While it was upholding the mandate, the court was striking down an equally important part of the law: the requirement that states greatly expand Medicaid coverage, at a cost of about $1 trillion between 2014 and 2022. The administration sought to force states to go along by threatening to take away all their Medicaid funds -- not just those provided for the expansion. But Roberts and Co. said no.
Does it matter? You bet. It's the first time the court has ever said Washington went too far in the conditions it places on money sent to state governments. The ruling will give states more latitude to make their own decisions in all sorts of areas.
The case also registered a victory for the notion that judges should apply the Constitution in an impartial way rather than simply impose their policy preferences. George Washington University law professor Orin Kerr, writing on the conservative-libertarian blog The Volokh Conspiracy, said the overall decision was "a largely conservative opinion that just happens to get to a liberal result."
Equally significant is that it took a worse health care option off the table. The irony of the challenge is that if Obamacare had been struck down, supporters of universal health coverage would have been left with no good option but a "single-payer" system, also known as "Medicare for all" -- which is undoubtedly constitutional.
Whatever the flaws of Obamacare, it at least builds on the existing system of private insurance. Vermont's self-proclaimed socialist senator, Bernie Sanders, used the court's decision to renew his call for a single-payer system. But for him, the verdict was the worst thing that could have happened.
For anyone even slightly open to evidence, letting Obamacare take effect will provide an illuminating experiment in how to afford the miracles of the American medical system to more people, including many in dire need. It may be a failure, or it may be a success. But it will not be uninformative.
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