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Supreme Court Upholds Health Care Law: Mandate Is Constitutional

June 28, 2012 at 12:00 AM EDT
The Supreme Court upheld the individual insurance requirement at the heart of President Barack Obama's historic health care overhaul Thursday. Betty Ann Bowser reports from the Supreme Court, while Marcia Coyle of the National Law Journal parses the ruling with Jeffrey Brown.

JUDY WOODRUFF: The many months of speculation finally came to an end today. The U.S. Supreme Court on the last day of its term issued a landmark decision on health care reform.

NewsHour health correspondent Betty Ann Bowser begins our coverage.

BETTY ANN BOWSER: The crowd gathered outside the Supreme Court broke into applause when the 5-4 decision was announced this morning.


BETTY ANN BOWSER: The court upheld the centerpiece of the 2010 health care law: the individual mandate. It requires nearly all Americans to get health insurance or pay a fine.

The goal is to expand coverage to 32 million Americans who don’t have it now. Conservative Chief Justice John Roberts joined the court’s four liberals, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan, and Sonia Sotomayor, in the majority.

Roberts wrote: “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.”

President Obama hailed the court’s finding when he appeared later at the East Room of the White House.

BARACK OBAMA, President of the United States: I know there will be a lot of discussion today about the politics of all this, about who won and who lost. That’s how these things tend to be viewed here in Washington.

But that discussion completely misses the point. Whatever the politics, today’s decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court’s decision to uphold it.

BETTY ANN BOWSER: Republican presidential hopeful Mitt Romney was also in Washington for the decision.

MITT ROMNEY (R), Presidential Candidate: What the court didn’t do on its last day in session, I will do on my first day if elected president of the United States.

And that is, I will act to repeal Obamacare. What the court did today was say that Obamacare doesn’t violate the Constitution. What they didn’t do was say that Obamacare is good law or that it’s good policy.

BETTY ANN BOWSER: Today’s decision was the result of lawsuits brought by Florida, 25 other states, the National Federation of Independent Business, and several individuals.

The justices also ruled on another key provision of the law that requires states to expand the Medicaid program, which provides health care to the poor. The court said that exceeded the federal government’s constitutional authority, but ruled states could refuse to participate in the expansion, and they could not be penalized for doing so.

JEFFREY BROWN: Marcia Coyle of The National Law Journal was in the courtroom this morning and, of course, is here with us tonight.

Marcia, yes to the mandate, but not on the grounds that had been the focus of so much attention. Explain.

MARCIA COYLE, The National Law Journal: That’s right.

Five justices, the conservative justices, this time, led by Chief Justice Roberts, did accept the opponent’s argument that there is a line in terms of how Congress can legislate under this Commerce Clause. The Commerce Clause regulars interstate commerce.

And Chief Justice Roberts said that presumes that there is activity to regulate. What the individual mandate did in terms of the Commerce Clause was attempted to regulate inactivity. Roberts said there are many things that people do not do. And if the court upheld Congress’ power under the Commerce Clause, it would open a new and vast area of regulation.

JEFFREY BROWN: But he accepted that it could be done under the tax powers.

MARCIA COYLE: That’s right, under Congress’ power to tax and spend for the general welfare.

JEFFREY BROWN: All right, I want to pull up a graphic that shows a line from Chief Justice Robert’s opinion.

He says: “Whether the mandate can be upheld under the Commerce Clause is a question about the scope of federal authority. Upholding the individual mandate under the taxing clause does not recognize any new federal power. It determines that Congress has used an existing one.”

How surprising was this that he went to that argument? It was argued in the — it was heard in the oral arguments, but never got much attention.

MARCIA COYLE: Well, it was surprising only because most of the commentary for the last two years by legal scholars, by political people, by court watchers, focused on the Commerce Clause argument.

And also in the lower courts, it seemed to dominate. But the government had always argued as a second basis for upholding the statute that the individual mandate was valid under Congress’ tax and spending power.

JEFFREY BROWN: And there’s no question here as to who the key figure is, right? It’s the chief justice.

MARCIA COYLE: Absolutely.

And on the tax and spending power, the chief justice this time was joined by the four of the court’s more liberal members. And there’s an old rule that the court has — does follow that if a statute of capable of being interpreted in two ways, and one way it’s unconstitutional, the other it is not, then the court will save the statute by looking to the constitutional way.

And that’s why the chief justice then, after disposing of the Commerce Clause argument, took a look at the tax and spending argument.

JEFFREY BROWN: In fact, people listening as it unfolded thought he was first getting rid of the mandate, right, because he…

MARCIA COYLE: Absolutely.

JEFFREY BROWN: So, you were surprised there listening?

MARCIA COYLE: Yes. It sounded very much like the statute was going to fall.

JEFFREY BROWN: So, he was striking down the whole thing.

MARCIA COYLE: It sounded that way. But those of us who followed it knew that there was — and he even announced at the beginning that there were two issues that he had to address.

It was very interesting. The solicitor general of the United States and almost his entire office was sitting at the table immediately in front of the court. And I’m sure that they also were getting worried.

JEFFREY BROWN: All right, now, the dissent was the four conservatives who the justice — chief justice often sides with, but they put up — they wrote a strong dissent.

Let’s look at one little excerpt from that.

“The court today decides to save a statute Congress did not write. The court regards its strained statutory interpretation as judicial modesty. It is not. It amounts to a vast judicial overreaching.”

MARCIA COYLE: The four dissenters, as you pointed out, are the more conservative members of the court.

Justice Kennedy read a summary of it. It was unusual, because it was a joint dissent, and that means that no one of the four took responsibility for prime authorship. But they would have struck the entire statute. They didn’t find anything that could stand once they felt that the individual mandate and the Medicaid portion of the statute, which they said were essential to the statute achieving its reforms, once they felt that was unconstitutional, everything had to fall.

JEFFREY BROWN: All right, now, you just said Medicaid…


JEFFREY BROWN: … because this is another whole key part that we’re going to be exploring through the program tonight.

MARCIA COYLE: Yes, that’s a very important part.

JEFFREY BROWN: But explain. This — that part of the decision was 7-2.


The chief justice and six other justices came to the conclusion that because the statute threatened to withhold all existing Medicaid funds from those states that didn’t agree to participate in an expanded Medicaid program, that that crossed the line from inducement to coercion. But the court then, in another — in another association of justices, saved that…


JEFFREY BROWN: It was a confusing day.





MARCIA COYLE: What the chief did then was to say the program will not be struck down, but we will remove the threat, and that threat of withholding the existing funds.

By removing the threat, it is now the choice of the states whether they want to participate or not.

JEFFREY BROWN: Now, we’re going to go into that later in the program with Susan Dentzer.

But I just want to ask you. This was so anticipated, right? What did it feel like sitting there in the courtroom today?

MARCIA COYLE: Well, it was electric.

As soon as the buzzer went off that the court was coming through the red velvet curtains to take their seat, it was packed. Most of the justices’ spouses were sitting in the guest section. Even retired Justice John Paul Stevens showed up. When the entire office of the Office of Solicitor General came in, that also upped the electricity.

There were visiting senators in the audience. The press section was filled to overflowing, even behind the pillars and the regular pews. So, yes, it was quite electric.

The justices, though, seemed very calm, and actually most of them seemed tired.


JEFFREY BROWN: Well, their work is done for this term. Right?

MARCIA COYLE: Yes, it is. That’s right.

JEFFREY BROWN: Marcia Coyle of The National Law Journal, thanks, as always. My pleasure.