“It was not very surprising that Roberts took an important role in this case. A lot of people thought that he would. The healthcare law really ended up rising and falling on the view of one person, and that person was Roberts, not Kennedy like a lot of people would have expected,” says H. Albert Young Fellow in Constitutional Law Erin Daly
of the U.S. Supreme Court’s ruling in National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, et al.
The Supreme Court’s historic ruling came down Thursday, June 28, 2012 and sets a number of important precedents certain to be debated by legal scholars. Professor Daly notes that the immediate significance of the ruling is that the Court “let the decision of Congress stand,” rather than overturn the law, meaning that the ultimate fate of the Affordable Care Act and its provisions rests with the elected representatives and by extension the people.
“If people don’t like the decision they can repeal the Act, and if they do, they can let it stand,” she says.
“The bottom line is that the Affordable Care Act is ruled constitutional,” agrees Professor John G. Culhane
, the Director of Widener’s Health Law Institute
In the court’s majority opinion, Chief Justice John Roberts wrote, "The Affordable Care Act's requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax," adding, "Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”
“Many people that that the ‘individual mandate’ would rise and fall on the Court’s interpretation of the Commerce Clause,” notes Daly, but the Robert’s opinion ruled the mandate constitutional not as regulation of interstate commerce, but as a tax.
“They did not ultimately do so, but it is important to note that five justices would have felt comfortable limiting Congress’s powers under the Commerce Clause,” she concludes.
Another part of the ruling that struck Professor Daly as significant on an initial analysis was the court’s problems with the expansion of Medicaid, which seven justices ruled unconstitutional as written. They concluded that the federal government does not have the power to withhold existing Medicaid funds from states that refuse the expansion, only future funds.
“This is a big victory for the President,” says Culhane, adding, "We can argue about the constitutionality of the Act, or about the politics of it, until we're blue. But for me, as a person interested in the public health dimension of health care, this is a bright day. It's a major step towards universal coverage.”
Reflecting on what happens now that the Supreme Court has ruled, he says, "Now the focus shifts to the hard work of implementation. Many states have been dragging their feet on setting up the health exchanges that will provide consumers with both choice and transparency about health care costs. Now they'll have to get busy. And the hard work of public education about how this important law will work is just beginning."