Federal judge strikes down health care law provisionPosted 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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