Obama defends his health-care law. Could this become a campaign theme?

Such a concept of federal power runs counter to the system of enumerated and limited national power established by the Founding Fathers, these justices said.

At the Supreme Court, the Obama administration argued that the justices should defer to the collective judgment of Congress to decide what could and could not be regulated under the Constitution’s Commerce Clause.

While it is true that the court has not invalidated such a major act of Congress since the 1930s, it is also true that Congress had never before advanced such an expansive concept of federal power.

Obama stressed that there was more to the constitutional showdown than just legal precedents and conflicting jurisprudential doctrines. “There is a human element to this that everyone has to remember,” he said. “It’s not an abstract exercise.”

“I get letters every day from people who are affected by the health-care law right now even though it’s not fully implemented,” he said. “Young people who are 24, 25, who say, ‘You know what, I just got diagnosed with a tumor. First of all, I would have not gone to get a checkup if I hadn’t had health insurance. Second of all, I wouldn’t have been able to afford to get it treated had I not been on my parents’ plan. Thank you and thank Congress for getting this done.’ ”

Most of the provisions of the Affordable Care Act don’t begin until 2014. But one measure now in force allows parents to keep their unmarried, adult children on their health-care plan until age 26.

The portion of the plan that is under attack is that part that requires young, healthy individuals to purchase insurance they might not otherwise buy. The Affordable Care Act bars insurance companies from refusing coverage based on a preexisting medical condition. It also bars insurance companies from charging higher rates to those with costly medical conditions.

The mandate is designed to help pay for those expensive reforms by forcing young, relatively healthy individuals to maintain a full line of medical insurance – even if they don’t want it or need it. Their forced participation is necessary to fund the reforms Congress and the president promised.

The president did not discuss this aspect of the Affordable Care Act. Instead, in his comments, he focused on a group of individuals who are uninsured but nonetheless obtain medical treatment at hospitals despite their lack of insurance and their lack of any ability to pay their own way. Such costs are passed by insurance companies to policy holders, increasing the average family premium by $1,000 a year, administration officials say.

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