Time to repeal it.
From SCOTUSblog’s liveblog:
Amy Howe: The individual mandate survives as a tax.
Tom: So the mandate is constitutional. Chief Justice Roberts joins the left of the Court.
Tom: The bottom line: the entire ACA is upheld, with the exception that the federal government’s power to terminate states’ Medicaid funds is narrowly read.
Now to get moving on repeal.
Update: This means that states can refuse to comply with it, and not be forced to by the government. This is not the great victory Obama wanted. The court is saying that he can pass a tax and force people to buy medical insurance, BUT–the individual states do not have to enforce it. If I’m interpreting the below correctly.
Lyle: The key comment on salvaging the Medicaid expansion is this (from Roberts): “Nothing in our opinion precludes Congress from offering funds under the ACA to expand the availability of health care, and requiring that states accepting such funds comply with the conditions on their use. What Congress is not free to do is to penalize States that choose not to participate in that new program by taking away their existing Medicaid funding.” (p. 55)
Amy Howe: Another way to think about Medicaid: the Constitution requires that states have a choice about whether to participate in the expansion of eligibility; if they decide not to, they can continue to receive funds for the rest of the program.
Update 2: Or not. Oops.
Tom: Apologies – you can’t refuse to pay the tax; typo. The only effect of not complying with the mandate is that you pay the tax.
Update 3: The analysis.
Amy Howe: In Plain English: The Affordable Care Act, including its individual mandate that virtually all Americans buy health insurance, is constitutional. There were not five votes to uphold it on the ground that Congress could use its power to regulate commerce between the states to require everyone to buy health insurance. However, five Justices agreed that the penalty that someone must pay if he refuses to buy insurance is a kind of tax that Congress can impose using its taxing power. That is all that matters. Because the mandate survives, the Court did not need to decide what other parts of the statute were constitutional, except for a provision that required states to comply with new eligibility requirements for Medicaid or risk losing their funding. On that question, the Court held that the provision is constitutional as long as states would only lose new funds if they didn’t comply with the new requirements, rather than all of their funding.