For three days this week, the Supreme Court will hear arguments for and against the landmark Affordable Care Act, which became law March 23, 2010. Their verdict, expected in late June, will have considerable impact on our economy, our politics and the future of health care in this country.
Six hours of arguments spread over three days may not seem like a lot, but by Supreme Court standards it's generous, befitting the importance of this decision. Not since the court heard challenges to Franklin D. Roosevelt's New Deal in 1935 have the justices deigned to weigh in on the signature legislation of a president while he seeks re-election.
The outcome will influence whether 32 million Americans will be covered by health insurance, whether an industry that makes up 18 percent of the U.S. economy will be overhauled, and who will win the November presidential election.
There are four issues before the court as a result of challenges brought by 26 states, the Nashville-based National Federation of Independent Business and four of its members.
1. Individual mandate. The court will decide if Congress has the right to require Americans to obtain health insurance or pay a penalty. The challengers maintain it's unconstitutional. President Barack Obama's administration says the mandate is well within congressional power to regulate interstate commerce and impose taxes.
2. Severability. If the individual mandate is found unconstitutional, does that nullify the rest of the Affordable Care Act, or could the mandate simply be severed from health care reform?
3. Medicaid expansion. Challengers maintain that the ACA's expansion of Medicaid, the federal-state health care program for the poor, unconstitutionally forces states to spend more on Medicaid.
4. Premature challenge. Under the 1867 Anti-Injunction Act, judges cannot rule on challenges to federal taxes until the taxes have actually been levied. In the case of the Affordable Care Act, the first penalties under the individual mandate would not be imposed until 2015.
While the justices rejected requests from lawmakers and the media to televise their health care reform hearings, the court will break from its customary weekly audio release and post audio on its website each afternoon during the three-day hearing.
While the Supreme Court is free to issue its rulings at any time, justices have been disposed to work on landmark cases right up to deadline, which in this case comes in late June.
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