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Supreme Court Rules on Affordable Care Act

The Supreme Court upheld the most controversial portion of the healthcare law, the individual mandate, but limited the Medicaid expansion provisions of the new law.

The key provision of the law, the individual mandate, which requires most Americans to buy health insurance meeting minimum Federal standards or be fined if they refuse, was upheld on a 5-4 decision. The court ruled that although the individual mandate was not protected under the commerce clause of the Constitution, the mandate could be upheld under Congress’ taxing power. The 5-4 decision split largely along party lines, with Chief Justice John Roberts siding with the majority. Provisions such as the one that helps close the gap in seniors’ Medicare drug coverage and another that requires employers with 50 or more workers to provide health insurance will also be upheld.

The justices greatly restricted the health care law’s Medicaid expansion provision. The provision would have expanded Medicaid coverage to an estimated 17 million individuals under the age of 65. The ruling will give states more flexibility with the decision of whether or not to expand their Medicaid programs.

"The court today limits the financial pressure the secretary may apply to induce states to accept the terms of the Medicaid expansion,” states the ruling. “As a practical matter, that means states may now choose to reject the expansion; that is the whole point. But that does not mean all or even any will."

Democrats largely applauded the Supreme Court ruling, while many Republicans in the House and Senate emphasized their commitment to repealing the law. House Majority Leader Eric Cantor, (R-Va.) announced that the House of Representatives will vote July 11 on full repeal. Even if the House votes in favor of repealing the complete law, the U.S. Senate is unlikely to do the same.

Read the full Supreme Court decision on the Affordable Care Act.

Read Reactions to the Ruling by Companies and Organizations


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