The U.S. Supreme Court resumed deliberations on the constitutionality of the individual mandate component to President Barack Obama’s health care reforms yesterday.
The Affordable Care Act, signed into law by Obama two years ago, has been challenged by lawsuits filed by numerous states, including Michigan, and conservative organizations since its implementation. Yesterday’s two-hour deliberation included pointed questions from the justices and a charge that the ACA was an unprecedented exercise of Congress’s authority. With the balance of the Court’s decision still in the air, experts say a verdict is not expected until June.
Despite the barbed questions from some justices, Law Prof. Richard Friedman warned against misinterpreting the meaning of the skepticism of the judges during the debate. Since they might offer questions for more than one reason — to probe both sides’ logic, for instance — Friedman said it was “easy to put too much stock into the arguments.”
“It’s often very difficult to tell from the questioning where (the case is) going,” Friedman said. “Some of the justices, they’re just trying out the arguments. You can’t predict easily.”
If the court rules the individual mandate — the provision in the Affordable Care Act compelling Americans to either purchase health insurance or pay a fee — is unconstitutional, it could invalidate the entire law or leave the legislation standing without the mandate.
Friedman said he anticipates that the court will most likely uphold the individual mandate on the basis that Congress has the authority to regulate interstate commerce and do what it deems necessary.
“This seems to me to be a mechanism that is perfectly plausible, perfectly reasonable for Congress, and it’s a matter of political choice,” he said. “And I think the court in the end is not going to find that it was beyond Congress’s power.”
However, for the Supreme Court to uphold the mandate, one of the five more conservative members on the bench would have to join its four liberal-leaning justices —Ruth Bader Ginsburg, Sonia Sotomayor, Elena Kagan and Stephen Breyer.
Friedman said he expects one of the five more conservative justices — Antonin Scalia, Anthony Kennedy, Clarence Thomas, Samuel Alito Jr. or Chief Justice John G. Roberts Jr. — to vote along with the court’s liberal bloc of the Court.
“It’s conceivable, I suppose, that all five will stick together and knock it out,” he said. “But it’d be the first time in 70 years that the Supreme Court is knocking out a major, comprehensive piece of federal legislation on the grounds that it’s beyond Congress power.”
The Affordable Care Act centers on a provision that allows young adults to stay on their families’ insurance policies until the age of 26. Last September, the Center of Disease Control and Prevention announced that the number of insured young adults under the age of 26 increased by about 900,000 between January 2010 and March 2011. The Obama administration attributed the rise to the provision in the Affordable Care Act.
The uptick lowered the percentage of uninsured 18-to-25 year olds to 24.2 percent in 2011’s second quarter from the 28 percent in third quarter of 2010, according to a Gallup poll released the same week as the CDC data.
Matthew Davis, an assistant professor in the Medical School and Ford School of Public Policy, said the provision could remain in place even if it is invalidated since it might bolster the election chances of members of Congress.
“If you think about it, a young adult who can get his or her parents’ plan can potentially bring in two votes, because the young adult votes, and so does the parent,” Davis said.
While Davis said the provision may continue, the planned expansion of Medicaid and the establishment of state marketplaces for insurance plans could fail without federal funding.
At the University, a University Health Services survey found that 9.4 percent of undergraduate students are uninsured, Robert Winfield, the University’s chief health officer and UHS director, said in an interview last week. The figure marked a 2-percent increase over the last three years.
Winfield said while fewer students are opting to enroll in the University-offered insurance program — 1,350 are enrolled today, compared to 3,000 a decade ago — the investment is worthwhile.
“It’s pretty common for appendicitis to be $10,000 to $15,000, or a bill for an auto accident to be substantially higher than that,” he said. “Everything we can do to assure a higher level of insurance for poor students is a good idea.”
The Associated Press contributed to this report.