Health care reform took center stage recently as the U.S. Supreme Court heard arguments on the constitutionality of the Affordable Care Act, otherwise known as Obamacare. The court’s ruling will come down around the end of June, just months before the 2012 presidential election, making the political ramifications of its decision even more apparent. This decision will not only affect our health care system, but also our economy as well as the nation’s world image. To better understand how the court will rule, we first need to understand exactly what questions have been presented to the court.

The first issue presented is a question based on legal standing. The court must decide whether taxpayers have been sufficiently affected by the bill to sue the government. If the court finds it is bound by the Anti-Injunction Act, a piece of legislation that prohibits taxpayers from filing suit until after the tax goes into effect and they are subjected to it, challengers may be forced to wait until after the bill goes into effect before bringing suit. This would push back any remedy to as late at 2015. However, most believe the court will allow the case to proceed.

The second and major issue facing the court is whether or not Congress has the constitutional power to require nearly every American to obtain health insurance or risk paying a penalty. Opponents of the law contend that Congress went beyond its authority in the reform measure. But Congress, under the Commerce Clause, clearly has the power to regulate the national health care market. Almost everyone needs health care at some point and, if uninsured people are unable to pay steep medical bills, they will get charity care that shifts the costs to others whose insurance premiums then rise to cover that cost. There is no denying that the health care market is interconnected and that individuals’ decisions to purchase insurance—or not—affect the whole system.

Republican-appointed judges on two appellate courts have found the insurance mandate constitutional. They have pointed out that past Supreme Court precedent has upheld federal laws that were much more intrusive on personal liberty and involved activities less clearly relevant to interstate commerce.