Arguments In Health Care Case

NPR's Julie Rovner describes the scene outside the Supreme Court on Tuesday, where both sides seemed pleased with the debate over the federal health law, and previews Wednesday's arguments.

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MELISSA BLOCK, HOST:

So that's what happened inside the court today. NPR's Julie Rovner was outside where things were louder.

UNIDENTIFIED GROUP: Hey hey. Ho ho. Obamacare has got to go. Hey hey. Ho ho. Obamacare has got to go.

BLOCK: And Julie's here now in the studio to talk about reaction to today's proceedings and to look ahead to the last day of arguments tomorrow. And, Julie, let's talk about that scene outside the court. Sounds like it was a bit more boisterous than yesterday.

JULIE ROVNER, BYLINE: Yes, it was. It was quite a bit more crowded with a lot more demonstrators from both sides, which makes sense since today was really when the court was taking up the heart of the case. But, you know, I've been to the court for a lot of big cases and one of the things that really struck me was how nice everybody was, including people on opposite sides of each other, even when they were shouting over each other. And that really hasn't been a hallmark of this health care debate.

I caught up with Iowa Republican Congressman Steve King as he was coming out of the court and here's how he described it.

SENATOR STEVE KING: What could be better? I mean, here's the United States Supreme Court in brilliant sunshine. There's the flag. It's peaceful. The officers are standing there just keeping an eye on it, but they don't have any real work to do. Over here is the United States Capitol, signs, chants from both sides, lots of media. I mean, this is America, and, you know, it brings the competing ideas of America together in one place.

BLOCK: Well, speaking of competing ideas, what did you hear from people who were in the courtroom about the actual arguments? Who did they think prevailed today?

ROVNER: Well, it seemed to be the ultimate inkblot test, that what you came out with depended on what you went in with. Those who were opposed to the law going in came out pretty confident that the court would vote with them and those who supported the law came out equally confident that they would pick up a conservative, either Justice Kennedy or Chief Justice Roberts and the law will be upheld.

And, of course, we won't know until the court delivers its decision, which will probably be at the very end of June.

BLOCK: And still one more day of argument to go. The court's looking at two different questions tomorrow, Julie. What's the first one?

ROVNER: Well, there's a morning and an afternoon session. In the morning, the court will take up the issue of severability which, in English, means what happens if it decides to strike down the requirement for people to have health insurance? Does that mean the entire law has to fall or, as one law professor described it, is it more like a kidney, where you can remove it and go on living just fine?

Or might the court have to remove the mandate, plus some other parts of the law that rely on it, like the requirement for insurance companies to sell policies to people with preexisting health conditions? Insurance companies say, unless healthy people are required to sign up, people will wait until they're sick to buy insurance and the companies will go broke or, at very least, insurance will become prohibitively expensive.

BLOCK: So that's the focus for the morning session. And in the afternoon, Medicaid, right?

ROVNER: Yes. In the afternoon, the court looks at whether the law's expansion of Medicaid is unfairly coercive to the states. Now, the federal government is actually paying almost all of the cost of this particular expansion. It will allow for the first time low income adults without children or disabilities onto the program. But the states say that unless they go along with the changes and pay even that small share, they could lose all of their other Medicaid money which, of course, amounts to billions of dollars they get from the federal government.

Very little attention's actually been paid to this part of the case, but it could end up having very important ramifications, not just for Medicaid, but for every program where the federal government gives money to states with conditions attached. So a lot of people are watching this very, very closely.

BLOCK: And we'll be talking about that with you tomorrow, Julie. Thanks very much.

ROVNER: You're very welcome.

BLOCK: NPR's health policy correspondent, Julie Rovner.

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