Supreme Court in final day of Obama health hearings

The US Supreme Court opened a third and final day of hearings into President Barack Obama‘s landmark health care law Wednesday, examining what happens to the legislation as a whole if they declare unconstitutional a requirement that all Americans buy insurance.

The top court’s nine justices set aside 90 minutes for oral arguments on the so-called “severability” of the requirement to buy insurance after hearings Tuesday, in which a swing judge raised doubts that it is constitutional.

A separate hour-long hearing will be held later in the day on the reform’s expansion of Medicaid, the public insurance program for the poor, which states oppose as coercive because they stand to lose all federal aid if they refuse to go along with it.

The 26 states challenging the health care law argue that Obama’s Affordable Care Act must be repealed in its entirety if the so-called “individual mandate” — the requirement that all Americans buy health insurance — is found to be unconstitutional.

Lawyers for the plaintiffs have said the mandate is “the very heart of the act itself,” arguing that it creates a mammoth subsidy to insurance companies that make possible other requirements of the law.

Those include requirements that insurance companies sell coverage to anyone who applies and forbids them to deny insurance to people with pre-existing medical conditions.

The government argues that while those requirements on insurance companies are not severable from the law, the individual mandate could be if it were found to be unconstitutional.

It has argued that “other provisions can operate independently and would still advance Congress’ core goals.”

The odds that the court would strike down the mandate appeared higher on Tuesday after Justice Anthony Kennedy who often holds the tie-breaking vote on the nine-member body appeared openly skeptical about its constitutionality.

“When you are changing the relation of the individual to the government in this, what we can stipulate is, I think, a unique way, do you not have a heavy burden of justification to show authorization under the constitution?” he said.

The health care law — Obama’s signature domestic achievement — encompasses the most ambitious reform of the troubled US health care system in decades.

It sets forth wide-ranging incentives and penalties to expand nationwide health care coverage, fining large firms that do not offer employees adequate insurance while offering subsidies to small businesses to lessen the cost.

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