The Supreme Court takes up health care reform

People wait to enter outside the U.S. Supreme Court in Washington, D.C.

KAI RYSSDAL: And if you want to know how serious the Supreme Court is about a given case, how big a deal it is, one good way to tell is how much time they allot for oral arguments. Your run-of-the-mill everyday case gets an hour, usually evenly divided.

So when the court announced this morning -- just as everybody on the planet expected -- that it is indeed going to take up the health care law, it was interesting to note arguments will last five and a half hours. An eternity in Supreme Court time.

So all other things being equal, come June we should have a ruling about what's called the individual mandate, whether the government can legally require Americans to have health insurance.

But what do we 'til then? From the Marketplace Health Desk at WHYY in Philadelphia, Gregory Warner reports on the costs of the waiting game.


GREGORY WARNER: A decision from the Supreme Court is expected around June. But the health care industry hasn't had the luxury to wait until then.

BOB ATLAS: There's no alternative really.

Bob Atlas is a health industry consultant with Avalere Health.

ATLAS: To gamble that the law would be overturned and then not be able to either be legally compliant or not meet the  market opportunity would be foolish.

By "market opportunity" he means the insurance exchanges. Those will be set up by 2014 in each state to sell insurance to millions of people who woiuld be required to have it under the new law. Insurance companies can only qualify to sell insurance to on these exchanges if they reform their policies: make the fine print more transparent, and stop disqualifying sick people. Insurers want to be ready.

CHRIS JENNINGS: They want to be in a competitive advantage when that time frame comes.

Chris Jennings was the senior health care adviser in the Clinton administration. He says it's not just insurance companies making those changes now.

JENNINGS: That certainly applies to hospital providers, and it applies to many states.

But not all states. For political and budget reasons, some states have stayed on the sidelines. Deborah Chollet is a health economist at Mathematica in Princeton.

DEBORAH CHOLLET: A number of states have lost time and funding for planning and probably will not be able to open an exchange.

That makes it kind of tough for employers to plan for future health costs. Gene Marks is a consultant to small-business owners.

GENE MARKS: They're looking ahead two, three years, and it really just adds that extra layer of uncertainty now.

Legal uncertainty. And even after that, there's that election to get ready for.

In Philadelphia, I'm Gregory Warner for Marketplace.

About the author

Gregory Warner is a senior reporter covering the economics and business of healthcare for the entire Marketplace portfolio.

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