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Court's Verdict on Health-Care Reform Holds Surprises, Legal Experts Say
Date:6/28/2012

o stay with that opinion the last few weeks though because everybody was so busy hedging their bets," she said. She was somewhat surprised at one of the four dissenters: "I thought [Justice Anthony] Kennedy would go over for it, but he didn't."

However, she wasn't surprised that Chief Justice John Roberts backed the majority decision.

"I think at the end that Roberts was motivated by that overturning an act of Congress is a really significant action by the court even though not [entirely] unprecedented, and if at all possible the court should work to uphold the Constitution," Landers said.

The decision did limit the expansion of Medicaid as proposed under the law.

"What they said was that the part of the expansion that would penalize states -- that would withdraw all Medicaid funding from the states if they didn't go along with the expansion -- is invalid," Landers explained. "The expansion still exists, but a state can either sign onto it or not and won't lose all its current Medicaid funding if it doesn't go along with the expansion."

While some states are already expanding their Medicaid roles and others are happy to cooperate because of the federal funding they'll receive, she said, "there are always those states who are very parsimonious -- not generous -- in granting Medicaid benefits to adults. So basically, this decision will have the effect of limiting the impact of the law in getting more adults insurance coverage."

Another expert, Robert Field, a professor of law in the department of health management and policy at Drexel University's School of Public Health, weighed in and found that each side may have gained from the decision.

"I do think this is potentially a win for both sides, although the losers in the case may not immediately see it this way," Field added. "I think [President Barack] Obama wins politically. He gets around the charge that [Republican Mitt] Romney had been making that he wasted
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