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Few Minds Are Changed By Health Care Arguments

The morning arguments before the Supreme Court had grown tense just as the lunch crowd was packing into the food court at a downtown Atlanta office complex to watch news coverage of the hearing.

Over a meal of fast food, Bebee Dillard, a cleaning business owner, could not have been more pleased with the conservative justices, who were asking tough questions about the constitutionality of President Obama’s Affordable Care Act, the law intended to overhaul the nation’s health system. Ms. Dillard objected to the individual mandate — the central provision of the law that requires most Americans to obtain health insurance — and was pleased by the adversarial nature of the arguments.

“It’s the idea of being forced to do anything,” Ms. Dillard, 47, told a reporter.

But just a table away, Ronald Henderson, a financial planner who supports the mandate, grew distressed. “I’m really surprised and appalled,” he said. “The general tenor and tone seems to be on the negative side. To me, that’s not looking at what’s good for the vast majority of our country.”

Three days of sharp debate over the fate of the Obama administration’s signature accomplishment seems to have reinforced what many Americans already believe about the health care overhaul, but with an extra dose of repulsion or delight. The arguments before the court that will ultimately decide whether the law is struck down will not have any practical impact until June, when the justices’ decision is expected. But many people across the country who paid close attention had already made up their minds, as interviews with nearly three dozen people over the last few days made clear.

“I think it’s unconstitutional to make people buy something just because they are alive, and I always have,” said Virginia Harper, 51, a lawyer from Glen Rock, N.J., who works in Manhattan. “It’s against everything America stands for, and it’s a slippery slope. What would we have to buy next? Will we have to buy broccoli?”

It was a point that Justice Antonin Scalia, one of the most conservative voices, had raised in one of the week’s most memorable sound bites, unpersuaded that a ruling to uphold the mandate could be a limited one. Chief Justice John G. Roberts Jr. asked why the government could not require people to buy cellphones to use to call emergency service providers.

This line of questioning, while satisfying to people like Ms. Harper, caused others who support the law to complain that the arguments have been more political than constitutional.

“To have a small group of politically appointed people adjudicate something like this that impacts every man, woman and child in the country is crazy,” said William Tumath, 66, a craftsman who was selling hanging wind ornaments and who is registered as an independent voter in San Francisco. “Everyone in this country should have health care. This has become a political issue when it really shouldn’t be.”

“If the court is conservative, which it is right now, it will support the conservative agenda,” he said. “This should be a mandate of the people.”

To Greg Indruk, 31, an engineer from Nashua, N.H., the broccoli and cellphone questions made the court look as though it had taken a tumble into the absurd.

“I do look at health care as being different in nature than some other things they’ve mentioned in the absurdity arguments,” he said. “Because society assumes the burden for it, it changes the nature of the product.”

In essence, that was Justice Ruth Bader Ginsburg’s counterpoint to Justice Scalia: the mandate is a response to the fact that uninsured people receive health care at no cost that ends up being financed by others. “The problem is that they are making the rest of us pay,” Justice Ginsburg said.

That idea was not lost on Brian Yumul, 46, who was enjoying a debate of his own with Alex Wilson, 32, at Lighthouse Roasters in Seattle on Tuesday.

Mr. Yumul, like many of those interviewed, had not been following the Supreme Court oral arguments, even though he is the sort of health care consumer whose predicament inspired the overhaul. He has not had health insurance for more than a year and spends $450 a month on medicine. Mr. Wilson, who supports the mandate, filled him in on the oral arguments before the court.

“I don’t pay attention because I don’t have health insurance,” Mr. Yumul said. “I mean, I do have it, because you’re paying for it, he’s paying for it” — he pointed at other customers — “he’s paying for it.”

“What if you broke your arm?” asked Mr. Wilson, a bike racer who was in an accident that required stitches. He has health insurance, and still paid about $600 for treatment.

“I’ll go up to Harborview hospital, and they’ll pay for it,” Mr. Yumul said matter-of-factly.

But, Mr. Wilson asked, what if you do not qualify for charity care? He noted that lack of health insurance is a leading cause of bankruptcy.

Mr. Yumul frowned. “I get it,” he said. “I’m in the gray area.”

Still, he said he would pay the penalty rather than buy insurance under the mandate. “I feel like my civil rights are being imposed on,” Mr. Yumul said. “I thought being an American was having liberties and being able to make my own decisions.”

To that, Mr. Wilson said, “It’s going to be 5-4, split along party lines. It’s the way everything in the Roberts court has gone. I don’t think they can make a decision on the Constitution. It’s all about politics. I mean, look, it’s tied to an election year.”

Oral arguments before the court came to a conclusion with the justices hearing arguments about whether the law would be viable without the mandate.

“I hope they don’t throw the baby out with the bathwater,” said Rohan Vilms, a medical student in San Diego. “If it gets struck down, it doesn’t seem like we’ll have another health reform deal for a while.”

“I’m 25, so because of this law I have coverage under my parents,” Ms. Vilms said. “I really appreciate that part.”

One thing is certain: Countless debates incited by the Supreme Court arguments are continuing in countless private dialogues.

John Steinkrauss, 65, a part-time business consultant in Nashua, supports the idea of universal health care, but is less sure about the legal case for it. He is conflicted, and was unimpressed with the solicitor general’s responses in defense of the law.

And his other complaint? There was not enough argument.

“They’re only taking arguments for three days. It’s such a complex law,” he said. “When you have so many challenge points and such a broad law, it seems they could spend a little more time.”


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