What can be said about the PPACA Supreme Court hearings that hasn’t already been said? Not much. Ever since the Supreme Court announced that it would hear cases brought by several states challenging the law, the coverage revved up day by day until going full-force over three days from March 26 to 28 as the nine justices listened to arguments for and against upholding the law.
People lined up for a chance to hear snippets of the proceedings and the Supreme Court expedited the posting of transcripts. In the days leading up to the hearings, while the hearings were being conducted and even now as we wait for the Supreme Court’s final decision that will likely come in June or early July, these articles helped me navigate through the webby legal system and gain a better understanding of what’s at stake, what’s being argued and a hint at what could happen.
In A Look At Health Reform On Its 2nd Birthday a detailed timeline with embedded video and links show the progress that PPACA has made since it was signed into law in March 2010. From keeping children on their parent’s insurance until their 26th birthday, establishing the Centers for Medicaid and Medicare Services Innovation Center and setting federal minimum guidelines for state health insurance exchanges, the PPACA has been a steadily moving train.
Two articles, one explaining the Anti-Injunction Act and another regarding the 1942 case Wickard v. Filburn, explain a key law and key case affecting the hearings. The Anti-Injunction Act was a focus of the day-one hearings. The Wickard v. Filburn case was particularly interesting because it laid the precedent for Congress’ extent of power over the Commerce Clause. Ironically, both sides argued how the case supports their argument over the other.
After each day of arguments, I visited the <a href=”" target=”_blank”>Kaiser Health News websiteand listened to legal analyst Stuart Taylor Jr.’s synopsis of the arguments and questions posed by the attorneys and judges. On the last day, he summarized each attorney’s recommendation to the court.
The decision, however, will have to wait until the summer, which does nothing to squelch the temptation to speculate. Most reports I’ve read predict it will be a slim 5-4 vote either for or against. As the justices discuss the matter behind closed doors, the only resource we have to foretell what could happen is what was asked inside the court during those three days.
Will they decide to uphold the whole law or strike it down entirely? And what’s to be done with the individual mandate, the most controversial aspect of the law which says either buy insurance or a pay a fine? If the individual mandate is struck down and the rest of the law upheld, many believe that other major and popular previsions such as the Guaranteed Issue and Community rating, which halt insurers from discriminating against those with pre-existing conditions, cannot stand — arguing that those aspects without the individual mandate bringing in large numbers of healthy insureds would send premiums sky-high.
But amidst the uncertainty, others believe the PPACA (that steadily-moving train) has made such progress that even if it were struck down in its entirety, </its legacy would still live on in very tangible ways . It has set a trend to improve care while lowering its costs and provided monetary incentives to organizations to better use technology and develop payment models based on outcome rather than procedures. Many providers and insurers adopted these trends even before PPACA was passed, even before they were trends, and it is unlikely they will stop.