1. RunningHead: U.S. Supreme CourtDecision onthe Affordable Care Act
An Opinion on the U.S. Supreme Court Decision on the Affordable Care Act
Ardavan A. Shahroodi
Northeastern University
Professor James J. Ferriter
HMG 6110- The Organization, Administration, Financing and History of Health Care in the U.S.
Written Assignment
Friday, May 10, 2013

2. U.S. Supreme CourtDecisiononthe Affordable Care Act
In my opinion, U.S. Supreme Court’s decision on the Affordable Care Act (ACA) is a
respectable, level-headed, well-reasoned, non-partisan and in the best traditions of the American
system of jurisprudence. In the most significant section of the decision, the Court has ruled that
Congress has indeed the authority “to mandate that an individual either maintain a minimum
level of health insurance or face a monetary penalty” (Barr, August 2012) under Article I,
Section 8 of the Constitution that grant such body the right “…To lay and collect Taxes…To
regulate Commerce…To make all Laws which shall be necessary…for carrying into Execution
the foregoing Powers” (The U.S. Constitution).
In a most insightful line of reasoning, the Court (Supreme Court Opinion on ACA, p. 30)
grants that “The commerce power thus does not authorize the mandate” (as cited in Barr, August
2012). In other words, the Court states, “The Framers…gave Congress the power to regulate
commerce, not to compel it” (Supreme Court Opinion on ACA, Syllabus, p. 3). This, the Court
argues “would open a new and potentially vast domain to Congressional authority” (Supreme
Court Opinion on ACA, Syllabus, p. 3) that in their opinion would be unconstitutional.
Nevertheless, the Court contends that the Constitution does permit Congress “to assess a
financial penalty for those who decide, of their own accord, not to take a specific action” (Barr,
August 2012). Consequently, the Court decides that ACA’s “requirement that certain individuals
pay a financial penalty for not obtaining health insurance may reasonably be characterized as a
tax” (Supreme Court Opinion on ACA, Syllabus, p. 3) and Congress clearly possesses such
powers and therefore this law is constitutional.
In the other significant portion of the Supreme Court decision, ACA’s requirement that
states either accept “the expansion of Medicaid to all persons who are citizens or permanent
residents and who have incomes below 133% of the federal poverty lines” (Barr, August 2012)

3. U.S. Supreme CourtDecisiononthe Affordable Care Act
or “drop out of Medicaid program altogether” (Ibid) is deemed as unconstitutional. Again here,
the court is applying a similar standard of the undesirability and unconstitutionality of “coercive”
(Barr, August 2012) measures in the application of governmental policy.
Nevertheless, Barr (August 2012) does bring to our attention that “Fifty-five percent of
all Medicaid spending goes to provide care for the sickest 5 percent of enrollees” and “75 percent
of beneficiaries…account for only one-third of Medicaid costs”. This is significant since the
great majority of those that would be eligible to acquire Medicaid insurance under ACA
“generally have low per capita cost” (Barr, August 2012). Barr (August 2012) argues that
internal constituencies such as hospitals who receive funding from the Medicare program in
order to cover the cost of the treated uninsured and those who would have been covered under
ACA would bring pressure with the ultimate purpose of the states joining the ACA.
In all accounts, the Court’s decision is a moderate interpretation of the Constitution that
does not create new law in an unfamiliar philosophical direction. In rendering her opinion, the
Court is using generally acceptable standards recognized as valid by all reasonable political
persuasions such as the right of Congress to regulate commerce or levy taxes or not to depend on
coercive measures in order to ensure compliance. This expression of judicial restraint is very
much evident in the statement that “When a court confronts an unconstitutional statue, its
endeavor must be to conserve, not destroy, the legislation” (Supreme Court Opinion on ACA,
2012, p. 6). In light of the incredible and unnecessary controversy surrounding this
indispensable piece of legislation, in addition to Supreme Court’s own tendency in recent years
to engage in heightened partisanship and thereby compromising her valued impartiality, this
particular decision may indicate the dawn of a new era of regained credibility.

4. U.S. Supreme CourtDecisiononthe Affordable Care Act
References
Barr, D. A. (2011). Introduction to U.S. Health Policy: The organization, financing, and
delivery of health care in America (3rd ed.). Updated information on the action by the
U.S. Supreme Court in response to legal challenges to the Affordable Care Act (August
2012). Baltimore, MD: The Johns Hopkins University Press.
National Federation of Independent Business v. Sebelius (Supreme Court of the United States,
June 28, 2012).
The United States Constitution