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Supreme Court Decision and Patient Protection and Care Act
The US Supreme Court majority held that the Act is valid under the Tax & Spending power because the Act leaves the uninsured with a rational choice about whether to buy the plan, and any State that "voluntarily and knowingly" accepts the terms of the new Medicare program agrees to be penalized if they do not do what they are told. But several USSC justices dissented that the Act was invalid because Congress can only regulate commerce and not create commerce. By forcing the citizens to buy a medical plan, Congress is directing the creation of commerce