Health Affairs: More light shed on healthcare reform's day in Supreme Court

The Supreme Court is filling its entire court calendar the week of March 26 with arguments relating to the impending review of the constitutionality of the Patient Protection and Affordable Care Act (PPACA); totaling five and a half hours over three days with a decision expected in late June.

T.R. Goldman, a journalist based in Washington, D.C., wrote an analysis in the January edition of Health Affairs which concluded that the nine Supreme Court justices will be thrust into the middle of a divisive debate over what is “arguably President Barack Obama’s signature legislative achievement” just months before the 2012 elections.

“Given the vagaries of an election year, it is impossible to predict which party might benefit from a decision to uphold or strike down the law—although such is the potential import of the case that it could tip the election results in either direction,” continued Goldman.

According to Goldman’s reporting, many scholars believe it’s likely the Court will deliver a Constitutional pronouncement that redefines the boundaries of congressional authority. At the other end of the spectrum, it is possible that the justices will render just a prosaic and hypertechnical tax decision. “If so, that decision would hinge on the meaning of the word penalty in connection with the requirement that most Americans have health insurance starting in January 2014 or pay a penalty administered by the Internal Revenue Service,” Goldman wrote. “Less likely, but still possible, is an even more profound decision that could effectively reorient the federal government’s long-standing relationship with the states.”

Goldman maintained that the government’s biggest hurdle is articulating a “limiting principle” for its contention that the mandate that Americans purchase health insurance is constitutional. “This principle will have to go beyond a simple claim that healthcare is somehow ‘unique’ and warrants this degree of power. After all, the argument goes, if Congress can mandate health insurance because everyone eventually needs healthcare, then why can’t it mandate that people must eat broccoli because everyone is in the market for food?”

Many legal scholars are betting that the Court will vote to uphold the law with anywhere from a five-to-four to an eight-to-one majority, Goldman concluded.