(CN) - The Supreme Court today upheld the constitutionality of health care reform, including a provision that requires most Americans to buy insurance, while four dissenting justices said the entire law should have been thrown out.
Chief Justice John Roberts joined a five-justice majority made up of the court's more liberal justices in upholding the so-called individual mandate of the Patient Protection and Affordable Care Act, which President Barack Obama signed in March 2010.
Though they agreed that the law was constitutional, Justices Ruth Bader Ginsburg, Sonia Sotomayor, Stephen Breyer and Elena Kagan argued for a more expansive interpretation of the law in a separate opinion. Justice Anthony Kennedy, who had been expected to cast the swing vote in the case, ultimately signed onto a joint dissent with Justices Antonin Scalia, Samuel Alito and Clarence Thomas.
A provision of health care reform known as the individual mandate took up most of the court's attention. Otherwise known as the minimum-coverage provision, it imposes penalties on eligible citizens who choose not to purchase health insurance. The provision is set to take effect in 2014, empowering the Internal Revenue Service to collect the penalty with an individual's taxes, just as it would collect a penalty against those who overstate their income tax refunds.
Roberts was the lone member of the majority to find that the provision violates the commerce clause of the U.S. Constitution, but all five agreed that the measure survived under taxing powers.
The government's commerce clause argument failed because the individual mandate does not regulate existing commercial activity, the 59-page decision states.
"It instead compels individuals to become active in commerce by purchasing a product, on the ground that their failure to do so affects interstate commerce," Roberts wrote. "Construing the commerce clause to permit Congress to regulate individuals precisely because they are doing nothing would open a new and potentially vast domain to congressional authority. Every day individuals do not do an infinite number of things. In some cases they decide not to do something; in others they simply fail to do it. Allowing Congress to justify federal regulation by pointing to the effect of inaction on commerce would bring countless decisions an individual could potentially make within the scope of federal regulation, and - under the government's theory - empower Congress to make those decisions for him." (Emphasis in original.)
Such logic could justify mandating that Americans eat a balanced diet, the court said, noting that this group has more members and also adds to health care costs.
"People, for reasons of their own, often fail to do things that would be good for them or good for society," Roberts wrote. "Those failures - joined with the similar failures of others - can readily have a substantial effect on interstate commerce. Under the government's logic, that authorizes Congress to use its commerce power to compel citizens to act as the government would have them act.
"That is not the country the framers of our Constitution envisioned."
Roberts also refused to let the government justify the individual mandate under the necessary-and-proper clause of the Constitution, but the majority was more receptive to the government's taxing powers.
They noted that "the government asks us to read the mandate not as ordering individuals to buy insurance, but rather as imposing a tax on those who do not buy that product."