Roberts Vote Key In Upholding Health Care Law

The law was upheld thanks to Chief Justice John Roberts, who sided with the court's more liberal wing, on a very narrow grounds: Instead of saying Congress has the authority to regulate interstate commerce, they said Congress has the authority to levy taxes. And the penalty for people who do not have health care is a tax and therefore constitutional.

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LINDA WERTHEIMER, HOST:

This is MORNING EDITION from NPR News. I'm Linda Wertheimer.

RENEE MONTAGNE, HOST:

And I'm Renee Montagne. The Supreme Court has upheld the constitutionality of President Obama's health care law, wrapping up its term with one of the most consequential cases in decades. The opinions run hundreds of pages, and we'll be bringing you news and analysis all morning, and in fact, all day long here at NPR News. Right now, in our studio, we have NPR's Ari Shapiro. He'll be talking along with us, as well as NPR's Mara Liasson, about what we do know, even though this is very early in the game. These opinions were just released within the last half-hour. So, good morning to both of you.

ARI SHAPIRO, BYLINE: Good morning.

MARA LIASSON, BYLINE: Good morning.

MONTAGNE: Ari, let's start with you again. For those who just picked up on this, what is the main game here?

SHAPIRO: Big headline: the vote is upheld, thanks to Chief Justice John Roberts. I said the vote is upheld; the law, the health care law is upheld, thanks to Chief Justice John Roberts, who sided with the court's more liberal wing on a very narrow grounds. Instead of saying that the president had the authority, Congress had the authority to regulate interstate commerce, they said the Congress has the authority to levy taxes. And the penalty for people who do not have health care is, in fact, a tax. That way, the individual mandate requiring everyone to have health coverage by 2015 is constitutional.

MONTAGNE: So, the majority, and it includes Chief Justice John Roberts. He, in a way, moved to the other side in this one. The majority took a small version - almost not noticed version by most of us out here - of the argument.

SHAPIRO: To uphold the law. What's so interesting is that when this law was being debated in Congress, Republicans said, this is a tax, this is a tax. The White House is trying to raise your taxes. The Democrats are trying to raise your taxes. And President Obama and congressional Democrats said, no, no, no, no, no, no, no. This is not a tax. We're not trying to raise your taxes. And when they argued it before the Supreme Court, they said you should uphold this law based on the commerce clause, but, by the way, if you don't want to do that, this also happens to be a tax. And it turns out, that's what saved them.

WERTHEIMER: That's the argument relied upon by the chief justice, although the other four people in the majority opinion relied both on the commerce clause and on the Congress' power to taxes. Isn't that right, Ari?

SHAPIRO: Exactly. And the four conservative in dissent, led by Justice Anthony Kennedy, begin their dissent by saying, quote, "In our view, the entire act before us is invalid in its entirety." So, clearly, President Obama will be sending a big thank you note to Chief Justice John Roberts later today.

MONTAGNE: And could I go on, just before we go on, because this is so interesting. How surprised will everybody be?

You know, I think everybody had expected that it would either be a 5-4 decision along classic partisan lines, striking down the law, or people predicted it might be a six - three decision, with Chief Justice John Roberts and Justice Anthony Kennedy joining the court's more liberal wing. There is a lot of surprise this morning that Justice Anthony Kennedy was in the dissent and Chief Justice John Roberts sided with the court's more liberal wing in the majority.

WERTHEIMER: Leading the dissent, writing the dissent. Ari, what about this. Two of most popular things about this bill, one of which started early, was that the question of whether the bill permits the older children of insured people to be covered under their...

SHAPIRO: To stay on their parents' plan.

WERTHEIMER: ...parent's plan.

SHAPIRO: That survives.

WERTHEIMER: That survives. And...

SHAPIRO: And also another very popular thing, that people with preexisting conditions cannot be denied health coverage. That survives. In fact, the only thing that the court dramatically limited was the expansion of Medicaid, which in some ways was unrelated to these other provisions of the law. The expansion of Medicaid said: states, if you don't want to cover more people under Medicaid, then you lose all of your federal money from Medicaid. The court said, you can attach conditions to the money, but you can only withdrawal the new money, you can't withdrawal all the money, if people refuse to expand Medicaid.

WERTHEIMER: So the conditions only apply, really, to - I mean, under this ruling, the conditions only apply to new Medicaid money and not to the money the states already have.

SHAPIRO: Exactly, for the expansion.

MONTAGNE: And that had something to do with an argument against undue burdening...

SHAPIRO: Of the states. Yeah, well, all of this - on so many levels boiled down to states rights versus the federal government. And how far can the federal government go in requiring the states to do one thing or another.

WERTHEIMER: Now, here's - the most interesting questions, it seems to me, are political questions. I wonder about how this is going to affect the campaign. I wonder about - why, we can only speculate that perhaps the Supreme Court is in some way trying to rescue its standing in the country by not taking such a controversial decision.

LIASSON: Well, if you're asking me...

(LAUGHTER)

WERTHEIMER: And I am.

LIASSON: First of all, those things are impossible to know. It's really hard to know exactly what the political fallout will be beyond the most basic, simple top line of this, which is: this is great for the president. Anything that was overturned in this law, whole or in part, would have been a bad day for him. Now, why the Supreme Court did this, why John Roberts did this, what his motivation was, there's going to be books written that. I don't know if he's motivated by polling on the Supreme Court's standing among people. I mean, the Supreme Court standing had fallen in the most recent - I think it was Gallup and Pew had it coming down to about 37 percent; people having faith in it as an institution, about the same on par with the presidency - way above Congress.

But that - who knows why John Roberts, who Barak Obama voted against when he was a senator, did, in effect, pull his fat out of the fire and save this law. Now, the political ramifications of this, it's hard to know. I think that up until this morning, I always felt that either way was a good day for Mitt Romney. Now, the law's upheld. He says the only way we get rid of this is to elect me as president.

The motivating factor for a lot of the Republican base is to get rid of what they call Obamacare. Now, the only way they do that is by coming out and voting for Mitt Romney.

WERTHEIMER: Who would then have to go to Congress to get the law repealed.

LIASSON: Yeah, that's right. That's right, but..

WERTHEIMER: Which would not be an easy thing to do.

LIASSON: Well, he'll have a Republican House, he might have a Republican Senate. Who knows? He can certainly do a lot to defund it, to cripple it. There's a lot a president and Congress can do, but - so, he still gets the motivating, energizing force of a defeat on his side. And the president gets to say, he gets not to have the charge made about him that he was a failure, he wasted three years, he took his eye off the ball of the economy, and he was a constitutional law professor who couldn't even figure out what was constitutional. I mean, all of that - those attack ads that were on the shelf are not going to used against him.

MONTAGNE: Now, let me ask you another question. The polls have also shown that the Affordable Care Act, even for people it would seem to benefit, is not popular. The majority of Americans in some way, shape or form are not happy with it.

LIASSON: The law as a whole has never been popular. Individual provisions are - and that's pretty much what the president has always campaigned on - ow, you know, Republicans want to get rid of keeping your kids on your policy till you're 26; helping seniors with money to pay for drugs; you know, not allowing insurance companies to ban people with preexisting conditions.

MONTAGNE: All of which is popular.

LIASSON: All of which is popular.

MONTAGNE: But the mandate, the main - the heart of the law has not been...

LIASSON: And the question is, now the mandate is gone as an irritant. The court said, there's no mandate. There's no mandate. Nobody's forcing anyone to get health insurance. We're merely going to tax you if you don't have it. There is no mandate, no one's being forced to buy health insurance. You're merely being taxed just like we tax you in myriad other ways.

MONTAGNE: So, the very fact that the ruling came out in this particular way and also it now has the imprimatur - if you want - the approval of the Supreme Court, do you think that will affect, Mara, do you think - and Ari - do you think that will affect the general perception of this law? You've suggested certain in one way.

LIASSON: OK, I can imagine how it could, but every time we have said something was going to make the law more popular, we have been wrong. We said when the law goes into effect, when these popular provisions go into effect, the top line, popularity of this law has never changed. So, I would be very reluctant to say that the Supreme Court stamp of approval will change the popularity of the law.

SHAPIRO: Yeah. Democrats keep saying, we're going to talk about this, we're going to sell this, we're going to make this popular. They keep failing to do it. Now, they've got another tool in their arsenal to try and make it popular, but we'll see whether that has any effect.

MONTAGNE: Ari Shapiro, Mara Liasson, thanks very much for joining us. Of course, you're going to stay with us now because we're going to keep talking about this throughout the rest of MORNING EDITION, and also throughout the rest of the day on NPR News.

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