By Brandon Long
At approximately 9:15 a.m. Central time this morning, the U.S. Supreme Court issued its long-awaited decision on the Patient Protection and Affordable Care Act (the Act). In a 5-4 decision delivered by Chief Justice John Roberts, the Court essentially upheld the entire Act, including the individual mandate. Interestingly, Roberts was the deciding vote in upholding the Act, joining Justices Ginsburg, Breyer, Sotomayor and Kagan. Conventional wisdom was that Justice Kennedy would be the swing vote, but as it turns out he joined Justices Scalia, Thomas and Alito in the dissent.
In the majority decision, the Court relied on Congress' taxing power to uphold the mandate: "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. That is sufficient to sustain it."
It appears that the only part of the Act that the Court held to be unconstitutional relates to the Act's expansion of Medicaid. The Court held that the Medicaid expansion violates the Constitution by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion: "Congress is not free to … penalize States that choose not to participate in that new program by taking away their existing Medicaid funding," wrote Justice Roberts.
The bottom line is that we must continue to focus our efforts to comply with the Act's requirements — especially those that will come into effect in 2013 and 2014. We are still reading through the 193-page, multi-part opinion and will keep you updated of any new developments or thoughts about today's decision. In the meantime, if you have any questions, please let us know.
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