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Jackie Judd: Good day and welcome to "Health Reform and the Court." I'm Jackie Judd. The second day of the historic Supreme Court hearings on the health reform law focused on this central question: Does Congress have the power to require Americans to purchase health insurance? Is the individual mandate constitutional? Our man at the court, Stuart Taylor - who is a legal contributor to many publications, including the National Journal - once again joins us. Welcome, Stuart.
Stuart Taylor: Nice to be here, Jackie.
Jackie Judd: A livelier argument today than yesterday.
Stuart Taylor: Much livelier. It was easier to follow, too. Yesterday was actually pretty lively, but lively about intricacies of the tax code.
Jackie Judd: Today, what were the overarching arguments that both the states made and the federal government?
Stuart Taylor: And the justices pitching in on both sides.
Full audio: ACA Supreme Court hearing, day 2
Jackie Judd: Absolutely.
Stuart Taylor: Donald Verrilli, the solicitor general arguing for the government, the Obama administration, started off. And his lead points were: Congress was confronted with a terrible problem – 40 million people without health insurance – and also a lot of cost-shifting, where when these people need emergency care, have terrible accidents, things like that, they can’t pay for their care, they’re not insured, and therefore the costs get shifted to everyone else.
He said the average health insurance policy of those of us who are insured is raised $1,000 by the need to subsidize all of these other costs. The other side disputes the numbers, but clearly it’s a big number. Those were his main themes. And also that health care is clearly a commercial service and everybody needs health care sooner or later - it’s just a matter of the timing. So all we’re doing is regulating the timing of how people finance their own health care.
ACA arguments before the Supreme Court (day 2)
Jackie Judd: And Paul Clement, who argued for the states?
Stuart Taylor: His main themes were: This requires people to buy a commercial product they don’t want. It requires people to enter commerce - people who don’t want to be engaged in commerce - and that’s unprecedented and unbounded. His point was: Once Congress can do that, if you let Congress do that, there’s nothing Congress can’t do. They could make us buy cars, buy broccoli, etc.
Jackie Judd: So the "essential relationship between the federal government and the individual shifts" was his argument?
Stuart Taylor: It certainly was. And some of the justices picked up with the same theme.
Jackie Judd: One report out of the court said that Verrilli got only 3 minutes into his prepared remarks before the justices started asking their questions. What were the most pointed questions?
Stuart Taylor: I don’t think he got three minutes. I could go back and count. But the most pointed questions came from the conservatives. Justices Scalia and Alito asked a bunch of hostile questions to Solicitor General Verrilli and no hostile questions to the other side. It became pretty clear that they, as well as Justice Thomas who was silent, are going to vote to strike the law down. They kept making the same points that the lawyer Paul Clement and Mike Carvin were making about this being an illimitable power. That they can make us buy broccoli, that they can make us buy car insurance - themes like that. And raising hypotheticals, something about burial insurance, in the case of Alito, raising that hypothetical: Everybody’s going to have to be buried.
It’s clear that the four liberals are going to vote to uphold the law. The two to watch, who seem up for grabs, were, arguably, Chief Justice Roberts and Justice Anthony Kennedy. Both of them, especially Roberts, were very tough on Don Verrilli, the solicitor general. Here are some samples of Roberts: a hypothetical, on emergency services, could they make us all buy cell phones, the broccoli thing, the car thing, requiring people to buy insurance for pediatric care, people who don’t have children, to subsidize others. And most importantly, I suppose, "all bets are off," something he said twice, meaning: If we uphold this, there's nothing Congress won’t be able to do.
Jackie Judd: Which justice said that?
Stuart Taylor: That was Chief Justice Roberts.
Jackie Judd: And did Roberts and Kennedy give an equally-challenging time to Clement?
Stuart Taylor: No. Kennedy was a little less hard on Verrilli, but the tenor of his comments was similar to Roberts, that this really can’t be limited.
Each of them asked kind of musing, philosophical questions of Clement and Carvin that sounded a little more like they were just making sure that all the bases were touched, and they didn’t sound so much as though: I’m not buying your argument.
Jackie Judd: What was the role today for the liberal justices? What did they seize on?
Stuart Taylor: All of them were very active. Justice Breyer, as is his wont, was asking long, hypothetical questions that would be hard to summarize.
Justice Kagan was a little punchier. One thing she said, for example, that they lawyers for the challengers were making a big point about this forces young, healthy people to subsidize old, unhealthy people. Justice Kagan said: Well, eventually the subsidizers all become the subsidized. As in: We all get old.
Justice Ginsburg kept analogizing this to the Social Security system. Her basic point was: That is young-subsidizing-old, too. And we do that as a government program with a tax. If that’s OK – and that is OK – why can’t we do it with a more open, commercial system that involves private insurers in this context. That was one of her main points.
Justice Sotomayor asked a lot of questions. One of my favorite moments was when Justice Breyer was asking was one of his long – good – hypotheticals, just hard to summarize, it kind of interrupted Kagan and a while later someone said, "Let's get back to Justice Kagan's question" and she said, "I've forgotten my question."
Jackie Judd: Stuart, it’s a little risky sometimes, I think, to judge how a justice will rule based on the way he or she questions during the arguments. But everything you’ve said today makes it sound like the federal government was very much on the defense today, far more than the states. Fair characterization?
Stuart Taylor: I think that’s a fair characterization. For that reason I heard some people coming out of the arguments – and I’m no better prognosticator than some of the others are – saying for sure the law is going to be struck down 5 to 4.
But others were saying they’re not so sure. They thought the law might be upheld. They thought that both Kennedy and Roberts might go over to the other side. Even though that’s not how they sounded today. And then part of the thinking is that if Kennedy gives a majority to the liberal side, rather than be in the dissent in a 5-4, Roberts might join the majority, too, in order to be able to write the opinion himself and control how broad it is.
Jackie Judd: Interesting. We’ll hear from you again tomorrow. Stuart Taylor will be back with us tomorrow at the conclusion of the hearings.
Previous coverage of health reform and the Supreme Court
Anticipating the Supreme Court's ruling
→ Supreme Court to rule Thursday on health care reform
→ New consumer protections depend on high court's ruling
→ Court challenge could result in Medicaid cutbacks instead of expansion
→ GOP promises smaller-scale health care agenda if court strikes down law
→ Some health system changes will stay, no matter how Supreme Court rules
→ Obama administration finds 3.1M young adults gained coverage under law
→ What's at stake for Medicare beneficiaries in health reform ruling
→ What's at stake for women if health law overturned
→ Washburn law professor holding to prediction that health reform law will be upheld
→ Even without the individual mandate, health law would still affect millions
The Great Health Reform Debate: Kansas experts weigh in
"The system we have in this country is a failure because people do not have equal access to care," said retired Stormont-Vail HealthCare CEO Maynard Oliverius. He is one of six Kansas experts who weigh in on the health reform debate ahead of the Supreme Court's ruling on the law.
→ Watch the six video shorts here.
Oral arguments before the Supreme Court
Day 1 — Anti-Injunction Act
→ Guide to what happened at the Supreme Court
Day 2 — Individual Mandate
→ Kansas AG Schmidt encouraged by justices' skepticism of health reform law
→ Justices grill Obama administration on health law
→ National media round-up
Day 3 — Medicaid Expansion and Severability
→ Vigorous severability, Medicaid questions
Preview to the Supreme Court oral arguments
→ Schmidt’s pledge to join ACA challenge bolstered candidacy
→ Full interview: Derek Schmidt on the legal challenge of the health reform law
→ The Health Law and the Supreme Court: A primer for the upcoming oral arguments
→ Video explainer: The health care reform challenge before the Supreme Court
→ Kansas rejects $31.5 million for insurance exchange
→ More archived stories and in-depth information on the Affordable Care Act
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