Those anticipating a U.S. Supreme Court ruling on the Affordable Care Act will have to wait a bit longer.
The nation's highest court is expected to release its much-anticipated ruling on sweeping health care reforms approved in 2010 on June 25. Many people had anticipated the court would issue its much-awaited ruling on June 21, but the court instead issued four other opinions on issues as varied as union contributions to political campaigns and decency standards for broadcasters.
Reed Rubinstein, a Dinsmore & Shohl partner in the firm's Washington, D.C. office, said the nation's highest court has four main questions to tackle in the health care reform law.
The Affordable Care Act was signed into law March 23, 2010. Shortly after, 13 states sued, challenging its constitutionality. Thirteen later turned into 26 states. However, West Virginia declined to join the suit.
According to court documents, the act covers several major aspects to reduce the number of uninsured people. Among those aspects, the act would alter private insurers' underwriting practices and restrict pricing structures. It also would create a state-run Health Benefit Exchange to serve as a marketplace where people could competitively purchase new insurance plans.
The U.S. Court of Appeals for the 11th Circuit, ruled by a 2-1 vote it was unconstitutional to require citizens to buy insurance.
However, the 6th Circuit concluded that plaintiffs have not shown the individual mandate exceeds Congress' power under the Commerce Clause.
Determining the constitutionality of the individual mandate will be one of the main decisions high court justices must make, Rubinstein said.
Rubinstein said the court must decide whether the individual mandate is a tax. If justices say the mandate is a tax, no one has standing to challenge it until it is paid, Rubinstein said, which would put proceedings on hold.
"The conventional wisdom is people are saying it is not a tax. The government says it's not a tax. It would be odd if the court said they're both wrong and it is a tax," he said.
The second question is whether the rest of the bill can stand if the mandate is struck.
"The answer is yes, it can. But the question is whether the court will rule that way. My guess would be the court will say the individual mandate can be severed from the rest of the act ," he said.
Justices also must address a federalism question, Rubinstein said. He said certain provisions in the Affordable Care Act requires the states to implement policies, which has been challenged on the basis that the federal government cannot require states to implement federal policies.
"Conventional wisdom is to uphold that provision. If there was a surprise, it would be here. This is something the court asked for arguments over the phone and no one saw that coming. There's a strong group on the court that really cares about federalism issues. … It's very possible we will get a federalist ruling, maybe 5-4, saying it's a congressional overreach."
If the court chooses to strike the individual mandate but leaves the rest of the act intact, what will be the plan of finance, Rubinstein asked.
"If you strike out the individual mandate, which is the funding source, then what's next? That's where it will be very interesting."
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