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Supreme Court Begins Review of Affordable Care Act
Date:3/26/2012

By Lisa Esposito
HealthDay Reporter

MONDAY, March 26 (HealthDay News) -- The U.S. Supreme Court on Monday began its review of the constitutionality of the controversial and massive health-reform initiative known as the Affordable Care Act. And the justices gave every indication that a little-known 19th century tax law wouldn't keep them from hearing the case.

The Affordable Care Act -- the most ambitious government health-care initiative since the Medicare and Medicaid programs of the 1960s, and the legislative landmark of President Barack Obama's presidency -- is the first federal effort to rein in health-care costs. It aims to extend insurance coverage to more than 30 million Americans through an expansion of Medicaid and a provision that people buy health insurance starting in 2014 or face a penalty.

The nine justices began the unprecedented three days of legal arguments with a 90-minute discussion of whether the high court has the right to hear the case at this time. At issue: whether the court can consider tax challenges before they take effect. Some, including a federal appeals court in Richmond, Va., have contended that the provision in the health-reform law that people pay a penalty if they don't have insurance is, in reality, a tax.

But the justices' questions Monday morning suggested that they did not think the insurance penalty was tantamount to a tax. An obscure 1867 law prohibits legal challenges to a tax until it has been collected. The penalty for not having health insurance wouldn't take effect until 2014, with payment due in 2015, the Washington Post reported.

Although the insurance penalty is "being collected in the same manner of a tax doesn't automatically mean it's a tax," said Justice Stephen Breyer, the Post reported.

Justice Antonin Scalia seemed to agree. The courts should not be deprived of jurisdiction in cases unless the reasoning is very clear, he said,
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