Health care law upheld

Updates at the bottom of post

Chief Justice Roberts turns out to be the deciding vote that upholds the law.

From the decision (via Scotusblog):

Our precedent demonstrates that Congress had the power to impose the exaction in Section 5000A under the taxing power, and that Section 5000A need not be read to do more than impose a tax. This is sufficient to sustain it.

More from Scotusblog:

Justice Ginsburg makes clear that the vote is 5-4 on sustaining the mandate as a form of tax. Her opinion, for herself and Sotomayor, Breyer and Kagan, joins the key section of Roberts opinion on that point. She would go further and uphold the mandate under the Commerce Clause, which Roberts wouldn't. Her opinion on Commerce does not control.

By the way, Justice Kennedy, who at one point was considered the swing vote, joined the dissenters. Kennedy said: "In our view, the entire Act before us is invalid in its entirety."

From the WSJ:

A divided Supreme Court upheld the constitutionality of the Obama administration's health-care law, in one of the most anticipated high-court rulings in a generation. The court said Congress was acting within its powers under the Constitution when it required most Americans to carry health insurance or pay a penalty -- the provision at the center of the two-year legal battle. It upheld the mandate as a tax, in an opinion by Chief Justice John Roberts.

A little more clarity from Scotusblog:

In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding.

Here's the early Washington Post story

Wall Street reacts: Stocks of hospital and drug companies rose sharply after the court decision. Stocks of big insurance companies dropped sharply. (AP)

Here's the majority decision. Check out page 31 - it lays out the rationale for upholding the individual mandate.

Still more clarity: Amy Howe at Scotusblog picks up on a key footnote in the decision: "Those subject to the individual mandate may lawfully forgo health insurance and pay higher taxes, or buy health insurance and pay lower taxes. The only thing they may not lawfully do is notbuy health insurance and not pay the resulting tax."

Republicans react: House Major Leader Eric Cantor says the House will vote to repeal the health care act the week of July 9, reports CBS. Early Republican strategy appears to brand the law as a tax - and that the president deceived Congress and the American people.

Romney to speak: The new mantra seems to be "repeal and replace."

Medicaid ruling: This one element might be getting lost in the shuffle. From the NYT:

The decision did significantly restrict one major portion of the law: the expansion of Medicaid, the government health-insurance program for low-income and sick people. The ruling gives states some flexibility not to expand their Medicaid programs, without paying the same financial penalties that the law called for.

Slate's Matthew Yglesias has a good explanation of the Medicaid decision.

CNN and Fox get it wrong: Their initial bulletins had the individual mandate going down. (CNN has apologized for the goof: "CNN regrets that it didn't wait to report out the full and complete opinion regarding the mandate.")

More Republican reaction: Senate Republican leader Mitch McConnell said, "Today's decision makes one thing clear: Congress must act to repeal this misguided law. Obamacare has not only limited choices and increased health care costs for American families, it has made it harder for American businesses to hire."

So much for Intrade: Percentage chance of the individual mandate being overturn was running around 75 percent on the trading website. Barry Ritholtz isn't surprised:

As I have said over the years (repeatedly) this is the sort of thing that Intrade gets wrong. Futures markets are really a focus group unto themselves: When the group is something less representative of the target market, they get it wrong with alarming frequency. Indeed, the further the traders are as a group to the target decision makers/voters, the worse their track record.

Romney speaks: Pretty much as you might expect: "Obamacare was bad policy yesterday. It's bad policy today." He also says it's a job killer and part of the liberal agenda.

Why Roberts chose the pro-mandate side: UCLA law professor Adam Winkler offers a nifty summation on what just happened (via Scotusblog):

With this deft ruling, Roberts avoided what was certain to be a cascade of criticism of the high court. No Supreme Court has struck down a president's signature piece of legislation in over 75 years. Had Obamacare been voided, it would have inevitably led to charges of aggressive judicial activism. Roberts peered over the abyss and decided he didn't want to go there.

Roberts' decision was consistent with his confirmation hearings pledge to respect the co-equal branches of government, push for consensus, and reach narrow rulings designed to build broad coalitions on the Court. He promised to respect precedent. His jurisprudence, he said, would be marked by "modesty and humility" and protection of the precious institutional legitimacy of the Court. Today, the institutional legitimacy of the Court was buttressed. President Obama wasn't the only winner at the Supreme Court today. So was the Supreme Court itself.

Obama speaks: "The highest court in the land has now spoken, we will continue to implement this law," the president said. He called the court decision a victory for "people all over this country."

Jeffrey Toobin tweets: The CNN contributor and New Yorker writer said that as Roberts read the decision, he "was red-eyed and unhappy." Justice Antonin Scalia, Toobin said, "walked into courtroom totally downcast." Toobin, if you recall, all but predicted that the health care law would be overturned.

Full statements on decision: Here's President Obama's and here's Mitt Romney's.

Updated post