Skadden Arps – Supreme Court Narrowly Upholds Health Reform Law but Limits Congress’ Authority Over States

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6 June 2012 – The Supreme Court issued a divided ruling on the core provisions of the Patient Protection and Affordable Care Act. The Court upheld the so-called individual mandate,1 finding that although the mandate violated the Commerce clause of the Constitution, the mandate was a constitutional exercise of Congress’ taxing power.

While this ruling enabled the Court to leave the Act’s significant health insurance reform measures in place, a majority of the Justices also found that the Act’s Medicaid program expansion violates Congress’ spending authority by predicating federal Medicaid funding — including funding for existing programs — on a state’s acceptance of the terms of the expansion. The court found that the remedy for this violation was to preclude Congress from placing current Medicaid funding in jeopardy for states that decline to expand

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