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Dialysis Discussion => Dialysis: News Articles => Topic started by: okarol on December 13, 2010, 02:28:41 PM
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Federal judge strikes down health care law provision
Posted 15m ago
By Richard Wolf and Joan Biskupic, USA TODAY
The linchpin provision of the landmark health care law extending insurance to 32 million Americans was struck down by a federal judge in Virginia on Monday, dealing the first major blow to President Obama's most far-reaching legislative achievement.
The ruling by U.S. District Court Judge Henry Hudson against the law's mandate that most Americans buy insurance, if upheld eventually by the U.S. Supreme Court, could undercut the law passed by Congress and signed by Obama in March. In the meantime, the judge didn't stop implementation of the law.
An appeal first to the U.S. circuit court level and then to the Supreme Court could take two years to decide, said Virginia Attorney General Ken Cuccinelli, who brought the challenge.
The decision marked the first court defeat for the law after two victories in Virginia and Michigan and a number of procedural wins as well. Another case brought by 20 state attorneys general is set for oral argument in Pensacola, Fla., on Thursday.
Though he ruled against the individual mandate, Hudson refused to strike down the entire health care law. He also left the mandate intact pending appeals, so the law's implementation schedule through 2014 remains on track.
Other parts of the law remain, such as setting up state health insurance exchanges that offer a choice of policies, offering tax credits to low-income Americans so they can buy insurance, expanding Medicaid and making changes in Medicare. "Some of the key provisions are totally unrelated to the individual responsibility provision," said Ron Pollack of Families USA, a liberal health care consumers group.
Proponents and opponents of the law agreed that without a mandate that individuals must purchase insurance, the law's insurance changes could quickly unravel. Healthy people could remain uninsured, forcing insurers to raise rates on others or quit the business rather than be forced to cover people with pre-existing conditions, as the law requires.
"We don't let people wait until after they've been in a car accident to apply for auto insurance and get reimbursed, and we don't want to do that with health care," said Stephanie Cutter, assistant to President Obama for special projects.
Cuccinelli acknowledged that the nation's health care system is in need of repair but said his state's challenge was about liberty, not health care.
"Expenses are out of control, and everyone's needs are not being met right now. But there are better solutions than giving up our freedom," he said. If the government can force people to buy health insurance, he said, other products — from cars to gym memberships to asparagus — could be next.
Hudson agreed. "The unchecked expansion of congressional power to the limits suggested by the (mandate) would invite unbridled exercise of federal police powers," he wrote in a 42-page decision. "At its core, this dispute is not simply about regulating the business of insurance or crafting a scheme of universal health insurance coverage. It's about an individual's right to choose to participate."
The dispute is likely to be decided by the Supreme Court, where cases on the reach of Congress' power to regulate interstate commerce have been narrowly decided in recent years. This has been difficult terrain for the justices, marked by shifting majorities, and it is hard to predict how the court under Chief Justice John Roberts would rule. Yet in one recent decision, testing federal anti-drug policy in a California medical marijuana dispute, the court in 2005 broadly interpreted congressional power to regulate commerce.
Florida Attorney General Bill McCollum, the lead plaintiff in the case involving 20 states, heralded the Virginia ruling but noted his case includes a challenge to the law's expansion of Medicaid, the federal-state health insurance program for the poor.
"I am hopeful we will obtain a favorable decision that will strike down the individual mandate and also halt the hundreds of millions of taxpayer dollars required to be spent by states to implement the Affordable Care Act," McCollum said.
The White House disagreed with Hudson's decision and predicted the law will stand the test of time.
"We're confident that when it's all said and done, the courts will find the Affordable Care Act constitutional," Cutter said. "History and the facts are on our side. Similar legal challenges to major new laws — including the Social Security Act, the Civil Rights Act, and the Voting Rights Act — were all filed and all failed."
At the core of the legal dispute is whether a person's decision not to buy health insurance can be considered economic activity that affects commerce.
Government lawyers contend that it is and stress that the uninsured affect costs throughout the system. They argued in a filing that the uninsured consume "tens of billions of dollars in uncompensated care each year." Those costs — $43 billion in 2008 — are borne by doctors, hospitals, insured individuals, taxpayers and small businesses.
"Make no mistake: Individuals who choose to go without health insurance are actively engaged in economic decision-making — the decision to pay for health care out-of-pocket or to seek uncompensated care," Cutter said.
Lawyers for Virginia countered that when someone doesn't buy insurance, there is no "economic activity" that affects commerce. Hudson agreed, narrowly interpreting the reach of Congress' commerce powers.
"Neither the Supreme Court nor any federal circuit court of appeals has extended Commerce Clause powers to compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market," he wrote.
Other lower court judges, including U.S. District Judge Norman Moon, also in Virginia, have interpreted Congress's commerce power in this area more broadly. Last month, Judge Moon spurned a challenge to the law.
http://www.usatoday.com/news/washington/2010-12-13-health-care-law-virginia-judge_N.htm
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Dec 13, 2010
Obama's health care law loses opening round in court
01:32 PM
By Charles Dharapak, AP
A federal judge in Virginia has struck down the Obama administration's requirement that all Americans buy health insurance, a key provision in the landmark health care bill that the president signed in March.
Today's ruling, if upheld, could undercut the entire health care plan, though U.S. District Judge Henry Hudson wrote that his decision will surely be appealed -- probably all the way to the U.S. Supreme Court.
"The outcome of this case has significant public policy implications," Hudson wrote. "And the final word will undoubtedly reside with a higher court."
Hudson ruled that the individual mandate "exceeds the constitutional boundaries of congressional power." He added that he won't stop implementation of the law as various challenges wind their way through the courts, noting that many provisions won't take effect until at least 2014.
White House spokesman Robert Gibbs cited those other cases in urging "perspective" about this one ruling from a single judge. He predicted that the new health care law will ultimately be upheld.
"We disagree with the ruling," Gibbs said. "The bill will continue to have its day in court."
Gibbs also said that rolling back the insurance requirement would damage other aspects of the law, such as efforts to cover people with pre-existing conditions.
Republicans who opposed the health care bill hailed Hudson's ruling against the requirement that all Americans buy insurance, according to our OnPolitics blog.
"Liberty requires limits on government, and today those limits have been upheld," said Sen. Orrin Hatch, R-Utah.
Rep. Eric Cantor, R-Va., who becomes the new majority leader when Republicans take control of the U.S. House next month, again vowed "a clean repeal of ObamaCare."
The Richmond-based judge did not pass judgment on provisions placing new restrictions on the health insurance industry, saying they were not related to the requirement all Americans buy health insurance.
By Charles Dharapak, AP
But many of those new rules -- forcing insurance companies to cover people with pre-existing conditions or who are ill -- hinge on the insurance mandate, creating a larger insurance pool that can reduce costs.
Hudson, a Republican appointed by President George W. Bush, is the first federal judge to strike down the law that Obama signed in March. The landmark bill has been upheld by judges in Virginia and Michigan, and several other lawsuits are pending.
In his 42-page opinion, Judge Hudson wrote that "at its core, this dispute is not simply about regulating the business of insurance -- or crafting a scheme of universal health insurance coverage -- it's about an individual's right to choose to participate."
In briefs and oral arguments, Obama administration attorneys -- as they have in other cases -- said the Commerce Clause of the Constitution gives Congress the authority to require the purchase of insurance; they also cited Congress' taxing authority.
The insurance requirements are a "penalty," not a "tax," Hudson ruled. As for the Commerce Clause, the judge said no appeals court has said it can "compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market."
Washington and Lee University law professor Timothy Jost, an expert on the health-care law, said other judges who have upheld the law interpreted the Commerce Clause more broadly to cover economic decisions that are more passive -- namely, the refusal to buy insurance. Jost said that when people choose not to buy health insurance they are still making an economic decision and affecting the nation's commerce.
(Posted by David Jackson, Richard Wolf and Joan Biskupic)
http://content.usatoday.com/communities/theoval/post/2010/12/obamas-health-care-law-loses-in-court/1?loc=interstitialskip
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Federal judge strikes down health care law provision
Hudson agreed. "The unchecked expansion of congressional power to the limits suggested by the (mandate) would invite unbridled exercise of federal police powers," he wrote in a 42-page decision. "At its core, this dispute is not simply about regulating the business of insurance or crafting a scheme of universal health insurance coverage. It's about an individual's right to choose to participate."
What utter nonsense. By the way, taxpayers, we pick up the tab for his healthcare, a scheme I would very much like to opt out of at the moment.
Florida Attorney General Bill McCollum, the lead plaintiff in the case involving 20 states, heralded the Virginia ruling but noted his case includes a challenge to the law's expansion of Medicaid, the federal-state health insurance program for the poor.
This is short-sighted idiocy....
"Make no mistake: Individuals who choose to go without health insurance are actively engaged in economic decision-making — the decision to pay for health care out-of-pocket or to seek uncompensated care," Cutter said.
....and this is so obvious that I marvel that anyone even needed to say it.
Yuck.
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Once the wording of the bill is changed from imposing a "penalty" to imposing some other sort of payment (ie "tax"), then this problem is solved.
With health care costs rising so high so quickly, those people who deem it unnecessary to buy health insurance because they happen to be young and healthy need to be aware that being young and healthy does not innoculate them against accidents putting them in the hospital which could easily bankrupt them. I don't understand why proponents of health care reform don't more strongly remind people of this.
I am not sure if the Republicans who are vowing to repeal the health reform bill intend to revoke the popular elements that have already gone into effect, ie coverage for children with pre-existing conditions or for young people up to the age of 26 who might need to be retained on their parents' policy. If I had a child who fell into one of those two groups, I would be quite nervous.
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I like Physicians for a National Health Program's response to this:
"By Don McCanne, MD
Although this is only the beginning of a protracted legal process, Judge Hudson's decision defines the nature of the constitutional challenge to the Patient Protection and Affordable Care Act (PPACA). The challenge is limited to Section 1501 which is the mandate for individuals to purchase health insurance. The remainder of the Act remains intact.
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."
http://www.pnhp.org/news/2010/december/court-ruling-against-the-individual-mandate
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Well, Plugger, that makes entirely too much sense. That will never happen given our current political climate, and I don't see anything changing for many, many years to come. Medicare for all sounds too much like "socialized medicine". ::)
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Sort of like "socialized" police, "socialized" fireman, "socialized" teachers, - and the scariest of all, "socialized" librarians!
It's everywhere! Even BusinessWeek came out for "socialized" medicine at the VA!
http://www.dialysisethics2.org/forum/index.php?topic=495.msg716#msg716
Is there nobody left to believe in!
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(http://www.dialysisethics2.org/open_images/Conan_librarian.jpg)
Conan the (socialist) LIBRARIAN - SCARY!!!!
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It angers me when "liberty" and "freedom" becomes code for "irresponsible" and "selfish". "Protecting the Constitution" is quickly becoming synonymous with "Screw you".
John King on CNN yesterday did a short interview with Virginia's Attorney General Cuccinelli yesterday, and King pointedly asked him, "If you were, say, a 35 year old healthy man who chose not to buy insurance but you were in a car accident, and you required extensive medical care, who would pay for that?" Mr Cuccinelli DID NOT ANSWER THE QUESTION. Instead he prattled on about protecting freedom and the Constitution. So, I am guessing if that 35 year old uninsured healthy man decided not to contribute to the insurance pool, then we taxpayers can decide to leave him dying on the side of the road while reading him the Constitution and applauding the fact that he so wisely chose not to buy insurance.
And what if that 35 year old man had children? Does he have the right to leave his children uninsured? My husband is divorced and has 4 kids; he is REQUIRED to purchase life insurance naming them as beneficiaries until they reach 18. So, should a parent be required to buy health insurance for his minor children? Just askin'.