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Supreme Court upholds Affordable Care Act's major provisions

By , - Last modified: June 28, 2012 at 8:45 AM

The U.S. Supreme Court ruled 5-4 Thursday morning that the health care act is constitutional.

Chief Justice John Roberts joined Justices Stephen G. Breyer, Ruth Bader Ginsburg, Elena Kagan and Sonia Sotomayor. Dissenting were Justices Samuel Alito, Anthony Kennedy, Antonin Scalia and Clarence Thomas.

The legislation, titled the Patient Protection and Affordable Care Act (PPACA), was signed into law in March 2010, and the court had been deliberating on challenges to it since March.

The four main issues and rulings are as follows, based on reports from experts at

1. Anti-injunction. This centered on whether there could be a ruling on the case before anyone was required to actually pay the penalty. It wasn't expected to prevent a ruling, and didn't.

2. Individual mandate. The key provision of the PPACA is that most Americans must obtain health insurance or pay a penalty for failure to do so. The court upheld this, interpreting the individual mandate as a tax and finding that Congress does have power to impose it.

3. Severability. This centered on whether, if the individual mandate was struck down, other parts of the PPACA could still stand. The individual mandate was not struck down.

4. Medicaid expansion. The Act increases the number of Americans eligible for Medicaid and the federal government will supply states with 100 percent of the funds for expansion for the first three years, phasing to 90 percent federal funding in subsequent years. The court ruled that Congress may require states accepting those funds to comply with conditions on their use but may not penalize states that choose not to participate in the program by taking away existing Medicaid funding.

Stock tickers show that the Dow Jones, S&P 500 and NASDAQ all dipped after 10 a.m., with the NASDAQ taking the hardest hit, down nearly 1.6 percent by 11 a.m. As noon approached, however, all three indicators started recovering, down only about 1 percent.

The verdict was not the only thing the stock market is keeping an eye on today, however: Investors are also watching an impending European summit.

As expected, the Supreme Court's ruling brought strong reactions from both sides.

Antoinette Kraus, project director for the Pennsylvania Health Access Network, called the ruling "a victory for millions of Pennsylvania families, seniors and small-business owners."

"Young adults can remain on their parents' health plans, insurance companies cannot deny us when we get sick and our grandparents will continue to get help with their prescription coverage," Kraus said. "Millions of Americans have already benefited from the Affordable Care Act, and millions more will benefit from additional consumer protections and a new insurance marketplace that will provide affordable health care options to small businesses and families.

"Nearly 1.3 million uninsured Pennsylvanians will now be able to find quality affordable health coverage."

Matthew J. Brouillette is president of the Commonwealth Foundation, which describes itself as a free-market think tank. He doesn't see the ruling as cause for joy.

"Unfortunately, the Supreme Court has upheld a law that most Americans wanted to see repealed and believed to be unconstitutional," he said. "More government intrusion into our health care isn't going to solve our problems, but we certainly know this is going to end up breaking the bank at all levels of government.

"I think it's going to be the taxpayers that were sold a bill of goods," Brouillette continued. "Clearly the ruling runs in the face of the arguments made by the Obama administration; what they were sold as — 'leads to better, more affordable health care' – will not be realized, so it will be ultimately the citizens of America that will be most upset."

Brouillette predicted that, as the ramifications of the ruling become understood, states will "realize the unsustainable financial burden this will impose." He said he expects that, in response, proponents of less government in health care will make more reform proposals.

Click here to read the full text of the Supreme Court's opinion.


To get updates via Twitter, follow staff writer Heather Stauffer on Twitter, @StaufferCPBJ, or our main Twitter account, @CPBJ. And check back on this story throughout the day for updates on what the court's ruling will mean for your business.

From A breakdown of the PPACA

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