Another morning of Supreme Court opinions came and went Thursday with no ruling on the national health care law, pushing the court's most anticipated decision in years to the final week of June.
The constitutionality of the national health care law, passed in 2010 without a single Republican vote, was challenged by 26 states that argued the law infringed upon states' rights and individual liberties. They contended the federal government could not compel citizens to purchase health insurance.
The government has asserted that every citizen is already a health care consumer because everyone requires care at some stage of life.
Uncertain is whether the law is inseparable -- that if the individual health insurance mandate were to fall, the rest of the law would have to go down with it.
The decision is monumental for President Obama, whose signature domestic achievement is at stake. He has insisted the law is constitutional.
"For years, what we've heard is the biggest problem on the bench was judicial activism or the lack of judicial restraint," the president said in April, "that an unelected group of people would somehow overturn a duly constituted and passed law. And I'm pretty confident that this court will recognize that and not take that step."
The health care law has featured prominently in the presidential election, with presumptive Republican nominee Mitt Romney pledging to repeal it and to grant compliance wavers to all 50 states in the meantime.
Romney led passage of a state health care law as governor of Massachusetts that also included an individual insurance mandate. Seeking to delegitimize Romney's criticisms, the Obama administration has dubbed Romney the "godfather" of the national law.
Romney has said the two laws are vastly different.
"When I was governor of Massachusetts, we instituted a plan that got our citizens insured without raising taxes and without a government takeover," Romney wrote in an op-ed published by USA Today in March. "Other states will choose to go in different directions. It is the genius of federalism that it encourages experimentation, with each state pursuing what works best for them. Obamacare's disregard for this core aspect of US tradition is one of its most egregious failings."
Whatever the court's ruling next week, some of the law's most popular elements will remain in place, at least in Massachusetts. The state's largest insurers have said they will continue to allow young adults as old as 26 to remain on their parents' plans. Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care, and Tufts Health Plan also have said they will not charge copayments for a range of preventive services, including select immunizations and screening for diabetes, depression, and colorectal and breast cancer.
But the fates of many other provisions of the law are on the line. Supporters have warned that overturning the law would jeopardize access to health care for tens of millions of previously uninsured Americans, particularly those with preexisting conditions, who cannot be denied coverage under the law.
Callum Borchers can be reached at email@example.com. Follow him on Twitter @callumborchers.