All eyes will be on the Supreme Court on Thursday morning, as justices are expected to hand down their ruling on the controversial healthcare reform law passed by President Barack Obama and a Democratically-controlled Congress in 2010.
The law was challenged by 28 states who argue that the federal government does not have the right to fine citizens for not buying a product and that by including such a mandate in the law it violates states' rights.
While the court is considered to have five conservative justices, appointed by Republican presidents, and four liberal ones, appointed by Democrats, the case's outcome is by no means a forgone conclusion. Not only is conservative Justice Anthony Kennedy thought to be a swing vote, but there is speculation that Chief Justice John Roberts, appointed by President George W. Bush, will craft the majority opinion no matter what side the court falls in order to make his mark on the highest-profile ruling of his court so far.
The four major outcomes the court could settle on are upholding the entire law, throwing out the entire law, stripping away just the 'individual mandate' or deciding they have no grounds to make a judgment until the mandate takes effect, in 2014.
No matter what the justices conclude, the verdict will be steeped in politics.
To begin with, the concept of requiring people to buy health insurance began in conservative circles as a cost control mechanism—the larger the insurance pool is, the more spread out the costs are. As governor of Massachusetts, Republican presidential candidateMitt Romney signed into law just such a mandate as part of his signature health policy. Romney, who has vowed to repeal the federal Affordable Care Act, also known as Obamacare, says while it's entirely appropriate for states to issue their own mandates, it's not something the federal government can do.
The very process by which the federal health care overhaul was crafted also contributed to its politicization.
Democrats, many of whom supported creating a 'public option' that would have amounted to government run healthcare akin to Medicare or what is provided to veterans, were accused of prioritizing their partisan goals rather than focusing on getting the country out of financial recession. And despite months of prolonged negotiations between the bipartisan Senate 'Gang of Six,' Republicans—claiming the process was rushed and that they were shut out of policy discussions—pulled back and uniformly voted against the measure. Ultimately the law that passed did not contain any form of public option, something that greatly disappointed progressives.
But Republicans still campaigned throughout the mid-term elections on the idea that Democrats had committed a government takeover of health care, spending billions of taxpayer dollars in subsidies, and cut Medicare benefits to seniors. Indeed the law does call for Medicare cuts, but the overall measure was also paired with student loan reforms that saved tax dollars—the combination of which meant the overall law would reduce the deficit, not add to it despite millions of dollars in subsidies.
The GOP cleaned up in the fall 2010 elections and their opposition to Obamacare is one of many factors that allowed them to harness the fiscally-conscientious Tea Party movement and win control of the House of Representatives.
Also adding fuel to the political fire were requests by conservatives that Justice Elena Kagan, a Democrat, recuse herself from the ruling and by liberals that Justice Clarence Thomas, a Republican, do the same. Kagan served in the Obama administration as Solicitor General while the administration was prepping for the lawsuit and Thomas' wife was paid more than $100,000 to lobby against the health care legislation.
Lower court rulings on the case have also largely fallen along partisan lines, upping the expectations and pressure on the Supreme Court, which purportedly strives to be as apolitical as possible. Although recent Roberts' court decisions, such as the campaign finance ruling in Citizens' United, have been criticized as politically motivated.