Reacting to the Affordable Care Act Ruling: Messages from ACS Experts

On June 28, the U.S. Supreme Court upheld the constitutionality of the Affordable Care Act (ACA).

The Court ruled 5-4 in National Federation of Independent Business v. Sebelius that the law's integral measure -- the minimum coverage provision or individual mandate -- was constitutional under Congress's power to tax. After holding that the minimum coverage provision was not justified pursuant to Congress's power to regulate interstate commerce, Chief Justice John Roberts Jr. found that Congress's power to tax was sufficient to uphold the provision, which requires many individuals to carry health care insurance starting in 2014 or pay a penalty when filing their income tax returns. "Our precedent demonstrates that Congress had the power to impose the exaction ... under the taxing power ...," Roberts wrote. "Upholding the individual mandate under the Taxing Clause thus does not recognize any new federal power. It determines that Congress has used an existing one."

A majority of the justices also limited the reach of the ACA's expansion of Medicaid. Citing limits on Congress's spending power, the majority held that the states cannot be penalized for not participating in the Medicaid expansion. Citing precedent, the majority held, "The legitimacy of Congress's exericse of the spending power 'thus rests on whether the State voluntarily and knowingly accepts the terms of the contract.' Respecting this limitation is critical to ensuring that Spending Clause legislation does not undermine the status of the States as independent sovereigns in our federal system."

All of the justices agreed that the Anti-Injunction Act, which allows lawsuits of some taxes only after they are due, did not prohibit the Court's reveiw of the ACA.

See the opinions of the Court here.

Following the ruling, ACS President Caroline Fredrickson said:

The U.S. Constitution and the American people won an important victory before the nation’s high court today. The Supreme Court wisely resolved the health care case, despite all the political posturing on the right. Chief Justice Roberts’ majority opinion for the Supreme Court, upholding the Affordable Care Act’s integral ‘minimum coverage’ provision, has allowed for progress providing health care for tens of millions of Americans. It remains to be seen what the impact will be of Chief Justice Roberts’ understanding of the difference between ‘activity’ and ‘inactivity’ under the Commerce Clause

The following are the messages from some of ACS’s top experts on this issue:

Walter Dellinger (during ACS's media briefing):

  • With today’s decision, the court stepped back from the brink. What is critically important, and dwarfs the politics and the legal policy, is what today’s decision means for families who will be able to have health insurance coverage even though they have a family member with a preexisting condition.
  • What is really breathtaking is how sweeping the restrictions on congressional authority would be if the position of four dissenting justices had prevailed in this case. It shows that the court is one vote away from severe limits on the authority of Congress and an extraordinary revolution in constitutional law.

Robert Weiner (during ACS's media briefing):

  • There’s no way to slice this other than as a very significant victory for the government.
  • No doubt some folks will try to make political hay out of the notion that this is a tax increase. It’s not. This is a penalty that is imposed on those people who don’t get insurance.
  • It is an exercise of the taxing power, but it would be an oversimplification and really a misreading of the decision to suggest what I'm sure will be suggested, that this is a tax hike on the American people.

Jeffrey Rosen (during ACS's media briefing):

  • Today, Chief Justice John Roberts chose bipartisanship over polarization. It was an act of judicial statesmanship and reflects Roberts’ stated intent to preserve the legitimacy of the court as an institution. But this is by no means an end to 5-4 decisions. In some ways, it may empower Roberts to side with the conservatives in other future cases. 

Adam Winkler (from his ACSblog post):

  • Today, the institutional legitimacy of the Court was buttressed. President Obama wasn’t the only winner at the Supreme Court today. So was the Supreme Court itself.
  • Despite today’s decision, the Roberts Court is hardly conservative in the sense of cautious or avoiding bold rulings. In contrast to an older conservatism that emphasized judicial restraint, the Roberts Court is not hesitant to forcefully asserts its power. Since John Roberts became Chief Justice in 2005, the Court has issued one landmark ruling after another. The Roberts Court:
    • gave us Citizens United, which struck down longstanding limits on corporate political spending
    • allowed new restrictions on women’s right to choose
    • became the first Supreme Court in American history to strike down a gun control law as a violation of the Second Amendment
    • effectively outlawed voluntary efforts by public schools to racially integrate and
    • curtailed the reach of environmental protections.

Pamela Karlan (From an interview with the Boston Review and an op-ed for The New York Times):

  • The decision suggests that there really are five justices who want to impose some limits on the Commerce Clause. Although most of the things that Congress regulates are quite different and won’t approach the limits set out in this case, the joint dissent is quite hostile to the idea that the Commerce Clause is intended to be a major source of governmental power for dealing with a pervasive social problem.
  • That the individual mandate was upheld should not overshadow the court's ruling on Medicaid expansion -- the part of the ruling that is most likely to affect other legislation in the near future. For the first time since the New Deal, the court struck down an exercise of Congress's spending power. It held that Congress lacked the power to deny Medicaid funds to states that refuse to expand their coverage. Chief Justice Roberts -- joined by the liberal justices Stephen G. Breyer and Elena Kagan -- held that while the government can deny additional Medicaid funds to the states that refuse to expand their coverage, it cannot penalize them by rescinding current Medicaid payments.

Neal Katyal (from an op-ed in The New York Times):

  • While the court upheld the mandate, it did so by rejecting the federal government’s claim that it was regulating commerce. There is no judicial precedent or language in the Constitution that compelled that result; instead, the majority reasoned by constitutional inference.