Jubilant supporters of the Affordable Care Act have paid little attention to the language the Supreme Court used to uphold the act’s individual coverage mandate. Opponents of the act, having failed to kill the mandate as a power grab by the government, may turn now to undermining it as something quite easy to ignore—not really a mandate at all.
By explicitly saying that noncoverage is not illegal, the opinion written by Chief Justice John Roberts could reduce the social stigma for people who don’t buy health insurance. If that stigma is diminished, many healthy people may decide they’re better off skipping coverage and paying a relatively modest tax instead. And if that happens, the “death spiral” of shrinking coverage that economists have warned about could still happen.
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