SCOTUS Decision Live


  • 10:01am: The decision of the 9th Circuit is affirmed in Alvarez (AKA Stolen Valor – Decision here)
  • 10:07am: First American was dismissed. Health Care imminent.
  • 10:08am: The individual mandate survives as a tax.
  • 10:10am: So the mandate is constitutional. Chief Justice Roberts joins the left of the Court.
  • 10:11am: The Medicaid provision is limited but not invalidated.
  • 10:13am: The bottom line: the entire ACA is upheld, with the exception that the federal government’s power to terminate states’ Medicaid funds is narrowly read.
  • 10:15am: Chief Justice Roberts’ vote saved the ACA.

Well, my head just exploded.

  • 10:20am: The court reinforces that individuals can’t simply refuse to pay the tax and not comply with the mandate. [Corrected typo from author]
  • 10:21am: 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.
  • 10:22am: 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)
  • 10:23am: The critical detail is that you cannot take away the existing Medicaid funds.
  • 10:28am: In opening his statement in dissent, Kennedy says: “In our view, the entire Act before us is invalid in its entirety.”
  • 10:32am: In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding.
  • 10:34am: Yes, to answer a common question, the whole ACA is constitutional, so the provision requiring insurers to cover young adults until they are 26 survives as well.
  • 10:40am: Among other comments, Ginsburg bench statement says that “seven members of the Court…buy the argument that prospective withholding of anticipated funds exceeds Congress’ spending power.”
  • 10:50am: Essentially, a majority of the Court has accepted the Administration’s backup argument that, as Roberts put it, “the mandate can be regarded as establishing a condition — not owning health insurance — that triggers a tax — the required payment to IRS.” Actually, this was the Administration’s second backup argument: first argument was Commerce Clause, second was Necessary and Proper Clause, and third was as a tax. The third argument won.
  • 10:52am: The rejection of the Commerce Clause and Nec. and Proper Clause should be understood as a major blow to Congress’s authority to pass social welfare laws. Using the tax code — especially in the current political environment — to promote social welfare is going to be a very chancy proposition.

Here is the courts Health Care opinion.

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