The Supreme Court is scheduled to hear five and one half hours of arguments on the constitutionality of President Obama’s far-reaching and bold health care law. The date for this hearing is March 26, after which the nine justices will have several months to deliberate on several issues which the Affordable Care Act will bring into focus, deciding by June if this law will survive and prove that President Obama is a man of vision and ideological boldness; or if the justices vote against the policy, proving that it is a bad idea to pursue large policy changes without ideological support which cuts through party affiliations.
Individual Mandate to Purchase Health Insurance
The first question the justices must consider is that of the individual mandate that the Act requires. The law compels individuals to purchase health insurance, or else they will be brought into the government run health care system. States already require people to buy car insurance as a condition before they can own and drive a car. But can the federal government force a person, no matter what the state of his health, financial ability or private beliefs? Federal District Judge Roger Vinson asked this question, if the mandate were to stand: “Congress could require that people buy and consume broccoli at regular intervals, not only because the required purchases will positively impact interstate commerce, but also because people who eat healthier tend to be healthier, and are thus more productive and put less of a strain on the health-care system.”
Another question the justices must ponder is whether the entire Affordable Care Act comes together as one great whole, or whether some of its parts can be severed from its other parts, known as severability. If the law is a bunch of separate parts that can exist without the others, then the judges will have to decide which parts can stay, and which will be deemed unconstitutional. The plaintiffs bringing the case to the Supreme Court, 26 of the 50 states and the National Federation of Independent Business, say that the entire bill must be struck down. The Obama Justice Department will argue instead that the parts can be separated and that most of the components can and should remain.
Tax First, Ask Questions Later
The third issue is slightly technical, having to do with a very old law which states that a tax cannot be challenged before it is implemented and imposed on taxpayers. If it is decided that this law, known as the Anti-Injunction Act does apply here, in other words that the Affordable Care Act is indeed a tax, then it will not need to make a decision on whether the mandate is constitutional until one year after it is supposed to go into effect, in 2014. In other words, the Supreme Court would not be compelled to make any decision until 2015.
State’s Rights, Too?
The last problem is if the federal government can compel individual states to implement the law. If so, already strapped-for-cash state governments will have to massively expand their Medicaid services in order to continue to get Medicaid funding from the feds. States are arguing that Medicaid is already one of the forces pushing states off the budgetary cliff. The National Association of State Budget Officers reports that Medicaid payments grew by 10.1 percent last year alone. That percentage is more than the rate of the growth of debt which is owed to education, prisons, infrastructure upkeep and other basic needs.