DN Editorial: Supreme Court hears case for and against Obamacare

THREE DAYS of arguments before the U.S. Supreme Court on the constitutionality of the Affordable Care Act - a/k/a "Obamacare" - began Monday with observers wondering aloud if the two main attorneys in the case possess the mental and physical stamina to get through it.

Of course, if the attorneys should crack under the strain, for sure they will have adequate health care since they no doubt can afford decent insurance.

Not so for millions of Americans if opponents of the law succeed in blocking its full implementation - in particular, the 30 million Americans who don't have insurance who would get it under the new law. Actually, though, pretty much every American will be affected by the court decision, if only because the nation's dysfunctional health-care system is a persistent drag on the economy.

Six hours of hearings have been scheduled over three days, more than any case in two generations. The major issue, which will be taken up Tuesday, is whether it is constitutional to mandate that everyone who doesn't get insurance through an employer be required to purchase a policy.

(Time out for a definition: In 2014, if a taxpayer doesn't get insurance through her employer, she must purchase a policy or be assessed a penalty when filing her federal income tax in 2015.)

Another set of arguments Wednesday will focus on whether the federal government, as part of the law, has the right to expand eligibility for Medicaid coverage to people earning below 300 percent of poverty.

But Monday's arguments focused on whether the court should even hear the case now. A federal appeals court in Virginia has ruled that an 1867 statute requires that the court put off a decision on the entire law until someone has been "hurt" by it - that is, until the tax penalty for not having insurance has been paid, giving those people the "legal standing" to bring the case.

During Monday's proceedings, it appeared that none of the justices thought much of this argument. Even so, it's significant that, two years before someone could legally argue they were "hurt" by the Affordable Care Act (ACA) that millions of Americans already have been helped by it. For example, with the law only partially implemented, 2.5 million young adults under 26 now are covered by their parents' health insurance. Five million seniors and people with disabilities have saved $3 billion already because the "doughnut hole" gap in prescription-drug coverage has been reduced. The lives and health of millions have been positively affected because, for nearly 18 months now, vaccinations, mammograms, and other cancer screenings are available at no extra cost.

What will happen to them if the ACA is found unconstitutional or repealed? The health-care crisis won't simply disappear. Those who so strenuously oppose the law need to explain what they would put in its place.