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The U.S. Supreme Court upheld the majority of the Affordable Care Act in a 5-4 decision on Thursday With Chief Justice John Roberts. writing the majority opinion, the court upheld the central component of the law — the individual mandate — which requires that most Americans have health insurance or pay a penalty. The court determined that the law was constitutional based on Congress's power to tax, but not its power to regulate interstate commerce. The decision should allow most of the law's more expansive changes to proceed, the bulk of which are scheduled to take effect in 2014. Part of the law that expanded Medicaid by threatening non-cooperating states with cuts to their Medicaid funding was struck down.
COMMENT: The decision was great news for those who feel that the United States should assure fair and equitable medical care for all of its residents. The feeling of most health policy gurus is that only if all are paying into the system so that the young and well can lower the costs of the older and disabled. For conservatives this is European-style socialism. For those of us who care for the poor and uninsured their mostly preventable disabilities and deaths are inexcusable for any developed country. The act is not perfect, but is the first major national overall of the health system since the sixties.