Massachusetts Medical Society: Supreme Court Hearings on Patient Protection and Affordable Care Act to Begin

Supreme Court Hearings on Patient Protection and Affordable Care Act to Begin

Federal Update

Vital Signs: March 2012

In late March, the U.S. Supreme Court is scheduled to hear arguments challenging the Patient Protection and Affordable Care Act. A ruling on the landmark 2010 health law is expected in June.

Because of the importance of this case, the court said it would allocate five-and-a-half days for oral arguments, as opposed to the usual one hour.

The Court is expected to hear arguments on four key issues: the constitutionality of an individual insurance mandate; whether other parts of the law can be maintained if the individual mandate is struck down; the constitutionality of requiring states to expand their Medicaid benefits or lose their federal Medicaid matching funds; and whether or not the nation's highest court should rule on any of the issues at this time, given that the mandate does not go into effect until 2014.

Options before the court include upholding the law, striking down the entire law, striking down the most controversial provisions, or deciding that any decisions at this time are premature given the 2014 implementation date for key provisions. The Obama administration maintains that Congress has the authority "to regulate commerce, levy taxes and enact any necessary and proper laws," and that without the individual mandate, requirements banning preexisting con­ditions and other insurance reforms would be virtually impossible to implement.

As significant as the Supreme Court's ruling will be this spring, the outcome of the 2012 presidential and congressional elections will also be critical. Most leading Republican candidates have campaigned on promises that, if elected, they intend to dismantle or even completely repeal the Obama administration's health care law. If President Obama is elected to a second term in November, his administration will likely seek to strengthen the law and to seek the appropriations necessary for its full implementation.

It seems that the American public is still split on the issue. A Kaiser Family Foundation poll conducted in January found that 37 percent of Americans have a favorable view of the law and 44 percent unfavorable. Another poll showed 50 percent of respondents favor keeping or expanding the law, and 40 percent either favor repealing the law or replacing it with an alternative approach.

- Alex. Calcagno

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