Case | HBS Case Collection | November 2013 (Revised January 2015)


by Matthew Weinzierl and Katrina Flanagan


One vote in June, 2012, decided the fate of President Barack Obama's crowning first-term achievement: universal health insurance. Chief Justice John Roberts of the U.S. Supreme Court cast the deciding vote to uphold the keystone of the reform: the mandate to purchase insurance. That mandate had a convoluted history. Though born in a conservative think-tank and originally adopted by Republican leaders as a necessary component of reform, it was rejected by Republicans when taken on board by the President and Democrats. Roberts' decision rested on an interpretation of the mandate as a tax.
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Keywords: Universal health insurance; Adverse selection; Leviathan; Courts and Trials; Judgments; Insurance; Health Care and Treatment; Government and Politics; Insurance Industry; Public Administration Industry; Health Industry; United States;


Weinzierl, Matthew, and Katrina Flanagan. "Obamacare." Harvard Business School Case 714-029, November 2013. (Revised January 2015.)