UPDATE: The Supreme Court did not announce a ruling on the health care case or the Arizona immigration law Thursday. The next time to announce decisions is Monday.
EARLIER: The Supreme Court's ruling on President Obama's health care law could be announced Thursday morning, a development that would have major implications regardless of the decision.
As HuffPost's Supreme Court correspondent Mike Sacks reported, the verdict is anyone's guess:
During oral arguments in late March, the court's five Republican-appointed justices appeared to lean strongly toward invalidating the Affordable Care Act's individual health-insurance mandate. The four Democrat appointees lined up solidly behind the law. Still, views may have softened in the weeks since the arguments, and the complexity of the issues involved may have left some room for twists and turns as the justices sat down to write their opinions.
After prolonged anticipation, the court is expected to hand down its decision on whether the Affordable Care Act's individual mandate is constitutional by the end of the month. If no ruling is issued on Thursday, the decision could come next Monday. The justices could also decide to add more decision days next week, further adding to the uncertainty of when the ruling will arrive.
The implications of the decision remain unclear. As the New Republic's Jonathan Cohn points out, the justices "could issue multiple opinions, with different justices ruling to uphold or strike down different parts of the law," making it difficult to discern the majority ruling and its consequences at first glance.
There are a variety of possible outcomes of the Supreme Court's decision, but Cohn outlines the four most likely scenarios: the court upholds the law entirely, the court strikes down the individual mandate but keeps the rest of the law, the court strikes down the individual mandate and the Medicaid expansion but retains the rest of the law, or the court strikes down the law entirely.
If the court does decide to strike down the Affordable Care Act, the implications reach beyond the issue of health care. The role of the Supreme Court would also come into question.
"If the court does overturn the mandate, it's going to be hard to know how to react," Mother Jones' Kevin Drum wrote earlier this week. "It would mean that the Supreme Court had officially entered an era where they were frankly willing to overturn liberal legislation just because they don't like it. Pile that on top of Bush v. Gore and Citizens United and you have a Supreme Court that's pretty explicitly chosen up sides in American electoral politics. This would be, in no uncertain terms, no longer business as usual."
If Obama's health care overhaul does stand up to scrutiny, there are still many Americans who won't be covered by the law. As the Associated Press reported, the law will expand coverage to approximately 30 million uninsured individuals. However, about 26 million people will still go without insurance, including many who cannot afford to pay out-of-pocket.
U.S. District Judge George Caram Steeh, a Clinton appointee sitting in the Eastern District of Michigan, released the first major Affordable Care Act decision in October 2010. In Thomas More Law Center v. Obama, Steeh sided with the government to hold the law constitutional. "The decision whether to purchase insurance or to attempt to pay for health care out of pocket is plainly economic," Steeh wrote. "These decisions, viewed in the aggregate, have clear and direct impacts on health care providers, taxpayers and the insured population, who ultimately pay for the care provided to those without insurance."
At the end of November 2010, another Clinton appointee, Judge Norman Moon of the Western District of Virginia, agreed with Judge Steeh. In Liberty University v. Geithner, Moon wrote that "by choosing to forgo insurance, plaintiffs are making an economic decision to try to pay for health care services later, out of pocket, rather than now, through the purchase of insurance."
In December 2010, however, Judge Henry Hudson, a George W. Bush appointee sitting in the Eastern District of Virginia, ruled otherwise. In Virginia v. Sebelius, Hudson struck down the individual mandate, writing that "an individual's personal decision to purchase -- or decline to purchase -- health insurance from a private provider is beyond the historical reach of the commerce clause." Importantly, Hudson also held that the individual mandate is severable from the rest of the Affordable Care Act, which means a court can strike it down while allowing the law's remaining provisions to stand.
Finally in January 2011, Judge Roger Vinson, a Reagan appointee in the Northern District of Florida, evened the score but upped the ante. In Florida v. Department of Health and Human Services, not only did he strike down the individual mandate as exceeding Congress' power under the commerce clause, but he also took the whole health care law down with it. "The act," Vinson wrote, "like a defectively designed watch, needs to be redesigned and reconstructed by the watchmaker."
In June 2011, the U.S. Court of Appeals for the 6th Circuit upheld, by a 2-1 vote, Judge Steeh's decision in Thomas More Law Center. Circuit Judge Jeffrey Sutton, a George W. Bush appointee, was the first judge chosen by a Republican president to reject the commerce clause challenge, writing that "no one must 'pile inference upon inference' to recognize that the national regulation of a $2.5 trillion industry, much of it financed through" national health insurance companies, "is economic in nature." He joined Judge Boyce Martin, a Jimmy Carter appointee, in the majority, while Judge James L. Graham, a Reagan appointee, wrote a vigorous dissent. In August, the 11th Circuit, reviewing Florida v. HHS, produced a near mirror-image result. Judge Frank Hull, a Clinton appointee, joined the Reagan-appointed Judge Joel Dubina to affirm District Judge Vinson's decision to strike down the individual mandate. Judge Stanley Marcus, a Clinton appointee, dissented, quoting heavily from Sutton's 6th Circuit concurring opinion. All three 11th Circuit judges found the mandate severable from the rest of the Affordable Care Act, reversing District Judge Hudson's decision to deep-six the entire law. Both appeals courts unanimously rejected the government's taxing power argument, insisting that if Congress had thought the penalty for not buying insurance was a tax, it would have explicitly called it a tax. On this issue, a third appeals court created another circuit split.
In September 2011, the 4th Circuit dismissed two challenges to the health care law, finding that the plaintiffs did not have standing to bring their lawsuits. The panel did find that the penalty for not buying insurance was a tax -- a good sign for the government's defense of the law. But rather than hold that the individual mandate was a valid exercise of Congress' taxing power, Judges Diana Gribbon Motz, a Clinton appointee, and James Wynn, an Obama appointee, said that another federal law, the Anti-Injunction Act, prevented the plaintiffs from challenging the mandate until they actually had to pay the tax -- which cannot happen before the provision goes into effect in 2014. The third judge, Obama appointee Andre Davis, said he wouldn't have dismissed the lawsuits and would have upheld the individual mandate based primarily on commerce clause ground. Regardless of the methodology, the Obama administration was now winning 2-1 in the courts of appeals against the Affordable Care Act's challengers.
The Supreme Court is most likely to choose to hear a case for one of three reasons: The constitutionality of a federal law hangs in the balance, the circuit courts disagree on the same issue, or the solicitor general advises the Court to take the case. Cases that fulfill just one of these considerations stand a good chance of reaching the justices. The health care cases had all three. In November 2011, the justices agreed to review the 11th Circuit's decision. To signal how seriously it took the challenges, the Court soon thereafter scheduled six hours of oral argument to take place from March 26 to 28, 2012. Normally, even for blockbuster cases, the justices only allot one hour for oral argument.
All eyes turned to the Supreme Court in late March 2012 when the justices heard oral argument and gave their first public hints of where they stood on the Affordable Care Act's constitutionality. On the first day, March 26, liberal and conservative justices alike showed little interest in following the 4th Circuit's decision to throw out the challenge to the health care law on a technicality before ever reaching the constitutional merits of the individual mandate. That display of unity disappeared on Tuesday, March 27, as the Court took on the main event: two hours of argument over the mandate. The Court's four Democratic appointees all appeared to find the mandate well within Congress' powers to regulate interstate commerce, as the 6th Circuit had held; the Court's five Republican appointees, in concert with the 11th Circuit, seemed to think otherwise. Only in the final moments did swing vote Justice Anthony Kennedy soften his tone by musing aloud whether the health insurance market is different enough, after all, to allow a mandate to prevent cost-shifting where it might not be permissible in another market. "[M]ost questions in life are matters of degree," he said. On Wednesday, March 28, the justices considered what other parts of the Affordable Care Act would fall if they found the mandate unconstitutional. No majority emerged. Several justices agreed with the challengers that the whole law must fall. Several others agreed with the Obama administration that two key (and popular) provisions could not survive without the mandate. Still others indicated some sympathy for severing the mandate alone and allowing the rest of the law to stand. A decision is expected by the end of June.