By Bridget Hunter

President Barack Obama delivers remarks regarding the U.S. Supreme Court decision upholding the “Patient Protection and Affordable Care Act,” in the East Room of the White House, June 28, 2012. (Official White House Photo by Pete Souza)

IIP Staff Writer
June 28,  2012

In the most eagerly anticipated decision of its 2011–2012 session, the Supreme Court of the United States upheld most of the 2010 health care law championed by the Obama administration.

The court, in a 5–4 decision, found most provisions, including the so-called “individual mandate,” of the Patient Protection and Affordable Care Act constitutional. Only one portion of the law — the right of the federal government to withhold funding from states that refuse to participate in an expansion of the Medicaid program — was rejected by the court.

The legislation aims to increase the number of Americans covered by health insurance and decrease the cost of health care. Its most controversial element has been a mandate that most Americans purchase health insurance or pay a penalty (collected by the Internal Revenue Service) to the federal government.

That provision, part of a hard-fought compromise forged in Congress, functions as the financial engine for other elements of the law. Without such a requirement, which enlarges the pool of those paying premiums, the cost of health insurance likely would rise sharply, according to many analysts.

The Obama administration argued that the individual mandate was a proper exercise of federal authority under both the Commerce Clause and the Tax Clause of Article 1 of the U.S. Constitution.

In an opinion written by Chief Justice John Roberts, the court found “the individual mandate is not a valid exercise of the Congress’s power under the Commerce Clause” because the law does not regulate existing commerce but instead compels individuals to engage in commerce.

However, the court concluded the individual mandate “must be construed as imposing a tax on those who do not have health insurance.” Such an exercise of federal power is constitutional because the Tax Clause specifically assigns the power to “lay and collect Taxes” to Congress.

“The Court today holds that our Constitution protects us from federal regulation under the Commerce Clause so long as we abstain from the regulated activity,” Roberts writes. “But from its creation, the Constitution has made no such promise with respect to taxes.”

The opinion quotes a 1789 letter in which Benjamin Franklin wrote, “Our new Constitution is now established … but in this world nothing can be said to be certain, except death and taxes.”

Justices Ruth Bader Ginsberg, Stephen Breyer, Sonia Sotomayor and Elena Kagan joined in the majority opinion, with Ginsberg and Sotomayor dissenting in part and expressing their view that the Medicaid expansion provision also should be upheld. Justices Antonin Scalia, Anthony Kennedy, Clarence Thomas and Samuel Alito dissented.

“I know there will be a lot of discussion today about the politics of all this, about who won and who lost,” President Obama said in a televised statement from the White House following the release of the decision. “But that discussion completely misses the point. Whatever the politics, today’s decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court’s decision to uphold it.”U.S. SYSTEM OF CHECKS AND BALANCES

Ensuring all Americans have access to health care is not a new concept. President Franklin Roosevelt pursued it in the mid-20th century and the Clinton administration aggressively promoted it in the 1990s, but it was not until 2010 that a federal law advancing that goal was enacted.

In the U.S. system of democracy, passage of a law requires approval by the legislative branch and the executive branch. Both chambers (the Senate and the House of Representatives) of the Congress passed the health care bill, which was then signed by the president.

With the June 28 decision, the third branch of the U.S. federal government, the judicial branch, has weighed in. Its role, as exercised by the Supreme Court, is to ensure that neither the Congress nor the president exceeds the authority bestowed by the Constitution.

The court’s nine justices make up the court of final appeal from the lower federal and state courts. The court is also the venue for settling legal disputes between states, between states and the federal government and between the United States and another nation.

The court receives more than 7,000 petitions for review each year, but generally agrees to hear 100 or fewer. Most cases have gone through an appeals process, in which they have been decided in a lower-level court. The health care case, formally titled National Federation of Independent Business et al. v. Sebelius, Secretary of Health and Human Services, was heard by the Court of Appeals for the 11th Circuit before being appealed to the Supreme Court.

Many pundits expressed surprise that Roberts, a justice appointed by President George W. Bush, penned a decision that upheld the landmark legislation of Bush’s Democratic successor, President Obama.

Perhaps they should have paid more attention to the chief justice’s confirmation hearing, when he pledged that if confirmed, he would consider each case carefully in light of the legal arguments presented to him, not with a political or personal agenda.

“I have no agenda, but I do have a commitment,” he said. “If I am confirmed, I will confront every case with an open mind,” Roberts told the Senate Judiciary Committee on September 13, 2005.

The framers of the Constitution would be pleased.

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