The US Supreme Court has agreed to decide the constitution issues of the Affordable Care Act.  The court will hear oral arguments in March and then is expected to render a decision in June 2012.  So, President Barack Obama’s hard fought first-term landmark legislation with be decided at the height of a heated re-election campaign.

The central issue to be decided is whether the mandate forcing all Americans to participate in the health care system is constitutional.  The challengers, which include 26 states, have argued that the insurance requirement is an intrusion on individual liberty and that Congress can’t use interstate commerce powers to force citizens to participate in the health-insurance market.  The Administration has argued that the insurance mandate is an essential part of the law’s insurance reforms which require insurers to accept everyone, even those with pre-existing medical conditions. Also, those that do not participate in health insurance burden the US health care system with huge costs that are unfairly borne by the insured.  

Conflicting rulings have come from four lower courts – 3 upholding the law and 1 striking down the insurance mandate.  Even if the US Supreme Court rules the insurance mandate unconstitutional other provisions of the law would remain in effect.   The full implementation of the law is set to take effect in 2014 including the state-based health exchanges.

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