Stanford Law Faculty React to Health Care Ruling

Stanford Law School's constitutional experts sound off over the historic SCOTUS ruling on the Affordable Care Act Thursday.


  1. In a 5-4 vote Thursday, the Supreme Court chose to uphold the controversial Affordable Care Act. Chief Justice John Roberts wrote the majority opinion claiming the law was a valid exercise of Congress’s power to tax.
  2. The Stanford Supreme Court Litigation Clinic's Thomas Goldstein, founder of SCOTUS blog, discussed the historic decision with Bloomberg News and other media outlets breaking down the "taxing power" portion of the decision. 
  3. Goldstein: What Conservatives Won in the Health Care Case
  4.     In his reaction to the decision Professor Tino Cuéllar, co-director of the Stanford Center for International Security and Cooperation, noted the historical importance of Chief Justice Roberts vote.
     "There is more to this Supreme Court than Justice Kennedy. At a time when questions about the scope of federal power have engaged much of the nation, it's enormously significant that Chief Justice Roberts just led a majority of the Supreme Court to uphold one of President Obama's signature initiatives. Courts are enormously important institutions in our system of separated powers. But the decision also underscores how the judiciary is a complicated setting where cases have multiple dimensions and statutes are interpreted in light of concerns about federalism and about the proper role of courts relative to elected representatives."
  5. Professor Michael McConnell, director of the Stanford Constitutional Law Center and co-author of the book, The Constitution of the United States  also weighed in on the justices' decision declaring it a "great day for constitutional principle."

  6. Michael McConnell, director of the Stanford Constitutional Law Center: Today was a great day for constitutional principle, not such a great day for sound health care policy. In an extraordinary display of legal dexterity, Chief Justice John Roberts crafted an opinion that left the ironically named “Affordable Care Act” mostly intact, while at the same time reaffirming — indeed strengthening — the limited nature of federal power under the Constitution. By a 5-4 vote, the Court rejected the Administration’s claim that the power to regulate commerce among the states is broad enough to require unwilling individuals to purchase private health insurance. And perhaps more significantly, an even more decisive 7-2 majority held that Congress cannot compel states to participate in a new or greatly expanded federal program by threat of revoking prior benefits. Only by defining the Act’s penalty provisions as a “tax” — directly contrary to President Obana’s assurances at the time of enactment — did the Court uphold the mandate. That ruling may twist the language of the statute a bit, but it does not enlarge or distort the constitutional powers of Congress. The Chief Justice thus scrupulously avoided interfering with the policy decisions of Congress. Those who had hoped a decision against the Act would give Congress a second shot at passing genuine health care reform must be disappointed, but it is not the Court’s role to rescue the nation from improvident policies. As an exercise in constitutional jurisprudence, which is the Court’s proper role, the decision deserves high praise. Both sides in this conflict can correctly claim victory. President Obama’s signature legislative achievement survived constitutional challenge, but on the narrowest of rationales. On both Commerce Clause and Spending Clause issues, the challengers won the case
  7. Professor Pam Karlan, co-director of the Supreme Court Litigation Clinic, offered her impressions of the justices' opinion and the dissent in a Q&A with David V. Johnson of the Boston Review

  8. I’m not surprised by this. What actually surprises me is two things. One is that the vote was 5-4. I would have expected it to be 6-3 on the taxing issue—that is, I would have expected Chief Justice Roberts would have brought Justice Kennedy along on that. So that’s the first thing that’s surprising.
  9. PK: One thing that’s very interesting is that the three main opinions—that is, the chief justice’s opinion, Justice Ginsberg’s opinion, and the joint dissent—have these little hints in them that, at some point, it looked as if the act was going to be struck down outright. Because the joint opinion has sections in it that wouldn’t have been necessary if the chief justice’s opinion had been the lead opinion from the beginning. That is, the joint opinion spends a lot of time explaining why the Medicaid expansion is unconstitutional—or, not why the Medicaid expansion is unconstitutional, but why threatening to take away the states’ existing Medicaid funding would be unconstitutional.
  10. Karlan also spoke with Stanford magazine about possible limitations on key Congressional powers she forsees based on the underlying considerations in the decision. 
  11. Karlan, on record before the ruling in support of the constitutionality of the health care legislation,  says the conclusions of a majority of justices “reveal some substantial shifts in the court’s approach to [Congress’s] commerce clause and spending clause.”
  12. Professor Hank Greely, director of Stanford's Center for Law and the Biosciences, summed his reaction up with this thought;
       "The legal bottom line – the Act is constitutional.  The positions five justices took on the reach of Congress’s power under the Commerce Clause and Necessary and Proper Clause make it unlikely that Congress will rely on those clauses if it tries to justify forcing people to buy things – but, as it hasn’t used that tactic for at least 200 years, this may not be very important.  States do get a choice about participating in the expanded Medicaid program – and we’ll have an enjoyable time watching some state politicians try to decide whether to participate in hated “Obamacare” or to turn down billions of dollars from the federal government, and ultimately, in part, from their own citizens’ federal taxes, to pay for healthcare for their  poorer citizens (money that will go to their doctors and hospitals).  Overall, it is victory for the Act and, at least at first blush, for the Obama Administration."
  13. You can read the full opinion on the case at: