“The Affordable Care Act’s requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax,” Chief Justice Roberts wrote in the majority opinion. “Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness.”
At the same time, the court rejected the argument that the administration had pressed most vigorously in support of the law, that its individual healthcare mandate was justified by Congress’s power to regulate interstate commerce. The vote was again 5 to 4, but in this instance Chief Justice Roberts and the court’s four more conservative members were in agreement.
The court also substantially limited the law’s expansion of Medicaid, the federal-state program that provides health care to poor and disabled people. Seven justices agreed that Congress had exceeded its constitutional authority by coercing states into participating in the expansion by threatening them with the loss of existing federal payments.
The court’s ruling was the most significant decision since the New Deal and the most closely watched case since Bush v. Gore in 2000. It was a crucial milestone for the law, the Patient Protection and Affordable Care Act of 2010, allowing almost all of its changes to roll forward. According to the law, in 2016, the first year the tax will be fully in effect, it amounts to $695 for an
individual and $2,085 for a family, or 2.5% of household income - whichever is
larger. The biggest obstacle in 2016 for the Government will be figuring out how to impose the tax.


