Supreme Court health care arguments enters third day

The justices aren't expected to hand down a decision on the law's constitutionality until June. (Photo: James Joslyn)

WASHINGTON (AP) - Several U.S. Supreme Court justices seemed receptive Wednesday to the idea that portions of the Obama administration's sweeping health care law can survive even if the court declares the heart of the law - which requires all Americans to have health insurance - unconstitutional.

On the third and final day of arguments, the justices questioned the lawyer for 26 states that seek to have the Patient Protection and Affordable Care Act tossed out in its entirety.

Justices Sonia Sotomayor, Elena Kagan and Ruth Bader Ginsburg - and even conservative Chief Justice John Roberts and Justice Antonin Scalia - seemed open to the idea that the law contains provisions that can be saved even if the mandate to buy health insurance is struck down.

That prospect seemed to increase Tuesday as justices challenged the mandate, casting doubt on a law that's considered Obama's signature achievement and would affect virtually every American.

The court's decision could come in June, in the midst of the campaign before November's presidential election.

Wednesday was the last of three days of arguments over the health law, which has the goal of extending health insurance to 30 million Americans who have no coverage but has come under spirited challenge. Opponents contend the law unconstitutionally extends the power of the federal government.

The justices seemed skeptical of the position taken by Paul Clement, a lawyer for the 26 states.

"The rest of the law cannot stand" if the mandate is struck down, Clement told the justices.

"What's wrong with leaving this in the hands of those who should be fixing this?" asked Sotomayor, referring to Congress.

Before the reforms were signed into law two years ago, the United States was the only developed country without a national health care program. The court's decision on the health care overhaul, regardless of how it turns out, likely will intensify the ideological differences splitting the country.

The Obama administration argues that the only other provisions the court should kill if the insurance mandate is stricken are ones that require insurers to cover people regardless of existing medical problems and limit how much they can charge in premiums based on a person's age or health.

The federal appeals court in Atlanta that struck down the insurance requirement said the rest of the law can remain in place, a position that will be argued by H. Bartow Farr III, a private lawyer appointed by the justices.

The justices were also spending part of Wednesday considering the states' challenge to the expansion of the federal-state Medicaid program for low-income and disabled Americans, an important feature of the plan. Conservative justices on the nine-member court on Tuesday pointedly questioned the law's core requirement that all Americans must buy insurance coverage or face a penalty.

Arguments focused on whether the so-called insurance mandate "is a step beyond what our cases allow," in the words of Justice Anthony Kennedy, who often is the swing vote on the court.

The high court justices are appointed for life terms by the president in office when vacancies occur. It currently is made up of four Democratic-appointed, reliably liberal judges and four Republican-appointed conservatives.

Kennedy, while chosen by conservative Republican President Ronald Reagan, can vote with either camp depending on the issue. While he sharply challenged the mandate, Kennedy also conceded that the absence of the requirement affects "the rates of insurance and the costs of providing medical care in a way that is not true in other industries."

Chief Justice John Roberts, appointed by President George W. Bush and typically a reliable conservative, also challenged the arguments of the lawyer representing the law's opponents.

"Everybody is in this market," Roberts said. "So that makes it very different than the market for cars or the other hypotheticals that you came up with, and all they're regulating is how you pay for it."

The health care overhaul, which squeaked through Congress when Democrats still controlled both houses, is constructed to expand the number of people who have insurance, including young and healthy people who may have fewer needs for the system.

That is designed to offset losses to insurance companies, which would now be prevented from denying coverage to people who already have health problems - so-called pre-existing conditions..