When Health Care Reform Goes to Court

The health care reform process is now 2 to 1 in federal court challenges after a federal district judge in Virginia ruled today that one of reform's basic provisions, that most currently uninsured Americans buy health insurance or face a federal penalty for not acquiring it, was unconstitutional. According to the NY Times: "In a 42-page opinion issued in Richmond, Va., Judge [Henry E.] Hudson wrote that the law’s central requirement that most Americans obtain health insurance exceeds the regulatory authority granted to Congress under the Commerce Clause of the Constitution.... The judge wrote that his survey of case law 'yielded no reported decisions from any federal appellate courts extending the Commerce Clause or General Welfare Clause to encompass regulation of a person’s decision not to purchase a product, not withstanding its effect on interstate commerce or role in a global regulatory scheme.'"

That's a big loss for Obamacare's mission to provide coverage to the nation's millions of uninsured since "insurers argue that only by requiring healthy people to have policies can they afford to treat those with expensive chronic conditions." The pro-reform argument is of course that government can compel individuals to pay for coverage since their failure to do so ultimately rolls over the final responsibility for their health services onto other taxpayers.


Two previous federal court cases on similar grounds were decided in favor of the constitutionality of the federal mandate. All three judges declined to freeze implementation of the reform law pending appeal, so the process will move forward despite this decision. There are as many as two dozen other court challenges to the 111th Congress's health care reform law (the Patient Protection and Affordable Care Act of 2010, good luck with that. Try Canada Health Act instead. Much easier read). Most legal analysts believe it will take the Supreme Court to issue a final ruling on the law's constitutionality, but the process could take years to reach that chamber.

Those hostile to reform will consider this the first winning battle in a long war of attrition against reform. Proponents of the health care reform may be reassured that it is so far this one aspect of the reform package, Section 1501, the government mandated purchase of insurance, that has drawn the most judicial attention. Other provisions of the law mean that reform is already expanding the number of people who can receive preventive and customary care under Medicaid. At least 12 million of the estimated 47 million or so U.S. uninsured will come under the care umbrella via an expansion of Medicaid, for example.

In fact I find myself wondering if a strategic loss on this aspect of the reform movement might not be such a terrible setback if your true goal happens to be universal coverage that is practical and affordable. Wouldn't a prohibition on constitutional grounds on the mandate only make it more likely that the public option, an early casualty in the February-March congressional campaign, may find itself returned to the field (if I can belabor that poor metaphor another beat or two). That prospect was certainly on the minds at the folks at the Physicians for a National Health Program had this to say about today's ruling:

This is a serious challenge. Without the requirement that everyone be included, the risk pools are subject to adverse selection (only those with greater health care needs enroll) which cause them to become unstable as premiums skyrocket. Even if Section 1501 survives this challenge, there are so many other flaws in the PPACA scheme that we can never hope to achieve universality and affordability—the two reasons that prompted the reform process in the first place.

Instead of a protracted battle in the courts, our government should pursue an approach that remains within the constitutional boundaries of congressional power and would actually work to provide everyone with affordable health care—an improved Medicare for all. After almost half a century of success, only a fool would challenge the constitutionality of Medicare.

Following this reasoning, Obamacare's opponents should be careful what they wish for; today's "loss" could be the first step to the end of health care reform as we've known it but toward a single-payer system that would radically alter the reach, manner and cost of American health care.

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Marie Rehbein
8 years 1 month ago
It is the case that the court found two things, one, that it is unconstitutional for the government to require people to do business with one another, and two, that it is constitutional for the government to tax people and provide services with that money.

No system is perfect, but a system that treats everyone for most things is better than one that appears to provide something only money can buy to only those who can afford it.  In other words, it is my opinion that the very superior health care that people fear will no longer be available under a single payer system, or even under socialized medicine, does not really exist but is one of those things like a luxury sweater that does nothing more than make the rich feel rich because they can afford to pay for it.  They only think it's better because it's costing them more.
8 years 1 month ago
"Following this reasoning, Obamacare's opponents should be careful what they wish for; today's "loss" could be the first step to the end of health care reform as we've known it but toward a single-payer system that would radically alter the reach, manner and cost of American health care."

*Roll eyes*

ed gleason
8 years 1 month ago
One of the first things our founding fathers did was start the US Public Health Service to care for sailors at ports. The year was 1798... way before the 'socialists' hijacked health care. this Spring 2010 (:.. [tea party please copy]
Tom Maher
8 years 1 month ago
Oh yeah.  Rasmussen weekly healthcare repeal poll  is still showing 60% in favor of repeal of the healthcare law but somehow they are going to jump at the chance for a entirely govermnet run program. 

Where you paying attention at all to the results of the last election less than forty-five days ago? 

The healthcare law is under attack and the stated goal of the new Republican majority in the House is to repeal the healthccare law as announce in the Promise to America.  

Even with the Democratic majorities of the 111th Congress Healthcare only passed by a fewe votes in the House and the Senate,  It had very shaky support  and was put together by all kinds of special side deals that Republicans will not be omc;inmd to honor.  Further support for the Healthcare will be an issue again for the one-third of the U.S. Senate that is up for re-election in 2012.  This willbe very difficult for many Democrates that supported the healthcare law to be re-elected in 2012 just as it was this year. Many senators had primary fights they could not win.

A now that we are finally reading the healthcare law we know what trouble the nation is inwith this rashly drawn law.

The healtcare law remains a election hazard for most Democrates including President Obama who becasue of it will like be a one-term president.


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