The U.S. Supreme Court heard oral argument over three days on March 26-28 concerning the constitutionality of the Patient Protection and Affordable Care Act (PPACA).  Four separate argument sessions were devoted to the following four issues:

• Does the Anti-Injunction Act bar current challenges to PPACA’s individual mandate?
• Is the individual mandate unconstitutional?
• Do PPACA’s Medicaid provisions unconstitutionally coerce the states into expanding coverage?
• If the mandate is declared unconstitutional, how does that affect the validity of the other provisions of PPACA?

Predicting the outcome of a Supreme Court case based on the questioning at oral argument is a hazardous and inexact science, but the oral arguments can provide insights into the Justices’ concerns and some basis for speculating about how the individual Justices might vote.  Miller & Chevalier’s Anthony Shelley, who is head of the firm’s ERISA and Fiduciary Litigation practice, and Alan Horowitz, who is head of the firm’s Supreme Court and Appellate Litigation practice – both of whom have argued before the Supreme Court – analyzed the oral arguments and discussed what is likely to happen when the Court issues its decision, which is expected to occur at the end of June. Among the topics discussed were the prospects for PPACA being upheld, what is the most likely scenario if the mandate is declared unconstitutional, and how PPACA compliance efforts will be affected going forward if the statute is struck down in whole or in part.