WASHINGTON, D.C. (WUSA) - The Affordable Care Act has been met with a firestorm of reaction from the day it was signed two years ago. Legal challenges were filed the same day President Obama signed it.
That's why a bioethicist we spoke to Monday at Johns Hopkins University says the legislation took such a speedy path to the nation's highest court. The justices will decide its constitutionality before the most controversial part of the law goes into effect.
Parts of the Affordable Care Act are already in effect. People with pre-existing medical conditions are now guaranteed coverage and most people under the age of 26 can remain covered under their parents' medical plan.
But the main focus of the legal challenges is the "individual mandate", which will require almost all Americans to buy health insurance by 2014 or face a tax penalty.
Bioethicist and legal professor Leslie Meltzer Henry of the Johns Hopkins Berman Institute of Bioethics says if that mandate is struck down by the Supreme Court, she believes the rest of the law is in jeopardy.
Meltzer Henry says, "I think severing the individual mandate from this act would be a devastating blow to the entire act. "
Henry says it is very difficult to force insurance companies to cover people with pre-existing sicknesses unless the companies also have healthier people in their pool. She says several states tried it, and insurance companies moved to other states that have less regulation.
That's why she also thinks requiring health insurance coverage can and should be decided at the national level.
Meltzer Henry says, "When we don't insure individuals, the cost of their uncompensated care devastates our national economy in important ways. It not only forces higher premiums on people who do purchase health insurance, but imposes costs on hospitals, the government and ultimately on tax payers to cover those who don't have insurance."
But there is no question the individual mandate is the least popular part of the law, and the critics who've dubbed it "Obamacare" say it gives the federal government too much intrusive power. Henry believes it is constitutional under the inter-state commerce clause, but that ultimately is for the High Court to decide this week, with enormous ramifications.
Supreme Court Justices begin hearing arguments on the individual mandate Tuesday.