After months of anticipation and obsessive speculation from political junkies on both sides of the aisle, a divided Supreme Court on Thursday weighed in with a monumental decision on ObamaCare, upholding the centerpiece of President Obama's health care law, which seeks to extend coverage to 30 million uninsured Americans. In a 5-4 vote, the court said that the widely unpopular individual mandate — which requires virtually all Americans to acquire health insurance or pay a fine — falls within Congress' constitutional authority to levy taxes. Chief Justice John Roberts, nominated to the high court by George W. Bush, sided with the court's four liberals to uphold the mandate, a stunning move that gives the ruling some unexpected bipartisan heft. The decision is a huge victory for Obama and Democratic attempts to implement a near-universal health care system, and is seen as one of the court's most important decisions in decades. Here five takeaways:
1. The individual mandate is a tax
In defending the law, the Obama administration argued that the mandate was constitutional under Congress' right to regulate interstate commerce. Roberts, who penned the majority's decision, rejected that argument, instead saying that the mandate "may reasonably be characterized as a tax," which he concluded was "sufficient to sustain it." He added that "because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness."
2. Conservatives justices wanted to throw out the whole law
Justice Anthony Kennedy, a swing voter who has often sided with the liberals on polarizing issues, delivered a stinging dissent on behalf of the court's conservatives. "In our view, the entire Act before us is invalid in its entirety," he wrote. Kennedy said the law, known formally as the Patient Protection and Affordable Care Act, is an unconstitutional expansion of the federal government's power. Conservatives on the court had argued that the individual mandate set a dangerous precedent that would allow the government to force people to purchase broccoli and other products.
3. ObamaCare's Medicaid expansion is curbed
The majority did not uphold the entire law. In a separate portion of the ruling, Roberts said the Affordable Care Act's expansion of Medicaid, the health insurance program for the poor and disabled, infringed on state rights. ObamaCare had required states to make millions more low-income Americans eligible for Medicaid, threatening to cut off all federal Medicaid funding to states that refused. Congress can still pay states to expand their Medicaid rolls, Roberts said, but "what Congress is not free to do is to penalize states that choose not to participate in that new program by taking away their existing Medicaid funding." Essentially, the chief justice gave states "some flexibility not to expand their Medicaid programs without paying the same financial penalties that the law called for," says John H. Cushman Jr. at The New York Times.
4. Republicans are still vowing to repeal ObamaCare
In response to the decision, House Speaker John Boehner (R-Ohio) vowed to repeal ObamaCare in its entirety. "The president's health care law is hurting our economy by driving up health costs and making it harder for small businesses to hire," Boehner claimed. "Republicans stand ready to work with a president who will listen to the people and will not repeat the mistakes that gave our country ObamaCare." A House vote to repeal has already been scheduled for July 11.
5. In the end, this is a landmark decision
"The potentially game-changing decision," say Robert Barnes, N.C. Aizenman, and William Branigin at The Washington Post, "will help redefine the power of the national government and affect the health-care choices of millions of Americans." The liberal dream of near-universal health care coverage is closer to reality, which will give Americans "new peace of mind," says Jonathan Cohn at The New Republic. Millions of Americans can now rest easier with "the knowledge that comprehensive coverage will always be there, no matter what their medical or financial status."