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To the U.S. Supreme Court now. Today, the justices heard arguments in a case that pits California's right to run its prisons against the Constitution's guarantee that those incarcerated get basic, minimum medical care. At issue is a federal court order from last year. It required California to take whatever measures necessary to reduce its prison population by 35,000 to 46,000 prisoners.

NPR's legal affairs correspondent Nina Totenberg reports.

NINA TOTENBERG: California's prison system, designed to house 80,000, housed twice that many by 2009 - with gymnasiums, classrooms, even clinics converted to inmate living space. The result is that the state itself admits prisoners are routinely denied minimum medical care, resulting in some 112 deaths over the last two years.

After 20 years of litigation, a special, three-judge federal panel heard prison experts from across the country testify that unless overcrowding was reduced, sufficient medical care simply could not be provided. The court then ordered the state to reduce the prison population to 137 percent of capacity within two years.

Court intervention didn't surprise Governor Arnold Schwartzenegger, whose own plan to reduce overcrowding by 37,000 in two years was rebuffed by the state legislature.

Governor ARNOLD SCHWARZENNEGER (Republican, California): I don't blame the courts for stepping in to try to stop the overcrowding crisis that we have because the fact of the matter is, for decades, the state of California hasn't really taken that seriously, and hasn't really done something about it.

TOTENBERG: Nonetheless, the state appealed the court order, asserting it needed more time to comply. Today in the Supreme Court, lawyer Carter Phillips, representing the state, said the lower court had not given adequate weight to public safety concerns. The reality, said Phillips, is that anytime you release 30,000 prisoners in a compressed time, I guarantee you there will be more crime, and people will die on the streets of California.

Justice Ginsberg: One of these cases has been going on for 20 years, with 70 court orders, and there's been no change. How much longer do we have to wait - another 20 years? Phillips urged the court to give the state at least five years to resolve its problem in an orderly way.

Justice Sotomayor: What are we fighting about? You want this to take 25 years instead of 22?

Justice Kennedy, likely to be the deciding vote: At some point, the court has to say you've been given enough time, and that's what the lower court did here. It seems to me entirely reasonable. Answer: Nobody doubts there have been very significant constitutional violations in the past, but there's been very significant movement recently. And if the court had not jumped the gun, this could have played out appropriately.

Representing the prisoners, lawyer Donald Specter told the court that California is an outlier in the way it treats prisoners and the number of people it imprisons for minor offenses.

Justice Alito: What justifies a court in ordering the release of 40,000 prisoners instead of ordering the building of more prisons, or the hiring of more medical staff? Answer: This is not a prison-release order. It's a crowding-reduction order. The state can move prisoners to out-of-state prisons. It can build more prisons. But just hiring more staff won't work, as the courts have found over the last 20 years.

Justice Alito: If I were a citizen of California, I would be concerned about the release of 40,000 prisoners. Do you really believe that wouldn't contribute to a serious increase in crime?

Specter noted that other states have reduced their prison populations without a crime increase. And he went on to note that in California, just eliminating the mandatory return of technical parole violators - people who, for instance, miss an appointment - would mean some 17,000 fewer prisoners.

Chief Justice Roberts: My concern about this kind of institutional reform litigation is that the state is responsible for a lot of different things. What happens when you have one court ordering the state to spend this much more on education for the disabled, and another court saying you have to spend this much more for something else? How does the state sort out its obligations?

Answer: In this case, the court gave the state all the flexibility it could to make choices, but the Constitution prevents the state from incarcerating somebody and then because of inadequate medical care, letting him die before his sentence is out.

Nina Totenberg, NPR News, Washington.

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