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Health Care Mandate Will Affect Few, Study Finds

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WASHINGTON -- Just 2 percent of the U.S. population would be subject to the aspect of health care reform at the center of a constitutional challenge before the Supreme Court this week -- the individual mandate, a study released Monday by the Urban Institute found. The analysis said 98 percent of Americans would either be exempt from the mandate -- because of employer coverage, public health insurance or low income -- or given subsidies to comply.

Including those who are subject to the mandate, but would get subsidies, increases the total number of people affected to 5 percent of the population, according to the Urban Institute, a non-partisan policy research organization based in Washington, D.C. (Some of those subject to the mandate who get subsidies would still need to dig into their pocket to cover the difference.)

Opponents of the mandate argue that it infringes on personal liberty by requiring the unwanted purchase of something from a private entity. Backers say the mandate is constitutional because everyone consumes health care services at some point, so it is reasonable to tax people who consume care without paying for it.

The Urban Institute study indicates that such a tax, or fine, would be levied on a small population.

Health care reform prevents insurers from discriminating against patients with pre-existing conditions and caps premiums that can be charged. The only way to accomplish such reform, backers say, is to require healthy people to insure themselves, rather than wait until they get sick.

The court spent Monday debating whether to delay a decision in the case, with the justices appearing to be intent on ruling this year.

Tuesday the court weighs the constitutionality of the individual mandate. HuffPost's Mike Sacks reports:

During today's two-hour argument -- twice as long as the 60 minutes the court usually allots each case -- the justices will pepper each side's superlawyers with questions that will give public hints of how they will ultimately decide the case by late-June.

The court's four Democratic appointees -- Justices Ruth Bader Ginsburg, Stephen Breyer, Sonia Sotomayor, and Elena Kagan -- are all expected to side with Solicitor General Donald Verrilli's primary argument on behalf of President Barack Obama's administration that the mandate falls within Congress' broad power to regulate interstate commerce. The inevitable consumption of health care services by the uninsured, Verrilli will argue, substantially affects the national insurance market by shifting costs to the insured and creating the problem of skyrocketing premiums that the Affordable Care Act was designed to solve.

Justice Clarence Thomas, on the other hand, need not break his six-year streak of silence at oral argument to reiterate his oft-written antipathy towards the New Deal precedents Verrilli's argument draws upon for support.

So while there is always a vanishingly slim chance that one or two of the liberal justices will surprise the public with some pointed questions for the solicitor general, it is more likely that they will try to win over their remaining four conservative colleagues by putting the screws into the challengers' lawyers.

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