Anthony Shelley is quoted regarding the Supreme Court’s 5-4 decision to uphold the Patient Protection and Affordable Care Act (PPACA).

"Some people think that big employers can't wait to get out of the statute, but I don’t think that big companies wanted the statute invalidated," Shelley said about the employer mandate. "It would have created chaos. Companies have come to grips with the law, begun to implement it, and have set programs in place. Large companies feared invalidation." He added, "Many parts of the statute have worked quite well for the insurance industry. However, to have had to live with the insurance reforms, such as community ratings, without having the individual mandate, would have been unacceptable."

Regarding the Court's decision that PPACA provisions relating to the expansion of Medicaid are unconstitutional, Shelley said, "The Medicaid decision is esoteric and turns on a matter of federalism. The states had pushed the opposition to the Medicaid expansion, but no lower court had opposed it. Even though there was no split in the circuits, the Supreme Court chose to take up the issue. The justices were clearly animated about the issue and apparently wanted to make some law. Justices Kagan and Breyer joined the Chief Justice and the four conservatives in invalidating the provision. However, five justices departed and said that the Medicaid issue was severable; therefore, its rejection did not invalidate the law as a whole. The dissenters, in a long opinion, concluded that the Medicaid provision was crucial to the law and was not severable."