Supreme Court to rule on health care overhaul

By Jesse J. Holland and Mark Sherman
The Associated Press

WASHINGTON — On Monday, the Supreme Court promised an extraordinarily thorough springtime review of President Barack Obama’s historic health care overhaul: more than five hours of argument, unprecedented in modern times. It will come in time for a ruling which could affect millions of Americans just before the presidential election.

The ruling, expected before next Independence Day, could determine the fate of Obama’s signature domestic achievement, which is vigorously opposed by all of Obama’s GOP opponents.

The Patient Protection and Affordable Care Act aims to provide health insurance to more than 30 million previously uninsured Americans.

But Republicans have branded the law unconstitutional since before Obama signed it in March 2010.

The court’s ruling could be its most significant decision since George W. Bush’s 2000 presidential election victory. But the justices left themselves an opening to defer the outcome if they choose by requesting arguments on one lower court’s ruling that a decision must wait until 2015, when one of the healthcare law’s many provisions takes effect.

Legal experts have offered a range of opinions about what the high court might do. Many prominent Supreme Court lawyers believe the law will be upheld by a lopsided vote, with Republican and Democratic appointees ruling in its favor. Others predict a close outcome with Justice Anthony Kennedy, a Republican appointee who sometimes joins his four colleagues appointed by Democratic presidents, holding the deciding vote on the nine-member court.

The White House has pushed for a final ruling as soon as possible. Communications Director Dan Pfeiffer said the administration was pleased the justices agreed to take the case now, with arguments in March.

“It’s important that we put to rest once and for all the issue of maybe the law will disappear,” said Health and Human Services Secretary Kathleen Sebelius.

Republicans also said they were happy the court would hear arguments on the constitutionality of the provision at the heart of the law and three other questions about the act.

The central provision in question is the requirement that individuals buy health insurance starting in 2014 or pay a penalty.

“That the Supreme Court is taking this up, I think, is a positive signal that there are legitimate concerns surrounding the constitutional aspects of mandating that individuals purchase health care insurance and purchase it according to Washington’s guidelines,” said House Majority Leader Eric Cantor of Virginia.

The exceptional five-and-a-half hours allotted for argument demonstrates the significance the justices see in this case. Normally, they allow only one hour split between two sides.

The health care overhaul would achieve its huge expansion of coverage by requiring individuals to buy health insurance starting in 2014, by expanding Medicaid and by applying other provisions, many yet to take effect.

The central question before the court is whether the government actually has the power to force people to buy health insurance.

The White House says Congress used a “quintessential” power in passing the overhaul: its constitutional ability to regulate interstate commerce, including the health care industry.

Opponents of the law and the 11th U.S. Circuit Court of Appeals in Atlanta say that Congress overstepped its authority when lawmakers passed that mandate.

A divided Atlanta court panel ruled that Congress cannot require people to “enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die.”

The Atlanta court is the only one of four appellate courts that found the mandate unconstitutional. The federal appeals court in Cincinnati upheld the entire law, as did appellate judges in Washington, D.C. in recent days.

The appellate court in Richmond, Va., ruled a judicial decision on the law cannot be rendered until 2015, after the penalties for not having insurance have gone into effect.

In addition to deciding the constitutionality of the central mandate, the justices also will determine whether the rest of the law can take effect even if the core is held to be unconstitutional. Opponents of the law say the whole overhaul should fall if the individual mandate falls.

The administration counters that most of the law could still function, but says requirements that insurers cover anyone and not set higher rates for people with pre-existing conditions are inextricably linked with the mandate and shouldn’t remain in place without it.

The court also will look at the expansion of the joint federal-state Medicaid program that provides health care to poorer Americans, although no lower court actually called that provision into question.

Florida and 25 other states argued unsuccessfully in lower courts that the law goes too far in coercing them to participate by threatening a cutoff of federal money. The states contend that the vast Medicaid expansion and the requirement that employers offer health insurance violate the Constitution.

Lastly, the justices will consider whether arguments are premature because a federal law generally prohibits challenges to taxes until the taxes are paid. The federal appeals court in Richmond year reasoned that the penalty for not purchasing insurance will not be paid before federal income tax returns are due in April 2015, therefore it is too early for a court ruling.

Ultimately, the high court chose the Atlanta court’s ruling as the primary case to review. That decision means that a highly regarded former Bush administration solicitor general, Paul Clement, is likely to argue on behalf of the challengers. The current solicitor general, Donald Verrilli Jr., is expected to defend the law before the justices.