My kids are excited about spring break. I'm even more excited than they are... but for an entirely different reason. Today is the first of three days of oral arguments in front of the Supreme Court regarding the Affordable Care Act. The High Court hasn't devoted this much time (approximately 18 hours of oral argument) to a single case in 40 years. The court room only has seats for 60 members of the general public (the rest are held for media, I suppose) and the line began to form on Friday afternoon for this morning's session.
The Court will actually consider four distinct issues over the next three days all related to the health care law. Today's argument focuses on a rather arcane, but quite critical, argument that the court doesn't even have the right to hear the remaining three issues at this point. The 1867 Anti-Injunction Act stipulates that a tax must be paid before its constitutionality can be contested. The individual mandate doesn't kick in until 2014 and the penalty for not having insurance (the "tax" being contested) isn't assessed until 2015. The government will argue that because the tax has yet to be paid, the rest of the case has no standing. Here's the reality, though: for the Court, this is a once-in-a-generation sort of case and this kind of technicality isn't going to get in the way of the justices casting opinions on the broader law.
Tuesday and Wednesday will bring the meat of the arguments, mostly revolving around the expansion of the Medicaid program and the individual mandate.
And for those as fascinated as I am comes this interesting twist: the Court will post the audio of the oral arguments each day this week by 4:00 pm. The Court has posted the audio of oral arguments online for some time, but typically a week or so after the case is heard. Not since Bush vs. Gore in 2000 has the Court posted the audio on the same day as the arguments. You can find the audio here:
http://www.supremecourt.gov/oral_arguments/argument_audio.aspx
These next three days, and the decision(s) that follow, will impact how we access, pay for, and receive health care services for at least a generation. The ripple effects cannot be overstated. The Supreme Court is going to decide how a $3 trillion industry should fundamentally operate. If you're in health care, this is the most important moment since LBJ signed Medicare into being in July of 1965.
Michael
On Twitter @PRIUM1
If the conservatives on the court are true to their beliefs thay will strike the individual mandate but leave the rest of the law intact which will have the affect of quickly leading to much higher health care costs and then to the necessity of a single payer system as carriers go broke under the requirements to provide low cost care even to those with pre-existing conditions.
ReplyDeleteOr will they legislate from the bench?
I think that Justice Kennedy will see what could happen if they only strike down the mandate and either decide to uphold it, or strike the entire act.