Often, a law (or contract) will contain a severability clause specifically saying what will happen. (Contracts almost always say that the contract should stand if any clause is found invalid.) The problem here is that the ACA's drafters (perhaps foolishly) did not consider the possibility of a constitutional challenge, and did not include a severability clause into the law.

If the mandate is found unconstitutional, the court will also need to rule on the severability question; it's very uncertain at this point which way they'll rule (if they have to rule at all).

(Bonus question: Do we want the ACA struck down if the mandate is struck down or not? The law does a lot of things, some of which are quite good, and would still work just fine without the mandate clause. On the other hand, guaranteed issue and community ratings without a mandate might completely destroy the health insurance market, without replacing it with anything else, which would be a disaster. The Court is highly unlikely to rule that it's partially severable, so we'll probably see the whole ACA struck down, or only the mandate. In theory, Congress could fix it either way the next day...but in practice it's likely to be terrible deadlocked. Messy.)

Probably the best example in Linda Greenhouse's essay for the NYT (http://opinionator.blogs.nytimes.com/2012/03/21/never-before...) is the Emergency Medical Treatment and Labor Act (it prevents hospitals from refusing care to uninsured patients; this coerces hospitals into commerce. (That a law had to be passed to make this the standard is IMO disgusting. Obviously the Hippocratic oath applies only to doctors and not to hospital bean counters.)

It's worth noting (a few paragraphs later) that EMTLA has a knock-on effect, too: you or your employer pays for all of this uninsured/underinsured treatment through higher premiums. Greenhouse: "The uninsured don’t exist apart from commerce. To the contrary, their medical care results in some $43 billion of uncovered health care costs annually and, through cost-shifting, adds $1,000 a year to the average cost of a family insurance policy. People who don’t want to buy broccoli or a new car can eat brussels sprouts or take the bus, but those without health insurance are in commerce whether they like it or not." This 1986 law actually makes your insurance more expensive, forcing you into commerce that you may not be interested in.

The flaw with Obamacare—and the only way it could have been passed because of the complete and total insanity of American politics today—is that it doesn't actually establish universal healthcare. If the individual mandate had been instead cast as a tax which is then used by the individual to select their insurer (IIRC a key feature of the Clinton healthcare plan that was scuttled), then it would have been no different than Social Security (which has whiners saying "but I will have a better retirement plan, so why should I be paying this?"—tell that to the people living large on their Enron 401(k)) or school taxes (which has childless and empty-nest whiners saying that they don't get benefit from schools) or anything else where there's a mandate that you pay something for a benefit that you may or may not use in a particular year.

Better yet, look at the houses that burned uncontrolled in the Tennessee county for want of a $75 annual fee (http://streeteasy.com/nyc/talk/discussion/22973-free-market-...).

Sorry. I'm completely baffled by what's happened to American politics in the last decade. I was disgusted enough with what was going on during the Clinton years that it was an easy choice for me to emigrate to Canada (not perfect, and some of our politicians are emulating American belligerence a little too much, especially the local moronic mayor), but now I don't even recognize the country in which I was born. It saddens me.

According to what I understand, the U.S. has had three chances at something approaching universal healthcare—in the late 60s/early 70s around the same time that Canada was dancing around the same question; in the 90s under Clinton; and under Obama. Given that it took about fifty years after Canada[1] to even get this passed…it will likely be a long time before anything rational gets passed.

[1] Per Wikipedia, the Federal framework for jointly-funded universal healthcare in Canada was passed in 1966 under Pearson, and it was strengthened in 1984. OHIP was first created (as OMSIP) in 1966, reinvented in 1969 (as OHSIP), and finally renamed in 1972 to OHIP.

I'm a Canadian and quite happy with our socialized health care. It's one of the reasons that I've been able to make the leap into entrepreneurship - I'm on my third product now. I have no pre-existing conditions, but I know that I'll receive no life-ruining bills from the government if something does change in my health situation.

The HSA plans are just as expensive as middle of the road plans as well and are geared towards people who save a lot to begin with.

Why don't we use that rationale to justify complete regulation of food consumption? Let's have the government force all citizens to eat a vegan diet. The economies of scale would certainly make it cheaper to consume. Overall health would improve. And we would all have a better quality of life...

Except for that little word "force". What if I feel like a milkshake today or a nice juicy steak every once in a while? If I can afford it, and it doesn't hurt anyone else (humans at least), I should be free to purchase those things.

When you're required to eat things, or required to pay for things... OR GO TO PRISON, you're not really free anymore, and that's why Americans don't like government programs like ACA or socialized health care. It might make sense on paper and look just like a big insurance pool, but in reality, it looks more like a centrally planned market, where price signals and efficiencies are non-existant, because when your doctor has a guaranteed paycheck from Uncle Sam, he lacks an incentive to make sure you get the best care. When medical students realize that reimbursement rates have dropped to the point that they can't afford to repay their student loan for a very long time, we'll get fewer doctors, or standards will drop.

I'd rather pay a little bit extra for poor people to get free care than to force me into a one-size fits all plan with long wait times for special procedures. Let's at least fix the problem of poor people not being able to afford a decent level of care before we force everyone into a one-size fits all government program with promises it can't keep, like Social Security and Medicare.