Obamacare appeals: The justices will see you now

Whether one supports or opposes President Barack Obama's health care reform law, the administration's choice not to prolong the appeals in the legal challenges to the act and to move the matter to the Supreme Court for review in the upcoming term should be welcome news. Much is at stake in the debate, and advocates and foes alike have now had an adequate opportunity to generate their arguments.

Naturally, last week's decision generated endless speculation inside the Capitol Beltway about the political implications of a possible Supreme Court ruling next June in the midst of a presidential election campaign. Would the court be influenced by those political factors? Would an adverse ruling hurt the president's chances or help them?

We are not so naive to assume presidential politics were not factored into the equation, but we are also not so cynical as to believe the White House didn't recognize the public interests at stake. So far, three appeals courts have weighed in on various legal challenges to the law, and the administration has prevailed in two, so it's reasonable to assume Mr. Obama believes the chances the law will be upheld are good.

The central issue, whether the federal government can require individuals to purchase health insurance, tests the limits of the U.S. Constitution's Commerce Clause. As a practical matter, that mandate gave Congress the means to expand health insurance to millions of Americans and amounts to a tax (which is the penalty for failing to purchase suitable insurance).

The Supreme Court may well side with the Sixth Circuit Court of Appeals, which ruled earlier this year that the insurance mandate is a reasonable way for Congress to regulate commerce. As the judges noted at the time, without a mandate, there's a danger some Americans would choose to remain uninsured and become free riders in the system at a significant cost to taxpayers.

Others speculate that the court could follow the lead of the 11th Circuit in ruling the insurance mandate as unconstitutional but allow the rest of the law to stand — including such popular components as the requirement that insurance companies extend coverage to those with pre-existing conditions. That kind of narrow ruling might be a particularly attractive option to any justices who may sympathize with Republican views on the issue but not wish to appear overtly political.

One can only hope that the justices are mindful of the danger of ideological excess taught by Bush v. Gore when it was clear a conservative majority of the court overstepped the law to achieve a satisfactory political resolution. Far better for the justices to stick to the constitutional question and not be swayed by political considerations.

The pundits can speculate all they want about whether an adverse ruling would help or hurt the president's re-election chances. Certainly, it's easy to see how a favorable decision from a court that otherwise appears set against him (witness the Citizens United ruling or read Justice Samuel Alito's lips at the subsequent State of the Union address) might be seen as a boost. But a rejection of what Republicans deride as "Obamacare" could also be helpful to Mr. Obama if it means the loss of insurance coverage to millions of Americans and a threat to the nation's economy, all because of GOP-based opposition.

This much is clear. Even though health care has fallen off the public's radar of late, problems in the traditional fee-for-service model continue to fester. Health insurance premiums soared last year, and raising the number of uninsured (whose medical costs are inevitably passed on to the rest of us) will only cause premiums to rise higher still.

The 2010 law is not a cure to all that ails this nation's medical care, but it was a step in the right direction. Should the Supreme Court uphold the law — much as an earlier court approved Social Security "taxes" in 1937 and assured a decent retirement to generations of Americans — a grateful nation will be free to focus on enhancing the efficiency and effectiveness of a still-ailing health care system instead of returning to Square One.

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