On Thursday, June 28th the United States Supreme Court finally announced its decision on the individual health insurance mandate. In a 5-4 decision, the Supreme Court upheld the individual mandate—the requirement that all Americans buy health insurance by 2014 or pay a penalty.
The original basis for getting this crucial aspect of The Affordable Care Act was that the government has the broad power to regulate commerce, assuming there is activity to regulate.
The government’s main argument was that Congress could require everyone to buy health insurance using its power under the Commerce Clause of the Constitution, because the failure to buy health insurance shifts the uninsured costs of health care to: health care providers, insurance companies, and those who do have health insurance.
While five justices disagreed with the government’s arguments, including Chief Justice Roberts, a different five justices, including Chief Justice Roberts agreed with an alternate route for the mandate. Chief Justice Roberts and Justices Kennedy, Scalia, Thomas, and Alito rejected the People’s argument because the Act does not regulate activity, it creates activity by requiring people to buy health insurance.
However, the Court did find a way to make the individual mandate work. Instead of finding that the mandate is constitutional under the power to regulate commerce—as the government had argued—the Court held, instead, that Congress had the power to impose a tax on people who did not purchase health insurance under the taxing powers granted by the Constitution.
Even so, the intent behind imposing taxes on the people is usually to raise money while mandate’s intent is to get people to buy health insurance. Justice Roberts acknowledged this difference in the opinion and stated it is still a tax if people choose not to purchase health insurance and are willing to pay the penalty, or tax.
Four Justices agreed with Justice Roberts in his taxing power conclusion, however, they disagreed with his Commerce Clause conclusion. Justice Ginsburg, joined by Justices Breyer, Sotomayor, and Kagan opined that Congress could use its power to regulate commerce to pass the mandate.
Yet the mandate still passed with five votes in favor of the taxing power as the vehicle to the constitutionality of the individual mandate.
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