At the heart of the legal showdown over the Affordable Care Act are questions of governmental power: How broad is Congress's authority to regulate interstate commerce, and does it extend to an individual's health care choices and the private insurance market? Can Washington unilaterally double the size of Medicaid, which is funded partly by the U.S. Treasury but run by the states? On the line, in the middle of an election year, is the President's key domestic-policy achievement. The Supreme Court proceedings begin March 26 and will last three days. A ruling is expected in late June.
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Differing Opinions
The Justices have been split over Congress's power to regulate commerce, the key issue in the health care case
Less power
Chief Justice John Roberts
Samuel Alito
Antonin Scalia
Clarence Thomas
Anthony Kennedy
More power
Elena Kagan
Ruth Bader Ginsburg
Stephen Breyer
Sonia Sotomayor
The Challengers
Republican attorneys general and governors from 26 states plus a trade group representing small businesses
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The Politics
The President asked for an expedited review of health care reform, thinking he'd win, but an election-year court rejection could backfire on his campaign
What the Court Might Do
Uphold the Law
The court could find that the entire Affordable Care Act is constitutional, with centrist Justice Anthony Kennedy and possibly some conservatives joining the court's liberal wing to hold that the government has the power to force Americans to buy health insurance. The court could also uphold the law if it decides that the fine imposed on Americans who don't buy insurance is technically a tax and therefore within the government's unquestioned power to raise revenue.
Toss All of It
The court's conservative wing could find that the entire reform law is unconstitutional, negating the signature domestic initiative of Barack Obama's presidency.
Toss Part of It
The Justices could rule that only parts of the law, such as the requirement that all Americans have insurance by 2014 or the government's huge expansion of Medicaid, are unconstitutional. This could leave the rest of the law in place but make reform prohibitively costly.
Punt
The court could decide that it is too soon to rule on a law that won't be fully in place until 2014. But whether there will be five votes to postpone a decision after months of preparation, briefing and anticipation remains uncertain.
Can They Make You Pay?
Over the past 70 years, the Supreme Court has found that Congress has extremely broad but not limitless powers to regulate your economic life under the Constitution's commerce clause.
WICKARD V. FILBURN