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By Andy Hirsch
LEWISBURG, Pa. — Scott Meinke, associate professor of political science, discusses the Supreme Court ruling on the Affordable Care Act.
Question: What's interesting about the health care decision from the perspective of a Court watcher?
Answer: First, the fact that Chief Justice John Roberts joined four more liberal justices in the core ruling that upheld most of the ACA (Affordable Care Act) was somewhat surprising. In doing so, he became the swing vote in a 5-justice majority. The Court's usual swing-voter in 5-4 decisions, Justice Anthony Kennedy, voted with three conservative justices to strike down the law in its entirety. The Chief Justice's decision might reflect not only his views about the law in question but also his concern about the Court's public legitimacy and his views about the Court's role.
Although the headlines today will read "Supreme Court Upholds Obamacare 5-4," it's important to note that the Court split in several different ways on a series of questions. Five justices — the five more conservative justices, including the Chief — held that the federal government's power to regulate commerce did not justify the mandate requiring Americans to buy health insurance. But it was the four liberals who provided the majority for allowing that mandate (and the penalty for violating it) to stand as a constitutional use of the government's taxing power. Roberts is the only justice who held both of these views.
The Obama Administration also lost — in part — on one important issue. The ACA included an expansion of Medicaid, which the government administers jointly with the states. Under the ACA, states that chose not to participate in the expansion could lose all of their federal Medicaid dollars. Only two justices would have upheld that provision outright. Roberts' opinion for the Court explains that the Medicaid expansion can stand, and the government can withhold funding from states that don't participate — but only the funding associated with the expansion itself. This is at least a small victory for the opponents of the health care law and it, along with Justice Roberts' arguments against using the commerce power to support the insurance mandate, seem to suggest some new limits on federal power.
Q: What are the political implications of the Court's ruling?
A: In the long run, today's result obviously is more important for its policy implications than for electoral politics. But I think the politics might be oversold in the short run too. We'll see a slew of stories in the next few days about what this does for Democrats' or Republicans' chances in the fall. I doubt that it changes the electoral playing field much at all, and not just because it mostly leaves the status quo in place. Most people who would be influenced by their outrage or enthusiasm over this issue (or by other people's outrage or enthusiasm) have long ago decided (a) that they are going to vote and (b) which candidate they will support, and it's hard to imagine how a ruling for either side today would change that much.
Q: What happens now?
A: The efforts at the state and federal levels to implement the law — most of which will be in effect by 2014 — will continue to go forward, and with a bit more certainty now except on the Medicaid expansion issue. But there will likely still be efforts to repeal the law through the political process. If Republicans keep the House and win the Senate and the Presidency in November, I'd expect to see a serious effort to repeal the law. And if Romney is elected but does not have a unified Republican Congress, he may choose to limit the law's implementation through executive action.
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