Twenty-six states are leading the legal fight against the Patient Protection and Affordable Care Act. Over the next three days of hearings, there will be four key questions raised, but at the heart of the argument is the constitutionality of the law. That debate will be argued on Tuesday.
The big thing on the first day was what didn't happen: No justice endorsed the idea that it's too soon for the Supreme Court to take on the health care law.
Seeming to dismiss the argument that an arcane 19th century law might prevent them from jumping into the bigger issues, the justices turned to firing off questions that previewed their complaints about both sides in the larger case unfolding Tuesday and Wednesday.
On Tuesday, the court will hear the big argument over whether Congress has the constitutional authority to require Americans to buy insurance whether they want it or not. If the high court upholds the act, here are a few of the changes that would go into effect:
- Most citizens and legal residents will have to carry health insurance.
- The government will be required to provide subsidies for many middle class people buying private health insurance through an exchange.
- Health plans would need to cover preventive care without charging co-pays.
- A variety of taxes and fees would be imposed on the health care industry.
- Cuts would be made to Medicare payments to hospitals, insurers and other providers.
This has been a very polarizing issue ever since the president signed it into law two years ago, and both sides remain confident the court will side with them.
"Where in the constitution do they give Congress the authority to dictate to any of our members, to any individual in America, that they must buy a product from some private company?" said Patrick Connor with the National Federation of Independent Business.
White House Adviser David Plouffe doesn't see it that way. He said the president's health care overhaul, derisively labeled "Obamacare" by its opponents, will come out ahead for Americans.
"We're going to be very glad they called it 'Obamacare,'" said Plouffe. "You're going to see more people covered. You're going to see savings in the health care system."
Over the weekend, protests were held and people lined up outside Supreme Court hoping to get one of the few seats available inside to see the actual hearing. The court's decision is expected by late June. With this being an election year, the stakes are very high on both sides. The Republicans have promised if the court does not strike down the law, they will fight to repeal it in Congress.
Meantime, California is moving ahead to implement a portion of the reform act called the Health Benefit Exchange. It would enable millions of uninsured residents to buy affordable insurance.
"Millions of Californians who have been uninsured will be able to have the security of knowing when they get ill or injured, they will have somewhere to go and they will not go into bankruptcy as a result," said Diana Dooley, secretary of the California Health and Human Services Agency.
The Associated Press contributed to this report.