NEVERMIND THIS RULING...:

FROM A HISTORICAL perspective, the ACA followed the path of least resistance to universal health insurance. Through most of the twentieth century, the model that many Democrats favored for health care was a tax-supported national program like Social Security or Medicare. They regarded private health insurance as inefficient and inequitable, and they saw Medicaid as providing only limited access to care. But after years of frustration, congressional Democrats pursued incremental reforms as a stopgap. During the 1980s, they worked with Republicans to extend Medicaid to pregnant women and young children in families with incomes up to 133 percent of the poverty level. These extensions, signed into law by Ronald Reagan and George H.W. Bush, began as options for states and were soon revised and became mandates, and the states all complied in expanding coverage. In the early '90s, as a counterproposal to President Bill Clinton's health plan, many prominent Republicans also endorsed a mandate on individuals to purchase health coverage as part of federal legislation to bolster private insurance and make coverage universal.

In short, both elements at issue in the legal challenge to the ACA--the individual mandate and the Medicaid expansion--had a Republican imprimatur. Serious questions had never been raised about their constitutionality. Perhaps the most worrisome aspect of the ACA case is that the Court nearly overthrew the entire act on the basis of arguments that Congress had no reason to take seriously when it passed the legislation.

Strictly interpreted, the Court's new limit on the scope of the Commerce clause should not have far-reaching consequences. Bill McCollum, Florida's former attorney general, unintentionally made this point when he said after the decision, "Well, at least it's clear that they can't order you to buy broccoli"--as if anyone had proposed to do that. Under the Commerce clause, according to Roberts as well as the four right-wing justices, the federal government cannot set a minimum requirement for health insurance any more than it can require people to buy vegetables. But by arguing that the ACA's insurance mandate was a novel and radical departure in federal legislation, Roberts and the conservative dissenters appear to concede that their ruling doesn't apply to any other existing legal requirement. In fact, the only recent proposal to mandate purchase of a private product has come from conservatives who want to replace Social Security with a requirement to buy private annuities--an idea safe under Roberts's tax-powers argument. The real worry about his Commerce clause ruling is that it may only be one in a series of new and dubious lines drawn to hem in federal regulatory powers related to the economy, environment, and other concerns.

Follow @brothersjudd