A Good Outcome

The US Supreme Court this morning issued what was perhaps the most awaited decision in over a decade, and the result was a surprisingly good call on both policy and legal grounds.

Most importantly, the Court has upheld the so-called "indiviudal mandate" provision of the Affordable Care Act. I haven't read the complete Opinion, of course, but I did read the Court's 6-page Headnote (what SCOTUS likes to call a "Syllabus"). With what seems to me to be admirable legal dexterity, the Chief Justice found that Congress in the ACA had described the penalty for not purchasing indurance as precisely that - a penalty - rather than a tax. Hence, the Anti-Injunction Act (which requires payment of a tax prior to any suit challenging its constitutionality) does not apply in this case. On the other hand, according to the Chief Justice's opinion, Congress's not calling it a tax "cannot control whether the payment is a tax for purposes of the Constitution." This allowed the Chief Justice to argue that, while the Commerce Clause cannot be construed to permit regulating what individuals do not do and that therefore the "indiviudal mandate" cannot be sustained as an exercise of Congress's power to regulate commerce, it is constitutional as an exercise of Congress's taxing power.
Personally, I am not one of those worried about absurd hypotheticals - like being compelled to purchase broccoli. But this seems like a good solution - simultaneously saving the madate while avoiding a possibly problematic expansion of federal power. (Since there is no doubt that Congress can levy a tax, a tax is precisley what the Court has decided to call it).

The Court did weaken somewhat the Medicaid expansion part of the Affordable Care Act, by overturning not the actual expansion in Medicaid coverage but the penalty levied on states which choose not to participate.  So some state governments for ideological reasons may avail themselves of this loophole in order thus to deny many of their poorer citizens the benefits of the law. That would be unfortunate. Sooner or later, this country must find a way to protect everyone from the inability to access needed health care. But, with the precedent now set that there are constitutional ways to do this, sooner or later that goal should be attained. 

The Court's judgment is a great victory for the long-cherished goal of expanding Americans' access to health care coverage. The United States Catholic Bishops, for example, have supported decent health care for all and advocated action to advance that goal since 1919. As has become evident recently, there remain serious unresolved problems with ACA's lack of guaranteed protection for religious communities to exercise religious freedom. A lawsuit challenging the HHSD contraception madate has already been filed, which will likely make it to the Supreme Court in due time.
All that said, the Court - in particular, the Chief Justice - seems to have crafted a very satisfactory solution.