In a narrow 5–4 decision, with Chief Justice John Roberts writing for the majority, the U.S. Supreme Court has upheld the constitutionality of the Patient Protection and Affordable Care Act. Opponents had argued that the “individual mandate,” which requires almost all U.S. citizens to buy health insurance, was an unlawful exercise of the Congress’s authority under the Commerce Clause. Although a 5–4 majority of the court agreed that the mandate was not supported by the Commerce Clause, by the same margin it ruled that the mandate can be supported as a valid exercise of Congress’s taxing authority. In a surprising twist, it was Justice Roberts, not perennial swing vote Justice Anthony Kennedy, who provided the decisive vote to uphold the mandate.

The other major issue in the case was whether Congress could expand the Medicaid program, effectively requiring states to spend more money on the program. A majority of the court held that the federal government can offer funds to expand the availability of health care and can require states that accept such funds to comply with conditions on their use, but states cannot be penalized if they choose not to participate in the new program by taking away their existing Medicaid funding.

The court decision effectively upholds all of the major provisions of the PPACA, including the employer provisions. ASA will present a Webinar for ASA members, July 12 at 2 p.m. Eastern time, to update staffing firms on efforts by the association to mitigate the effects of the employer provisions on the staffing industry and to discuss the political implications of the Supreme Court’s ruling on the fall elections.

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