As reported earlier, the Supreme Court (SCOTUS) upheld the vast majority of the Patient Protection and Affordable Care Act, sometimes referred to Obama Care. Chief Justice Roberts, who wrote the majority opinion, joined with the 4 so called "liberal justices", Ginsburg, Breyer, Sotomayor and Kagan as to Parts I, II, and III-C. Justices Scalia, Kennedy, Thomas and Alito dissented.
The main issue addressed was that of the individual mandate, requiring individuals to have insurance, or pay a penalty/tax if they do not . Roberts found that the individual mandate is NOT a valid exercise of Congress's power under the Commerce Clause and the Necessary and Proper Clause. "Construing the Commerce Clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority", and would be unconstitutional. However, Roberts found "that the individual mandate MUST be construed as imposing a tax on those who do not have health insurance, if such construction is reasonable." He found it to be a tax, and thus constitutional.
The other area addressed was that of Medicaid expansion at the state level, The law gives the Secretary of Health and Human Services "the authority to penalize States that choose not to participate in the Medicaid expansion by taking away their existing Medicaid funding." Roberts, in a complicated plurality opinion, found that this portion is unconstitutional, and struck down the provision that allows HHS to withhold all Medicaid funds. States that do not agree to the expansion will not have their existing Medicaid funds withdrawn.
Practice pointer. This is a very long and complex opinion, and many questions are still not answered. Obama Care will stay a focal point of the upcoming elections, and much will be said and written about it. The law is still being gradually implemented, with the mandate not effective until 2014. Time will tell what the real impact of this law will be on employers, individuals and the government.