In a series of complicated majority and minority opinions totaling 193 pages, the United States Supreme Court has upheld the constitutionality of the individual mandate under the Patient Protection and Affordable Care Act (“ACA”) by a 5-4 vote. Chief Justice John Roberts wrote the majority opinion, in which the individual mandate was upheld under the Taxing Clause of the U.S. Constitution, not the Commerce Clause.
However, the Court ruled that the ACA cannot threaten the loss of federal funding to states declining to comply with the proposed expansion of the Medicaid program. This provision, Section 1396c of the ACA, was held to be unconstitutional under the Spending Clause. This means that the federal government cannot apply Section 1396c to withdraw existing Medicaid funds from states for failure to comply with the expansion.
We will provide a detailed update on the entire decision in the upcoming days