REVEALED: Here's How The Supreme Court's Health Care Decision Could Go Down

obama health care

The American public is eagerly awaiting the Supreme Court’s verdict on health reform.

That case – unlike many that come through the high court’s pipeline – could have a very real impact on regular people.

But how will the decision shake out?

We asked Supreme Court experts from the across the U.S. to tell us what could happen later in June when the decision is expected.

Read on to find out about the fate of the health care law, and how the aftermath of the ruling could affect the country.

Chief Justice John Roberts' vote hinges on Anthony Kennedy.

'I think the court is, in my best guess, more likely than not to uphold the individual mandate,' Stanford Law School professor Hank Greely said.

Greely predicted the most likely outcome was a 6 to 4 vote with both Justice Anthony Kennedy and Chief Justice John Roberts voting in the majority.

But everything hinges on Kennedy.

'I think Roberts will go whatever way Kennedy goes,' Greely said.

Under the law, the federal government will give the states funding so they can expand Medicaid, the health insurance program for low-income Americans.

Greely predicts the justices will uphold the Medicaid expansion, but that they might do so reluctantly.

The proposed expansion isn't that different from the current system and court precedent says Congress can bribe states to accept federal mandates, Greely said. But the bribe has to be within reason.

'Well this is a pretty big bribe,' Greely said.

The court won't pass on the opportunity to judge the individual mandate.

'The first question they've got to get over is 'are we going to decide the mandate issue,'' said Lyle Denniston, a reporter for Bloomberg's SCOTUSblog.

The fate of health reform turns largely on whether the federal government can police health insurance under its Constitutional powers to regulate commerce between states.

But before the court weighs in on the Constitutional issue, it must decide whether the requirement that people buy insurance or pay a penalty is simply a tax.

If the court decides it is a tax measure, it can't vote on the mandate until it's implemented in 2014.

But Denniston said he believes the court will vote on the constitutional merits of the mandate -- controversial as it may be.

While the mandate is close to the edge of Congress' power, the court will recognise it owes some respect to Congress' judgment and uphold the mandate, Denniston predicted.

If the justices uphold the mandate, then the court will not have to decide whether the law can still survive without the controversial measure, which has been described as the heart of the law.

But the high court could still strike down another part of the law even if it upholds the mandate.

'Nothing else will fall with the possible exception of the expansion of Medicaid,' Denniston said.

While he wouldn't offer a definitive prediction about the fate of the expansion, Denniston said the states made a pretty good argument that it would increase the burden on their budgets.

'I do think it is at risk,' he said.

Say goodbye to the Medicaid expansion.

While she also thinks the court won't pass on the opportunity to judge the mandate, legal expert Abby Moncrieff isn't so sure about other controversial parts of the law.

'I'd be surprised if they don't invalidate the Medicaid expansion,' said Moncrieff, an associate professor at the Boston University School of Law.

Five of the Supreme Court justices are serious advocates of federalism, meaning they'd like to limit the government's spending.

Plus, the Supreme Court took the time to debate the Medicaid expansion even though it was not required to do so, she pointed out.

It's hard to imagine why the court would agree to debate the expansion unless the justices had decided to declare it unconstitutional, Moncrieff said.

While Moncrieff doesn't think much about the case could surprise her anymore, one oddball decision still has the power to shock experts.

'If they held that the case is barred by the anti-injunction act, I'd be surprised by that,' she said, referring to the law that would put off a decision on the mandate until 2014.

'I don't think they're going to hold they can't decide the case right now,' Moncrieff added.

The wild card justice, Kennedy, isn't likely to help Obama.

For years Adam Winkler predicted Obamacare wouldn't pass muster with the nation's highest court.

'I predicted in 2010 when the law was passed that the Supreme Court would strike it down,' said Winkler, a professor at UCLA's law school.

While he doesn't put much stock in oral arguments, Winkler noted the government definitely didn't come out on top after the justices heard their case.

And to make matters worse for Obama, a conservative court is judging his campaign's signature issue.

But, unlike other experts, Winkler said Obama shouldn't expect any relief from Justice Anthony Kennedy.

'If the swing vote is Justice Kennedy, that doesn't bode well for the government,' he said.

The public often views Kennedy as a moderate, but nothing could be further from the truth, Winkler said. Rather, Kennedy is an extremist whose views swing from right to left, according to Winkler.

'What determines whether he goes right or goes left in a particular case is in his libertarian impulses,' according to Winkler.

Chief Justice John Roberts is also an unexpected wild card. Many people were too optimistic about Roberts and his desire to protect the court's legitimacy, Winkler said.

But from affirmative action to abortion, Winkler pointed out, Roberts has issued anything but moderate opinions designed to protect the court.

Based on oral arguments, the individual mandate is toast.

There is at least a 55 per cent chance the court will strike down the individual mandate, Supreme Court expert Glenn Cohen said.

Justice Anthony Kennedy will prove to be the swing vote, but in the four or five exchanges Kennedy had with lawyers, he seemed to express doubts about the way the mandate changed the relationship between the federal government and the people, said Cohen, a professor at Harvard Law School.

'Only at the very end of the argument was there an exchange that seemed favourable to the mandate,' Cohen said.

While he is 'sheepish' about offering any predictions, Cohen said oral arguments 'did not go well for the government and the mandate.'

If the mandate falls, the court is faced with the issue of severability -- something it seemed to struggle with during arguments.

The high court seems likely to adopt the view that the mandate can't be severed from the parts of the law that guarantee everybody health insurance, he said.

Don't bet the family farm on Justice Kennedy upholding the law.

Justice Kennedy might not be the only wild card.

Unlike many experts, Duke University's Neil Siegel believes the Supreme Court could uphold the law 6-3.

Roberts seemed more hostile than sympathetic to the law during oral arguments, Siegel acknowledged.

But he also asked tough questions of ex-solicitor general Paul Clement, who was arguing against health reform.

If Roberts does vote to uphold the entire law, he could gain praise in liberal and moderate circles that would give him political capital to spend on future cases, Siegel said.

While Siegel said he can see a 6-3 vote in favour of the law, he would be genuinely shocked if the court strikes down the entire law because it has popular provisions that aren't being challenged.

A loss in June could be a big win in November for Obama.

While law professor Wendy Parmet said it's difficult to predict which way the court will rule, Obama could actually get a political boost if the justices strike down all or part of the law.

In a 'strange and paradoxical way' striking down the law could actually help the president, she said.

A negative opinion from the Supreme Court could initially be a blow to the president, but at least that ruling would put the issue front-and-centre in the election.

And a renewed focus on high health care costs and the uninsured could make Democrats look more appealing, according to Parmet, an associate dean for Northeastern University School of Law.

Parmet believes Obamacare as a whole isn't popular with the country. But the public might start to warm up to the Democrats' individual arguments for reform once the law gets dissected piece by piece, she said.

Obamacare is going down.

'I think it's about two to one odds that the court will strike down the individual mandate and that Justice Kennedy is the deciding vote on that,' policy expert and lawyer Ilya Shapiro said.

And if the individual mandate falls, a substantial amount of the law is likely to fall with it.

But that isn't a bad thing, according to Shapiro, a senior fellow at the Cato Institute, a libertarian think tank.

'I don't think there's a good outcome for President Obama,' Shapiro said.

If the law gets struck down, his administration's signature achievement has failed.

But if the law is upheld, the tea partiers and independents who oppose Obamacare might be energized enough to defeat the president in the upcoming election, he said.

This doesn't have a whole lot to do with law.

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