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Health Insurance Mandate Constitutional — Early Reactions

The Court held that the mandate within the Affordable Care Act to purchase health insurance is constitutional as long as states would only lose new federal funds if they fail to comply with the new requirements, rather than existing sources of healthcare-related funding.

"The individual mandate survives as a tax," wrote Amy Howe of the ScotusBlog at 10:08 Eastern this morning, commenting on the Court's 5-4 decision affirming the constitutionality of the Obama administration's Affordable Care Act. Her colleague "Tom," offered a gloss a few minutes later: "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."

The opinion in the case, known as National Federation of Independent Business v. Sebelius, which can be read here, was written by Chief Justice John Roberts, with Justices Ginsburg, Breyer, Sotomayor and Kagan joining. Justices Scalia, Kennedy, Thomas and Alito dissented.

Characterizing the decision as a victory for the Democratic Party and President Obama, the Wall Street Journal reported that "Congress was acting within its powers under the Constitution when it required most Americans to carry health insurance or pay a penalty—the provision at the center of the two-year legal battle."

ScotusBlog offers the following summary of the decision:

In Plain English: 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. . . . Yes, to answer a common question, the whole ACA is constitutional, so the provision requiring insurers to cover young adults until they are 26 survives as well.

Anthony O'Donnell has covered technology in the insurance industry since 2000, when he joined the editorial staff of Insurance & Technology. As an editor and reporter for I&T and the InformationWeek Financial Services of TechWeb he has written on all areas of information ... View Full Bio

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