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Appeals court backs Obama health care law: What comes next?

Health cost headlines, a stethosocope and a rising graph paint a grim picture of inflation in the medical world.
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Health cost headlines
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(CBS/AP) President Obama's health care law overcame a major legal hurdle Tuesday, as an appeals court upheld the controversial law's constitutionality. The U.S. Court of Appeals for the District of Columbia upheld the lower court's ruling that found Congress did not overstep its authority in requiring people to have insurance or pay a penalty, beginning in 2014.

PICTURES: Health insurance horror stories

The requirement is the most controversial of Obama's signature domestic legislative achievement and the focus of conflicting opinions from judges nationwide. The Supreme Court could decide as early as Thursday during a closed meeting whether to accept appeals from some of those earlier rulings.

The ruling in Washington grew out of a lawsuit brought by evangelist Pat Robertson's legal group, the American Center for Law and Justice. The group claimed that the insurance mandate is unconstitutional because it forces Americans to buy a product. It also violates the religious freedom of those who choose not to have insurance because they rely on God to protect them from harm, the group said.

What did the court say? Congress had the power to pass the requirement to ensure that all Americans have health care coverage, even if it infringes on individual liberty.

"That a direct requirement for most Americans to purchase any product or service seems an intrusive exercise of legislative power surely explains why Congress has not used this authority before - but that seems to us a political judgment rather than a recognition of constitutional limitations," Judge Laurence Silberman wrote in the court's opinion.

Judge Brett Kavanaugh disagreed with the conclusion, arguing the court lacks jurisdiction to review the health care mandate until after it takes effect in 2014.

Jay Sekulow, chief counsel for the American Center for Law and Justice, said the group is considering whether to ask the full appeals court to hear the case or make a request directly to the Supreme Court. "We still remain confident that Obamacare and the individual mandate, which forces Americans to purchase health insurance, is the wrong prescription for America and ultimately will be struck down as unconstitutional by the U.S. Supreme Court," Sekulow said.

The White House said it's confident that the Supreme Court will uphold the law. Obama adviser Stephanie Cutter said in a White House blog post that opponents who say the individual mandate provision exceeded Congress' power "are simply wrong."

"People who make a decision to forego health insurance do not opt out of the health care market," she wrote. "Their action is not felt by themselves alone. Instead, when they become ill or injured and cannot pay their bills, their costs are shifted to others. Those costs - $43 billion in 2008 alone - are borne by doctors, hospitals, insured individuals, taxpayers and small businesses throughout the nation."

More than 48 million Americans do not have health insurance, according to the CDC - about 18 percent of the population.

What do you think? Is it wrong to require Americans to purchase health insurance?