am:  Justice Kennedy reading from the dissent.  The dissent (Kennedy, Alito, Scalia, and Thomas) takes the view that whole ACA is invalid in its entirety.  But again, that's the dissent, so it's not controlling.

10:32 am:  Time to think about the political fallout.  Romney this week said (I'm paraphrasing) "If Obamacare gets overturned, then Obama's first term was a waste".  Well, it got upheld.  So what does that make Obama's first term out to be?  Worthwhile, using Romney logic.

10:34 am:  A "plain English" recap from SCOTUSBLOG:

"The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding."

10:36 am:  Here's a clip of Obama taking the position that the individual mandate is NOT a tax:


Oh, well.  A win is a win.

10:39 am:  Here is the opinion in the health care cases: /images/2012/06/11-393c3a2.pdf

And that concludes my liveblogging.Google-ChromeScreenSnapz028