Welcome to MedeAnalytics’ resource center on the Supreme Court’s review of health reform! This online resource provides a complimentary educational service to the healthcare industry.

The debate over health reform in the United States has been a contentious political issue for several decades, with various foci: increasing coverage, reducing the cost and social burden of healthcare, improving the quality of care, insurance reform, and the philosophy of its provision, funding and government involvement.

The Patient Protection and Affordable Care Act (ACA, generally referred to as the health reform law) was enacted in March 2010. It passed the Congress without a single vote from the opposition party—in contradistinction to other major social reform legislation, including the Social Security Act, the Civil Rights Act, the Voting Rights Act, Medicare and Medicaid—all of which enjoyed substantial bipartisan support. For example, the Social Security Act of 1935 was supported by 92 percent of those representatives who voted in the House, including 84 percent of the Republicans (the opposition party) who voted. Similarly, in the Senate, 93 percent of the senators who voted supported the Act, with 76 percent of the Republicans who voted in support.

Since its enactment, about 30 lawsuits challenging various provisions of the ACA were filed in federal courts. Many of those cases were dismissed, but some federal appellate courts issued rulings on the merits of the law. In November 2011, the United States Supreme Court agreed to consider issues related to the constitutionality of the ACA arising out of two cases in the 11th Circuit Court of Appeals, National Federation of Independent Business v. Sebelius, and Florida v. Department of Health and Human Services. The plaintiffs in the latter case were 26 states.

Four primary questions were placed before the Supreme Court:

• Whether the Tax Anti-Injunction Act (AIA) precludes review of the health reform law until April 15, 2015, when the first financial penalty resulting from enforcement of the individual mandate is assessed.
• Whether Congress has the authority to require most United States citizens to purchase health insurance or pay a penalty (the individual mandate or minimum coverage requirement).
• If the Supreme Court were to rule the individual mandate unconstitutional, whether the rest of the ACA must also be overturned or whether the mandate is “severable” from the rest of the law.
• Whether the ACA’s expansion of Medicaid is unconstitutionally coercive because it compels or “commandeers” the states to enact a federal regulatory program without choice.

On March 26-28, 2012, the Supreme Court held oral argument for a total of six hours on the constitutionality of the health reform law, the most time devoted to a case in 50 years.

On June 28, 2012, the Supreme Court ruled that the ACA is constitutional in part (the individual mandate) and unconstitutional in part (the Medicaid expansion).

This resource center serves as an objective gateway to a wide range of credible information, including general background materials, details about the lawsuit, arguments and key issues, gauges of public sentiment, predictions, summary and analysis of the ruling, and assessment of its implications. In the wake of the Supreme Court’s decision, this resource center will expand its scope to cover post-ruling developments regarding the status of the health reform law.