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Supreme Court mostly upholds Affordable Care Act

Updated 12:43 PM: Jeremy Lazarus, MD, president of the American Medical Association, also expressed his support for the Supreme Court's ruling. Saying in a statement that the decision "protects important improvements" to our health-care system, Lazarus also pointed out that the changes "have been made while maintaining our American system with both private and public insurers.”


Updated 10:38 AM: Terrific analysis from Swampland's Kate Pickert on today's "winners" and "losers." (Among those in the former category? The sick and uninsured.)


Updated 9:44 AM: I’ve been waiting for NPR correspondent Nina Totenberg, who always makes complicated legal cases easier to understand, to weigh in on today’s announcement. She did so earlier this morning, calling the decision a surprise ("Almost every prognostication was wrong") and commenting on the implications of the Medicaid ruling: "I would imagine that it will be the rare state that doesn’t accept the Medicaid expansion – but they don’t have to."


Updated 9:16 AM: President Barack Obama is now speaking about the high court's decision. Among his opening comments:

Whatever the politics, today's decision was a victory for people all over this country whose lives will be more secure because of this law and the Supreme Court's decision to uphold it.


Updated 8:11 AM: Darrell Kirch, MD, president and CEO of the Association of American Medical Colleges, provides his thoughts on the Supreme Court's ruling:

The AAMC is extremely pleased that the Supreme Court has upheld virtually all of the Affordable Care Act (ACA). This law is an important step toward an improved health care system that gives all Americans access to the care they need when they need it. However, we are closely examining the court’s ruling as it relates to the Medicaid expansion...

He goes on to discuss the importance of fixing our country's physician shortage, saying that we must "ensure that Americans have access to care - not just an insurance card."


Updated 7:47 AM: Politics Now is offering more insight on the Medicaid piece of the decision:

Chief Justice Roberts, who wrote the opinion for a 5-4 majority, said the required expansion of Medicaid violates states’ rights may be unconstitutional.

“The states are given no choice in this case. They must either accept a basic change in the nature of Medicaid or risk losing all Medicaid funding,” he wrote.

He said the federal government cannot require the states to follow this part of the law.


Updated 7:42 AM: The full decision (.pdf) has been posted on the Supreme Court's website.


Updated 7:35 AM: Amy Howe of SCOTUSblog offers more of an explanation on the decision:

The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn't comply with the new requirements, rather than all of their funding.


7:29 AM: This morning, the U.S. Supreme Court announced its decision on the Affordable Care Act.

From SCOTUSblog:

The bottom line: the entire ACA is upheld, with the exception that the federal government's power to terminate states' Medicaid funds is narrowly read.

We'll be sharing additional comments and analysis from Stanford as they become available.

Previously: The Supreme Court on health reform: Summing up, Health reform opponents lose in another appellate court and Thoughts on the Eleventh Circuit health-care law ruling
Photo by Mark Fischer

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