What the SCOTUS Ruling Means for Health Care

The Supreme Court has upheld the Affordable Care Act (ACA), a frustrating situation in which conservatives won the policy battle but lost the war over the Act. The Court held that Congress cannot use the Commerce Clause to compel commerce. The individual mandate qua mandate is unconstitutional. However, the Congress has the right to impose taxes (if not punitive and excessive), which permits the Obama administration to add a tax on millions of uninsured Americans in addition to the ACA’s already-massive tax burden on the middle class.

The Court ruled that a Medicaid expansion could be an unconstitutional federal coercion of the states, but this expansion does not have a penalty large enough to pass that threshold. Interestingly, the Court opened up the possibility that governors could refuse the Medicaid expansion. Those individuals that would have been added to the Medicaid rolls would then be eligible for subsidies in the exchanges. If all the governors refused the expansion, and if individuals take up subsidized insurance, the federal cost heads even farther north.
In a bit of a pyrrhic victory for us, the American Action Forum’s amicus briefs, signed by over 200 economists, were cited twice in the Court’s dissenting opinion. (See my amicus brief.)

Read more: http://www.nationalreview.com/corner/304302/what-scotus-ruling-means-health-care-douglas-holtz-eakin