Health Care Law Takes Twisted Path To The Supreme Court (SLIDESHOW)

09/30/2011 02:54 pm ET | Updated Nov 30, 2011

The Obama administration this week urged the Supreme Court to decide once and for all the constitutionality of the 2010 health care overhaul. With the Court all but certain to hear the case next spring and decide it by the end of June, the justices have a wealth of advice from the lower courts to guide their decision.

The so-called individual mandate is the centerpiece of the Patient Protection and Affordable Care Act, which is the signature legislative achievement of Obama's first term. The mandate, which goes into effect in 2014, says that virtually all Americans must purchase minimum health insurance coverage or pay a penalty in their next tax return.

Under longstanding Supreme Court precedent, Congress has the power under the Constitution's commerce clause to regulate economic conduct that substantially affects interstate commerce. But almost immediately after Congress passed the health care act last year, lawsuits were filed in federal courts to argue that the individual mandate is unconstitutional because it seeks to regulate inactivity -- namely, a person's decision to go without health insurance.

The government responded in court that the decision not to buy health insurance is hardly inactivity; rather, it is an active choice that affects the national health care market. Further, the government contended that because the law essentially characterizes the penalty for not obtaining minimum coverage as a tax, Congress' taxing power gave it authority independent of the commerce clause to pass the law.

In the year since, among the federal judges who have heard challenges to the act, all but one judge appointed by a Democratic president upheld the individual mandate's constitutionality, while all but one Republican-appointed judge struck it down. Some decisions were sweeping, others were narrow. Most judges tackled the issue on the merits, but a few dispatched the case on technicalities. And now, with the flurry of petitions for Supreme Court review filed Thursday, it's worth looking back at the paths the justices may take in reaching their final judgment.

Legal Battle Over Health Care Law