Juliette Mullin, staff writer
The federal health reform law wound its way through the courts in 2011 and ultimately landed before the Supreme Court, which will hear legal challenges against the overhaul early next year.
Although health experts say the law already has made irreversible changes to the industry, funding for its various programs depends on the court's ruling. Moreover, canceling planned expansions to Medicaid and repealing the individual health insurance mandate would reshape many stakeholders' plans, as many providers, insurers, and other stakeholders have spent the past year preparing for large-scale changes.
Path to the Supreme Court
Even before its March 2010 passage, opponents pledged to challenge the health reform law in court. Specifically, they took aim at the bill's individual mandate and Medicaid expansion provisions.
Nearly two dozen lawsuits were filed after the overhaul became law. At least 13 of those suits were dismissed on procedural grounds. After some wins and losses on both sides, four cases made it to the Supreme Court, which decided to consider only one case, filed by 26 states, the National Federation of Independent Business, and two individuals.
The case argues that the reform law's individual mandate exceeds Congress' power to regulate interstate commerce. It also argues that the law's Medicaid expansion is unconstitutional and "coercive."
In an earlier ruling on the case, U.S. District Court Judge Roger Vinson sided with the plaintiffs and concluded that the mandate is "inextricably bound" to other provisions in the law, invalidating the entire overhaul. An appeals court then struck down the individual mandate in a 2-1 ruling, but left the Medicaid expansion intact.
Department of Justice lawyers argue that residents who do not buy health insurance pass on billions of dollars in costs to taxpayers. They also suggest that the decision to not purchase insurance is an action worthy of taxation, legitimizing the individual mandate.
The Supreme Court will review the constitutionality of the individual mandate and the issue of “severability,” which will determine whether individual provisions can be struck down without jeopardizing the entire law. It also will weigh whether a separate federal law prohibits the court from ruling on the individual mandate prior to 2014, when it takes effect. Oral arguments will begin on March 26, and the court is expected to rule by June.