Supreme Court to Hear Challenges to Healthcare Reform

The U.S. Supreme Court will devote several days in March to President Obama's healthcare reform law.

The U.S. Supreme Court will devote several days in March -- and more than five hours of oral argument time -- to hearing challenges to various aspects of the Patient Protection and Affordable Care Act, President Obama's healthcare reform law. In November of 2011, the Court announced that it will spend the last week of March, 2012, hearing argument in three cases challenging the law's constitutionality.

There are four issues the Court has agreed to decide:

  • Whether opponents to the individual mandate (the law's requirement that everyone purchase healthcare insurance, with or without government assistance, or pay a fine) brought their challenge too soon. The individual mandate doesn't go into effect until 2014. If the fine to be imposed is categorized as a "tax," a federal law called the Anti-Injunction Act prohibits anyone from challenging it until they are actually required to pay the tax -- and that's a couple of years off.
  • Whether the individual mandate is constitutional (assuming it can be challenged now). The question here is whether the Commerce Clause of the Constitution, which gives Congress the right to regulate interstate commerce, allows Congress to require people to purchase insurance. Supporters of the law argue that it does, because otherwise those who don't buy insurance will incur costs that ultimately have to be borne by everyone else. Opponents argue that allowing Congress to regulate inactivity -- someone's refusal or failure to do something (buy insurance, in this case) -- exceeds the limits of the Commerce Clause, and would essentially allow Congress to regulate anything it wanted.
  • Whether the rest of the healthcare law can remain in effect if the individual mandate is found to be unconstitutional. Sometimes, the Court finds that a part of a statute can be struck down while the rest continues in force: In this situation, the part that is found unconstitutional is said to be "severable" from the rest of the law, in that it can stand or fall on its own. Sometimes, the Court finds that the unconstitutional part of the law is so intertwined with the rest of the law that it's an all or nothing proposition.
  • Whether the law's expansion of the Medicaid program is constitutional. The healthcare reform law requires states to change their Medicaid programs to allow more people to be eligible for coverage or lose all of their federal funding for the program. The argument here is over state versus federal rights.

You can find a comprehensive and straightforward discussion of the issues and history of these cases at SCOTUSBLOG ("The Healthcare Grants, In Plain English"). The Court is expected to issue decisions in June 2012.