A legal challenge by 26 states to U.S. President Barack Obama's game-changing healthcare reform policy of 2010 kicked off in the Supreme Court this week, and it could potentially alter the very fortunes of the President's own campaign in this election year.
At the top of the list of core issues the Court will hear the arguments on is the so-called individual mandate, the requirement that all Americans either purchase an insurance policy or pay a penalty.
In its basic essence, Mr. Obama's Patient Protection and Affordable Care Act aimed to extend healthcare insurance cover to over 30 million uninsured Americans, with up to 50 million citizens potentially standing to benefit from the reform, according to some estimates.
Even after a Herculean effort to get the bill passed in the U.S. Congress on March 21 2010, by the narrowest of voting margins, the Act came under fire immediately in a host of states, many of the Republican-controlled, challenging the right of the federal government to compel any entity to participate in an insurance scheme.
Subsequently, opposition to the Act intensified through the political propaganda of the Tea Party, the conservative group pressing for smaller government, and also gained traction during this year's Republican presidential nomination race.
Frontrunner and former Governor of Massachusetts Mitt Romney, for instance, has promised to repeal what he and his rivals pejoratively refer to as “Obamacare” on his first day in office, if elected.
Ironically the strongest attack against Mr. Romney has been the charge that Mr. Obama designed his healthcare reform bill based on Mr. Romney's own healthcare bill in Massachusetts, one that similarly did not shy away from the individual mandate.
This week numerous other provisions of the Act may be challenged, resulting from the question of which other provisions of the Act ought to be struck down in the event that the Supreme Court justices decide to knock down the individual mandate. Among these provisions would be the Act's requirement that pre-existing conditions are not sufficient grounds to disqualify a person from having insurance.
With the decision of the Court expected around June, the outcome in one of Mr. Obama's highest domestic policy priorities will either receive a major boost or face a debilitating political setback over the summer, with echoes of the result likely to influence November's presidential race.