Political News Updates by James Catledge

Lake Jackson, Tex. — Ron Paul says he has by no means given up on winning the Republican presidential nomination, but he acknowledges that he might not make it.

“The odds are right now that Romney, he pulls it off,” Mr. Paul, a Texas congressman, said in an interview here. “But he doesn’t even have a guarantee in a week. That whole thing can shift rather quickly.”

So even as his aides plot a strategy to pick up delegates, they are beginning to plan how to use the leverage they are gaining to try to force the party to take his and his supporters’ views into account, signaling what Mr. Paul would want to party officials and rival candidates who are eager for the backing of his fervent following but nervous that he might undertake a third-party bid.

One person close to the Paul campaign said this could include support for greater transparency at the Federal Reserve, a commitment to address what Mr. Paul views as the Patriot Act’s infringement on civil liberties and a curb on the powers of any president to wage war without Congressional approval. And the campaign wants Mr. Paul’s supporters to have a voice and a role in the national party machinery — just like they do in many state Republican parties — no matter who becomes the nominee.

“The more delegates I have, the more leverage I have,” Mr. Paul said in the interview here, during which he candidly discussed his hopes but remained circumspect about some issues. “We’ll go after delegates, and we have staying power.”

Asked whether he believed he would have the leverage to make Republicans more willing to accommodate his supporters and positions, he said: “I don’t know how they’re going to handle it. Because we’re very precise on what we would like, and I can’t imagine all of a sudden one of the other candidates changing their position on their desire to go to war constantly.”

He added: “How much leverage do I have? How many more votes am I going to get? You know, the more pressure they feel, the more they might be willing to look at some of those issues. We want to change things.”

But that is a fallback strategy, and Mr. Paul and his advisers say they are in it to win. They see a route to obtaining the 1,144 delegates needed by not overemphasizing primaries in expensive media markets, especially those where it is harder for independents to vote, and focusing on less-flashy contests where the expected cost per delegate is weighted more in their favor.

They will also try to win delegates through the machinery of state parties, where Paul supporters are now embedded in the apparatus. In Iowa, for example, whose delegates are not explicitly tied to caucus results, they believe they can take delegates that might otherwise be awarded to Rick Santorum, who essentially tied for first place with Mr. Romney, one Paul official said.

This “Moneyball”-like approach to delegates, which takes a page from the 2008 campaign of Barack Obama, is about to be put into play. Mr. Paul may make only one stop in Florida before that state’s Jan. 31 primary and will instead focus his efforts after the South Carolina primary on Saturday on caucuses in Colorado, Maine, Minnesota and Nevada and other places where the cost of television and mail programs is less expensive and where election rules favor his strategy.

People close to the Paul campaign say it would cost them $9 million to $10 million to run an effective campaign in Florida, where only about 50 delegates are at stake. Florida is a closed primary, so independent voters important to Mr. Paul’s strong showing in Iowa and New Hampshire cannot register just before the election. The state is also a winner-take-all contest, meaning only the victor walks away with delegates.

“There are four big caucuses coming up, with twice as many delegates as Florida, that will cost a third as much money, and we are focused on those,” one Paul official said.

With 28 delegates at stake, North Dakota also illustrates the strategy: the Paul campaign estimates that it will cost just $500,000 to run an effective campaign there, and delegates are awarded proportionately, so even if they do not finish first they could walk away with a decent allotment.

Read the full article here

2011 Was The Year That Obama’s Signature Issue Unraveled

ON CBS’ “60 MINUTES”, OBAMA CALLED HIS HEALTH CARE PACKAGE ONE OF HIS MAJOR ACCOMPLISHMENTS

CBS’ STEVE KROFT: “Why do you think you deserve to be reelected? What have you accomplished?”

PRESIDENT OBAMA: “Not only saving this country from a great depression, not only saving the auto industry, but putting in place a system in which we’re going to start lowering health care costs and you’re never going to go bankrupt because you get sick or somebody in your family gets sick.” (CBS’ “60 Minutes,” 12/11/11)

YET AMERICANS SAW THEIR HEALTH CARE PREMIUMS INCREASE

PROMISE: Obama Promised His Plan “Would Save The Average Family $2,500 On Their Premiums.” (Sen. Barack Obama, Remarks Of Senator Barack Obama’s Plan To Fight For Working Families And Take On Special Interests In Washington, Indianapolis, IN, 6/20/08)

FAIL: “The Cost Of Health Insurance Skyrocketed In 2011 After Several Years Of Relatively Small Increases.” (Jane M. Von Bergen, “Health Insurance Costs Skyrocketing,” The Philadelphia Inquirer, 9/27/11)

Workers Paid An Average Of $132 More For Family Coverage This Year. “Although premiums rose, employers kept the percentage of the premium workers pay about the same: An average of 18 percent for single coverage and 28 percent for family plans. Still, with rising costs, workers paid more, up an average of $132 a year for family coverage. Since 1999, the dollar amount workers contribute toward premiums nationally has grown 168 percent, while their wages have grown by 50 percent, according to the survey.” (Julie Appleby, “Cost Of Employer Insurance Plans Surge In 2011,” Kaiser Health News, 9/27/11)

• Cost Of Single Employee Coverage Grew 8 Percent According To The Survey. “Family plan premiums hit $15,073 on average, while coverage for single employees grew 8 percent to $5,429, according to a survey released Tuesday by the Kaiser Family Foundation and the Health Research & Educational Trust. (KHN is an editorially-independent program of the foundation.)” (Julie Appleby, “Cost Of Employer Insurance Plans Surge In 2011,” Kaiser Health News, 9/27/11)

MORE PEOPLE LOSING THEIR COVERAGE

PROMISE: President Obama Promised That “If You Like Your Health Care Plan, You Will Be Able To Keep Your Health Care Plan. Period.” OBAMA: “So let me begin by saying this: I know that there are millions of Americans who are content with their health care coverage – they like their plan and they value their relationship with their doctor. And that means that no matter how we reform health care, we will keep this promise: If you like your doctor, you will be able to keep your doctor. Period. If you like your health care plan, you will be able to keep your health care plan. Period. No one will take it away. No matter what. My view is that health care reform should be guided by a simple principle: fix what’s broken and build on what works.” (President Barack Obama,Address To The American Medical Association, Chicago, IL, 6/15/09)

FAIL: Survey Found That Only 60 Percent Of Employers Offered Medical Coverage This Year, A 9 Percent Decrease From 2010. “Sixty percent of employers said they offered medical benefits this year, a decrease from 69 percent in 2010.” (Jeffrey Young, “Health-Benefit Costs Rise Most In Six Years,” Bloomberg, 9/27/11)

GALLUP: “The Percentage Of American Adults Who Get Their Health Insurance From An Employer Continues To Decline, Falling To 44.5% In The Third Quarter Of This Year.” (Elizabeth Mendes, “Employer-Based Health Insurance Continues To Trend Down,” Gallup, 11/11/11)

Businesses Will Continue To Scale Back Health Care Benefits For Employees To Handle Increasing Health Care Costs And Mandates From ObamaCare. “Governments and businesses have and will continue to cut back and/or reform their health coverage offerings to handle tough economic circumstances, rising health care costs, and requirements of the Affordable Care Act.” (Elizabeth Mendes, “Employer-Based Health Insurance Continues To Trend Down,” Gallup, 11/11/11)

• The Wall Street Journal: “The nonpartisan Congressional Budget Office, in a March 2010 report, found that by 2019, about six million to seven million people who otherwise would have had access to coverage through their job won’t have it owing to the new law.” (Janet Adamy, “Study Sees Cuts to Health Plans,” The Wall Street Journal, 6/8/11)

30 Percent Of Employers “Definitely Or Probably” Plan To Drop Coverage According To A McKinsey Study. “While only 7% of employees will be forced to switch to subsidized-exchange programs, at least 30% of companies say they will ‘definitely or probably’ stop offering employer-sponsored coverage, according to the study published in McKinsey Quarterly.” (Russ Britt, “Firms Halting Coverage as Reform Starts: Survey 30% of Companies Say They’ll Stop Offering Health Plans,” Market Watch, 6/6/2011)

• Companies That Plan To Drop Health Care Coverage Of Retirees Is More Than 25 Percent. “More than one-quarter of companies plan to discontinue retiree medical sponsorship in 2012 for at least one segment of current and/or future retirees.” (“16^th Annual Towers Watson/National Business Group on Health Employer Survey on Purchasing Value in Health Care,” Towers Watson, March 2011)

SPENDING THAT CONTINUES TO GO THROUGH THE ROOF

PROMISE: Obama: “This Legislation Will Also Lower Costs For Families And For Businesses And For The Federal Government, Reducing Our Deficit By Over $1 Trillion In The Next Two Decades. It Is Paid For, It Is Fiscally Responsible, And It Will Help Lift A Decades-Long Drag On Our Economy.” (President Barack Obama, Remarks On Signing The Patient Protection And Affordable Care Act, Washington, D.C., 3/23/10)

FAIL: Health Care Spending To Hit $4.6 Trillion In 2020. “The nation’s health care tab is on track to hit $4.6 trillion in 2020, accounting for about $1 of every $5 in the economy, government number crunchers estimate in a report on Thursday …  Including government and private money, health care spending in 2020 will average $13,710 for every man, woman and child, says Medicare’s Office of the Actuary.” (Ricardo Alonso-Zaldivar, “Health Tab To Hit $4.6 Trillion In 2020,” The Associated Press, 7/28/11)

• ObamaCare To Increase Costs More Than Had It Never Been Enacted. “Despite President Obama’s promises to rein in health care costs as part of his reform bill, health spending nationwide is expected to rise more than if the sweeping legislation had never become law.  Total spending is projected to grow annually by 5.8 percent under Mr. Obama’s Affordable Care Act, according to a 10-year forecast by the Centers for Medicare and Medicaid Services released Thursday.  Without the ACA, spending would grow at a slightly slower rate of 5.7 percent annually.” (Paige Winfield Cunningham, “Health Care Law Won’t Rein In Costs, Study Says,” The Washington Times, 7/28/11)

Health Care Spending “Doesn’t Seem To Be Slowing Down.” “The report from Medicare economists and statisticians is an annual barometer of a trend that many experts say is unsustainable but doesn’t seem to be slowing down.” (Ricardo Alonso-Zaldivar, “Health Tab To Hit $4.6 Trillion In 2020,” The Associated Press, 7/28/11)

• CMS Chief Actuary Rick Foster: “If implemented as written, the health care law will ‘create a whole new world of health care spending,’” (Brett Norman, “CMS: Health Law Will Lead To Rise In Spending,” Politico, 7/28/11)

Health Care Spending Will Continue “Gobble Up” U.S. Resources. “The United States will find little relief from its bleak long-term fiscal outlook so long as growing federal health care and retirement programs gobble up more and more of the country’s resources, said a new economic report issued on Wednesday.” (Donna Smith & Richard Cowan, “CBO Sees Government Benefits Swamping Economy,” Reuters, 6/22/11)

MAJOR PORTIONS OF OBAMACARE ALREADY FAILING

Obama Abandoned ObamaCare’s CLASS “Gimmick”

The Obama Administration Pulled The Plug On The Community Living Assistance Services And Supports (CLASS) Program. “The Obama administration says it is unable to go forward with a major program in the president’s signature health care overhaul law — a new long-term care insurance plan. Officials said Friday the long-term care program has critical design flaws that can’t be fixed to make it financially self-sustaining.” (Ricardo Alonso-Zaldivar, “Obama Pulls Plug On Part Of Health Overhaul Law,” The Associated Press, 10/14/11)

CLASS Was To Account For 40 Percent Of The Savings In ObamaCare. “By scrapping the CLASS Act, HHS is losing about 40 percent of the savings healthcare reform was supposed to generate. The Congressional Budget Office’s most recent estimates projected $210 billion in total deficit reduction from the healthcare law, $86 billion of which would have come from CLASS.” (Sam Baker, “Obama’s HHS Ends Controversial Program In Health Reform Law,” The Hill’s “Health Watch,” 10/14/11)

Despite Knowledge That CLASS Was “Designed To Fail,” Democrats “Went Ahead Anyway.” “The emails, obtained by a joint Republican panel led by Sen. John Thune and House Energy and Commerce Chairman Fred Upton, reveal that the administration knew the program was designed to fail and went ahead anyway.” (Joseph Rago, “GOP Vets an ObamaCare Program,” The Wall Street Journal, 9/19/11)

Medicare Scorekeeper Rick Foster Predicted The “Program Would Collapse In Short Order And Require Significant Federal Subsidies To Continue.” “‘Thirty-six years of actuarial experience,’ Mr. Foster wrote to the Medicare legislative affairs office, ‘lead me to believe that this program would collapse in short order and require significant federal subsidies to continue.’ He later wrote that ‘I assume you’ve conveyed these concerns to the staff but, if not, let me know and we can express these concerns in a memo.’” (Joseph Rago, “GOP Vets an ObamaCare Program,” The Wall Street Journal, 9/19/11)

HHS Secretary Kathleen Sebelius: “I Do Not See A Viable Path Forward For CLASS Implementation At This Time.” (Alex Wayne & Drew Armstrong, “Obama Ends Kennedy-Backed Long-Term Care Program As Too Costly To Sustain,” Bloomberg, 10/15/11)

CLASS “Was Amongst The Worst Accounting Gimmicks Used To Make It Seem As If National Health Care Would Reduce The Deficit.” “Known by the acronym CLASS, the government-backstopped insurance for nursing homes, home health aides and the like was among the worst accounting gimmicks used to make it seem as if national health care would reduce the deficit.” (Joseph Rago, “GOP Vets an ObamaCare Program,” The Wall Street Journal, 9/19/2011)

And ObamaCare’s High-Risk Pools Failed To “Meet Expectations”

ObamaCare’s High-Risk Pools Are “Failing To Meet Expectations.” “Democrats’ healthcare reform law set aside $5 billion to help people with pre-existing conditions obtain affordable coverage before insurance exchanges go online in 2014. The program has come under criticism for failing to meet expectations, with fewer than 22,000 people enrolled as of April 30, far short of the 200,000 to 350,000 that had been predicted.” (Julian Pecquet, “Report:  States Better Than Feds In Getting Sick People Enrolled In High-Risk Pools,” The Hill’s “Health Watch,” 8/26/11)

The PCIP Plan Was Estimated To Insure 375,000 But Only 30,395 People Have Signed Up. “Since its creation in July 2010, the Pre-Existing Condition Insurance Plan has insured 30,395 people, according to the Department of Health and Human Services, which oversees the program. Officials initially estimated the initiative could reach as many as 375,000 by the end of 2010. There are up to 25 million uninsured Americans who have pre-existing conditions like heart disease or diabetes.” (Arthur Delaney, “PCIP Enrollment Far, Far Below Expectations In First Year,” The Huffington Post, 10/5/11)

The Program Has Proven Much Costlier Than Originally Estimated. “A temporary program created by the 2010 health care reform law has provided health insurance to fewer people than expected. Yet at the same time, in one big state, the program has turned out to be much costlier than expected.” (Arthur Delaney, “Health Care Reform Program Much Costlier Than Expected In California,” Huffington Post, 11/29/11)

• For California, The Program Has Cost “Three Times As Much Per Enrollee Than Previously Estimated.” “But California’s PCIP has turned out to cost three times as much per enrollee than previously estimated. The state’s Managed Risk Medical Insurance Board, which administers the plan, initially figured it would have to pay $1,000 a month in claims per enrollee. New data show claims cost $3,100 per member each month, meaning that the government will have to cap California’s enrollment at 6,800 unless more funds are made available. As of October, 5,290 people are signed up in the state.” (Arthur Delaney, “Health Care Reform Program Much Costlier Than Expected In California,” Huffington Post, 11/29/11)

AND HEALTH CARE BEING TURNED OVER TO UNELECTED BUREAUCRATS

ObamaCare Created The Independent Payment Advisory Board (IPAB) “To Come Up With Ways To Cut Medicare Spending If It Grows Too Fast.” “That’s the job description for the 15 members of the Independent Payment Advisory Board — the new panel created by President Barack Obama’s health care law to come up with ways to cut Medicare spending if it grows too fast.” (David Nather, “Medicare Cost-Cutting Job Could Be Worst in D.C.,” Politico, 5/14/11)

With IPAB, Obama Is Not Reducing Costs But “Limiting Or Denying Care.” “His plan: Use the Independent Payment Advisory Board to limit care and squeeze doctors and hospitals. In other words, he’s not reducing costs; he is limiting or denying care.” (Jennifer Rubin, “Obama’s Reverse Course On The Debt,” The Washington Post’s “Right Turn Blog,” 9/19/11)

HHS Secretary Kathleen Sebelius Admits That IPAB Threatens Seniors’ Access To Certain Procedures. “‘If Congress accepted the recommendations and made the decision that cuts in dialysis were appropriate,’ Sebelius replied, ‘I assume there could be some providers who would decide that would not be a service they would any longer deliver…’” (Kathleen Sebelius, House Energy And Commerce Committee’s Health Subcommittee, Testimony, 7/13/11, 0:57:23/4:54:54)

EVEN DEMOCRATS ARE CALLING FOR REPEAL OF IPAB

Twelve Democrats Have Signed On To Repeal IPAB. (H.R. 452, Introduced 1/26/11)

The Tampa Tribune: “Bipartisan Consensus … That IPAB Is A Mistake.” “There is bipartisan consensus on Capitol Hill that IPAB is a mistake. Physicians groups don’t like it, hospital lobbies don’t like it, and even the American Medical Association, whose support helped pass ObamaCare into law, has called for its repeal. Some Democrats, including U.S. Rep. Kathy Castor of Tampa, have signed on to Tennessee Republican U.S. Rep. Phil Roe’s repeal bill.” (Editorial, “Return Control To The Patient,” The Tampa  Tribune, 10/15/11)

SO IT’S NO SURPRISE THAT AMERICANS DON’T WANT OBAMACARE

Polls Show That Voters Don’t Support ObamaCare, One Of Obama’s “Signature Accomplishments.” “Heading into his re-election campaign, the president faces a conflicted public that does not support his steering of the economy, the most dominant issue for Americans, or his reforms to health care, one of his signature accomplishments.” (Ken Thomas and Jennifer Agiesta, “AP-GfK Poll: More Than Half Say Obama Should Lose,” The Associated Press, 12/16/11)

Half Of Americans Oppose ObamaCare While Only 29 Percent Support It. “The poll found unpopularity for last year’s health care reform bill, one of Obama’s major accomplishments. About half of the respondents oppose the health care law and support for it dipped to 29 percent from 36 percent in June.” (Ken Thomas and Jennifer Agiesta, “AP-GfK Poll: More Than Half Say Obama Should Lose,” The Associated Press, 12/16/11)

36 Percent Of The People Surveyed “Strongly Favor Eliminating” ObamaCare. (NBC News / Wall Street Journal, 1000 A, MoE 3.1%, 12/7-11/11)

“Only About A Quarter Of Independents Back The Law.” (Ken Thomas and Jennifer Agiesta, “AP-Gfk Poll: More Than Half Say Obama Should Lose,” The Associated Press, 12/16/11)

Even Among Democrats, The Health Care Law Has “Tepid Support” With Just 50 Percent Expressing Support. “Even among Democrats, the health care law has tepid support. Fifty percent of Democrats supported the health care law, compared with 59 percent of Democrats last June.” (Ken Thomas and Jennifer Agiesta, “AP-Gfk Poll: More Than Half Say Obama Should Lose,” The Associated Press, 12/16/11)

And Doctors  Are Calling Obamacare A “Step In The Wrong Direction”

Deloitte Poll Finds That Doctors Are Mixed On Their Views Of ObamaCare With 44% Surveyed Agreed That ObamaCare Is “A Step In The Wrong Direction.” “Doctors’ feelings about the health-care overhaul law passed last year are about as mixed as their patients’, research released today shows. Some 44% of doctors said the law was ‘a good start,’ according to a survey carried out by the Deloitte Center for Health Solutions consulting group. Another 44% agreed that the law was ‘a step in the wrong direction.’” (Louise Radnofsky, “Survey: Doctors Have Mixed Feelings About Health Law,” The Wall Street Journal’s “Health Blog,” 12/13/11)

• Even Surgical Specialists, Along With Other Doctors Strongly Oppose ObamaCare. “Surgical specialists were angriest about the law — 60% of those participating in the survey said they opposed it, compared with 39% of primary-care providers and 36% of other specialists.” (Louise Radnofsky, “Survey: Doctors Have Mixed Feelings About Health Law,” The Wall Street Journal’s“Health Blog,” 12/13/11)

Read more: http://www.gop.com/index.php/briefing/comments/the_year_in_review_obamacares_failed_promises#ixzz1hfqJo9Y1

James Catledge, owner of Catledge Companies, is a motivational speaker and business marketing expert. Please visit: http://jamescatledge.com

By Larry Elder

There ain’t no such thing as a free lunch. Everything demanded by the Occupy Wall Streeters — whether “free” health care, a “world-class education” or a “guaranteed living-wage income regardless of employment” status — costs money.

When a CEO makes a lot of money in the private sector, it is because his company — rightly or wrongly — values that CEO’s services at that price. To say it is “not right” that a CEO makes (fill in the blank) times more than the janitor is to say it is not right for the marketplace to set wages. If the marketplace ought not set wages, then who or what should?

Most people work for the private sector, which cannot exist without profit.

Is the OWS objection to bank bailouts on the grounds that government should not protect businesses from the consequences of their actions? Or is the objection that bailouts should be for everybody?

We already have a huge welfare state, with entitlements — Social Security, Medicare and Medicaid — the biggest expenditure of the federal budget. Europe’s welfare state is larger, with a slightly smaller “gap” between the rich and the poor. Yet its citizens also take to the street to denounce inequality. Puzzling, isn’t it?

No one can legally ask about the immigration status of a public school student, so Americans and non-Americans, including illegal aliens, receive a K-12 public education at taxpayers’ expense.

Per-pupil spending for public education increased 49 percent from 1985 to 2005. Community colleges are cheap, and many states guarantee a junior college graduate admission to a public four-year college.

The physical advantage that men possess over women is an increasingly small advantage — given the decline of labor-intensive jobs and the technology that makes it easier for machines to do hard, dangerous, repetitive work.

There are more tenants than landlords, which thus exemplifies the stupidity of “rent-control” laws. Rent-control laws disproportionately benefit the non-poor because the elite pull strings, work the system and are better connected than the non-poor. All of this matters when items of scarcity (in this case, apartments) are dispensed by government dictates rather than through prices.

Government possesses no money of its own. It raises money by taxing, by borrowing or by printing.

The bigger the government, the smaller the private sector.

Individuals can spend their money more wisely, efficiently and more humanely than can government.

People value and spend their money more wisely when they acquire it by their own efforts — also known as work. There are real-world, direct consequences on you for squandering your own money, as opposed to when government squanders the money of its people.

Government employees enjoy job security unknown in the private sector and are often paid more than their private-sector counterparts. Greed?

People spend their money more humanely because they won’t waste as much of it. Consider that to deal with “the poor,” the federal government has a vast array of agencies, programs and policies. But only about 30 cents of each dollar designated for the poor actually gets in the hands of the recipient. Contrast this with the United Way, Salvation Army and other private charities where 90 cents of each dollar donated gets to a beneficiary.

Americans agree that some people — whether faultless or irresponsible — need assistance, if only occasionally. The only issue is (SET ITAL) how (END ITAL) they will be helped.

Americans are the most generous people of any industrial nation. We give more of our time and money than do the Germans, British and Japanese. Note that those states have a bigger public sector than we do. Maybe they feel they gave at the office.

The U.S. Constitution isn’t just any ordinary document. It is the contract between the government and its people, the ones who empower government and who — once upon a time — expected the Constitution to restrain government, not empower it.

Government’s involvement in housing caused the meltdown — not greedy Wall Street bankers. The same Occupy mindset caused the Community Reinvestment Act of 1977, placed on human growth hormones by President Clinton, who pushed banks into lending to poor credit risks and allowed Wall Street to play with taxpayers’ money.

There is no bad guy. It’s not the Koch brothers, Grover Norquist or the Maltese Falcon. There is no evil entity, snorting steam from his nose, standing in an office full of Nazi memorabilia, staring out the window with the cityscape view, laughing: “Ha! Ha! Ha! Pretty soon, all this will be mine. Mine, I say!”

Life has never been so good, with so many choices, with so many more conveniences, so much less danger of dying from disease, with so many choices for entertainment and affordable travel.

When you rob Peter to pay Paul, you can always count on the support of Paul. But at some point Peter begins to feel taken advantage of.

Read more here

The Supreme Court said Monday it will hear arguments next March over President Barack Obama’s health care overhaul — a case that could shake the political landscape as voters are deciding if Obama deserves another term.

This decision to hear arguments in the spring sets up an election-year showdown over the White House’s main domestic policy achievement. And it allows plenty of time for a decision in late June, just over four months before Election Day.

The justices announced they will hear an extraordinary five-and-a-half hours of arguments from lawyers on the constitutionality of a provision at the heart of the law and three other related questions about the act. The central provision in question is the requirement that individuals buy health insurance starting in 2014 or pay a penalty.

In the modern era, the last time the court allotted anywhere near this much time for arguments was in 2003 for consideration of the McCain-Feingold campaign finance reform. That case consumed four hours of argument. This argument may spread over two days, as the justices rarely hear more than two or three hours a day.

The 2010 health care overhaul law aims to extend insurance coverage to more than 30 million Americans, through an expansion of Medicaid, the requirement that individuals buy health insurance starting in 2014 or pay a penalty and other measures.

A White House spokesman said, “We are pleased that the court has agreed to hear this case.”

“We know the Affordable Care Act is constitutional and are confident the Supreme Court will agree,” communications direct Dan Pfeiffer said in a statement.

Senate Republican Leader Mitch McConnell of Kentucky called the law an “unprecedented and unconstitutional expansion of the federal government into the daily lives of every American.”

“In both public surveys and at the ballot box, Americans have rejected the law’s mandate that they must buy government-approved health insurance, and I hope the Supreme Court will do the same,” McConnell said.

Republicans have called the Patient Protection and Affordable Care Act unconstitutional since before Obama signed it into law in March 2010. But only one of the four federal appeals courts that have considered the health care overhaul has struck down even a part of the law.

The federal appeals court in Atlanta said Congress exceeded its power under the Constitution when it adopted the mandate. The federal appeals court in Cincinnati upheld the entire law, as did appellate judges in Washington, DC, in recent days.

The case could become the high court’s most significant and political ruling since its 5-4 decision in the Bush v. Gore case nearly 11 years ago effectively sealed George W. Bush’s 2000 presidential election victory.

In addition to deciding whether the law’s central mandate is constitutional, the justices will also determine whether the rest of the law can take effect even if that central mandate is held unconstitutional. The law’s opponents say the whole thing should fall if the individual mandate falls.

The administration counters that most of the law still could function, but says that requirements that insurers cover anyone and not set higher rates for people with pre-existing conditions are inextricably linked with the mandate and shouldn’t remain in place without it.

The court also will look at the expansion of the joint federal-state Medicaid program that provides health care to poorer Americans, even though no lower court called that provision into question. Florida and the 25 other states say the law goes too far in coercing them into participating by threatening a cutoff of federal money. The states contend that the vast expansion of the joint federal-state Medicaid program and the requirement that employers offer health insurance violate the Constitution. No appeals court has agreed.

“The court recognized the seriousness of these vitally important constitutional challenges by allocating an extraordinary amount of time for oral argument,” Florida Attorney General Pam Bondi said.

Lastly, the justices will consider whether arguments over the law’s validity are premature because a federal law generally prohibits challenges to taxes until the taxes are paid. The federal appeals court in Richmond, Va., ruled earlier this year reasoned that the penalty for not purchasing insurance will not be paid before federal income tax returns are due in April 2015, therefore it was too early for a court to make a ruling on the law.

The administration agreed to seek prompt Supreme Court review of the health care overhaul, though it had options for trying to delay the court’s consideration of the law until after the election. The Justice Department passed up the chance to ask the appeals court in Atlanta to reconsider its decision. It is common for the Justice Department to seek review by the full appeals court when a three-judge panel rules against the government.

Early on, at the district court level, rulings followed political affiliation. Judges appointed by Democratic presidents upheld the law, while Republican appointees struck it down.

But party lines blurred at three federal appeals courts. In Atlanta, Judge Frank Hull, a Clinton appointee, joined with a Republican colleague in striking down the mandate. In Cincinnati, Judge Jeffrey Sutton, a Bush appointee, was the deciding vote in upholding the law. And in the District of Columbia, Senior Judge Laurence Silberman, named to the bench by President Ronald Reagan, and Senior Judge Harry Edwards, a Carter appointee, voted together to uphold the law.

Legal experts have offered a range of opinions about what the high court might do. Many prominent Supreme Court lawyers believe that the law will be upheld by a lopsided vote, with Republican and Democratic appointees ruling in its favor. Still others predict a close outcome, with Justice Anthony Kennedy, a Republican who sometimes joins his four Democratic colleagues, holding the deciding vote.

Six separate appeals have been filed with the high court. Three come from the Atlanta court, where the administration, the states and the National Federation of Independent Business appealed different aspects of the court ruling. From Richmond, Liberty University and Virginia appealed decisions turning back their challenges to the law. The Thomas More Law Center of Ann Arbor, Mich., appealed a ruling by the Cincinnati-based court upholding the law.

Ultimately, the court chose the Atlanta court’s ruling as the primary case to review. That decision means that the highly regarded former Bush administration solicitor general, Paul Clement, is likely to argue on behalf of the challengers. The current Solicitor General, Donald Verrilli Jr., is expected to defend the law before the justices.

Read more here