March 26, 2012

The Supreme Court on Monday heard the first of three days of arguments on President Barack Obama’s health care overhaul, a law that touches core political divisions in the United States and will have a major impact on the life of virtually every American.

Since Obama signed the legislation into law two years ago, 26 states have challenged the constitutionality of the overhaul, the largest expansion in the nation’s social safety net in more than four decades.

All four Republicans battling for the nomination to challenge Obama in November have promised to undo the overhaul, provided the conservative-dominated Supreme Court doesn’t strike it down in a decision that’s expected in June.

The fight over the law, aimed at extending health insurance to more than 30 million Americans, has further inflamed deep divisions in a country knocked off balance by the Great Recession and embroiled in a political battle about the role of government.

In active questioning over 90 minutes, none of the justices appeared to embrace the view that the case has been brought prematurely according to an obscure 150-year-old law that bars tax disputes from being heard in the courts before the taxes have been paid. Under the new health care law, taxpayers who don’t buy insurance will have to pay a penalty on taxes due in 2015.

At issue is whether that penalty is a tax. The question is key because the health overhaul’s so-called “mandate” — the requirement that all Americans buy or have health insurance coverage — will not become effective for three years.

Solicitor General Donald Verrilli Jr., defending the health law, urged the court to decide what he called “the issues of great moment” at the heart of the case.

By refusing to issue a ruling because the mandate provision does not go into effect for two years, the justices would avoid rendering a decision just months before the presidential election.

Until the health care law, the United States was the only major developed country without a national health care system.

Demonstrators chanted outside the court Monday. “Care for you, care for me, care for every family,” supporters shouted. A half-dozen opponents yelled, “We love the Constitution!”

Republicans are leading the fight to kill the law either via the court or through congressional repeal. They say the worst fears about what they derisively call “Obamacare” already have come to pass in the form of higher costs and regulations — claims that the law’s supporters dispute.

Polls have consistently shown the public is at best ambivalent about the benefits of the health care law and that a majority of Americans believe the requirement to buy insurance is unconstitutional.

The hearings this week will be closely followed for clues about what the nine Supreme Court justices are thinking. The court has four liberal-leaning justices appointed by Democratic presidents — two by Obama — and five conservatives appointed by Republican presidents. In order for the law to stand as written, at least one of the conservative justices will have to join the liberals in ruling to uphold the law.

The insurance mandate that likely will dominate the hearings was designed to protect the profits for insurance companies by expanding the number of people who are customers. That is envisioned as an offset to losses as a result of federal laws preventing insurers from denying coverage to people with medical problems, forbidding them from dropping coverage for individuals who become seriously ill and limiting how much they can charge older people.

Opponents of the mandate provision argue that Congress lacked authority under the Constitution for its unprecedented step of forcing Americans to buy insurance whether they want it or not.

The administration argues Congress has ample authority to do what it did. If its action was rare, it is only because Congress was dealing with a problem that has stymied Democratic and Republican administrations for decades: How to get adequate health care to as many people as possible, and at a reasonable cost.

The justices also will take up whether the rest of the law can remain in place if the insurance mandate falls.

By 2019, about 95 percent of the country will have health insurance if the law is allowed to take full effect, the Congressional Budget Office estimates.

Reams of court filings attest that the changes are being counted on by people with chronic diseases, touted by women who have been denied coverage for their pregnancies and backed by Americans over 50 but not yet old enough to qualify for Medicare, the federal health insurance program for Americans when they reach age 65.

People hoping for a glimpse of the action waited in line all weekend for the relatively few seats open to the public. The justices allotted the case six hours of argument time, the most since the mid-1960s. The usual time is an hour, with 30 minutes for each side.

The court, which has steadfastly denied access to television cameras, will release audio recordings of the arguments on the same day they take place. The first time that happened was when the court heard arguments over ballots in Florida in a case that decided the 2000 presidential election in favor of George W. Bush. The last occasion was the Citizens United case that freed businesses and labor unions to spend unlimited money in the current presidential contest.