In perhaps the most widely anticipated Supreme Court decision since Bush v. Gore in 2000, the Patient Protection and Affordable Care Act (“PPACA”) was upheld on Thursday in a narrow 5 to 4 decision. Many believed that the Court would hold the law unconstitutional because of a provision known as the “individual mandate,” which requires most U.S. citizens to purchase health insurance or pay a penalty. Instead, the Court decided that the mandate was constitutional because the penalty that one must pay for not buying insurance is a tax, which Congress has the authority to impose. The Court did reject a provision of PPACA requiring states to comply with new eligibility requirements for Medicaid or risk losing their existing Medicaid funding, but the fundamental core of the law was upheld and remains intact. Our analysis of the Court’s decision follows.

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