The Affordable Care Act Heads to the Supreme Court

The constitutionality of the health reform law's individual mandate will be at the center of the debate.

On March 26, a new kind of March Madness will ensue on Capitol Hill when the U.S. Supreme Court begins hearing oral arguments in a lawsuit challenging the constitutionality of the Affordable Care Act. Conservative and liberal groups will also have their say in planned rallies and protest demonstrations for and against the legislation that could get heated. Here’s what all the fuss is about.


Who is challenging the health care reform law?


Twenty-six states and the National Federation of Independent Business filed in Florida the lawsuit that the Supreme Court will hear. In addition, 25 other lawsuits opposing the law have been filed. Courts in Michigan and the District of Columbia ruled in favor of the law, the 11th Circuit Court ruled it unconstitutional and a U.S. Court of Appeals for the 4th Circuit dismissed two cases challenging the law.


Why is the health reform law being challenged?


At the center of the challenge to the Affordable Care Act is the individual mandate requiring most individuals to purchase health insurance or pay a fine. Opponents of the law say that the mandate is unconstitutional because it uses the Commerce Clause in the Constitution, which gives the federal government the authority to regulate multi-state economic activity. In addition to arguing that not buying insurance is an economic inactivity and therefore not subject to the clause, they contend that the federal government cannot force individuals to pay for something they would not otherwise buy.


Health reform supporters say that choosing to not buy coverage is an economic decision because individuals who don’t have health care coverage will go to the emergency room when they get sick and if they’re unable to pay the bill, it will be passed on to hospitals and taxpayers. They also argue that requiring everyone to have insurance keeps costs down.


What happens if the individual mandate is ruled unconstitutional?


The Supreme Court justices have a few choices. They could strike down the mandate and let the rest of the bill stand. They also could rule in favor of the mandate because without it the entire law falls apart. Another option is to not rule at all because the mandate doesn’t kick in until 2014.


What is the timeline for oral arguments and a decision?


From March 26 to 28, the court will hear six hours of oral arguments: two hours will focus on the constitutionality of the individual mandate. Then 90 minutes will be spent on whether the mandate can be severed from the rest of the law. One hour will be spent on the law’s Medicaid expansion and the final 90 minutes will be spent debating whether it’s too soon to offer arguments about something that hasn’t even gone into effect. The Supreme Court justices are expected to provide what could be a landmark decision the case in the summer, just as the presidential general election cycle begins heating up.


Why should African-Americans care that the law could be struck down?


According to the White House, hundreds of thousands of African-American young adults have already benefitted from the law by being able to stay on their parents’ plans until age 26. In addition, 5.5 million now have access to preventive care without co-pays and millions will no longer face lifetime limits on coverage, which is particularly important for individuals and families dealing with such conditions such as diabetes and heart disease, which disproportionately affect African-Americans.


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(Photo:  Marvin Joseph/The Washington Post via Getty Images)

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