Supreme Court puts healthcare law in campaign spotlight


The Supreme Court’s decision to hear arguments on the fate of President Obama’s healthcare law sets the stage for a ruling just as the presidential election shifts into full swing, putting the law — and the justices — in the center of the campaign.

Both sides see the case as posing a profound legal dispute over the size and scope of the federal government, reminiscent of the 1930s court battles over President Franklin Roosevelt’s New Deal.

At stake now is whether Congress has the power under the Constitution to require all Americans to buy health insurance — a linchpin of the new law. Conservatives have made the “individual mandate” a key part of their argument that Obama and congressional Democrats tried to expand government regulation to an unprecedented degree.


Democrats argue that the requirement will help control costs and spread the risk. Otherwise, individuals could refuse to buy insurance until they were taken to a hospital with a medical emergency. In 2008, hospitals, insurers and taxpayers paid $43 billion to cover the medical costs racked up by uninsured people.

“Probably no court case in modern times would have the impact this would” in the middle of a presidential campaign, said Ed Rollins, who directed Ronald Reagan’s 1984 reelection. The impact comes both because the case involves one of the most hotly debated issues of the campaign, and because the decision will come at a key moment of the general election contest — most likely June of next year.

If the court rules for Obama, the president will be able to say that in his first term he had enacted a healthcare plan “that people have been trying to accomplish since Roosevelt was president, and ‘I got it done,’ ” said Democratic strategist Paul Begala.

Striking down the law would be a major victory for the tea party movement that has been pushing Republican candidates to the right. But depending on how the justices divide, a ruling against the law could also rally support for Obama among Democrats, Begala said. The high court has a majority of Republican appointees, and a decision that appears partisan might leave many Democratic voters “up in arms,” he said.

The healthcare dispute has sharply divided Democrats and Republicans. In the main case before the court, Republican officials from Florida and 25 other states asked the justices to strike down the sweeping set of insurance rules and healthcare subsidies that were passed by Democrats in the House and Senate with no GOP support.

So far, however, the rulings in the four federal appeals courts that have considered the law have not followed a simple partisan pattern.


Of the four, only the Atlanta-based 11th Circuit ruled the law unconstitutional; it is that ruling the justices have agreed to review. Two appellate courts have upheld the law, and one ruled that the challenge to the law was premature. In the appeals courts, the judges voting to uphold the law have included prominent conservatives appointed by Republican presidents, giving supporters of the law some optimism about their chances in the high court.

The court said Monday it would devote five and a half hours to oral arguments in March, a departure from the normal one hour that underscored both the importance and the complexity of the case.

The justices said they would consider four questions:

Is it constitutional for the federal government to require all people to have basic health insurance by 2014?

If not, can this provision be severed from the law, or must the entire statute be struck down?

The third question came as something of a surprise. The justices agreed to consider the states’ complaint that it is unfair to force them to pay more for expanding the Medicaid program. Sponsors of the law estimate that 16 million children and low-income adults will be eligible for government-subsidized healthcare, and the federal government will pay at least 90% of the cost. No judge has decided this part of the law exceeds the federal government’s powers.

The fourth question asks whether the court should put off a decision until 2015, when the first taxpayer would pay a penalty for not having insurance. Under a law known as the Anti-Injunction Act, judges are barred from deciding on tax cases until the tax has been paid. Lawyers differ over whether the new healthcare law adds a “tax” for those who lack insurance or instead imposes a “penalty” that must be paid to the Internal Revenue Service. The Obama administration says it is the latter.


If the justices find themselves closely divided and unable to agree, they could opt to put off a final decision by invoking the Anti-Injunction Act.

Paul West in the Washington bureau contributed to this report.