After the US Supreme Court [official website] upheld the Patient Protection and Affordable Care Act (PPACA) [text; JURIST backgrounder] on Thursday, reactions from lawmakers and parties of interest inundated press coverage. US President Barack Obama [official website], who has made the implementation of PPACA a cornerstone of his administration, held a press conference on the decision [video; transcript], praising the court for "reaffirm[ing] a fundamental principle that here in America—in the wealthiest nation on Earth—no illness or accident should lead to any family’s financial ruin." Several of the losing parties, 26 states and the National Federation of Independent Businesses (NFIB) [advocacy website], expressed their unhappiness with the decision. The NFIB suggested [press release] that "Americans have lost the right to be left alone" and that they will continue to back the law's potential repeal in Congress. Indeed, several lawmakers vowed to repeal PPACA, including Speaker of the House John Boehner [press release]. Others agreed that although the court ruled the law constitutional, they believe it is not good policy [AP report]. Virginia Attorney General Ken Cuccinelli [official website], who spearheaded the initial suit, appreciated the opinion [press release], if not the ultimate conclusion it reached on PPACA:
My initial reaction when the decision was announced that the insurance mandate was upheld was that it was a dark day for the Constitution and for American liberty. However, upon analyzing the 193 pages of opinions from the court, I contend that—while I do not agree with the majority's result—there was a silver lining in that the court affirmed that the Commerce Clause—the constitutional vehicle the federal government was attempting to use to compel citizens to buy health insurance—only allows Congress to regulate people who are currently engaged in commercial activity. In this way, the court affirmed that there ARE constitutional limits to Congress's power. This represents the court's first express acknowledgement of the actual limits on the federal government's commerce power since the New Deal.The decision was hailed in many circles for the practical implementation of PPACA, regardless of the reasoning behind it, including by the American Civil Liberties Union (ACLU) [advocacy website] which said [press release]: "The decision is especially welcome for disadvantaged minorities, who are more likely to be uninsured, and for women, who are more likely to suffer gaps and discrimination in their health care coverage." Retired Justice John Paul Stevens attended the announcement of the decision [AP report] though he and the other two retired justices, Sandra Day O'Connor and David Souter, have not commented on the holding.
On Thursday, the Supreme Court upheld PPACA [JURIST report] in a 5-4 decision, which many have described as a 1-4-4 decision due to Chief Justice John Roberts' controlling majority opinion. Roberts found that the law's mandate to purchase health care or receive a fine was permissible under Congress' taxing power [Cornell LII backgrounder]. His opinion delineated that he did not believe it was constitutional under the Commerce Clause [Cornell LII backgrounder], although the four justices who joined his opinion wrote separately to suggest that the mandate was valid under that reasoning as well. The four justices in dissent argued that the entire act was invalid under any reasoning because the mandate could not be severed from the rest of the Act, and the mandate was unconstitutional. The majority opinion also narrowly construed the application of the PPACA to the states' rights to control Medicaid funds.