The Supreme Court heard arguments in the Affordable Health Care case back in March. They have had three months to vote on their positions and write their opinions.
And it probably took them all that time to craft their decisions.
This is a complex law, with many interconnecting pieces, but the Court will rule on four questions.
The Individual Mandate
The centerpiece of health care reform is the individual mandate, which requires everyone to have some kind of health insurance coverage, starting in 2014, or pay a penalty on their income taxes.
The question: Is this constitutional?
Using the Commerce clause of the U.S. Constitution, Congress said it does have the power to force people to purchase something, thus, commerce.
Opponents said this is an overreach of power, that the Commerce clause doesn't allow for this type of action.
Lower courts were split on this, but the D.C. Circuit Court of Appeals, considered one of the more conservative courts in the country, and the next rung down the judicial ladder from the Supreme Court, ruled the individual mandate was constitutional.
The individual mandate is so intertwined in the law that what happens to it could determine what will happen to the rest of the law.
Which leads to …
So if the individual mandate is struck down, what happens to the rest of the law?
There are some popular provisions of the law already in place, like allowing young adults to stay on their parents' insurance plan until age 26.
If the Court upholds the individual mandate, then more than likely the whole law would stand.
But if the Court strikes down the individual mandate provision, can the rest of the law stand or would it be thrown back to Congress for consideration?
And speaking of Congress …
Expansion of Medicaid
Another major provision of health care reform is expansion of the Medicaid program.
Medicaid is the federal health care program for the poor. The Affordable Care Act requires the states to expand the Medicaid program, and the federal government would pay 100 percent of the costs … in the beginning.
The Court should rule if Congress overstepped its power in the Spending clause of the Constitution by requiring the states to expand the program.
The states claim the feds put strings on the money, which they say is unconstitutional.
But there is a chance that all of this might not happen because if …
The Court can't actually rule on health care reform yet
The first day of arguments back in March focused on an obscure 150-year-old law that pertains to taxes — the government's revenue stream.
The arguments boiled down to this: Is the penalty that Congress set in the health care law considered a “tax,” and, since the individual mandate doesn't kick in until 2014, do opponents of the law have standing to sue, since they haven't been charged anything?
It is possible, however, unlikely, that the Supremes say we can't decide on this yet, and punt it back to Congress.
Now, let's be honest, the Court has never shied away from issues of great national importance (see: Marbury v. Madison, Brown v. Board of Education, Roe v. Wade, Bush v. Gore, U.S. v. Nixon).
So let's assume they will rule, but which way?
Reading tea leaves
Justice Ruth Bader Ginsburg recently said those who are guessing on the outcome of the health care reform law case don't know and those who do, aren't saying.
We can infer what we want to from the types of questions the justices asked and their ideological backgrounds.
But I'm betting on a surprise — one that comes out of left field, that no one is expecting.
Hey, the Court has to keep the president and Congress on their toes, right? After that, that IS in the constitution.
To learn more
- SCOTUSBlog will begin live-blogging at 8:45 a.m. They are usually the source to get the rulings out the fastest.
- The Oyez Project has a great primer on the health care cases, with legal experts parsing the arguments in plain language.
- The Twitter hashtag #otherSCOTUSdecisions has some speculative predictions on what OTHER decisions the Supreme Court will hand down today ... with hilarious results.