I am surprised and was prepared for the worst, a 5-4 ruling overturning the entire law. Instead we have a 5-4 ruling essentially upholding the entire law. The limitations regarding the title II expansion of Medicaid are not fatal at all. It turned out not to be the Commerce Clause that saved it; it turned out to be the essential power of Congress to levy taxes.
Here's at least one of many money quotes:
From the beginning of the Chief's opinion: "We do not consider whether the Act embodies sound policies. That judgment is entrusted to the Nation's elected leaders. We ask only whether Congress has the power under the Constitution to enact the challenged provisions."
As the Chief Justice notes, you don't have to like a law to reject arguments that it is unconstitutional. If you don't like a law passed by your Member of Congress, you work to defeat that member and replace him/her with someone more to your liking.
Which moves us to the next stage:
The threats to the implementation of the ACA are not over. The big one comes on 11/6/2012. If Mitt Romney takes the White House, if Republicans take control of the Senate, and if Republicans hold the House, then they will repeal most of the law's major portions in early 2013 using the Congressional budget reconciliation process so repeal can pass the Senate with as few as 50 votes (plus the VP's).
Supporters of health reform and health justice in the United States did not dodge a bullet today, we dodged a cannonball. It's not the only one aimed at us -- more ahead.
Those who try to advance reform have to win every battle; those who try to take down reform have to win only once.
It's good day, and it ain't over yet. Not by a long shot.
The author is solely responsible for the content.