U.S. Supreme Court upholds health care law

On Thursday, the U.S. Supreme Court upheld most of President Barack Obama’s signature health care reform law as constitutional.

Of particular importance, the court said the individual mandate was constitutional as a form of a tax. The majority opinion, delivered by Chief Justice John Roberts said "the shared responsibility payment may for constitutional purposes be considered a tax."

The ruling allows a host of health policies established under the Affordable Care Act to remain in place.

For instance, Obama promised to close the "doughnut hole" for the Medicare Part D Prescription Drug Plan. That was part of the law, so we rated his pledge Promise Kept.

Obama promised to require that all children have access to health insurance coverage, which we also rated Promise Kept with the law’s enactment.

One campaign promise that appears to be undermined by the ruling is the expansion of Medicaid eligibility, yet another component of the health care law. Prior to the Supreme Court decision, we rated it Promise Kept. The court’s majority opinion said it was a violation of the Constitution "by threatening States with the loss of their existing Medicaid funding if they decline to comply with the expansion."

We say "appears" because the court’s decision includes a remedy where Congress could, to some extent, keep the expansion intact through a voluntary program.

Here’s the exact language, from Roberts’ opinion: "Some States may indeed decline to participate, either because they are unsure they will be able to afford their share of the new funding obligations, or because they are unwilling to commit the administrative resources necessary to support the expansion. Other States, however, may voluntarily sign up, finding the idea of expanding Medicaid coverage attractive, particularly given the level of federal funding the Act offers at the outset."

PolitiFact has tracked 81 separate promises Obama made about health care reform in the 2008 election. Among those we’ve updated, Obama kept 52 percent of those promises, broke 29 percent, and compromised on the other 15 percent. The Supreme Court’s ruling does not affect the vast majority of these promises. We have yet to give final ratings on the last 29 promises.

With the Supreme Court decision, our past ratings on Obama’s health care promises stand. Check back for updates on the remaining promises later this summer.