Health Care Challenges: Supreme Court Decision Expected in Late June

June 18, 2012 -- It's been a wild roller coaster ride. More than two years ago, after a brutal congressional battle, President Obama signed the historic Affordable Care Act. Sometime this month the Supreme Court will decide it's fate.

"After a century of striving, after a year of debate, after a historic vote, health care reform is no longer an unmet promise," Obama said at the time.

During a White House ceremony, Vice President Joe Biden was so swept up in his enthusiasm, that he embraced his boss, and then, unaware of the hot microphones, whispered to the President, "This is a big f**king deal."

Joe Biden had no idea just how big.

Even before the ink was dry, challengers to the law filed lawsuits across the country. Central to their case was the argument that Congress had exceeded its authority in mandating that most every American buy health insurance by 2014. Some federal judges ruled in favor of the law, and others ruled against it, providing highs and lows for both supporters and opponents of the health care law.

In the early days, even before the law was signed in March 2010, Randy Barnett, a professor at Georgetown law school, was surprised that more people weren't questioning whether the law violated the Constitution.

"No one was paying attention to the law's constitutionality," Barnett said in a recent interview. At the time, he wrote a paper attacking the law that attracted the attention of Republicans in the Senate, but most people dismissed the potential challenges that came as soon as the law was signed.

A turning point occurred in December 2010 when Judge Henry Hudson of the U.S. District Court for the Eastern District of Virginia struck down the individual mandate. He was the first federal judge to strike down any part of the law

"Most legal experts dismissed the arguments as frivolous even after the lawsuits were filed," said Barnett. "Only after District Judge Henry Hudson found the mandate unconstitutional did some skeptics start to take the matter more seriously."

In January 2011, Judge Roger Vinson of the Northern District of Florida went even further. He said the mandate was unconstitutional, and the rest of the law could not survive without it. He struck down the entire law.

Even though other district courts have upheld the mandate, the rulings of Vinson and Hudson energized opponents of the law.

Pam Biondi, Florida's attorney general, had brought the challenge to the Northern District of Florida on behalf of Florida and 25 other states. She spearheaded the hiring of Paul Clement--one of the best appellate lawyers in the country--to argue the case in the 11th Circuit Court of Appeals. Barnett signed on to help represent an independent business group that was also challenging the law. The 11th Circuit would eventually rule to strike down the mandate.

But supporters of the law, disappointed by the rulings of Hudson, Vinson and the 11th Circuit, took great solace in the votes of two other appeals court judges who ruled in favor of the individual mandate.