Health News

Obama's health law hangs in balance with skeptical court

By Anne K Walters and Frank Fuhrig Mar 27, 2012, 19:56 GMT

Washington - The Obama administration defended its landmark 2010 health care reform Tuesday before the US Supreme Court, which is weighing whether to strike down some or all of President Barack Obama's signature domestic policy.

During a two-hour hearing in the landmark case, Justice Anthony Kennedy, usually the most likely of the court's five conservatives to join the four left-leaning justices in forging majority decisions, called the law's impact 'concerning.'

The justices subjected both sides to tough questioning, with Kennedy saying that the law's requirement for people to buy health insurance would change 'the relationship between the individual and government in a fundamental way.'

The four left-leaning justices seemed favourable to the law. Among the five court conservatives, Chief Justice John Roberts posed the most even-handed questions, and called the health care business 'very different than the market for cars' and other goods.

The justices' questions during oral arguments can sometimes hint at their leanings. A decision is expected this summer.

The health care measure has been a hot button issue since its passage, and the Supreme Court hearing moves it back to the centre of public debate ahead of the November presidential elections.

The measure requiring the purchase of health insurance is deeply unpopular with the American public. Only 28 per cent support the mandate and 66 per cent oppose it, in a United Technologies/National Journal poll released Tuesday. The broader health care measure is more popular, with 43 per cent in favour and 46 per cent opposed.

Some court watchers queued up for days to get seats in the chamber, where six hours of arguments were to be heard over three days, instead of the single 60-minute session allotted for most cases.

The court was weighing whether the federal government can force individuals to purchase health insurance or pay a fine, as part of Obama's effort to expand health insurance coverage to nearly all Americans.

The 2010 health care law was intended to reform a system that 'does not work,' said Solicitor General Donald Verrilli Jr, the government's lawyer for Supreme Court cases.

He argued that all Americans will eventually need to purchase medical care - so the new law's requirement for individuals to buy insurance is a reasonable exercise of Congress' constitutional power to regulate interstate commerce.

He argued that there was no time limit on congressional power under the so-called commerce clause of the constitution: 'They're just regulating in advance, and that's the kind of thing that ought to be left to Congress and the democratically elected branches of government.'

Paul Clement, an attorney for the 26 states opposing the Patient Protection and Affordable Care Act, argued that the so-called individual mandate in the law regulates private economic inaction: 'The question is whether for the first time in our history Congress has the power to force people into commerce.'

The justices put forward a series of hypothetical questions to test the limits of what Congress could legislate if it can require insurance purchases.

'Can the government require you to buy a cell phone because that would facilitate communication in an emergency?' Roberts asked.

Other conservatives asked whether burial insurance could be required since everyone will die, while some pointed to potential requirements to eat broccoli or join a health club.

Liberals on the court seemed to argue the government's case.

'Unlike food or any other market, when you made the choice not to buy insurance, even though you have every intent in the world to self-insure, to save for it, when disaster strikes, you may not have the money,' noted Justice Ruth Bader Ginsburg.

Demonstrators gathered outside, with some supporters of the measure waving signs that read, 'Protect my health care.'

Hundreds of other activists were present on behalf of the Tea Party movement, a Republican, small-government faction that sprouted in 2009-10, largely in response to Obama's health care proposals.

'We're opposed to it, as is the Constitution of the United States,' said Vincent Ferro, who drove with a friend from New York state overnight.

The hearings began Monday with procedural arguments about whether the court can hear a challenge to a law whose main provisions will not go into effect for years. On Wednesday, the court will consider whether the law must be struck down as a whole if parts are determined unconstitutional and debate an expansion of state health care for the poor.

Obama pushed for the law to help an estimated 30 million people without health insurance and address soaring costs in one of the few wealthy nations that do not guarantee insurance coverage to all citizens.

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