Supreme Court upholds key part of Obama health law

Claire McAndrew of Washington, left, and Donny Kirsch of Washington, celebrate outside the Supreme Court in Washington, Thursday, June 28, 2012, after the courts's ruling on health care.

Claire McAndrew of Washington, left, and Donny Kirsch of Washington, celebrate outside the Supreme Court in Washington, Thursday, June 28, 2012, after the courts's ruling on health care.

By Mark Sherman, Associated Press

WASHINGTON — The Supreme Court on Thursday upheld the vast majority of President Barack Obama's historic health care overhaul, including the hotly debated core requirement that virtually all Americans have health insurance.

The 5-4 decision means the huge overhaul, still taking effect, will proceed and pick up momentum over the next several years, affecting the way that countless Americans receive and pay for their personal medical care.

The ruling hands Obama a campaign-season victory in rejecting arguments that Congress went too far in approving the plan. However, Republicans quickly indicated they will try to use the decision to rally their supporters against what they call "Obamacare."

Stocks of hospital companies rose sharply, and insurance companies fell immediately after the decision was announced that Americans must carry health insurance or pay a penalty.

Breaking with the court's other conservative justices, Chief Justice John Roberts announced the judgment that allows the law to go forward with its aim of covering more than 30 million uninsured Americans.

The justices rejected two of the administration's three arguments in support of the insurance requirement. But the court said the mandate can be construed as a tax. "Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness," Roberts said.

The court found problems with the law's expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to withhold states' entire Medicaid allotment if they don't take part in the law's extension.

The court's four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.

Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.

Kennedy summarized the dissent in court. "In our view, the act before us is invalid in its entirety," he said.

The dissenters said in a joint statement that the law "exceeds federal power both in mandating the purchase of health insurance and in denying non-consenting states all Medicaid funding."

In all, the justices spelled out their views in six opinions totaling 187 pages. Roberts, Kennedy and Ginsburg spent 57 minutes summarizing their views in the packed courtroom.

The legislation passed Congress in early 2010 after a monumental struggle in which all Republicans voted against it. House Majority Leader Eric Cantor, R-Va., said Thursday the House will vote the week of July 9 on whether to repeal the law, though such efforts have virtually no chance in the Democratic-controlled Senate.

GOP presidential candidate Mitt Romney has joined in calls for complete repeal.

After the ruling, Republican campaign strategists said Romney will use it to continue campaigning against "Obamacare" and attacking the president's signature health care program as a tax increase.

"Obama might have his law, but the GOP has a cause," said veteran campaign adviser Terry Holt. "This promises to galvanize Republican support around a repeal of what could well be called the largest tax increase in American history."

Democrats said Romney, who backed an individual health insurance mandate when he was Massachusetts governor, will have a hard time exploiting the ruling.

"Mitt Romney is the intellectual godfather of Obamacare," said Democratic consultant Jim Manley. "The bigger issue is the rising cost of health care, and this bill is designed to deal with it."

More than eight in 10 Americans already have health insurance. But for most of the 50 million who are uninsured, the ruling offers the promise of guaranteed coverage at affordable prices. Lower-income and many middle-class families will be eligible for subsidies to help pay premiums starting in 2014.

There's also an added safety net for all Americans, insured and uninsured. Starting in 2014, insurance companies will not be able to deny coverage for medical treatment, nor can they charge more to people with health problems. Those protections, now standard in most big employer plans, will be available to all, including people who get laid off, or leave a corporate job to launch their own small business.

Seniors also benefit from the law through better Medicare coverage for those with high prescription costs, and no copayments for preventive care. But hospitals, nursing homes, and many other service providers may struggle once the Medicare cuts used to finance the law really start to bite.

Illegal immigrants are not entitled to the new insurance coverage under the law, and will remain one of the biggest groups uninsured.

Obama's law is by no means the last word on health care. Experts expect costs to keep rising, meaning that lawmakers will have to revisit the issue perhaps as early as next year, when federal budget woes will force them to confront painful options for Medicare and Medicaid, the giant federal programs that cover seniors, the disabled, and low-income people.

The health care overhaul focus will now quickly shift from Washington to state capitals. Only 14 states, plus Washington, D.C., have adopted plans to set up the new health insurance markets called for under the law. Called exchanges, the new markets are supposed to be up and running on Jan. 1, 2014. People buying coverage individually, as well as small businesses, will be able to shop for private coverage from a range of competing insurers.

Most Republican-led states, including large ones such as Texas and Florida, have been counting on the law to be overturned and have failed to do the considerable spade work needed to set up exchanges. There's a real question about whether they can meet the deadline, and if they don't, Washington will step in and run their exchanges for them.

In contrast to the states, health insurance companies, major employers, and big hospital systems are among the best prepared. Many of the changes called for in the law were already being demanded by employers trying to get better value for their private health insurance dollars.

"The main driver here is financial," said Dr. Toby Cosgrove, CEO of the Cleveland Clinic, which has pioneered some of the changes. "The factors driving health care reform are not new, and they are not going to go away."

Justice Ginsburg said the court should have upheld the entire law as written without forcing any changes in the Medicaid provision. She said Congress' constitutional authority to regulate interstate commerce supports the individual mandate. She warned that the legal reasoning, even though the law was upheld, could cause trouble in future cases.

"So in the end, the Affordable Health Care Act survives largely unscathed. But the court's commerce clause and spending clause jurisprudence has been set awry. My expectation is that the setbacks will be temporary blips, not permanent obstructions," Ginsburg said in a statement she, too, read from the bench.

Tagged: Supreme Court, Obamacare, health insurance


just_another_bozo_on_this_bus 5 years, 11 months ago

Chief Justice Roberts sides with the insurance companies.

Bob Forer 5 years, 11 months ago

Sure, it hands money to the insurance companies, and of course, a single payer system is the only proper way to go, but if you are one of around 50 million folks without health insurance, the decision is a good thing, a very good thing.

blindrabbit 5 years, 11 months ago

Second big Republican loss from SCOTUS this week; Immigration and Health Care! Time for Herr Koback to give up on his consulting work and get back to doing what he was elected to do in Kansas! Hopefully, he will screw up enough to get rid of his bigoted and repressive concepts at the next opprotunity Now to get the crook Darrell Issa (look into his investigated past (Maseratis and Mercedes, gun possession and insurance gains fires)) out of his political Don Quixote chasing of Fast and Furrious (Started under Dubya anyway)!

woodscolt 5 years, 11 months ago

What a predicament. This Supreme Court has always ruled in favor of big business. Today's ruling could have gone against their number one policy, big business, or for the first time vote against big business. They stayed true to their previous rulings and went against the Republicans today and for the Republicans who cooked up the "individual mandate". So in the end, Republicans 2 to Republicans 1. So, the consensus, Big business wins again.

Bob Forer 5 years, 11 months ago

Kinda like coke vs. pepsi. Not much of a difference. One tastes sweeter than the other, but they are both bad for you.

Alyosha 5 years, 11 months ago

Here's the ruling itself:

And here's a thought: how about everyone actually read it and think about it before going off hack cocked? :)

Leslie Swearingen 5 years, 11 months ago

Alyosha, When I clicked onto the link I got a message saying the file is damaged and cannot be repaired.

Leslie Swearingen 5 years, 11 months ago

Tried again and now it works, don't know what happened.

woodscolt 5 years, 11 months ago

What a predicament for this supreme court. They have always ruled in favor of big business without exception. This would put them against the recent flip flop of the Republican party or in line with the Republican party that cooked up the individual mandate to begin with. Todays's score: Big business won, flip flop republicans lost, republicans who cooked up the mandate won. So, final score Republicans 2 to Republicans 1.

bevy 5 years, 11 months ago

The only prediction I will make: This thread will eventually set the record for the most vitriolic and largest number of reader responses. Other than that - I'm happy!

Leslie Swearingen 5 years, 11 months ago

This is wonderful! I thank God for President Obama because he is a caring man who has worked so hard to help people. They may have money now, but it wasn't always that way and he and his wife are both people who remember what it was like. It was not easy at all for them to get to where they are. And, no, that did not make a thrill go up my leg, but it does make me feel good in my mind to know that this has passed muster with the Supreme Court. You know.....mind?

ENGWOOD 5 years, 11 months ago

The American worker loses and the free loaders win. Businesses will layoff employees and raise the price of goods in order to cover the cost. So be happy until it bites you in the butt!!!!

salinalawrence 5 years, 11 months ago

False. The American job creator now has a tremendous burden lifted in the form of coverage costs for full-time employees. They can hire more full-time employees now and be able to afford competitive health care packages to lure in more skilled workers... which I guess was what you were talking about? You didn't really lay out any points, just started regurgitating Kool-Aid so it's hard to know what you meant.

ENGWOOD 5 years, 11 months ago

False!!! The cost will be covered by raising the cost of goods and services which will be another burden on the economy with less jobs being created.

salinalawrence 5 years, 11 months ago

What cost will be covered by raising the cost of goods and services? Universal Health costs way less than the status quo. So employers pay out less to cover their employees, so using your logic they will lower the cost of goods and services. Again, I'm assuming that's what you meant, it's very difficult to tell.

squawkhawk 5 years, 11 months ago

If true, this increase will be off set by healthcare costs which should stop spiraling out of control.

salinalawrence 5 years, 11 months ago

Obama doesn't make laws, this is called the "Affordable Care Act", and it was passed by Congress. Sensational headline is sensational/indicative of poor journalism.

blindrabbit 5 years, 11 months ago

Obama 1 , Brewer, Kobach, and GOP, 0 (Immigration) Obama 1, Boehner, McConnell, Romney, 0 (Health Care) Obama ?, Issa ? (Fast and Furrious) Political gotcha game Obama 1, Romney, et al, 0 (DreamAct) Obama ?, McCain ? (Security Leaks) Political gotcha game Obama 1, Bush, Cheney, Rumsfeld and Rice 0 (Quaddafi, Bin Laden, Iraq,) Obama 1, Bush et al 0 (job gains)

salinalawrence 5 years, 11 months ago

False. They put it under Congress's Taxing powers because it's unconstitutional for it to be a Congressional Commerce power. This is a whole new precedent that, while falling under the general guidelines of a tax, deserve to be acknowledged as its own thing. Additionally, you pay taxes for lots of social services, the worst of which is the three-times-as-expensive war. The best of which is health coverage for your fellow Americans.

blindrabbit 5 years, 11 months ago

Funny thing a Bush appointed conservative Republican Supreme Court Justice, John Roberts said "it is a tax" and therefore constitiutional, and not part of the Commerce Clause. My guess, Roberts saw the light and thought about his (and the Court's) legacy, and the right thing to do. Now Romney is further lost and flip-flopping

Unlike Rehnquist, and the Orange Juice salesperson Katherine Harris back in 2000, who was toddering on the verge of sanity (really) who botched-up the Florida vote in Bush-Gore, giving it to the looser; and forever sullying his and The Court's history and reputation.

tbaker 5 years, 11 months ago

All things considered, I think this is a good thing and the larger scope of things.

I believe it is wrong for the government to force people to buy things, and having a SCOUS precedent in place saying so is a very difficult thing to eventually change. I think it clears the way for massive tax increases, massive increases in the size and scope of government, and more and more erosion of personal freedoms and liberties turning our country into the socialist nanny state many on the left crave.

That said this forces the politicians to finally square off and fight this out. This contest is long overdue and needs to happen. The presidential election will now be all about this. The only way to get rid of ObamaCare is to get rid of Obama.

booyalab 5 years, 11 months ago

It certainly reflects badly on Obama that this thing was considered a tax, but that fact also means the Federal government's powers are expanded much more. That's why Obama denied that it was a tax in the first place. It's not a good thing.

salinalawrence 5 years, 11 months ago

Republican Congress denied that it was a tax thing because the Supreme Court wouldn't have been allowed to rule on it until after the first tax payments had already been made and the program would then have successful statistics to beef up support. It was the Supreme Court that manipulated the ACA to fall under Congress's Tax powers instead of their Commerce powers. It is an extremely good thing!

salinalawrence 5 years, 11 months ago

p.s. despite the media calling the Affordable Care Act "ObamaCare", it is a Law passed by Congress. The Executive branch can't make laws, so if this "reflects badly on Obama" it's because people are incorrectly assigning him blame. Furthermore, the law Congress finally agreed upon has only a passing resemblance to the suggestions initially made by Obama's team. If it sucks it's because Republican Congress made it suck.

blindrabbit 5 years, 11 months ago

All the anti's on this issue were so convinced that this issue would be overturned by SCOTUS, that they are now grabbing at straws to come up with a position. Been watching TV, funny seeing Boehner, McConnell, Romney and Faux commentators trying to lipstick on their pig of a position.

Kirk Larson 5 years, 11 months ago

I think Roberts saw that if the ACA was struck down, the Democrats would have a great campaign issue to run on once people who are already benefiting from the Act realize that the republicans are taking health care access away. It's like he was reaching for some excuse to say it's constitutional.

verity 5 years, 11 months ago

Whatever his reason, I think he knew there would be a big backlash if Obamacare went down. Took one for the team, he did. I was very surprised at first, but after thinking about it, it makes sense.

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