How the Supreme Court ruled

Individual Mandate

Is the penalty in the law equivalent to a tax that therefore—
under the Anti-Injunction Act—cannot be challenged until it's
actually levied? YES and NO

In voting to uphold the mandate, the justices ruled that a penalty for refusing to obtain health insurance amounts to a tax. But the court did not accept that the Anti-Injunction Act precludes a decision on the health-care law.

Is the law's individual mandate constitutional? YES

The court rejected the administration's commerce-clause argument, but ruled that Congress has "the power to impose" the individual mandate under its taxing authority. The provision "need not be read to do more than impose a tax," the opinion said. "That is sufficient to sustain it."

Medicaid Expansion

Is the law's provision expanding Medicaid to cover a greater share of the poor constitutional? YES, but . . .

The justices found that the law's expansion of Medicaid can move forward, but not its provision that threatens states with the loss of their existing Medicaid funding if the states declined to comply with the expansion. The finding raises questions as to how effectively the federal government will be able to implement the expansion of the joint federal-state insurance program for the poor.

Comments

1. There is concern that the Court chose to use the federal government's taxing authority as the basis for upholding the law, and the reason is that the commerce clause has been the basis for most legislation that has provided a countervailing check on the greed and bigotry. And the decision certainly does not preclude the eventual necessity for there to be one health care plan for all Americans. 
2. In my view the Court was correct in basing it holding on the taxing power. A tax is a tax no matter what it is called (for political reasons). Since the decision was based on the taxing power, it is not a precedent limiting in any way what the Court might in the future hold under the Commerce Clause. Without having read the opinions, I am mystified as to how the Court could refuse to enforce the provision withholding federal support for medicaid to a state that refuses to extend coverage as required by the Affordable Health Care law. This sounds like a superlegislature, not a court operating under judicial restraint.

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