Mixed Decision on Obamacare: Supreme Court Upholds Individual Mandate While Striking Down State Mandate for Medicaid Expansion

After reading (okay, I skimmed some parts) the majority, concurring and dissenting opinions in Unted States Supreme Court's decision in National Federation of Independent Business v. Sebelius, i.e. the decision on the Patient Protection and Affordable Care Act, i.e. "Obamacare," I have concluded that every clerk writing for appellate judges should have a mentor like I had in Indiana Court of Appeals Judge Paul H. Buchanan, Jr.   He insisted that we clerks write with clarity and brevity, using subheadings so that people could easily read and comprehend the decisions we wrote. Unfortunately that is the exception to the rule when it comes to appellate opinions, including the Obamacare case.  The good news is I think I can easily summarize what happened.

United States Supreme Court

ISSUES:  There were two of them addressed. First is the indivdual mandate, in particular the requirement that a person who is not covered by insurance policy through employer, or purchased individually, pay a "shared responsibility payment" when they pay their taxes, which amount initially will be the $695.   The second issue addressed was the PPACA's dramatic expansion of the state Medicaid programs which the federal government was going to mandate by threatening to cut off all Medicaid funding to states if they didn't expand the program.

DECISION ON INDIVIDUAL MANDATE:  Writing for the majority, Chief Justice Roberts found: 1) that Congress could not use the Interstate Commerce Clause within Article I, Section 8 as the authority to impose the mandate: 2) that Congress could not use the Necessary and Proper Clause (that clause at the end of the enumerated powers in Article I, Section 8 that grants Congress any additional power to carry out a power specifically listed) as justification even though it directly was not commerce.  3) that the individual mandate was a "tax" and that Congress has the power to impose the mandate through it power to Tax and Spend for the general welfare.

Ironically, when the individual mandate was before Congress, the Obama administration took pains to argue that the individual mandate was not a tax.   It was not called a tax in the legislation.  The fact Congress did not call it a "tax" was the basis by which Chief Justice Roberts said an anti-injunction law that prohibits the challenge of a "tax" did not apply.  However, when it came to the constitutionality of the tax, Chief Justice Roberts said the label did not matter.  The conclusion that the individual mandate is a tax is the sole factor saved Obamacare from being completely struck down.

The vote on #1, #2 and #3 above, as far as I can tell were 5-4.  Only on #3 did Justice Roberts break with the conservatives and vote with liberal justices, Ginsburg, Kagan, Sotomayer and Breyer.

DECISION ON STATE MANDATE FOR MEDICAID EXPANSION:  Chief Justice Roberts found that the Medicaid expansion part of the PPACA, which sought to punish states which didn't adopt the expansion by denying them all Medicaid funds, violated federalist principles.  Chief Justice Roberts said that while "relative mild encouragement" to encourage states to adopt certain programs favored by Congress is allowed under the Constitution, the state mandate in the PPACA amounted to a "gun to the head" of states. 

What is shocking to me is that the vote striking down of the Medicaid state mandate was 7-2.  Liberal Justices Breyer and Kagan crossed over to vote with Roberts and the conservatives on a vote in support of states rights.  Justices Ginsburg and Sotomayor dissented on the issue.