Top US court to announce fate of Obama health plan

People line up in front of the U.S. Supreme Court on the eve of Thursday's expected ruling on whether or not the Affordable Care Act passes the test of constitutionality Wednesday, June 27, 2012 in Washington. (AP Photo/Alex Brandon)

(AP) — The U.S. Supreme Court was expected to decide the fate Thursday morning of President Barack Obama's health care overhaul, a ruling that could touch the lives of virtually every American and mark a pivotal point in the U.S. presidential election.

People lined up overnight outside the court to get access to the historic ruling, wrapping themselves in blankets or sprawling on the sidewalk. This is the most closely watched case before the court since a 2000 ruling resulted in George W. Bush being declared the winner of the presidential election.

The health care plan is Obama's signature accomplishment in the first 3 ½ years of his presidency, extending coverage to most of the estimated 50 million Americans now left uninsured. Republicans are almost unanimously opposed to it. They say it will swell the U.S. deficit while increasing government meddling in people's lives with its requirement that Americans obtain insurance. Polls show most Americans don't support it.

Obama recently has avoided mentioning the impending court ruling directly, but he has vigorously defended the health care overhaul as critical to the public's health and well-being in campaign events this week.

"I think it was the right thing to do. I know it was the right thing to do," he told supporters in Boston.

Journalists wait outside the Supreme Court for a landmark decision on health care on Thursday, June 28, 2012 in Washington. (AP Photo/Evan Vucci)

The plan faces a tough test before the nine-member court, which has a narrow majority of conservative justices nominated by Republican presidents. Their tough questioning during oral arguments suggested doubts about whether the bill conforms to the U.S Constitution. Still, that is not a sure-fire indicator that the justices will rule against it. The court could uphold the entire plan, strike it down completely, or find some parts constitutional and others not.

Neither candidate has any direct influence over the ruling. However, both Obama and his likely Republican rival, Mitt Romney, are poised to seize on it for any momentum as the presidential election approaches in November.

Romney firmly opposes the plan, known formally as the Affordable Care Act and nicknamed, often derisively, as "Obamacare," even though it is similar to a state health care plan he had pushed through as governor of Massachusetts. Romney says health care programs should be done on a state, not federal, level.

"If Obamacare is not deemed constitutional, then the first three-and-a-half years of this president's term will have been wasted on something that has not helped the American people," Romney said Tuesday. "If it is deemed to stand, then I'll tell you one thing, we're going to have to have a president — and I'm that one — that's going to get rid of Obamacare. We're going to stop it on day one."

A court ruling that largely supports the health care law would be a clear win for Obama. Still, he could use a defeat to rally his Democratic supporters, especially if popular provisions are rejected by the court, such as allowing college-age students to remain on the parents' health plan. An adverse ruling would also be a jarring reminder for Democrats about the consequences of having another Republican president pick Supreme Court justices. He could also challenge Romney to offer a detailed plan that would address America's high medical costs, widespread waste and vast number of uninsured.

The core of the case deals with the requirement that Americans buy insurance or face a fine. The so-called individual mandate offsets other provisions prohibiting insurance companies from denying coverage to people with existing health problems. With more people buying coverage, insurance companies would be effectively compensated for taking on more high-risk customers.

The Obama administration says constitutional provisions giving Congress the right to regulate interstate commerce allowed it to require insurance. Republicans reject that. One conservative Supreme Court justice, Antonin Scalia, questioned whether the administration's reasoning means that Congress can force people to buy broccoli.

Obama advisers say the Supreme Court showed reasonableness earlier this week in a ruling on an Arizona immigration case, and they see it as a hopeful sign for how the court might rule on health care.

If the court upholds the law, Obama could get a welcome push with his vision and leadership validated. If the court strikes down the overhaul, the White House would seek to cast the decision as detrimental to millions of Americans by highlighting popular elements of the law that would disappear, such as preventive care and coverage for young adults on a parent's plan.

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