The Supreme Court has ruled 5-4 that the Affordable Care Act meets constitutional muster and can be allowed to continue its slow process of transforming the nation’s health care system.
Thursday’s historic decision, authored by Chief Justice Roberts, was by no means a fait accompli. Though the consensus among constitutional scholars has always been that the law’s insurance mandate did not exceed Congress’ Commerce Clause powers, its opponents erected a counterargument that quickly became an article of faith on the right. In the end, Roberts’ decision upheld the mandate as an exercise of Congress’ taxing power.
That’s right, Chief Justice John Roberts, the conservative judge appointed by George W. Bush, handed down the opinion with the liberal justices on this one. And yes, out in the twitter verse and right wing blogs, Republican heads are exploding over this. The Chief Justice’s reasoning:
“The Commerce Clause is not a general license to regulate an individual from cradle to grave, simply because he will predictably engage in particular transactions,” Roberts wrote. “Any police power to regulate individuals as such, as opposed to their activities, remains vested in the States.”
But Roberts nonetheless determined that, by allowing consumers to choose between purchasing insurance and paying a penalty, the mandate should be allowed to stand as an exercise of Congress’ taxing power.
“[I]t is estimated that four million people each year will choose to pay the IRS rather than buy insurance. We would expect Congress to be troubled by that prospect if such conduct were unlawful,” Roberts wrote in his controlling opinion. “That Congress apparently regards such extensive failure to comply with the mandate as tolerable suggests that Congress did not think it was creating four million outlaws. It suggests instead that the shared responsibility payment merely imposes a tax citizens may lawfully choose to pay in lieu of buying health insurance.”
Roberts went on: “Congress’s use of the Taxing Clause to encourage buying something is, by contrast, not new. Tax incentives already promote, for example, purchasing homes and professional educations. … 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.”
And the best part?
The ruling ends a Quixotic conservative quest to vanquish Obama’s signature achievement by fiat. It also devastates the GOP’s long-standing appeal to voters that the law exists as a monument to liberal overreach, in defiance of accepted limits on federal power. That Roberts, a conservative emissary to the Court, voted to uphold is particularly devastating.
There’s going to be a lot of talk today about who wins and loses politically. I’m more concerned about something else. Millions of Americans won today-those with preexisting conditions, those too poor to afford health insurance, those who would have been bankrupted by a major illness. They’re what matters here, not who’s going to win the White House, and as usual they were lost in the conversation in Washington and in the traditional media.
And credit where credit was due. I’ve generally been pretty harsh on John Roberts in the past. And yes, he has deserved it. But he took a principled approach here rather than an ideological one and he deserves applause for it. Besides, anyone who tells the “Let him die!” crowd to go jump in a lake is okay by me.
So yeah, this was a good day for millions of Americans. And let’s not forget to thank the man who made this all possible, the man who originally pioneered the individual mand

And let’s not forget that the moment you hand your state or Congress to the RedCoats…you lose!