No Supreme Court ruling on national health care law

False alarm. The Supreme Court on Monday withheld its much-anticipated ruling on the Affordable Care Act, delaying a pivotal moment for the American health care system and the presidential election.

The court is expected to announce a decision by the end of the month, and news outlets across the country were on stand-by Monday morning, believing the health care ruling might be among those handed down at 10 a.m. It was not, so the drill will repeat itself Thursday, the next day Supreme Court decisions will be be released.

The constitutionality of the national health care law, passed in 2010, has been challenged by 26 states that argue the federal government cannot require citizens to purchase health insurance and that the law infringes upon states’ rights.

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The government contends that every citizen is already a client in the health care marketplace because everyone needs care at some stage of life.

During oral arguments in March, some justices appeared fiercely skeptical of the government’s case. In one memorable exchange, Justice Samuel Alito likened mandatory health insurance to compulsory burial insurance.

“Suppose that you and I walked around downtown Washington at lunch hour,” Alito said to Solicitor General Donald B. Verrilli Jr., “and we found a couple of healthy young people and we stopped them and we said: You know what you’re doing? You are financing your burial services right now because eventually you’re going to die, and somebody is going to have to pay for it, and if you don’t have burial insurance and you haven’t saved money for it, you’re going to shift the cost to somebody else. Isn’t that a very artificial way of talking about what somebody is doing?”

Verrilli said health insurance and burial insurance are “completely different” but struggled to articulate why people should be required to buy the former and not the latter.

Justice Antonin Scalia questioned whether Congress could impose a health insurance mandate without violating states’ sovereignty under the commerce clause of the Constitution.

Whatever the Supreme Court’s ruling, some of the law’s most popular elements will remain in place, at least in Massachusetts. The Globe reported Monday that the state’s largest insurers will continue to allow young adults as old as 26 to remain on their parents’ plans. Blue Cross Blue Shield of Massachusetts, Harvard Pilgrim Health Care and Tufts Health Plan also said they would not charge copayments for a range of preventive services, including select immunizations and screening for diabetes, depression, and colorectal and breast cancer.

But the fate of many other provisions of the law is uncertain. Obama has warned that overturning the law would jeopardize access to health care for millions of Americans, most notably those with preexisting conditions, who cannot be denied coverage under the Affordable Care Act.

Presumptive Republican presidential nominee Mitt Romney has vowed to repeal the health care law, calling it a job-killing burden on businesses.