OBAMACARE AND SCOTUS, 10 YEARS LATER

THE PATIENT PROTECTION and Affordable Care Act of 2010, better known as Obamacare, was designed to patch the insurance gaps between Medicare, Medicaid, and employer-sponsored health care, which is bolstered by a tax carve-out for workplace benefits.

- PETER SUDERMAN

Obamacare was barely two years old when it faced its first challenge at the Supreme Court.

A decade after that first challenge, the law remains on the books. But the outcome of that case has shaped both the health law's evolution and its public perception, leaving Americans with a major federal program that even its fiercest advocates say does not live up to its goals.

The justices heard arguments for and against the constitutionality of Obamacare's health insurance mandate, which required every American who did not qualify for an exemption to carry federally approved health insurance. They also considered arguments over the law's mandatory expansion of Medicaid, which penalized noncompliant states with a massive clawback of federal funds.

A year earlier, Judge Roger Vinson of the United States District Court for the Northern District of Florida had struck down the individual mandate and declared that, because it was central to Obamacare, the entire statute should fall. Many observers expected the Supreme Court to likewise rule against Obamacare. They thought the only question was whether the Court would strike down just the mandate or the entire sprawling bill.