The five members of the Supreme Court that voted to declare the Affordable Care Act constitutional did so by finding a way to support the individual mandate and massaging the expansion of Medicaid, says Bill Bernstein, a health care attorney and partner in the Manatt, Phelps & Phillips law firm in New York City.

The court upheld the individual mandate, but did so by sidestepping constitutional arguments about the Commerce Clause and adopting a theory that the mandate is a tax and Congress has the constitutional authority to impose the tax.

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