What to Watch for During Today's Final Obamacare Hearing

The third and final day of the Supreme Court's Obamacare review looms large as all bets are off regarding the constitutionality of the bill's individual mandate.

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The third and final day of the Supreme Court's Obamacare review looms large as all bets are off regarding the constitutionality of the bill's individual mandate. Yesterday, we went through the possible scenarios of what will happen to the Affordable Care Act if the Supreme Court strikes it down. Today, we'll get a better sense of where the justices stand on this issue and the issue of the bill's Medicaid expansion, which could have a dramatic impact on not just the Affordable Care Act but other areas of state-federal partnership programs as well. Here's what to look out for:

The arguments  For some observers, the issue of the bill's Medicaid expansion is far more consequential than the issue of slicing up the Affordable Care Act because it could affect other state-federal partnership programs. The main argument here comes from the 26 states that say the law's push to open Medicaid to a larger population of the poor is too coercive. As The Washington Post explains, "The Supreme Court has said there is a limit to what the government can force states to do in order to receive federal funds — a condition cannot be 'so coercive as to pass the point at which pressure turns into compulsion.'" The states say the Medicaid expansion counts as compulsion and will cost them millions of dollars. The government says that's a weak excuse because the feds will foot the bill until 2016 and pay 90 percent of the bill beyond that.

Then, of course, the court will decide on the breakup of Obamacare, should an individual mandate fall through. On this issue, the feds and the 26 states share some common ground. For instance, the Obama administration is not arguing that the Affordable Care Act should be preserved completely if the mandate is struck down. "Without mandatory insurance rules, the government says those provisions would create an industry 'death spiral,' in which only patients with costly health conditions would obtain insurance," reports Bloobmerg. The government says with no mandate, it would lead to "higher premiums, which would prompt healthy policyholders to drop coverage, causing more rate increases."

The reactions Depending on how the justices respond to the Medicaid expansion issue, the ruling could "upend decades of precedent that underlie scores of massive federal programs, from health care to transportation to civil rights," writes Talking Points Memo's Brian Beutler. "If the five conservative justices agree, it would call scores of similar programs that states operate in conjunction with money and strings from the federal government — or at least make it very difficult for Congress to revisit those strings in the future."
The justices' reactions to the individual mandate also has the opportunity to make history, note Bloomberg's Greg Stohr and Bob Drummond. "The court hasn’t overturned legislation with such sweeping impact since the 1930s, when it voided parts of Franklin D. Roosevelt’s New Deal, the package of economic programs enacted in the 1930s in response to the Great Depression," writes the news service. "The health law would extend coverage to 32 million people who lack insurance by 2016, and revamp an industry that accounts for 18 percent of the U.S. economy, in part through the coverage mandate."

The media  As always, for a wonky, penetrating take, follow the SCOTUS Blog and the ACA Litigation Blog. For a conservative take, The Washington Examiner'Philip Klein. For a liberal take, The New Republic's Jonathan Cohn. Politico reporters Kate Nocera, Jason Millman and Jennifer Haberkorn are reporting on the issue closely. The New Yorker's and CNN's SCOTUS expert Jeffrey ToobinNational Journal's Jill Lawrence and Naureen Khan. And of course, stay with us for coverage throughout the day. 

This article is from the archive of our partner The Wire.