It is telling, and a sign that we don't have an entirely new Chief Justice here, that the decisive point for Roberts was that the expansion "accomplishes a shift in kind, not merely degree," and "transformed [it] into a program to meet the health care needs of the entire nonelderly population with income below 133 percent of the poverty level".
That would leave 7.3 million people – 3 percent of the nonelderly population – who would be required by the mandate to buy coverage at full cost or pay a penalty.
In particular, what would happen in California, where more than a fifth of the nonelderly population is uninsured, and the individual insurance market is largely unregulated?
"The health of nonelderly Americans is improving consistently, and we have more technology to help people at work," observed Mark Duggan, an economist at the Wharton School of the University of Pennsylvania who has advised Social Security on the assumptions underpinning the trustees' forecasts.
On the other hand, the elderly population may have been easier to reach than today's uninsured nonelderly people, because the elderly had already been participating in the Social Security pension program.
"Medicaid already covers poor children through age 18 and could be expanded to cover all nonelderly poor people, regardless of age," Ms. Rosenbaum said.
(Interestingly, it's similar to the system envisioned for the nonelderly by President Obama's Affordable Care Act).
And an estimated 6.9 million nonelderly disabled people receive Social Security payments under the Supplemental Security Income program, according to federal government figures.
(Answer: most able-bodied, nonelderly adult recipients are in the work force).
The study found that older people received slightly more than half of government benefits, while the nonelderly with disabilities received an additional 20 percent.
According to a July 2009 report from the Kaiser Family Foundation entitled "Health Care and the Middle Class: More Cost and Less Coverage": "Nonelderly adults with medical debt are almost twice as likely to have an ongoing or serious health problem compared to others with private coverage.
