SCOTUS upholds ACA as tax

UPDATE: The opinion is now up.

Update: UPHELD. Not under the commerce clause, but under the taxing authority of Congress.

Via SCOTUSblog:

“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. This is sufficient to sustain it.”

On the Medicaid issue, a majority of the Court holds that the Medicaid expansion is constitutional but that it w/b unconstitutional for the federal government to withhold Medicaid funds for non-compliance with the expansion provisions.

The key comment on salvaging the Medicaid expansion is this (from Roberts): “Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. 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.” (p. 55)

Hmm. This part is not so good. Removes big stick that permits administration to compel states to comply with Medicaid expansion. Republican governors could be really big problem.
Justice Ginsburg makes clear that the vote is 5-4 on sustaining the mandate as a form of tax. Her opinion, for herself and Sotomayor, Breyer and Kagan, joins the key section of Roberts opinion on that point. She would go further and uphold the mandate under the Commerce Clause, which Roberts wouldn’t. Her opinion on Commerce does not control.

Justice Ginsburg would uphold Medicaid just as Congress wrote it. That, too, is not controlling.
In opening his statement in dissent, Kennedy says: “In our view, the entire Act before us is invalid in its entirety.”

Strikes down mandate. Sort of. “Upheld as a tax.”WTF? Looking for details. No, apparently it’s been upheld. CNN was wrong.

Roberts joins the left of the court in the decision. Medicaid provision is “limited but not invalidated.”

“The exception that the federal government’s power to terminate states’ Medicaid funds is narrowly read.”

8 thoughts on “SCOTUS upholds ACA as tax

  1. The victory dance is way premature. Every Republican Governor will opt out on provisions for the poor. Remember that post about welfare in Georgia? Then the radicals in the House will figure out that if everyone is required to buy insurance, there is no reason to require hospitals to aid the uninsured. Next they refuse to budget for the low income purchase assistance and you have $700 tax on “freeloaders”. Finally you will see all of those business interests freeze their contribution levels for health care pointing employees to the exchanges. I predict an ugly death for the ACA.

  2. Dunno. Good for the people getting crumbs from the stupid bill. But it probably sets back any real universal health care in the US by years (decades?).

    Big Insurance had plenty of money for lobbying before, and now they have a huge windfall of captive customers starting in 2014. Their stocks are up nicely today.

  3. SC: You can “tax” the individual mandate into existence, but you can’t “force” people to buy into it. Now there’s a distinction without a difference. The SC and the Democrats have been given the green light to hand trillions of taxpayer dollars over to the for-profit health care industry. This is a gigantic win for the Capitalist 1% profiteers and a supreme defeat for the 99% who have just had their pockets picked. Makes one proud to be a Capitalist American.

  4. Very concerned about implications for other areas of the law that rely on the Commerce Clause.

  5. quixote: “But it probably sets back any real universal health care in the US by years”

    Keep tilting at windmills. The ACA ain’t perfect, but it’s base on the model used in France, Holland, and Switzerland, all of which require people to purchase insurance, and mandate that insurers provide coverage to everyone.

    Would I have preferred single payer? Probably. Maybe. I don’t know. All I care about is that it works.

  6. My take on Roberts is that he plays a long game, very, very long. He will accept tactical retreats, such as being the 5th vote for the mandate, if only as a tax, in order to set in place the groundwork for future decisions which might well result in negating Obamacare. I bet he wanted to write the decision so that he could have language he could use in future decisions which will forward his strategy of removing the great social safety nets and prevent such things as Medicare for All.

    I also believe he is a Corporatis foremost and saw this as a great way to preserve the private for-profit health insurers’ profitability, as Obama intended it to be.

    But he has begun to limit Congressional use of the Commerce Clause and his take on states’ rights concerning Medicaid is quite interesting. Heretofore, SCOTUS said that he who pays the piper calls the tune. Roberts is saying he who pays the piper, but doesn’t get the tune played still has to pay what he’d been paying the piper when the piper did play the tune. Ramifications of this might be very interesting.

  7. Yes, Roberts is all about preserving the enormous profits of the private insurance companies and all other corporate interests. There might be something to cheer about if this decision called for government national health insurance, as in France. But no, this merely props up the thieves who have made our health care system a worldwide disgrace.

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