Chief Justice Roberts, regarded
as one of the more conservative members of the United States Supreme Court,
announced that one of the key elements of the Patient Protection and Affordable
Care Act of 2010 a/k/a the Health Care Reform Act – the individual mandate is constitutional. Another element – Medicaid Expansion Sanction
– was declared unconstitutional, and the Government was barred from sanctioning
States for failing to expand their Medicaid Programs.
This is an apparent loss for Conservatives who argued that
the Health Care Reform Act exceeded the powers granted to the federal Government
under the Constitution. In fact, Chief
Justice Roberts applied well-settled principles of Constitutional law in
analyzing the constitutionality of the Individual Mandate. He concluded that the Individual Mandate is a
tax, and the Constitution clearly grants Congress the power to impose taxes.
Actually, this opinion is a victory for Conservatives and
advocates of states rights. In a portion
of the opinion that will most likely receive less notice, Chief Justice Roberts
reigned in the ability for the federal government to use federal funds to force
states to participate in programs.
Although Congress is free to use funds as an incentive, it cannot use
the threat of denial of funds as a penalty.
In an apparent effort to fend off criticism from his
conservative supporters, Justice Roberts opened his opinion with the statement
that:
We do not consider whether
the Act embodies sound policies. That
judgment is entrusted to the Nation’s elected leaders.
He concluded his opinion with the following statement:
The Framers created a
Federal Government of limited powers, and assigned to this Court the duty of
enforcing those limits. The Court does
so today. But the Court does not express
any opinion on the wisdom of the Affordable Care Act. Under the Constitution, that judgment is
reserved to the people.
Hidden in the decision are
many fundamental principles that will likely be cited by the Court in future
years. Here are some key elements:
The “individual mandate”
provision of the Healthcare Reform Act requires all Americans to maintain
“minimum essential” healthcare insurance coverage.
·
The Commerce Clause allows Congress to regulate
activity. It does not allow Congress to
regulate inactivity.
·
“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.”
·
Congress cannot compel individuals to engage in
activity on the ground that their failure to do so affects interstate commerce.
·
The Commerce Clause does not permit Congress to
mandate participation in commerce.
·
“People,
for reasons of their own, often fail to do things that would be good for them
or good for society.” Congress does not
have the authority under the Commerce Clause to force people to act or do what
Congress believes is best for them.
·
The “Necessary and Proper” Clause is not an
independent grant of authority to Congress.
That interpretation would literally gut the federal system of
government.
·
The Necessary and Proper Clause has always been
interpreted as supplementing the specific powers granted by the Constitution.
·
If it looks like a tax, it is a tax regardless
of what Congress called it.
·
Taxes may be levied whether or not the
individual engages in an activity.
·
Permitting the Federal Government to force the
States to implement a federal program would threaten the political accountability
key to our federal system.
·
Congress
can use financial rewards as a carrot to encourage states to adopt programs
but, the state must have a legitimate choice as to whether to accept federal
funds.
·
Congress is able to use conditions of the use of
funds as a carrot.
·
Congress cannot use the threat to terminate
other independent programs to “coerce” behavior.
·
Calling the penalty a “gun to the head,” Justice
Roberts noted that the Medicaid expansion mandated by the Act would result in the loss
of 20% of some State budgets. This
penalty makes the condition an unconstitutional “coercion” and not a carrot.
·
Congress cannot impose post-acceptance or
“retroactive” conditions upon States once they accept a program.
See Decision.
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