Healthcare law: supreme court to focus on mandate in second day of hearings

The supreme court will hear arguments Tuesday on the core of President Barack Obama's historic health care reforms, a provision that forces all Americans to buy insurance coverage or face a penalty. At the close of the first of three days of hearings on Monday – the longest in decades – questioning by the nine justices had indicated they did not embrace the contention that a 19th-century tax law would cause them to delay a decision on the constitutionality of the health care overhaul. The first day of arguments dealt with the 150-year-old law that holds courts cannot decide tax questions until the taxes are levied. The penalty for not acquiring health insurance does not become effective until 2014 and would be collected along with federal income taxes that become due in April 2015. Both sides of the health care issue want a decision in this court session and argued the law does not apply. Tuesday's arguments will allow the justices to examine the constitutionality of the so-called mandate that requires everyone to buy insurance or face a fine. The Democrat-appointed liberal minority of four justices was expected to uphold the Obama plan. But a ruling in favour of the law would require at least one of the five conservative, Republican-appointed judges to break ranks. Monday's session mixed dense arguments with a barrage of pointed questioning from the justices that seemed to suggest they are prepared to allow the case to go ahead rather than put the issue off for several years. "This case presents issues of great moment, and the Anti-Injunction Act does not bar the court's consideration of those issues," said the US solicitor-general, Donald Verrilli, representing the government. "Congress has authority under the taxing power to enact a measure not labeled as a tax." One of the more liberal justices, Ruth Bader Ginsburg, suggested in her line of questioning that she agreed that the measure is not a tax because it is not primarily designed as a means of raising revenue. "This is not a revenue-raising measure, because, if it's successful … nobody will pay the penalty and there will be no revenue to raise," she said. The administration says Congress has ample authority to impose the insurance mandate, arguing that health care costs consume 17% of the American economy and are susceptible to the federal regulation of national commerce. Opponents demand the law be struck down as an unprecedented extension of federal power over individual liberties. They say that not even decades of high court rulings that endorsed an expansive view of congressional authority can support the health care law. A decision is expected by late June, about four months before the election that will determine whether Obama has a second White House term. All of Obama's top Republican challengers oppose the law as an assault on economic freedoms and, should they win, promise its repeal if the high court hasn't struck it down by then. "If I'm elected president, I will repeal 'Obamacare.' And I will stop it in its tracks on day one," Mitt Romney, the likely Republican nominee to challenge Obama in the fall, said on CNN. Rick Santorum, Romney's main opponent for the party's nomination, joined the protesters outside the supreme court on Monday. He declared that Romney has no standing to challenge Obama on the law since Massachusetts passed a nearly identical state law with an insurance mandate when Romney was governor. 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 Obama plan would extend medical insurance to 30 million Americans who go without coverage, either out of choice or an inability to pay the fast-rising premiums in the insurance private marketplace. Obama signed the measure into law two years ago, and it has since been challenged on constitutional grounds by 26 US states and a business organisation. The health care overhaul, which squeaked through Congress when Democrats still controlled both houses, is constructed to expand the number of people who have insurance, including young and healthy people who may have fewer need for the system. That is designed to offset losses to insurance companies, which would now be prevented from denying coverage to people who already have health problems so-called pre-existing conditions. The plan also expands Medicaid, the federal-state government program that insures low-income and disabled Americans, with most of the additional cost borne by Washington. Before the Obama health reforms were signed into law, the United States was the only developed country without a national healthcare program.