Court lets health law stand (with ruling)
By JOHN H. CUSHMAN Jr. / The New York Times | June 28,2012
Court's ruling (PDF) Click here for entire ruling
WASHINGTON -- The Supreme Court on Thursday largely let stand President Obama's health care overhaul, in a mixed ruling that Court observers were rushing to analyze.
The decision was a striking victory for the president and Congressional Democrats, with a majority of the court, including the conservative chief justice, John G. Roberts Jr., affirming the central legislative pillar of Mr. Obama's term.
Many observers called the case the most significant before the court since at least the 2000 Bush v. Gore ruling, which decided a presidential election. In addition to the political reverberations, the case helps set the rules for one of the largest and fastest-growing sectors of the economy, one that affects nearly everyone from cradle to grave.
The debate over health care remains far from over, with Republicans vowing to carry on their fight against the law, which they see as an unaffordable infringement on the rights of individuals. The presumptive Republican presidential nominee, Mitt Romney, has promised to undo it if elected.
But the court ruling is a crucial victory for the law that will allow its introduction to continue in the coming years. Passed in 2010, the law is intended to end the United States' status as the only rich country with large numbers of uninsured people, by expanding both the private market and Medicaid.
The key provision that 26 states opposing the law had challenged – known as the individual mandate – requires virtually all citizens to buy health insurance meeting minimum federal standards or to pay a fine if they refuse.
Many conservatives considered the mandate unconstitutional, arguing that if the federal government could compel people to buy health insurance, it could compel them to buy almost anything, with broccoli becoming the central example in court arguments.
It remained unclear whether the court officially upheld the mandate or chose a more technical path that effectively allowed it to stand.
The mandate's advocates said it was necessary to ensure that not only sick people but also healthy individuals would sign up for coverage, keeping insurance premiums more affordable. The law offers subsidies to poorer and middle-class households, varying with their incomes. It also provides subsidies to some businesses for insuring their workers.
The law requires states to expand Medicaid coverage for poor and nearly poor households. In all, tens of millions of people are expected to gain insurance from the law, according to the Congressional Budget Office, as part of a march toward universal coverage, a goal that has eluded legislators and presidents – including Franklin Delano Roosevelt, Harry S. Truman, Lyndon B. Johnson, Richard M. Nixon and Bill Clinton – for generations.
The decision came on the last day of the term, which the justices extended by three days to deal with the crush of major issues. On Monday, the court delivered a mixed ruling on an Arizona law intended to crack down on illegal immigrants, which the Obama administration opposed.
Under Chief Justice Roberts, the court has delivered a series of major victories to conservatives, including the Citizens United campaign finance decision, which on Monday it declined to reconsider. In next year's term, it could take up other major issues, including affirmative action, same-sex marriage and the Voting Rights Act.
The health care ruling came three months after an extraordinary series of oral arguments in which the differences on the bench, if not the ultimate outcome, were disclosed in sharp relief.
Until those arguments, many observers – within the White House and beyond – had seen the law as likely to survive a legal challenge that even many Republicans once viewed as a long shot. But the skeptical questioning of a majority of the justices – and Justice Kennedy in particular – called that view seriously into doubt.
Rulings by appeals courts had split on the question, with two upholding the law and one striking down the mandate. A fourth appeals court deferred consideration of the law until 2015, reasoning that the courts lacked jurisdiction until the first penalties enforcing the mandate became due.
Although there were some exceptions, in the lower courts most judges appointed by Democrats voted to uphold the law, while most appointed by Republicans voted to reject at least part of it.