A sharply divided Supreme Court on Thursday upheld the centerpiece of President Barack Obama's signature healthcare overhaul law that requires that most Americans get insurance by 2014 or pay a financial penalty. (Though CNN didn't get the message.)
"The Affordable Care Act's requirement that certain individuals pay a financial penalty for not obtaining health insurance may reasonably be characterized as a tax," Chief Justice John Roberts wrote for the court's majority in the opinion.
"Because the Constitution permits such a tax, it is not our role to forbid it, or to pass upon its wisdom or fairness," he concluded. The vote was 5-4.
In another part of the decision and in a blow to the White House, a different majority on the court struck down the provision of the law that requires the states to dramatically expand the Medicaid health insurance program for the poor.
The upholding of the insurance purchase requirement, known as the "individual mandate," was a major election-year victory for Obama, a historic ruling on the law that aimed to extend coverage to more than 30 million uninsured Americans.
The 2010 law constituted the $2.6 trillion U.S. healthcare system's biggest overhaul in nearly 50 years.
Critics of the law had said it meddles too much in the lives of individuals and in the business of the states.
Twenty-six of the 50 U.S. states and a small business trade group challenged the law in court. The Supreme Court in March heard three days of historic arguments over the law's fate.
The court's ruling on the law could figure prominently in the run-up to the November 6 election in which Obama seeks a second four-year term against Republican challenger Mitt Romney, who opposed the law.
Boehner renews vow to try to repeal Obama health law
House of Representatives Speaker John Boehner on Thursday renewed his vow to try to repeal President Barack Obama's healthcare law after a divided Supreme Court key parts of it.
"Today's ruling underscores the urgency of repealing this harmful law in its entirety," Boehner said in a statement just minutes after the court released its ruling. Boehner's Republican-led House will likely vote to repeal the measure, but Obama's fellow Democrats in the Senate are certain to block it.
U.S. healthcare by the numbers
The U.S. Supreme Court's healthcare ruling on Thursday has far-reaching implications for a healthcare system that, according to the Paris-based Organization for Economic Cooperation and Development, is highest in spending but just 31st in providing coverage to its people among the OECD's 34 members.
The following information ranking the United States by category against the OECD's other members comes from the November publication "Health at a Glance 2011 - OECD Indicators."
1st in Spending - Annual healthcare spending totals $2.6 trillion, equal to 17.9 percent of U.S. annual gross domestic product, or $8,402 for every man, woman and child.
1st in Good Health Self-Assessments - 90 percent of U.S. adults aged 15 and older describe themselves as being in good health versus an OECD average of 69.1 percent.
1st in Obesity - More than one-third of American adults are obese, up from 15 percent in 1980.
2nd in Prevalence of Diabetes - 10.3 percent of the U.S. population suffers from diabetes, surpassed only by Mexico's 10.8 percent. The OECD average is 6.5 percent.
3rd out of nine in Waiting Time for Specialists - Out of nine countries from Europe, North America and Australia and New Zealand, the United States has the third shortest waiting time for specialist appointments at 20 weeks; Germany and Switzerland had shorter waiting periods.
4th in Preventing Death from Stroke - The United States ranks behind Israel, Switzerland and France with 32 stroke-related deaths per 100,000 people.
7th in Cancer Incidence - Cancer afflicts more than 300 people per 100,000 in the United States, compared with an OECD average of 261 per 100,000.
9th in Preventing Death from Cancer - At 185 deaths per 100,000, the United States is well above an OECD average of 208 per 100,000.
10th in Number of Practicing Nurses - 10.8 per 1,000 population versus an OECD average of 8.4 per 1,000.
11th of 11 in Unmet Need for Care Due to Cost - The United States ranks last among 11 OECD countries in its ability to provide affordable care: 39 percent of people with below-average income and 20 percent of people with above-average income report foregoing a doctor visit or prescription because of the cost.
25th in Preventing Death from Heart Disease - At 129 deaths per 100,000 people, the U.S. heart disease mortality rate is below an OECD average of 117 per 100,000.
27th in Life Expectancy - Americans can expect to live 78.2 years on average, below the OECD average and just behind Slovenia and Chile.
29th in Number of Practicing Doctors - The United States has 2.4 practicing doctors per 1,000 population, placing it below an OECD average of 3.1.
29th in Doctor Consultations - At 3.9 annual doctor visits per capita, the United States leads only Ireland, Mexico, Sweden and Chile versus an OECD average of 6.5 percent per capita.
30th out of 39 in Hospital Beds - 3.1 per 1,000 population.
30th in Medical Graduates - 6.5 per 100,000 population, ahead of only France, Japan and Israel. The OECD average is 9.9 per 100,000 population.
31st in Health Coverage - An estimated 81 percent of Americans are covered by private or government health insurance, placing the country ahead of only Turkey, Mexico and Chile; 25 OECD countries cover 99 percent or more of their citizens.
31st out of 40 in Infant Mortality - 6.5 babies die per thousand live births in the United States, placing the country behind Poland and the Slovak Republic and below an OECD average performance of 4.4 per thousand live births.
31st in Preventing Premature Death - The number of years lost in the United States to premature death is surpassed only by Hungary, Mexico and Russia. The main causes are accidents, violence, cancer and circulatory disease.
The OECD was established in Europe after World War Two to promote peace through cooperation and reconstruction. Its members are Australia, Austria, Belgium, Canada, Chile, Czech Republic, Denmark, Estonia, Finland, France, Germany, Greece, Hungary, Iceland, Ireland, Israel, Italy, Japan, Luxembourg, Mexico, Netherlands, New Zealand, Norway, Poland, Portugal, Slovak Republic, Slovenia, South Korea, Spain, Sweden, Switzerland, Turkey, the United Kingdom and the United States.
The full text of the decision
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