The Supreme Court has upheld the Patient Protection and Affordable Care Act.

In its most hotly anticipated decision of the session, the Court decided to uphold the individual mandate provision of the health care reform law.

The biggest issue was the constitutionality of the individual mandate, which requires all Americans to purchase health insurance or pay a penalty.  Also at issue was the expansion of Medicaid.  The Act increases federal aid to the states for Medicaid, but puts their current funding at risk if states fail to comply with the new requirements.

With Chief Justice John Roberts siding with the majority, the individual mandate survives as a tax. Without it, the rest of the law was considered unworkable, due to the reliance on the individual mandate to finance it.

“Our precedent demonstrates that Congress had the power to impose the exaction in Section 5000A under the taxing power, and that Section 5000A need not be read to do more than impose a tax,” said the court. “This is sufficient to sustain it.”

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