The United States Supreme Court has upheld the federal health care law, finding the critical individual mandate provision valid under Congress’ taxing powers, although not under its power to regulate commerce.
Virginia Attorney General Ken Cuccinelli, who opposed the health care law, initially said the court’s decision marked a “dark day for American liberty.” Later, Cuccinelli walked back some of his criticism, finding some “silver linings” in the court opinion. Nevertheless, the attorney general said the decision “has saddled us with a budget-busting health care law that will most assuredly increase health care costs and thrust a new tax on the American People.”
Cuccinelli cheered the court’s pronouncement that the Commerce Clause would not support a mandate for individual citizens to obtain health insurance. “This represents the court’s first express acknowledgement of the actual limits on the federal government’s commerce power since the New Deal,” he said.
The court found problems with the law’s expansion of Medicaid, but even there said the expansion could proceed as long as the federal government does not threaten to withhold states’ entire Medicaid allotment if they don’t take part in the law’s extension, according to the Associated Press.
Cuccinelli hailed that aspect of the decision as a rare brake on Congressional spending power.
The court’s four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Chief Justice John Roberts in the outcome.
Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.
Richmond lawyer Mark S. Hedberg, who has advised health care providers on the implications of the Patient Protection and Affordable Care Act, said the court’s decision brings the wait-and-see period to an end. With one small exception, he said, “Everything in the Act proceeds just as the Act prescribes.”
The exception, he said, is the Medicaid limitation. States will have the option to forgo the Medicaid expansion, since the court held the federal government could not withhold all Medicaid funding from states that did not follow the plan.
Employers, insurers and health care companies now can move ahead with some certainty about what the Act will require, Hedberg said.
States also must get off the mark. Hedberg noted Virginia officials have been holding off on planning for a state insurance exchange, to help citizens shop for insurance coverage. “Now they’ve got some decisions to make,” Hedberg said.
Hedberg found the court’s opinion a “fascinating Constitutional result,” with Roberts holding the line against expansion of the Commerce Clause along with other conservative justices, yet voting with the “liberal wing” to keep from overturning the Act.
-By Peter Vieth