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In a 5-4 ruling, the Supreme Court upheld the individual mandate—the requirement that all Americans obtain health insurance by 2014—at the heart of the health-care law.
In voting to uphold the mandate, the justices ruled that a penalty for refusing to obtain health insurance amounts to a tax. But the court did not accept that the Anti-Injunction Act precludes a decision on the health-care law.
The court rejected the administration's commerce-clause argument, but ruled that Congress "has the power to impose" the individual mandate under its taxing authority. The provision "need not be read to do more than impose a tax," the opinion said. "This is sufficient to sustain it."
The justices found that the law's expansion of Medicaid can move forward, but not its provision that threatens states with the loss of their existing Medicaid funding if the states declined to comply with the expansion. The finding raises questions as to how effectively the federal government will be able to implement the expansion of the joint federal-state insurance program for the poor.