The Supreme Court Declares Private Health Insurance Requirement Constitutional

The Supreme Court of the United States has come to a decision about Obama’s polarizing health care law: The individual mandate, which requires Americans above a certain income level to sign up for health insurance, is constitutional.

U.S. President Barack Obama risked part of his re-election prospects on this decision. The 69 million votes that were cast in 2008 were irrelevant to the nine people — three women and six men; three Jews and six Catholics; four Democrats and five Republicans — that issued the ruling about the constitutionality of the U.S. health care reform. After a brief meeting of about 45 minutes, they ultimately validated that Obama had emerged the winner.

Barack Obama’s presidency was not the only thing at stake. The economic future of the United States was too. The country spends approximately 19 percent of its gross domestic product on health care. This means that it spends as much in relation to its economy as Spain spent on the housing sector in 2007.

Health care expenses are growing twice as fast as GDP, and threaten to bury the American economy.

The focus of the judges’ decision has been the “universal mandate,” which requires Americans to sign up for a private health insurance plan starting from a certain level of income. It also forces businesses to contribute to employees’ plans in certain cases.

Altogether it is a hefty win for the president. Furthermore, it includes other issues that are also at stake, although they are of less political significance. Among these is the expansion of the public-private health care system for the elderly, known as Medicare.

Another issue is that insurers must provide medical assistance to people less than 26 years old who live with their parents. In practice, this means that parents’ insurance plans cover their children.

The “pre-existing conditions” limitation is a truly mixed bag. Previously, hospitals and insurance companies had shielded themselves to avoid paying for medical treatment.

Leading up to the decision, what was clear was that three judges — Alito, Scalia and Thomas — were going to vote against. Four — Kagan, Sotomayor, Ginsburg and Breyer — in favor. There remained the president, Chief Justice John Roberts, a Republican who has an ideological and personal clash with Obama, as a possible vote against. He ultimately decided to vote in favor of the law.

The primary unknown was Anthony Kennedy, a conservative who sometimes votes with the Democrats. In the oral arguments, Kennedy questioned the defense more aggressively than usual, but that did not necessarily imply that he was set to vote against.