WASHINGTON >> The Supreme
Court upheld the vast majority of President Barack Obama's historic
health care overhaul, including the hotly debated core requirement that
virtually all Americans have health insurance.
Today's 5-4 decision means the
huge overhaul, still taking effect, will proceed and pick up momentum
over the next several years, affecting the way that countless Americans
receive and pay for their personal medical care.
The ruling hands Obama a
campaign-season victory in rejecting arguments that Congress went too
far in approving the plan. However, Republicans quickly indicated they
will try to use the decision to rally their supporters against what they
call "Obamacare."
Stocks of hospital companies
rose sharply, and insurance companies fell immediately after the
decision was announced that Americans must carry health insurance or pay
a penalty.
Breaking with the court's other
conservative justices, Chief Justice John Roberts announced the judgment
that allows the law to go forward with its aim of covering more than 30
million uninsured Americans.
***
“We do not consider whether the Act embodies sound policies. That judgment is entrusted to the Nation’s elected leaders,” Roberts wrote. “We ask only whether Congress has the power under the Constitution to enact the challenged provisions.”
Although he answered that question in the affirmative, Roberts agreed with the law's conservative critics -- and the court’s four other conservatives -- who said Congress does not have the power to require people to buy a product such as health insurance.
But, he said, the law does not truly impose such a mandate on Americans. It simply requires those who do not have health insurance to pay a tax penalty. That tax requirement, he said, passes constitutional muster.
"The federal government does not have the power to order people to buy health insurance," he wrote. "The federal government does have the power to impose a tax on those without health insurance."
The justices also upheld a major expansion of the Medicaid program, which is one of the chief ways the law sought to expand coverage of the uninsured. But, they said, the federal government cannot force states to participate. Those states that do not want to expand Medicaid, even if the federal government pays for most of the expansion, will have to be given the right to opt out.
That part of the ruling could open the way for significant differences in healthcare coverage between liberal states, which already have said they welcome the additional federal money for expanded coverage, and conservative ones. Some Republican governors have indicated they want to reject the expanded coverage.
***
Now that the Supreme Court has upheld the health insurance mandate, most Americans must be insured starting in 2014 or pay a penalty.
The penalty will be assessed on your tax return and administered by the IRS. But exactly how is a big question.
The IRS has not issued its guidance yet. But IRS Commissioner Douglas Shulman addressed the issue shortly after the law was enacted in 2010.
Based on his comments, a reading of the Affordable Care Act and information from the Kaiser Family Foundation, here's a look at just how the mandate will work and how it will be enforced.
***
“We do not consider whether the Act embodies sound policies. That judgment is entrusted to the Nation’s elected leaders,” Roberts wrote. “We ask only whether Congress has the power under the Constitution to enact the challenged provisions.”
Although he answered that question in the affirmative, Roberts agreed with the law's conservative critics -- and the court’s four other conservatives -- who said Congress does not have the power to require people to buy a product such as health insurance.
But, he said, the law does not truly impose such a mandate on Americans. It simply requires those who do not have health insurance to pay a tax penalty. That tax requirement, he said, passes constitutional muster.
"The federal government does not have the power to order people to buy health insurance," he wrote. "The federal government does have the power to impose a tax on those without health insurance."
The justices also upheld a major expansion of the Medicaid program, which is one of the chief ways the law sought to expand coverage of the uninsured. But, they said, the federal government cannot force states to participate. Those states that do not want to expand Medicaid, even if the federal government pays for most of the expansion, will have to be given the right to opt out.
That part of the ruling could open the way for significant differences in healthcare coverage between liberal states, which already have said they welcome the additional federal money for expanded coverage, and conservative ones. Some Republican governors have indicated they want to reject the expanded coverage.
***
Now that the Supreme Court has upheld the health insurance mandate, most Americans must be insured starting in 2014 or pay a penalty.
The penalty will be assessed on your tax return and administered by the IRS. But exactly how is a big question.
The IRS has not issued its guidance yet. But IRS Commissioner Douglas Shulman addressed the issue shortly after the law was enacted in 2010.
Based on his comments, a reading of the Affordable Care Act and information from the Kaiser Family Foundation, here's a look at just how the mandate will work and how it will be enforced.
