Although some may argue the relevance of this ruling to readers of HN, thank you for posting the link to the PDF. Effectively, it comes down to this: (1) buy he

Although some may argue the relevance of this ruling to readers of HN, thank you for posting the link to the PDF. Effectively, it comes down to this: (1) buy health insurance and pay lower taxes; or (2) don't buy health insurance and pay higher taxes. You can't refuse to purchase health insurance and refuse to pay higher taxes. This is relevant, because of the potentially adverse impact it will have on small businesses. The dissent nails it: this act eviscerates the actuarial analysis many young, healthy people use to decide whether to purchase health insurance by compelling them to subsidize health insurance of the population. This occurs because the Act binds the hands of insurers: they can't use any health characteristics of those that that they insure in deciding their premium. Ultra-healthy individuals will not be entitled to lower premiums, which is to say that the active and healthy 50-something will pay the same insurance premium as the sedentary, overweight 50-something with diabetes. Politics aside, the Supreme Court made it clear that the USA is not a welfare state (they didn't believe the government's arguments that this was legal under the Commerce Clause or Necessary and Proper Clause), and instead upheld the mandate because of a tenuous link with Congress's ability to tax & spend for the general welfare of the population. Phrased alternatively, the Supreme Court upheld the mandate as a tax--NOT a penalty.