Supreme Court Finishes Hearing Oral Arguments in Healthcare Reform Case

The Supreme Court finished hearing oral arguments in healthcare reform case Wednesday, although a final decision is not anticipated to be released until June. (Click here to read the official Supreme Court transcripts of this week’s sessions.)   

The justices strayed from strictly constitutional and legal issues in their questioning and asked many questions on the functioning of provisions of the Patient Protection and Affordable Care Act of 2010 (ACA), such as health insurance exchanges and economic consequences if the individual mandate were to be struck down. Due to the nature of some of the justices’ questions, many observers believed the court was critical of the ACA’s “individual mandate” provision.  Justices also appeared to be interested in the importance of the law’s various components and the impact of leaving them in place or ruling them out by deeming them non-severable. This has led to speculation that the court may also consider leaving some of the ACA provisions in place, should they ultimately decide to strike down the individual mandate.  

Based upon the justices’ questioning in Monday’s oral arguments related to the applicability of the Tax Anti-Injunction Act, it appears doubtful that they will decide that the Act, which precludes challenges to tax laws in Federal courts until a complainant has paid the tax, is applicable in the ACA case. Finding the Tax Anti-Injunction Act applicable would postpone a final decision on the health care overhaul’s constitutionality until after penalties for not having insurance are collected with 2014 tax returns.

Many healthcare transformation initiatives authorized by the ACA are related to or dependent upon health information technology.  These could be nullified by the Supreme Court’s decision if the court strikes down the entire ACA.  However, most health IT-related provisions would not be impacted because they are unrelated to the “Individual Mandate” provision.  Examples include: quality reporting initiatives, pay-for-performance initiatives, adoption of state HIEs, operating rules and standards, and health IT work force development, just to name a few.