Washington (CNN) — Most of us go about our daily business never thinking about the U.S. Supreme Court or the cases it decides. But sometimes, it gets a case so big — and could affect your life so much — you simply have to take notice. Next week will be one of those times.
The highest court in the land is preparing to tackle perhaps the most important appeals to reach it in more than a decade: the massive health care reform legislation championed by President Barack Obama.
The court will soon hear six hours of oral arguments over three days on the law’s constitutionality — and your health and your finances could be on the line. Their eventual rulings in an election year will not only guide how every American receives medical care but would also establish precedent-setting boundaries of government regulation over a range of social areas.
“The implications in the health care litigation are impossible to overstate,” said Thomas Goldstein, a prominent Washington attorney and publisher of SCOTUSblog.com. “It has tremendous consequences for President Obama’s re-election because it’s a signature achievement. But in terms of law, this case is really going to decide how much power Congress has to regulate spheres that we’ve often thought of as the jobs of the states or of just individuals.”
A century of federal efforts to offer universal health care culminated with the 2010 passage of the Patient Protection and Affordable Care Act. After months of bare-knuckled fights over politics and policy, the legislation signed by Obama reached 2,700 pages, nine major sections and 450 some provisions.
The partisan debate around such a sweeping piece of legislation has encompassed traditional hot-button topics: abortion and contraception funding, state and individual rights, federal deficits, end-of-life-care and the overall economy. The high court now gets the final word.
“These issues are really central to whether the federal government can regulate anything it wants to, or whether there are some things that only the state governments can regulate,” said Paul Clement, the attorney who will argue against the law, on behalf of a coalition of 26 states.
On the other side are progressives who back the Obama administration and its congressional supporters.
“Congress thought it necessary to regulate the nearly 20% of our nation’s economy that makes up the health care industry and to make sure insurance companies did not discriminate against people with pre-existing conditions, for example,” said Elizabeth Wydra, chief counsel at the Constitutional Accountability Center. “That is squarely within Congress’ authority.”
Debate comes down to four key issues
Despite its complexity, the high court has narrowed its focused to just four key issues:
One: Constitutionality of the individual mandate (also known as the “minimum coverage” requirement), the key funding provision.
Two: Whether the individual mandate is a “tax,” thereby limiting authority of the courts to immediately decide the mandate question.
Three: Whether other parts of the law can survive if the mandate is struck down.
Four: Federal vs. state conflict over expansion of the cooperative Medicaid program.
It is the “individual mandate” that has sparked the most controversy. It requires nearly every American to purchase some level of insurance or face a tax penalty of up to about $700 a year.
Typical of the ideological divide, the opposing sides do not even agree on what the individual mandate was designed to accomplish. Supporters see it a way of spreading health care costs to a larger pool of individuals, ensuring affordable, quality medical care. They say regulating commerce and the economy has long been a federal prerogative.
The Justice Department will tell the high court that since every American will need medical care at some point in their lives, individuals do not “choose” to participate in the health care market. Federal officials cite 2008 figures of $43 billion in uncompensated costs from the millions of uninsured people who receive health services, costs that are shifted to insurance companies and passed on to consumers.
But opponents see a fundamental constitutional violation, an intrusion into citizens’ personal lives, forcing Americans to purchase a commercial product they might not want or need. The states equate such a requirement to a burdensome regulation of “inactivity.”
One federal appeals court has found the act unconstitutional. Two others have has said it is a proper exercise of congressional mandate. A third court has ruled against the states on technical grounds, saying local officials lack authority to even go into to court and argue the individual mandate issue. Twenty-eight states and countless individuals and groups have sued the administration.
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Article Source: CNN