US Supreme Court decision: Key excerpts

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Key excerpts from the decision by the US Supreme Court to uphold a key component of US President Barack Obama's landmark healthcare reform act, called the "individual mandate". We also include some excerpts of the dissenting opinion.

From Chief Justice John Roberts' introduction:

We do not consider whether the Act embodies sound policies. That judgement is entrusted to the Nation's elected leaders. We ask only whether Congress has the power under the Constitution to enact the challenged provisions.

In this case, we must again determine whether the Constitution grants Congress powers it now asserts, but which many States and individuals believe it does not possess.

Why the anti-injunction Act does not apply

Congress did not intend the payment to be treated as a "tax" for purposes of the Anti-Injunction Act. The Affordable Care Act describes the payment as a "penalty," not a "tax". That label cannot control whether the payment is a tax for purposes of the Constitution, but it does determine the application of the Anti-Injunction Act. The Anti-Injunction Act therefore does not bar this suit.

Why it is unconstitutional under the Commerce clause

As expansive as this Court's cases construing the scope of the commerce power have been, they uniformly describe the power as reaching "activity"... The individual mandate, however, does not regulate existing commercial activity. It instead compels individuals to become active in commerce by purchasing a product... The Framers knew the difference between doing something and doing nothing. They gave Congress the power to regulate commerce, not to compel it. Ignoring that distinction would undermine the principle that the Federal Government is a government of limited and enumerated powers. The individual mandate thus cannot be sustained under Congress's power to "regulate Commerce".

Why it can be upheld as constitutional as a tax

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.

Excerpts from the dissenting opinion:

The Act before us here exceeds federal power both in mandating the purchase of health insurance and in denying non-consenting States all Medicaid funding. These parts of the Act are central to its design and operation, and all the Act's other provisions would not have been enacted without them.

It is not a tax

Against the mountain of evidence that the minimum coverage requirement is what the statute calls it - a requirement - and that the penalty for its violation is what the statute calls it - a penalty - the Government brings forward the flimsiest of indications to the contrary... to say that the Individual Mandate merely imposes a tax is not to interpret the statute but to rewrite it.

On why, if the individual mandate is unconstitutional, the entire Act falls

When we are confronted with such a so-called "Christmas tree", a law to which many non-germane ornaments have been attached, we think the proper rule must be that when the tree no longer exists, the ornaments are superfluous. We have no reliable basis for knowing which pieces of the Act would have passed on their own. It is certain that many of them would not have, and it is not a proper function of this Court to guess which.

Response to the decision to uphold

The Court today decides to save a statute Congress did not write. It rules that what the statute declares to be a requirement with a penalty is instead an option subject to a tax. And it changes the intentionally coercive sanction of a total cut-off of Medicaid funds to a supposedly non-coercive cut-off of only the incremental funds that the Act makes available. The Court regards its strained statutory interpretation as judicial modesty. It is not. It amounts instead to a vast judicial overreaching. It creates a debilitated, inoperable version of healthcare regulation that Congress did not enact and the public does not expect.

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