The US Supreme Court decision on the constitutional legitimacy of the Affordable Care Act

摘要

I am writing this introduction on the day after the 2012 US Presidential election. We now know that Mitt Romney will not get a chance to carry out his pledge to repeal the Affordable Care Act (ACA), an Act that, on a national scale, bears much resemblance to the set of health care reforms that he himself desired for the people of Massachusetts. This does not mean that the implementation of ACA - or, in other words, the extension of health care insurance to tens of millions of American citizens - will be an easy ride; there are likely to be many implementation barriers in the years ahead. But it does mean that one potentially very high hurdle has been avoided. Another, possibly even more dangerous, hurdle was very narrowly cleared in June 2012 - so narrowly cleared in fact, that it took some of the skin off the ACA's knees, but ultimately left its bulk intact. That hurdle was the Supreme Court deliberation on whether the ACA violated the US Constitution.