Live: Healthcare Informatics has learned, shortly after 10:07 AM eastern time Thursday, June 28, that the Supreme Court has ruled 5-4 to affirm the Affordable Care Act, President Obama's signature domestic act. According to information we are receiving live at this moment, Chief Justice John Roberts wrote the majority opinion. The individual mandate for the purchase of health insurance was affirmed not under the Commerce Clause of the U.S. Constitution, but in the form of a tax. We will bring our readers more information throughout the day, as more information becomes available, and will bring reactions from healthcare leaders.
With regard to the individual mandate, the court ruled that the federal government cannot use the Commerce Clause to justify the individual mandate, as the government cannot force people to purchase services. However, it sustained the mandate under the concept of its being a tax, as there is no criminal or civil penalty for not purchasing health insurance under the ACA.
Ruling on another significant element of the ACA, the nation's high court ruled that the Medicaid expansion provided for in the act is constitutional, but that it would be unconstitutional for the federal government to withhold Medicaid funding for non-compliance with the expansion provisions. Chief Justice Robts wrote: "Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of healthcare, 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."
In writing for the court's majority, Chief Justice Roberts began his 59-page opinion by saying, "We do not consider whether the Act embodies sound policies. That judgment is entrusted to the Nation's elected leaders. We ask only whether congress has the power under the Constitution to enact the challenged provisions."
Chief Justice Roberts' opinion was one of several, given that different justices agreed or disagreed on different aspects of the law, and joined with others in full and in part regarding different elements. As a result, Justice Ruth Bader Ginsburg has a 61-page opinion, while the four dissenters wrote a 65-page opinion, followed by a two-page opinion from Justice Clarence Thomas, according to SCOTUSBLOG, the leading Supreme Court-watching blogging entity.
Check back to HCI for more coverage of the Supreme Court's ruling on the Affordable Care Act.