8 Things to Know About the Supreme Court and Obamacare


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8 Things to Know About the Supreme Court and ObamacareThe controversial Affordable Care Act, more popularly called Obamacare, made its way to the Supreme Court this week, with the justices hearing arguments on several pieces of the law President Barack Obama signed two years ago. The decision could affect the health care plan that Democrats fought so hard to get approved and Republicans have fiercely opposed. Of course, any time politics, legality, and insurance combine, things are going to get confusing. Here are the eight things you really need to know to understand what's going on with the Court, the health care law, and what the possible outcomes could be.

  1. There's more to the law than the individual mandate

    You hear a lot about the part of the health care plan requiring all Americans to purchase health insurance or pay a penalty, but what about the rest of the act? There is a lot contained in the Affordable Care Act that you may have forgotten about. Just a few of the many services included in the law are more insurance options for people with pre-existing conditions, children not being kicked off their parents' insurance plan until age 26, and drug discounts for some seniors. The expansion of Medicaid is another important part to the Affordable Care Act getting less ink than the individual mandate, even though the Supreme Court is taking it on as an issue for debate. The justices heard arguments on Wednesday for and against states being forced to take on more Medicaid expenses.

  2. But the mandate is still the most contentious issue

    The least popular part of the law is still the idea of the government mandating that everyone must buy health insurance. People who can't afford the minimum policy with 8% of their income wouldn't have to buy it, but would likely receive subsidies to make it affordable. Others would receive a penalty of at least $695 a year if they didn't have health insurance. The Commerce Clause is at the center of the legal debate, which allows the government to regulate interstate activity. Proponents of the mandate say that people not buying insurance has an economic effect that the government can regulate. Opponents say that choosing to not buy something is economic inactivity and thus not able to be regulated. The Court heard two hours of oral arguments on the topic on Tuesday, longer than many issues receive.

  3. The ruling should be made before the 2012 elections

    With the Supreme Court hearing arguments now on the issues of the health care plan, their decisions and written opinions will be released before the end of the Court term this summer. This means the Affordable Care Act should be upheld, struck down, or dismantled by late June, in plenty of time for the November elections. It's unclear what effect the decision will have on the election, but we're sure it's going to be a big campaigning point for whichever side feels they benefited from the ruling.

  4. But the decision could be delayed by an old tax act

    The first issue that the Supreme Court will decide on regarding the health care act is whether it has the jurisdiction to rule on it right now at all. The Anti Injunction Act, created in 1867, is a federal tax law that prohibits anyone from challenging a tax until after the tax has gone into effect. The justices requested to hear arguments about whether the penalty Americans would pay for not buying health insurance is considered a tax. If they decide it is a tax, the Court would not have jurisdiction to rule on the individual mandate until 2015, after it has gone into effect. The arguments regarding the tax act were heard Monday and justices appeared to be against considering the mandate as a tax, which would let them take on the other issues of the health care law. We likely won't know officially until the summer.

  1. Overturning the mandate could take down the whole law

    There are a handful of possible outcomes for the Supreme Court's decision. The first is that the Court declares the individual mandate unconstitutional and the entire health care reform law would crumble. On Wednesday, the Court's first issue of the day was the severability of the individual mandate — in other words, whether that one part of the law could be taken out without destroying the whole statute. There are hundreds of provisions in the law, but many argue that the individual mandate is the "heart" of the plan, its source of funding, and inseparable from the rest of it. This scenario would send Congress and reform supporters back to the drawing board.

  2. The mandate could be struck down without affecting anything else

    If the justices decide that the individual mandate is unconstitutional but severable, the rest of the law could remain unchanged. The other provisions would go into effect as planned. If this happens, it's likely that Congress would try to replace the mandate with something that might perform some of the same purposes as the mandate. Some experts have suggested that a tax could be an easy solution. It could go into effect relatively quickly and raise the necessary revenue to make the rest of the law's provisions feasible.

  3. The administration wants two provisions thrown out if the mandate is overturned

    While the preceding scenario could happen, you might be surprised to find out that the Obama administration doesn't want it to. Not totally, at least. Because the individual mandate was conceived as the source of the money that would pay for some rather expensive provisions in the law, letting all parts of the health care plan stand besides the mandate would put a serious financial burden on the insurance companies. They'd be required to provide services to more and very likely sick Americans, but wouldn't necessarily be getting more business from the healthier people to help offset those costs. The administration argued in a brief to the Court that if it gets rid of the mandate, it should also get rid of two popular but expensive rules: guaranteed issue and community rating. These are the provisions, respectively, that keep insurance companies from refusing coverage because someone has a pre-existing condition and from charging more based on a person's medical history. Getting rid of these provisions might allow the rest to stand without facing revenue shortages.

  4. It could still all be upheld

    Many who heard the oral arguments and the justices' pointed questions throughout the week felt the Affordable Care Act's prospects were looking grim, but it's not over until it's over. Many legal experts point out that judges often ask hard questions and end up voting in a surprising way. Doubts the justices have expressed may just be part of the information-gathering process and will help them form their written opinions later. Many are looking to swing justice Anthony Kennedy, as his may be the decisive fifth vote for the winning opinion. We'll see how it shakes out come June.

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