Aaron Carroll, an Indiana University health policy expert, has written an explanation of the issues that will confront the U.S. Supreme Court if the court takes up a Patient Protection and Affordable Care Act (PPACA) case during the current term.

Both the Obama administration and PPACA opponents want the court to resolve the dispute, which centers partly on whether the Commerce Clause of the U.S. Constitution gives Congress the authority to mandate an action – such as the purchase of health insurance, or of broccoli.

Some people believe the PPACA individual health insurance ownership mandate “is an overreach of government,” Carroll writes. “If you can be forced to buy health insurance, then what can’t you be forced to buy?

“Others believe that health care is different, and that allowing this provision does not lead to a slippery slope. Still others believe that the individual mandate is simply a kind of tax, and completely fine.”

The likelihood that some consumers in a guaranteed-issue system might wait till they get sick to buy coverage is another problem, Carroll says.

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