US Supreme Court hears arguments against health reform act

The US Supreme Court took an unusual six hours over three days to hear arguments challenging Barack Obama’s health reform act, passed two years ago (BMJ 2010;340:1635, doi:10.1136/bmj.c1635), while crowds outside protested for and against the law.

The court is expected to issue its ruling in late June, in the midst of the US presidential campaign. It may have a major effect on the positions of Obama and his likely Republican opponent, the former Massachusetts governor Mitt Romney.

In Massachusetts in 2006 Romney championed a mandatory health insurance plan that was the model for Obama’s health reform act. Romney’s plan provides health insurance for almost all Massachusetts residents. However, in his campaign for the Republican nomination he has worked hard to distance himself from his Massachusetts plan.

The nine Supreme Court justices are thought to be divided, with more leaning to the conservative side. But with one or two “swing votes,” the ultimate decision is hard to predict.

The court considered …