The second, and possibly even more important, comment came from Justice Anthony Kennedy, a key swing vote on the Court. Justice Kennedy appeared to voice some sympathy for the government’s argument that the health care market is “unique.” Even if a healthy young person without insurance may not need health care in a particular time period, he reasoned, that young person will nonetheless be “very close” to having an effect on insurance rates – for example, on the theory that, as he ages, he will eventually need care that he can’t afford without insurance – in a way that just doesn’t happen in other markets.
During his four minutes of rebuttal, Solicitor General Verrilli tried to return the Court to the big picture, reminding it once again that Congress had enacted the ACA to deal with a “grave problem” and that it opted to do so (and rejected the permissible alternative of having everyone buy insurance if and when they need it) with a method that it knew would actually work. This is exactly the kind of choice, he concluded, that the Constitution leaves to the democratic process.