Supreme Court Upholds Key Part of Obama Health Law

A person carries an American flag while marching in favor of the Patient Protection and Affordable Care Act in front of the U.S. Supreme Court.

The Supreme Court has upheld the individual insurance requirement at the heart of President Barack Obama's health care overhaul.

Obama described the 5-4 decision to uphold the Affordable Care Act as a victory for “people all over this country.” The historic overhaul that aims to cover more than 30 million uninsured Americans will go into effect over several years.

Acknowleging the law had been the source of rancor among parties, Obama said shortly after the decision that he didn't push for the health care reform because it was politically popular.

"I did it because I believed it was good for the country," he said.

The court said the expansion of Medicaid could proceed as long as the federal government does not penalize states if they don't participate in the program by taking away their existing funding. 

The court's four liberal justices, Stephen Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor, joined Roberts in the outcome.

Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas dissented.

GOP presidential hopeful Mitt Romney vowed to repeal so-called Obamacare if he is elected president, saying the “job killer” policy puts “the federal government between you and your doctor.”

 “If we want to get rid of Obamacare, we’re going to have to replace President Obama.” he said.

The main goal of ACA has been to reduce the number of uninsured, make health care more affordable and cut down on overall health care costs.

While the focus has been on the constitutionality of the individual mandate — that is mandating people to buy health insurance —  that is just one part of the health care law. The law would also expand Medicaid, provide insurance for people with pre-existing conditions, create health care exchanges — a marketplace where people without insurance or too poor to buy it on their own can pool their purchasing power — and extend family coverage for young adults up to age 26.

The arguments in March marked out potential legal signposts for the three paths. The justices heard questions on terminology — in other words is “Obamacare” a “tax.”

A 1876 law called the Anti-Injunction Act prevents people from challenging the constitutionality of a tax before the tax has been collected. The ACA does not kick in until 2014 and the first tax returns that would reflect penalties as a result of ACA wouldn’t be until 2015, so it would be too early for the court to hear a case on ACA.

The argument for striking down the individual mandate hinged on whether the federal government could force people to buy health insurance. The government argued health care is different from any other product, and requiring people to buy it would not open the door for Congress to require the purchase of other goods and services. Using the commerce clause, the government’s lawyer argued Congress has the authority to regulate interstate commerce, and could force people to purchase health insurance in the name of regulating such commerce.

The lawyer representing Florida and 25 other states challenging the law argued if the federal government could force citizens to purchase insurance, it could then force people to buy anything.

The lawyer for the states also argued that if you strike down the individual mandate — the pillar on which all the other ACA reforms stand — the court should strike down the entire act, arguing it would be a “hollowed-out shell” without the mandate. The justices questioned lawyers on whether the individual mandate was “severable” from the other provisions of ACA.

After Thursday, the Supreme Court won’t meet again until October.

With the Associated Press