Critical Condition

Court Upholds What Congress Disavowed

The Supreme Court ruled that Obamacare’s individual mandate is not constitutional under the Commerce Clause, which was how Congress framed the mandate to avoid a political backlash from calling it a tax. Congress and the president swore up and down that the mandate was not a tax. Yet the Court upheld the mandate as a valid use of that disavowed taxing power. 

Where does that leave us? What Congress said the individual mandate is, the Court said is not constitutional. What Congress said the mandate is not, the Court ruled is constitutional. Everybody got that? And the Supreme Court just told Congress it is okay to lie to the people to avoid political accountability.

The key provision of the Court’s ruling on Obamacare’s Medicaid mandate is this: “Nothing in our opinion precludes Congress from offering funds under the Affordable Care Act 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.” This makes no sense. New Medicaid conditions can only come with new Medicaid money? Congress cannot reform Medicaid unless it spends more?

The silver lining to this ruling is that states have the power to block all of Obamacare’s new Medicaid funding, in addition to the employer mandate (tax!) and subsidies for private health-insurance companies.

Michael F. Cannon — Mr. Cannon is director of health-policy studies at the Cato Institute and co-author of Healthy Competition: What’s Holding Back Health Care and How to Free It.


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