By vowing to do what Democrats in Washington couldn’t do, California’s left-wing loons prepare to launch the California Healthcare System (CHS) with the introduction of Senate Bill 810 in the California Legislature.  This bill would make California the primary health provider in the state and would eliminate and make it illegal for Californians to purchase private health insurance. 

If this sounds far-fetched, please note legislation doing exactly this has been introduced in the past and was approved by both the House and Senate in California only to be vetoed by then Governor Arnold Schwarzenegger. 

This time (if SB810 passes in the Legislature), the decision falls to Democrat Governor Jerry Brown, and it remains an open question as to whether or not he will sign the bill. 

If Governor Brown signs SB810 into law, Californians will say good bye to Kaiser Permanente, Blue Cross of California, Blue Shield of California, Aetna and all private health insurance carriers. 

And all of this from a state that has accrued an aggregate debt of 612 billion dollars.  Where will the money come from?

Cary Hall, America’s Healthcare Advocate

Would you trust Sacramento with your health?

Bill creating state ‘single-payer’ insurance system is back again. Would Brown sign it?

The Orange County Register

January 13, 2012

California never seems to pull the plug on bad ideas. That’s why single-payer – government – medical insurance legislation is back on the operating table in Sacramento. Senate Bill 810 is authored by state Sen. Mark Leno, D-San Francisco.

On Jan. 9, union groups led rallies in front of the state Capitol in favor of the bill. The protest was called, “SB810 Rally Sacto – Jan 2012″ Protest signs read, “Health Care Yes, Insurance Companies No” and “Healthcare for the 99%.”

Supporters of the bill include powerful public-employee unions, chiefly the California Teachers Association and the California School Employees Association.

SB810 would replace the current system of competing insurance companies with a vast new California Healthcare System that would be run by a mammoth new bureaucracy, the California Healthcare Agency.

In the bill’s language, it also, “[p]rohibits the sale of any private health care service plan or health insurance policy in the state, and makes the CHS the primary payer for health care services in California.” Although private doctors and hospitals would still exist, they would operate under the thumb of the CHS and the CHA.

Voters in 1994 rejected Proposition 186, which would have imposed a similar single-payer scheme on the state, 73 percent to 27 percent. As recently as 2007, a similar initiative failed even to qualify for the ballot. And Gov. Arnold Schwarzenegger, although in general supporting more state government involvement in health care, twice vetoed bills similar to SB810.

Proponents claim SB810 would save Californians $8 billion a year on insurance premiums and medical costs. But when has a government program ever been cheaper than a private program?

“They’re sticking their heads in the sand,” Grace-Marie Turner told us; she’s president of the Galen Institute, which promotes free-market ideas for medical reform. “In countries with single-payer systems, more people die because they can’t get care. They’re forced to jump through bureaucratic hoops. In every other area, people don’t want a bunch of bureaucrats making decisions.”

For example, dozens of private automobile companies compete for customers by producing hundreds of different models. But when government builds a car, it assembles the Yugo.

Another aspect is that it isn’t clear how Obamacare would mesh with SB810. The U.S. Supreme Court is reviewing whether the federal health care law’s mandate that every American buy approved health coverage is constitutional. A decision is expected in June.

We believe that better solutions to the high cost of health care involve reducing, not increasing, government involvement. For example, the state should allow people to buy medical insurance from companies in other states. That certainly would increase competition and reduce costs.

SB810 likely will pass in the Legislature. The question then is whether Gov. Jerry Brown will reverse Gov. Schwarzenegger’s vetoes and sign the bill. If he does so, it would be another burden for businesses and citizens already sick from so many state regulations and mandates.

It is fascinating for me as a conservative Catholic to watch people like Sister Carol Keehan of the Catholic Health Association and Notre Dame’s Father John Jenkins claim shock and surprise at Health and Human Services Secretary Kathleen Sebelius’s latest dictate forcing Catholic institutions to provide contraceptives like the morning after pill. 

Why is it fascinating you might ask?  Because these are the very people who stood with the White House and President Obama endorsing ObamaCare as they saw ObamaCare as another step toward social justice.  Now they find themselves in a trap they weren’t prepared for.  You see the bill says over one thousand times “the Secretary shall,” which gives Health and Human Services  Secretary Katheen Sebelius the ability to write into the law regulations as she sees fit.  In this case, forcing Catholic institutions, hospitals, Catholic charities, schools, etc. to do something that is diametrically opposed to Catholic philosophy. 

While liberal “cafeteria” Catholics chose to wink at the abortion issue which was papered over by Congressman  Bart Stupak’s agreement with President Obama for an executive order which supposedly prevents Federal funds from subsidizing abortion (giving liberal Catholics cover for something many of them believe should be their right regardless of Church philosophy), the current issue of contraception presents a much bigger problem that they are now required to face and cannot run away from.  Meanwhile, Kathleen Sebelius, herself a liberal Catholic, has dug her heals in and, so far, refuses to resend the regulation. 

This all presents a fine kettle of fish for the President who received sixty percent of the Catholic vote in the last election and will certainly need that vote again.  This ruling, however, could very well put that vote in jeopardy since it appears the cafeteria is now closed.

Cary Hall, America’s Healthcare Advocate

ObamaCare’s Great Awakening

HHS tells religious believers to go to hell. The public notices.

From The Wall Street Journal, Wednesday, February 8th

The political furor over President Obama’s birth-control mandate continues to grow, even among those for whom contraception poses no moral qualms, and one needn’t be a theologian to understand why. The country is being exposed to the raw political control that is the core of the Obama health-care plan, and Americans are seeing clearly for the first time how this will violate pluralism and liberty.

***

In late January the Health and Human Services Department required almost all insurance plans to cover contraceptive and sterilization methods, including the morning-after pill. The decision came after passionate lobbying by religious groups and liberals from the likes of Planned Parenthood, amid government promises of compromise.

In the end, Planned Parenthood won. HHS chose to draw the rule’s conscience exceptions for “religious employers” so narrowly that they will not be extended to religious charities, universities, schools, hospitals, soup kitchens, homeless shelters and other institutions that oppose contraception as a matter of religious belief.

The Affordable Care Act itself is ambiguous about what counts as a religious organization that deserves conscience protection. Like so much else in the rushed bill, this was left to administrative discretion. What the law does cement is the principle that the government will decide for everyone what “health care” must mean. The entire thrust of ObamaCare is to standardize benefits and how they must be paid for and provided, regardless of individual choices or ethical convictions.

To take a small example: The HHS rule prohibits out-of-pocket costs for birth control, simply because Secretary Kathleen Sebelius’s regulators believe no woman should have to pay anything for it. To take a larger example: The Obama Administration’s legal defense of the mandate to buy insurance or else pay a penalty is that the mere fact of being alive gives the government the right to regulate all Americans at every point in their lives.

Practicing this kind of compulsion is routine and noncontroversial within Ms. Sebelius’s ministry. That may explain why her staff didn’t notice that the birth-control rule abridges the First Amendment’s protections for religious freedom. Then again, maybe HHS thought the public had become inured to such edicts, which have arrived every few weeks since the Affordable Care Act passed.

Bad call. The decision has roused the Catholic bishops from their health-care naivete, but they’ve been joined by people of all faiths and even no faith, as it becomes clear that their own deepest moral beliefs may be thrown over eventually. Contraception is the single most prescribed medicine for women between 18 and 44 years old, and nine of 10 insurers and employers already cover it. Yet HHS still decided to rub it in the face of religious hospitals.

Mr. Obama’s allies among Catholic liberals are also professing shock—even the Catholic Health Association’s Sister Carol Keehan, who lobbied for ObamaCare, and Notre Dame’s Father John Jenkins, who invited Mr. Obama to speak on campus in 2009. But if they now claim they were taken for a ride by the secular left, the truth is that they wanted to be deceived in the name of their grander goal of government-enforced equity. The Catholic left was one of ObamaCare’s great enablers.

Speaking of scales from the eyes, we’re eager to hear from former Michigan Congressman Bart Stupak, who for a brief moment led a faction of pro-life Democrats against ObamaCare in 2010. They surrendered when Mr. Obama gave them the fig leaf of an executive order that will supposedly prevent federal funds from subsidizing abortions. Mr. Stupak is now a lobbyist at the D.C. law firm Venable LLP.

This is also a teaching moment for Mitt Romney, who has joined the calls to defend “the right to worship in the way of our own choice,” as he put it in a Colorado speech on Monday. “This is a violation of conscience. We must have a President who is willing to protect America’s first right, our right to worship God,” he added.

This is fine as far as it goes, but as usual the GOP front-runner is missing the larger policy and moral issue. The HHS diktat isn’t something unique to President Obama. It is the political essence of government-run medicine. When politics determines who can or should receive what benefits, and who pays what for it, government will use its force to dictate the outcomes that it wants—either for reasons of cost, or to promote its values, which in this case means that “women’s health” trumps religious conscience.

If Mr. Romney can’t make the obvious connection between this infringement of American values and all the other infringements that are inherent in government health care, then he needs better political advisers.

***

The White House is now trying to cauterize the political damage and saying it is open to some “compromise” on its own contraception decision. But the rule is already final. HHS tried to sell it as a compromise when it was announced, and in any case HHS would revive this coercion whenever it is politically convenient some time in Mr. Obama’s second term. Religious liberty won’t be protected from the entitlement state until ObamaCare is repealed.

I have often made the claim at public speaking events around the country that we have the best healthcare system in the world.  That premise is challenged from time to time by people who like to talk about our World Health Organization ranking and other measurement tables which seem to belie that fact. 

The below listed article, The Cancer Revolution, talks about the cancer rate between the 1980’s and 1990’s falling 18 percent.  It also talks about the 5-year survival rate climbing to 68 percent since 1975.  And here’s one that is absolutely astounding:  the prostrate cancer 5-year survival rate in the United States is 99.9 percent.  Survival rates for breast cancer and colorectal cancer continue to rise. 

The question is will the Patient Protection and Affordable Care Act aka ObamaCare choke off medical innovation through taxes, restraints and government intervention via agencies like the new 15-member Independent Payment Advisory Board appointed by President Obama to determine what procedures and medications Medicare will pay for and how much they will pay? 

I always find it interesting to listen to the arguments against our healthcare system and then look at the number of foreign dignitaries who come to our country for medical treatment like former Prime Minister of Italy Silvio Berluscone and former Newfoundland and Labrador Premier Danny Williams, both of whom have a government run healthcare system in their country but chose to have medical treatment in the U.S.A.  As the article clearly states, the cancer revolution in the United States will continue if the government lets it. 

Cary Hall, America’s Healthcare Advocate

The Cancer Revolution

January 9, 2012

The Wall Street Journal

Forty years ago President Nixon declared a “war on cancer” and signed the National Cancer Act in December 1971, which dramatically increased government funding for oncology research. More than a few Jeremiahs are using the anniversary to lament the supposed stagnation of progress against the disease, but this is more accurately a moment to celebrate the rapid and ongoing U.S. revolution in cancer diagnosis and treatment.

Pessimism was more warranted in the late 1980s and early 1990s, as the cancer death rate continued to climb and a new generation of cancer drugs seemed to stall out. But the death rate has since fallen by 18%, which shows that medical advances are usually incremental and provisional.

A better measure is the five-year survival rate, the share of all patients who are still alive a half-decade after their diagnosis. That measure has climbed to about 68% for all cancers from 45% in 1975, according to the National Cancer Institute. Another way of putting it is that two-thirds of patients can live many productive years with a chronic condition and in many cases even be cured.

Progress is particularly evident against the four most common cancers: For prostate cancer, the five-year survival rate has surged to 99.9% today from 67% in the 1970s. Survival rates have been rising for breast cancer since 1983 and for colorectal cancer since 1975. Even for lung cancer—the No. 1 cancer killer—the survival rate has been rising since 1988, though it is still less than 20%.

If the pace of anticancer progress has been remarkable in some areas, more modest in others, that’s because Nixon’s formulation had it wrong. This is a war against cancers.

Today we have a far more sophisticated and profound understanding of the biology of cancers, to the point where they are less medically defined by the location in the body where they happen to begin. There is no such thing as “lung cancer,” but rather a constellation of different cancers with diverse biologies and behaviors. Treatment is now guided by cancer “panomics,” the individual combination of genes, proteins and molecular pathways that drive the uncontrolled growth of malignant cells.

This scientific ferment is starting to diffuse through drug development, and oncologists will increasingly be able to target therapies to the patients most likely to benefit. The first anticancer drug, nitrogen mustard, emerged in 1949, and the number expanded to about 25 by 1971. Today there are hundreds, yet only about 5% to 8% of new cancer drugs succeed.

One problem is that the next generation of anticancer medicines is being delayed by a regulatory system that is far too rigid and controlling. A 2010 Institute of Medicine report noted that the traditional Food and Drug Administration clinical trials system, which was designed in the 1950s and has barely changed, is too slow, complex and inefficient. For progress to continue it needs to be modernized—most of all with so-called adaptive trial design.

That model evolves as a trial proceeds to incorporate new knowledge and recognizes that often only narrow patient subgroups will have a specific molecular defect and thus respond. But the FDA rejects such methods as insufficiently pure and its institutional culture continues to adhere to only a few crabbed measures of the value of a new treatment.

Federal funding for the National Cancer Institute and other programs has grown moderately in recent years. But it has been losing its buying power as medicine becomes more complex, and it has not grown as fast as the rest of the budget as entitlements begin to crowd out all other spending.

One of the great ironies of the post-1971 cancer era is that the failure to reform Medicare and Medicaid is devouring the money available for the basic medical and scientific research that is a proper role for government. The cancer revolution will continue if government allows it.

Led by Secretary of Health and Human Services, Kathleen Sebelius (who is Catholic), the Obama administration is forcing Catholic institutions to implement portions of ObamaCare that are in direct contradiction to the Catholic Church’s theological teachings and that could threaten the existence of entities like Catholic charities, Catholic colleges, hospitals and parochial schools. 

The irony in all of this is that without crucial support from liberal Catholics like Cardinal Mahoney from Los Angeles, Father Jenkins (the president of Notre Dame) and other left-wing Catholics who appeared with Obama during the battle over ObamaCare, the bill never would have passed. 

Now, the administration, led by Kathleen Sebelius, has turned its guns on Catholic institutions as noted in The Wall Street Journal editorial by Archbishop Timothy Dolan.  Archbishop Dolan points out that in addition to infringing on the Catholic Church’s religious liberty, the rules requiring insurance carriers to provide a host of contraceptive treatments at no charge (including the morning after pill) will be paid for by you, the consumer.  And, as he states in the editorial, there is no free lunch even though the Obama administration and Secretary Sebelius continue to tout the “free services” ObamaCare is reported to offer. 

What is surprising to me is that it took this long for Catholics to understand the secularist agenda that drives the ideologues in the Obama administration. 

Cary Hall, America’s Healthcare Advocate

ObamaCare and Religious Freedom

How about some respect for Catholics and others who object to treating pregnancy as a disease?

from The Wall Street Journal, January 25, 2012

By TIMOTHY M. DOLAN

Religious freedom is the lifeblood of the American people, the cornerstone of American government. When the Founding Fathers determined that the innate rights of men and women should be enshrined in our Constitution, they so esteemed religious liberty that they made it the first freedom in the Bill of Rights.

In particular, the Founding Fathers fiercely defended the right of conscience. George Washington himself declared: “The conscientious scruples of all men should be treated with great delicacy and tenderness; and it is my wish and desire, that the laws may always be extensively accommodated to them.” James Madison, a key defender of religious freedom and author of the First Amendment, said: “Conscience is the most sacred of all property.”

Scarcely two weeks ago, in its Hosanna-Tabor decision upholding the right of churches to make ministerial hiring decisions, the Supreme Court unanimously and enthusiastically reaffirmed these longstanding and foundational principles of religious freedom. The court made clear that they include the right of religious institutions to control their internal affairs.

Yet the Obama administration has veered in the opposite direction. It has refused to exempt religious institutions that serve the common good—including Catholic schools, charities and hospitals—from its sweeping new health-care mandate that requires employers to purchase contraception, including abortion-producing drugs, and sterilization coverage for their employees.

Last August, when the administration first proposed this nationwide mandate for contraception and sterilization coverage, it also proposed a “religious employer” exemption. But this was so narrow that it would apply only to religious organizations engaged primarily in serving people of the same religion. As Catholic Charities USA’s president, the Rev. Larry Snyder, notes, even Jesus and His disciples would not qualify for the exemption in that case, because they were committed to serve those of other faiths.

Since then, hundreds of religious institutions, and hundreds of thousands of individual citizens, have raised their voices in principled opposition to this requirement that religious institutions and individuals violate their own basic moral teaching in their health plans. Certainly many of these good people and groups were Catholic, but many were Americans of other faiths, or no faith at all, who recognize that their beliefs could be next on the block. They also recognize that the cleverest way for the government to erode the broader principle of religious freedom is to target unpopular beliefs first.

Now we have learned that those loud and strong appeals were ignored. On Friday, the administration reaffirmed the mandate, and offered only a one-year delay in enforcement in some cases—as if we might suddenly be more willing to violate our consciences 12 months from now. As a result, all but a few employers will be forced to purchase coverage for contraception, abortion drugs and sterilization services even when they seriously object to them. All who share the cost of health plans that include such services will be forced to pay for them as well. Surely it violates freedom of religion to force religious ministries and citizens to buy health coverage to which they object as a matter of conscience and religious principle.

The rule forces insurance companies to provide these services without a co-pay, suggesting they are “free”—but it is naïve to believe that. There is no free lunch, and you can be sure there’s no free abortion, sterilization or contraception. There will be a source of funding: you.

Coercing religious ministries and citizens to pay directly for actions that violate their teaching is an unprecedented incursion into freedom of conscience. Organizations fear that this unjust rule will force them to take one horn or the other of an unacceptable dilemma: Stop serving people of all faiths in their ministries—so that they will fall under the narrow exemption—or stop providing health-care coverage to their own employees.

The Catholic Church defends religious liberty, including freedom of conscience, for everyone. The Amish do not carry health insurance. The government respects their principles. Christian Scientists want to heal by prayer alone, and the new health-care reform law respects that. Quakers and others object to killing even in wartime, and the government respects that principle for conscientious objectors. By its decision, the Obama administration has failed to show the same respect for the consciences of Catholics and others who object to treating pregnancy as a disease.

This latest erosion of our first freedom should make all Americans pause. When the government tampers with a freedom so fundamental to the life of our nation, one shudders to think what lies ahead.

Timothy Dolan is archbishop of New York and president of the U.S. Conference of Catholic Bishops.

America’s Healthcare Advocate is happy to announce we will be the new hit on KDKD’s Today’s New Hit Country station 95.3FM, broadcasting throughout west central Missouri in Clinton, Harrisonville, Warsaw and Sedalia.

Bob May, General Manager, says that America’s Healthcare Advocate brings a much needed source of information to KDKD’s audience about healthcare and health insurance related topics as well as about the upcoming changes in national healthcare.

KDKD will begin airing the show Wednesday, February 1st, during the primetime evening drive: 6:00pm to 7:00pm.

Cary Hall, host of America’s Healthcare Advocate, states, “This is a wonderful opportunity for us to reach a new audience on the powerful country music signal of KDKD. I want to thank Bob May, Stephanie Swaim and all of the good folks at KDKD for giving us this opportunity.”

One of the most difficult things that people have trouble understanding in life seems to be the need to do what they truly want to do and not what they think they’re expected to do. It has always been my perspective on life that if you cannot get out of bed in the morning, put your feet on the floor and be happy with the day in front of you (meaning your job, your career), then you’re doing something wrong and you will never truly fulfill your life’s expectations. In the paragraph below, Steve Jobs clearly puts this point into perspective. So, whether you’re twenty-five or eighty-five, this applies to all of us.

Remembering that I’ll be dead soon is the most important tool I’ve ever encountered to help me make the big choices in life. Because almost everything—all external expectations, all pride, all fear of embarrassment or failure—these things just fall away in the face of death, leaving only what is truly important. Remembering that you are going to die is the best way I know to avoid the trap of thinking you have something to lose. You are already naked. There is no reason not to follow your heart.

p. 457, Steve Jobs, by Walter Isaacson

I just finished reading Steve Jobs’ biography by Walter Isaacson.  It is one of the most fascinating books I have ever read.  Mr. Jobs was a complex and brilliant individual of whom there was much to be admired and a considerable amount that shouldn’t be admired.  However, his contrarian nature and dogged tenacity rang true with me, and I thought this paragraph best summed up how he saw himself and how many people who start companies have a vision they refuse to let go of even when they’re told they’re crazy, it will never work, etc:

Here’s to the crazy ones.  The misfits.  The rebels.  The troublemakers.  The round pegs in the square holes.  The ones who see things differently.  They’re not fond of rules.  And they have no respect for the status quo.  You can quote them, disagree with them, glorify or vilify them.  About the only thing you can’t do is ignore them.  Because they change things.  They push the human race forward.  And while some may see them as the crazy ones, we see genius.  Because the people who are crazy enough to think they can change the world are the ones who do. 

p. 329, Steve Jobs, by Walter Isaacson

In the article below, David Twiddy presents an interesting argument for what is going to happen to brokers as the result of PPACA and the failure of Health and Human Services to take broker compensation out of the MLR (Minimum Loss Ratio).  Another of the unintended consequences of PPACA is that broker compensation will be reduced to a point where brokers are not able to service the smaller groups of less than fifty because it simply will not be economically feasible for them to make a living at it. 

What’s even more interesting is the commentary by Anna Lambertson, executive director for the Kansas Health Consumer Coalition,  who basically states that the end game is to get rid of brokers and force businesses and individuals to buy off the state and the federally run health insurance exchanges.  Unfortunately, Ms. Lambertson fails to recognize the service portion of the broker client relationship in handling issues like claims problems, network issues, network and provider issues, COBRA requirements and a host of other day-to-day problems that employers experience with health insurance plans. 

This isn’t as easy as buying an airline ticket, and I would argue with Ms. Lambertson’s conclusion that the “more we support that rule, the better off consumers will be.”  In actuality, the consumer will be in far worse shape when trying to navigate the health insurance system without the service of an experienced, qualified and licensed broker.  For example, would you show up in a courtroom and represent yourself in a serious legal case without an attorney?   Would you rely on a medical website to diagnose and treat a major illness without a doctor?  It’s going to be really interesting to see how consumers react when they call the 1 800 Exchange number and sit on hold waiting for some government bureaucrat to help them solve a particular problem.  If you’d like to get a feel for how this is going to work, pick up the phone and call Social Security or CMS Medicare and see how long it takes for someone to answer the phone and even begin to help you with your problem.

Cary Hall, America’s Healthcare Advocate

Health care reform rules foreshadow tough times for insurance brokers

from the Kansas City Business Journal

December 9-15, 2011

By David Twiddy

Area insurance agents are making dire predictions for their future after federal officials released new health care rules regarding how broker compensation is counted.

“As the regulations stand today, come 2014, we will not be offering products in the traditional medical fully insured market,” said Bill Ashley, CEO of Allied National Inc., an Overland Park-based company specializing in small group benefits.

The Affordable Care Act requires insurance companies to spend at least 80 percent of health care premiums on medical care and health care quality improvement.  Large group insurers must spend at lest 85 percent.

Companies that don’t reach those levels will be required next year to give policyholders rebates.

Brokers had hoped that final regulations the U.S. Department of Health and Human Services released on Dec. 2 would exclude broker compensation from the percentage allowed for administrative costs.  Federal officials denied that change.

Brokers said insurers will look to reduce the fees they pay to those selling coverage to avoid paying rebates.

“It costs money to distribute products to individuals, and agent compensation has been restricted,” Ashley said.  “If agents aren’t selling it, nobody’s buying it.  How can you stay in business?”

Shane Davolt, CEO of Liberty-based GM Peters Insurance, said a significant loss of brokers could leave individuals and small companies without anyone to help design affordable coverage or even to sell them a plan.

“If people start ignoring the five- or 10-person groups because the big brokers say, ‘We can’t make any money at this,’ or there’s no incentive to help these small businesses, the service level for those small businesses could really suffer,” Davolt said.

Anna Lambertson, executive director for the Kansas Health Consumer Coalition, said that she understands brokers’ concerns but that state health insurance exchanges opening in 2014 should fill some of the brokers’ role.

“I think it’s important to maintain a focus on the premium dollars going where they’re intended, which is actual health care, instead of administrative costs,” she said.  “The more we support that rule, the better off consumers will be.”

The Supreme Court agrees to hear the challenges to Obamacare brought forth by twenty-six states and the NFIB (National Federation of Independent Business).

The court will hear arguments on a number of issues including:  the mandate, the states’ petition regarding Medicaid funding and the AIA (Anti-Injunction Act) tax issue.

Cary Hall, America’s Healthcare Advocate

Court To Hear Obamacare Challenge: What It Means

by Hans von Spakovskyand Elizabeth Garvey

November 15, 2011

It’s official. The Supreme Court will consider challenges to Obamacare stemming from the Eleventh Circuit decision striking down the law’s individual mandate.

In that case, 26 states and the National Federation of Independent Business (NFIB) partially won their suit, claiming that the Patient Protection and Affordable Care Act (PPACA) should be voided as unconstitutional. The Eleventh Circuit ruled that the mandate — considered by many to be the linchpin of the overhaul of the U.S. health system — was unconstitutional. But the court declined to strike down the law in its entirety.

The Supreme Court agreed to hear arguments on a number of issues raised in the suit: severability, Medicaid, and the Anti-Injunction Act, to name a few. Specifically, it will hear arguments on whether Congress “had the power under Article I of the Constitution to enact the minimum coverage provision.”

The Court directed the parties to brief and argue whether the Anti-Injunction Act (which bars suits to stop a tax before it has been imposed) bars NFIB’s and the states’ challenges to the PPACA’s minimum coverage provision.

The Court will also hear arguments on whether the individual mandate provision is severable from the rest of the PPACA. The parties will address whether the law “must be invalidated in its entirety because it is non-severable” and whether the mandate “exceed[s] Congress’s enumerated powers.”

Last, the Court will hear from the states’ petition whether Congress exceeds its enumerated powers and federalism generally by “coerc[ing] States into accepting onerous conditions that it could not impose directly by threatening to withhold all federal funding under [Medicaid].”

By our count, the oral argument will be at least four and one-half hours long — a record time — and argued by an“all-star” lineup of Supreme Court litigators. A typical Supreme Court argument is one hour. The Court has rarely extended oral argument longer than two hours, but has done so in important cases such as the 2003 challenge to the Bipartisan Campaign Reform Act. The Court has not set a date for argument, but it could be as early as this March.

The Court’s term is set to end on June 25, and the Court would usually announce all its decisions for the term by then. Occasionally the Court has extended its term or ordered reargument (as in Citizens United v. FEC).

We are likely to get a decision by June 25 — right in time for the final months of the political battle for the November election.