Supreme Court upholds Obama’s health care overhaul

The Supreme Court on Thursday upheld the heart of President Obama’s health care law, ruling the federal government can compel Americans to buy health insurance, and striking a new balance for the scope of federal authority in the 21st century.

The ruling lets Mr. Obama continue to push the law ahead of its full implementation in 2014 and will likely amp up pressure on a number of states who had been awaiting a court decision before plowing ahead with state requirements.

The complex 5-4 decision is a major legal boost to Mr. Obama just months before he faces voters in a battle for re-election, and it complicates matters for Republicans on Capitol Hill, who had turned to the courts after their repeated efforts to repeal the law fell short in Congress.

Chief Justice John G. Roberts Jr., who wrote the controlling opinion, attempted a delicate balancing act: He said the Commerce and Necessary and Proper clauses of the Constitution cannot be bent to compel Americans to buy insurance, but said it is allowed under Congress’s tax and spending powers, which are broader, but are subject to the checks of the political system.

“The Affordable Care Act’s requirement that certain in­dividuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax. Be­cause the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness,” he wrote.

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Dr. Hamsakumari Ramasubramaniam, left, examines patient Fabian Vasquez at Camillus Health Concern, ... more >

The court’s four Democratic-appointed justices all joined the Roberts ruling but wrote separately to say they would have allowed the individual mandate under the Commerce Clause, too.

Four justices dissented, saying in an opinion written by Justice Antonin Scalia that the court has granted nearly unlimited authority to Congress to control Americans’ lives.

“Whatever may be the conceptual limits upon the Commerce Clause and upon the power to tax and spend, they cannot be such as will enable the Federal Government to regulate all private conduct and to compel the states to function as administrators of federal programs,” Justice Scalia wrote.

They said they would have struck down not only the individual mandate but the rest of the law as well, arguing that the other provisions could not have stood without the compulsion of forcing Americans to buy insurance.

Chief Justice Roberts‘ ruling also upheld the law’s massive expansion of Medicaid, but said states cannot be compelled to expand their own programs through the threat of removing federal funding altogether. Instead, states have the choice of expanding and collecting new federal money, or staying at current coverage and federal funding levels.

The political fight was already ramping up Thursday morning, with Senate Minority Leader Mitch McConnell saying the court has stripped away the pretense and exposed the tax increases in the law.

“The Supreme Court has spoken. This law is a tax. The bill was sold to the American people on a deception,” Mr. McConnell said, adding that the GOP will continue to pushing to ax the law.

“The court’s ruling doesn’t mark the end of the debate. It marks a fresh start on the road to repeal,” he said.

And Majority leader Eric Cantor said the House will vote to repeal the health care law next month, delivering on GOP promises to try to repeal the rest of the law even if the court upheld it.

“The Court’s decision brings into focus the choice the American people have about the direction of our country,” he said. “The president and his party believe in massive government intrusions that increase costs and take decisions away from patients.”

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