The Supreme Court upheld the federal health care law Thursday in a complex 5-4 opinion that ruled that the individual mandate, the requirement that individuals purchase insurance or pay a fine, was unconstitutional under the interpretation of the Commerce Clause. However, the provision is held constitutional under Congress’ power to levy a tax.
University of South Carolina political science professor Mark Tompkins, who studies healthcare politics and policy said today after the ruling was announced, “Congress has the power to tell you either you have th have an (health) insurance policy or you have to pay a tax to account for the fact that you basically trying to catch a free ride on the healthcare system; so there is a tax you have to pay if you don’t have health insurance. If you do have health insurance then you don’t have to pay that tax.”
Beginning in 2014, those who do not comply with the mandate must make a “shared responsibility payment” to the federal government.
With the Commerce Clause getting bound up in ideological controversies over the past couple of years, Tompkins said the strongest and most compelling case for Congress passing the healthcare law was for the majority of justices to interpret the individual mandate as a tax.
“The tax argument is a simpler argument in law and therefore it’s an appealing one for proponents of health reform, and an appealing one for the Court not to get itself in the middle of a tough and very polarizing political fight,” said Tompkins.
Tompkins says persons with pre-existing conditions and adult children under the age of 26 who are still on their parents’ insurance plan are probably relieved following the court’s decision.
Tomkins said, “It’s possible you could imagine a scenario where the mandate was overturned, but some of the other coverage changes were left in place; but that’s not what happened. They have upheld the mandate and so all those other coverage expansions are still in place.”
While the individual mandate remains 18 months away from implementation, many other provisions already have gone into effect, such as free wellness exams for seniors and allowing children up to age 26 to remain on their parents’ health insurance policies.