In the end, it was less bad than many had feared. Of the on-line commentary, I recommend this interview with Pam Karlan (Stanford) as a good place to start. A few quick comments of my own, with the caveat that while I keep up with parts of constitutional law, I haven't taught it since 1995.
(1) As most readers will know, the Court upheld the key provision of the act, the individual mandate, on the grounds that it was a proper exercise of Congressional taxing power, but five justices, including the Chief Justice (who endorsed the taxing power theory, thus providing the key fifth vote for upholding) agreed that the mandate was not justified as an exercise of the commerce power (this was based on what must surely be the most significant appearance of the act/omission distinction in the history of American constitutional law--if you fail to purchase insurance, that's not commercial activity, so can't be regulated, even though that omission has obvious and massive consequences in aggregate on the national health care market). Readers not familiar with constitutional law may be surprised to learn that a huge amount of federal social legislation, including many of the most famous civil rights laws of the 1960s (such as those prohibiting private businesses, like restaurants and hotels, from discriminating on the basis of race), were justified as exercises of the Commerce Clause power, on the grounds, e.g., that race discrimination in restaurants affects interstate commerce. Starting in the 1990s, as the Court shifted further to the right, resistance began mounting to the expansive use of the commerce power, and in some cases, the Court actually invalidated Congressional action as overreaching the commerce power, which had not happened since the 1930s. Five justices, including Chief Justice Roberts, very clearly signalled that they are willing to endorse a new conceptual trick for blocking federal legislation, namely, when it tries to regulate an omission, not an action.
(2) Why did Chief Justice Roberts join the four "liberal" justices in voting to uphold the Act? My best guess is that he figured the political fallout for the Court from wiping out this legislation on the basis of silly arguments would be too much--the Roberts Court has already done huge damage to democracy and settled precedents, but this would have been a much more serious case of right-wing activism.
(3) The limitation on the expansion of Medicaid raises some more complex issues--the Court basically says the provision is constitutional unless the federal government threatens to withold existing [CORRECTED] Medicaid funds from states that fail to comply, in which case it becomes unconstitutionally coercive (the federal government could withhold new funds). The coercion question is a subtle and vexed one in constitutional law; there is an interesting discussion by my former colleague Mitch Berman (Texas) here. This does raise the prospect that citizens in some states won't benefit from the expansion of Medicaid coverage (basically coverage for the poor) thanks to their reactionary/Tea Party governors. But I may write more about this once I get a chance to learn more about it.
UPDATE: This piece by Bruce Ackerman (Yale) is also apt.
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