U.S. Supreme Court agrees to take on health reform law

As expected by observers on both sides of the debate about the health system reform law, the U.S. Supreme Court officially has decided to consider several constitutional challenges to the statute, setting up a legal showdown over President Obama's signature legislative achievement amid his re-election bid.

The high court on Nov. 14 announced that it will review the Patient Protection and Affordable Care Act, consolidating two pending lawsuits that seek to overturn the statute. The key question at stake is whether the measure is constitutional -- specifically a provision that requires individuals to obtain health coverage starting in 2014 or pay a penalty.

The Obama administration requested in September that the high court review the law, after an appeals court panel ruled that the individual mandate was unconstitutional but that the rest of the reform law should remain in force. The 26 states that were the plaintiffs against the administration in that case also asked justices to take up the issue, as did petitioners in four other cases that the justices reviewed as part of their official docket.

In taking on the issue, justices consolidated the 26-state lawsuit with a separate suit brought against the reform statute by the National Federation of Independent Business.

To rule on the lawsuits, the high court will need to reconcile several conflicting rulings by lower courts. Most recently, the U.S. Court of Appeals for the District of Columbia Circuit on Nov. 8 upheld the reform law as constitutional in a suit brought by the American Center for Law and Justice. Although the case was not officially on the Supreme Court's docket when it made its determination, the ruling could influence justices. In its 2-1 opinion, the appeals court judges said the plaintiffs could find no support for their argument in the Constitution nor in prior high court opinions.

"That a direct requirement for most Americans to purchase any product or service seems an intrusive exercise of legislative power surely explains why Congress has not used this authority before, but that seems to us a political judgment rather than a recognition of constitutional limitations," wrote Senior Judge Laurence Silberman. "It certainly is an encroachment on individual liberty, but it is no more so than a command that restaurants or hotels are obliged to serve all customers regardless of race, that gravely ill individuals cannot use a substance their doctors described as the only effective palliative for excruciating pain, or that a farmer cannot grow enough wheat to support his own family."

That court decision clashes with an August opinion by the 11th U.S. Circuit Court of Appeals on the multistate lawsuit, finding that Congress exceeded its authority by requiring all Americans to obtain health insurance or pay a tax penalty. In another case, the 6th U.S. Circuit Court of Appeals ruled in June that the mandate and the rest of the law were constitutional.

More than a dozen legal challenges have been filed against the health reform law since 2010, the majority of which were dismissed by lower courts, which stated that the plaintiffs had no standing to sue yet, because the major provisions of the reform law had not yet been implemented. If the high court takes a similar stance, the next chance for reform law opponents to defeat the statute, outside of a legislative repeal, might not come until after 2014.

In addition, even if the justices invalidate the individual mandate, the rest of the reform law would remain in force unless they also decide that the remainder of the statute is not severable from the mandate language.

Oral arguments in front of the Supreme Court probably will occur in the spring of 2012, meaning that a ruling later in the term will arrive in the thick of the 2012 election cycle. Legal and policy observers said a lawsuit dismissal or another ruling that leaves the reform statute intact would be a big win for Obama as he seeks re-election, but any decision that goes against the law would be used to try to weaken his campaign.