Supreme Court Upholds Healthcare Law

WASHINGTON — THURSDAY, June 28, 2012 (MedPage Today) — In a big win for the Obama administration, the Supreme Court has ruled that the landmark Affordable Care Act (ACA) is constitutional.

By a 5-4 vote, the court ruled that the law's controversial individual mandate — which requires nearly everyone to have health insurance — is constitutional. "The individual mandate may be upheld as within Congress's power under the Taxing Clause," Chief Justice John Roberts said.

The much-anticipated 193-page ruling was handed down Thursday morning.

The court notably took a stance that no lower court did: that the law's requirement that everyone have insurance is a tax. Both the Obama administration and the 26 states suing the federal government argued that the mandate is a penalty, not a tax.

Even though the mandate is a tax, the court decided that an old tax law called the Anti-Injunction Act does not apply. If law had applied, the court wouldn't have been able to rule on the law until 2015.

The court also, for the most part, upheld the ACA's expansion of Medicaid to cover nearly all people under age 65 with household incomes at or below 133 percent of the federal poverty level. That provision is set to go into effect in 2014.

However, the court struck down the provision that gives the Secretary of Health and Human Services the authority to penalize states for not complying with the Medicaid expansion, something that many states considered too onerous.