Washington. The Supreme Court upheld Barack Obama’s health care reforms to insure another 32 million Americans on Thursday in a major victory for the president in the heat of a tight re-election contest.
Republican House Speaker John Boehner vowed to fight on to repeal the president’s signature domestic achievement, saying “we don’t have to accept ‘Obamacare,’” in a rallying cry to conservatives for the November elections.
The key provision that underpinned Obama’s health care overhaul, an “individual mandate” requiring almost every US citizen from 2014 to take out health insurance or be subject to a fine, was upheld in a tight 5-4 vote.
Chief Justice John Roberts, the conservative-leaning leader of the court often seen as a bete noire by Democrats, was the unlikely hero for liberals as he provided the key swing vote that saw the massive reforms stand.
Writing the majority opinion, Roberts said the court believed that if the mandate was seen as a tax then it was constitutional for the Congress to impose such a provision on America’s 50 individual states.
“It is reasonable to construe what Congress has done as increasing taxes on those who have a certain amount of income, but choose to go without insurance. Such legislation is within Congress’ power to tax,” he wrote.
Underlining how polarizing the health reforms are in a nation where the right dreads big government overreach and has attacked “Obamacare” as ghastly overspend, there was a stinging dissent from Justice Anthony Kennedy.
“In our view, the entire Act before us is invalid in its entirety,” wrote Kennedy, who had been seen as the key figure who might have joined the four more liberal members of the bench — instead it was Roberts.
Despite the worst fears of the Obama administration that the court might throw out the whole law, the only restriction as it turned out was on the Medicaid provision, expanding coverage to 16 million more poor Americans.
The court decided that the clause could be upheld but only if the government withdrew its threat to withhold federal Medicaid funding from states that don’t comply.
Two years after Obama signed into law an act to insure most of the 50 million uninsured Americans and prevent coverage from being refused on the basis of patients’ medical histories, its fate lay in the hands of six men and three women.
There were cheers outside court from liberals and Democrats, for whom this issue has been a burning crusade for more than two decades, when the long-awaited ruling was made public at 1407 GMT.
“Victory for the American people! Millions of American families and children will have certainty of health care benefits + affordable care,” former House speaker Nancy Pelosi, a key driver of the law, said on Twitter.
Hundreds of protesters waving American flags or toting signs in support of the law had gathered from the small hours along with banks of TV cameras outside the court’s neo-classical building opposite the Congress.
Obama, who was due to speak at 1615 GMT after his crowning achievement was upheld, had issued a staunch defense of his signature domestic policy achievement at a fundraiser in Miami on Tuesday night.
“I believe health reform was the right thing to do,” he said. “I believe it was right to make sure that over three million young people can stay on their parent’s health insurance plan.
“I believe it was right to provide more discounts for seniors on their prescription drugs. I believe it was right to make sure that everybody in this country gets decent health care and is not bankrupt when they get sick.”
Republicans say the reforms will increase costs, cause insurance premiums to rise and hurt the quality of health care.
“Whatever the Supreme Court does tomorrow, one thing we know: If I’m elected president, we’re going to get rid of Obamacare and replace it with real reform,” Obama’s Republican presidential challenger Mitt Romney said at a campaign event in Virginia on Wednesday.
The non-partisan Congressional Budget Office says the legislation would reduce the ballooning US deficit a little over the first decade and substantially more over the second.
Underlining the size and scope of the decision, the nine Supreme Court justices held almost six hours of oral arguments over three days in late March, the longest time allotted to a single issue in more than 45 years.
Although the United States is the world’s richest nation, it is the only industrialized democracy that does not provide health care coverage to all its citizens.