After the landmark health care reform law, the Affordable Care Act (ACA), was enacted in March 2010, opponents of the law filed several lawsuits in federal court, challenging various provisions of the ACA as unconstitutional. While most cases were dismissed on procedural (technical) grounds, judges – including judges from four federal appeals courts – issued divergent rulings upholding the ACA in full or striking down some or all of the law.

In November 2011, the United States Supreme Court agreed to review several constitutional issues arising out of two of the appellate decisions. In March 2012, the Court heard six hours of oral argument over three days. A decision is expected in late June 2012.

This paper summarizes briefly the four constitutional issues that are stake. It also discusses some of the most likely outcomes from the Court’s ruling, and the implications of those rulings for Pennsylvania.

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