Judge Tosses Out Healthcare Reform Law

[okarol]

Judge Tosses Out Healthcare Reform Law

By Emily P. Walker, Washington Correspondent, MedPage Today
Published: January 31, 2011
 

A federal judge in Florida has ruled that the healthcare reform law is unconstitutional, siding with the 26 states that sued to block enforcement of the Affordable Care Act (ACA).

The lawsuit is considered likely to go all the way to the Supreme Court.

Judge Roger Vinson, of the U.S. District Court for the Northern District of Florida in Pensacola, stopped short of directing the federal government to stop implementing the law. Still, the ruling is the harshest legal action yet against the ACA.

Unlike a ruling last month by a judge in Richmond, Va., stating that the individual mandate portion of the ACA violates the Constitution, Vinson ruled the entire law "void" because the individual mandate provision can't be separated out from the rest of the law.

Two other judges have rejected challenges to the law, ruling that the ACA's individual mandate provision is constitutional.

Congress "exceeded the bounds of its authority in passing the Act with the individual mandate," Vinson wrote in his 78-page ruling, which was released Monday afternoon. The mandate requires all citizens to have health insurance by 2014 or else pay a penalty.

"Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void," he concluded.

He did contend that Congress has the power to address the "problems and inequities in our healthcare system," but that Congress overstepped its power in passing the ACA.

"There is widespread sentiment for positive improvements that will reduce costs, improve the quality of care, and expand availability in a way that the nation can afford," Vinson wrote. "This is obviously a very difficult task. Regardless of how laudable its attempts may have been to accomplish these goals in passing the Act, Congress must operate within the bounds established by the Constitution."

While it was widely expected that Vinson would side with the states, it comes as somewhat of a surprise that he declared the entire law "void."

The original lawsuit -- which was filed just hours after Obama signed the ACA into law on March 23, 2010 -- alleged that the "individual mandate" in the law exceeded Congress' authority under the Commerce Clause of the Constitution, but didn't argue that the whole of the law is unconstitutional. The Commerce Clause permits the federal government to regulate interstate commerce.

In October, when Vinson ruled the case could proceed, he said the states "had a plausible claim" in their argument that the law's individual mandate violated the Commerce Clause.

The states argued that the government cannot force individuals to participate in the stream of commerce -- in this case, the health insurance market.

The federal government responded that at some point, every U.S. citizen will seek medical care, and if that person chooses to not have insurance, the cost of his or her medical care is passed on to those with insurance. Thus, a choice to not participate in the commerce of healthcare doesn't actually exist.

Officials in the Obama administration called Vinson's ruling an "outlier," and said the federal government would not stop implementation of the law.

"We believe this ruling is well out of the mainstream of judicial opinion," said a senior administration official. "We're quite confident it won't stand."

The Department of Justice immediately came out against the ruling and said it intends to appeal.

"There is clear and well-established legal precedent that Congress acted within its constitutional authority in passing this law and we are confident that we will ultimately prevail on appeal," said Tracy Schmaler, a spokeswoman for the Justice Department.

GOP physicians in the Congress, meanwhile, applauded the ruling.

"This ruling is a direct rejection of Obamacare, and it is another confirmation that the law went too far," said Rep. Phil Roe, MD (R-Tenn.) in a statement. "The House already voted to repeal Obamacare, and I urge the Senate to push forward and do the same so we can replace it with commonsense - and constitutional - legislation that aims at lowering health care costs."

On the other side of the aisle, meanwhile, Democratic members of Congress sided with the administration.

"Today's court ruling is one of many," said House Minority Leader Nancy Pelosi (D-Calif.). "We strongly believe that health reform is constitutional, and is consistent with longstanding precedents of the Supreme Court."

Other states that have joined the lawsuit are: Alabama, Alaska, Arizona, Colorado, Georgia, Indiana, Idaho, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin and Wyoming.

The National Federation of Independent Business is also part of the lawsuit.

http://www.medpagetoday.com/Washington-Watch/Reform/24614?utm_source=breaking-news&utm_medium=email&utm_campaign=breaking-news

[Jean]

Kudos to this judge. Wonder how many more states will join in the fight.

[KarenInWA]

Frankly, this news scares me sh!tless.  Republicans idea of Health Care Reform for those of us with pre-exisiting conditions is high risk pools.  I would like to know how a pool of high-risk individuals (read: expensive) can be sustained without imploding on itself and having all individuals in the pool drown (die).  I know the HCR bill is not perfect and needs some serious tweaking, but High Risk Pools???  Really??? Why don't you just give me a card with my number on it, so I can get in line and go await my death.  After all, I had the audacity to be born, and with that, I somehow inherited crap-ass kidneys.  I was a genetic mistake and must be voided.  I know we have these high-risk pools now, but that is only until 2014, as the law is currently written.  Anyone have an explanation on how these pools will "work" permanently?

KarenInWA

[The Lone IT from HM]

This judge and this court were hand picked because both are straight up Republican.  It really wasn't in the Judge's abilities to make the WHOLE law unconstitutional.  He could rule that forcing everyone to buy insurance was unconstitutional.  The Health care package is a bit far reaching, but should be fixed, not thrown out.

[carol1987]

I am with you Karen... Sadly my dd has inherited this stupid PKD... that I did not even now I had until after I had my children. 

Don't throw the baby out with the bath water!! Tweek as needed but we surely need health care reform in the US!!!!

[carol1987]

If mandating Heath care insurance is illegal... then why do I have to buy Car Insurance in NJ??? That should be unconstitutional too!!
(not that I am advocating  getting rid of car insurance)

[paul.karen]

I dont think republicans just want to toss everything out the window.  It would have been nice if this would have been done in a better manner.  With both sides adding and debating certain aspects of the bill.  But it was a RUSHED threw process that only passed due to the president BUYING off votes in several states if you recall.  Dems like to blame the repubs but they had full power of the house and senate and the bill still barley passed.  Only passed because of unscrupulous payoffs.

Funny how the president himself is giving passes to many companies why?  Because the law is flawed and slanted. 

Repubs agree we need reform.  They just have different variations.  Good or bad we will have to wait and see.
One thing that is MUCH needed and the president just didnt worry about is putting a cap on lawsuits which Drives up the price of insurance.

I mean lets be real one of the biggest bills ever in American history and NO ONE READ THE BILL.  Pelosis famous statement you wanna see whats in the bill pas the bill still erks me and im sure many others.

I have not met one person who has said we dont need reform.  But when the people and both parties dont have a say it is worrisome.  Also seems to be unconstitutional.

Hopefully both parties can come together and bring a new bill that EVERYONE can agree on.  it can be done but will it??

[YLGuy]

Only passed because of unscrupulous payoffs.

Wasn't it our new speaker who got caught handing out checks from the tabaco industry on the floor of the house to to fellow Republicans?

[paul.karen]

Sorry thought we were talking about healthcare.
But  many dems do like to deflect i quess.

[YLGuy]

I am sorry but I do not want people who are in the pockets of the tabaco industry having my health care determined.  I do not think that my best interests will be even a passing thought to them.

[KarenInWA]

I am sorry but I do not want people who are in the pockets of the tabaco industry having my health care determined.  I do not think that my best interests will be even a passing thought to them.

Okay, I'm going to get real catty here, but...I can't help it!!!

I also don't want my healthcare to be determined by those who obviously spend some time doing the fake 'n' bake.  As a future transplant patient, I will have to be careful of things like melanoma.  Obviously, our current head speaker of the house does not care about that, as is evident from the unnatural color of his skin.  Granted, he is of the same party as McCain, who has suffered from melanoma, so maybe my concern is unfounded.  But still! Yuck!!!!

[MooseMom]

http://www.huffingtonpost.com/adam-winkler/health-care-ruling-shows_b_816629.html

I thought we were supposed to be against "activist judges." 

As far as I'm concerned, let people opt out of buying insurance.  Their SSN's can be entered into a data base so that when they get sick or have a car accident and doctors show up to help them, they can punch in the person's SSN, see that he voluntarily opted out of buying insurance and then patch them up in the ER and send them on their way without any follow up care.  Treat them like illegal immigrants.   It's strange to me how in this instance, denying personal responsibility is tarted up as "liberty".

The Republicans (mainly Coburn and Ryan) outlined their Patients' Choice Act as an alternative to the ACA, and there were elements of that that I really liked, like trying to unwind access to health insurance from employment.  But ironically, the act basically says that if you like your current insurance plan, you can keep it.  Sounds familiar, doesn't it?  And on top of that, it was actually working toward "universal coverage" which some people, unfortunately, find synonymous with "socialism".

As for not liking the ACA because it was "rushed through", I'm not sure about that.  We've been arguing about health care for literally decades; nothing about health care has EVER been "rushed".  There were elements on the Republican side whose sole tactic was to drag their feet and not really debate anything, and you can't talk forever and ever.  Most of the bill won't be enacted until 2014, so if there is something in it that the Republicans can vastly improve, they will get their chance to debate, vote on and then enact those changes.

This will be my only post on this subject.  I've stopped caring.  As long as I get my medical care, what someone else chooses to do with their own life makes no difference to me anymore.  I bust my guts looking after myself, and if you don't want to do that for yourself, then get out of my damn way and don't make things harder for me.  Go out and enjoy your liberty but don't crap on me in the process.

[paul.karen]

http://www.facebook.com/l.php?u=http%3A%2F%2Fbit.ly%2FfvxSvU&h=577d5

Flip FLop??

Maybe its fake?

[cookie2008]

In this country no one should be turned away for health care, with all the aid going to other countries and all the aid going to the big companies, so wrong.

[Sax-O-Trix]

 If the powers that be are exempt from this expanded form of medicaid/medicare and get to keep their golden healthcare plans, I am completely against it.  If the healthcare plan they have for us is not good enough for them to use, then the healthcare plan they have planned for the rest of us is not good enough for me or my family.

[The Lone IT from HM]

Not sure I understand that last one.....I would kill the health care package if they were to offer me that the Senate and House members are offered.  But I am not offered that, and neither is too many others.  I like the opt out idea, but with the clause that if you opt out, you don't get free healthcare by going to the emergency room and not paying for it.  Medicare and medicaid are whole different programs, and should be non players for this conversation.

Instead of repealing the whole package, if the House republicans had of offered a major rework....that I would have got behind.

[Bill Peckham]

The judge said the whole law is unconstitutional, even the student loan part - there was a student loan part. But if the ruling takes effect it'll disrupt a lot of business not to mention rescind discounts people who vote with Part D are already using, so this has to be seen as a way to frame the conversation as it goes to the Supreme Court. The bottom line is that this whole issue is up to Justice Kennedy so the question to ask is does this make Justice Kennedy more or less likely to vote for or against the Affordable Care Act's mandate.


I don't know the answer to what Kennedy is going to do but now the far right of the continuum of possibilities has been staked out.

[Bill Peckham]

http://www.facebook.com/l.php?u=http%3A%2F%2Fbit.ly%2FfvxSvU&h=577d5

Flip FLop??

Maybe its fake?

Not that you were watching but this was pretty much the entire difference between Obama and Clinton, jump forward to the ONE YEAR LONG debate about healthcare and when the Republicans bailed - remember Wydon/Benett? - it became apparent that to get 60 votes in the Senate you had to go with the mandate. Instead of what I and many other Democrats who voted for Obama would have preferred a Medicare for all or public option. The mandate was the more bipartisan path because it was the Republican option in '93/'94 (as Clinton well remembered) and it was what Romney used in Massachusetts. That's the painful irony.


The element the Republicans are using to demonize the Affordable care Act is the element that they were suppose to find appealing. It's their approach.

[Genlando]

This judge and this court were hand picked because both are straight up Republican.  It really wasn't in the Judge's abilities to make the WHOLE law unconstitutional.  He could rule that forcing everyone to buy insurance was unconstitutional.  The Health care package is a bit far reaching, but should be fixed, not thrown out.

The judge had throw out the whole law, because Congress failed to include a severability clause in the Affordable Healthcare Bill.  Most legislation has this clause added so that if the rest of the law would remain in force is any portions of it are deemed unconstitutional.  However, this massive bill was rushed through Congress, so somebody forgot to include the severability clause.  The judge had no choice but to throw out the whole thing.

If mandating Heath care insurance is illegal... then why do I have to buy Car Insurance in NJ??? That should be unconstitutional too!!
(not that I am advocating  getting rid of car insurance)

Car insurance laws are mandated by the individual states; the Healthcare requirement is an attempt to federally mandate coverage.  The Constitution doesn't give the Federal Government such authority. 

The Founding Fathers never intended for our country to have a powerful, central government.  Rather, they envisioned a bunch of separate, independent nations (states), united for mutual defense and commerce.  The Federal Government was to have minimal say-so in how each of these states were to function.  We've gotten so far away from this concept that most people aren't even aware of this.  However, situations like this occasionally come up and remind us how the US government's supposed to work.

The Healthcare Law was hastily written by a single political party (the Democrats).  There was no attempt at creating a bipartisan bill.  It's a 3,000-page monstrosity that will never stand. The good thing is that once the bill is officially deemed as unconstitutional by the Supreme Court (and it will be), Congress will have to sit down and come up with another solution.  Fortunately, the power structure in Congress has shifted, so both parties will have to come to an agreement on how to fix the healthcare mess. No telling what we'll end up with, but I hope it's better than the nightmare that was ram-rodded through Congress last year.

[kyshiag]

I'd vote for anything that gives me an opportunity to at least die in a bed.  The health care system has been run by the pharmaceutical companies too long.  Most people are paying HMOs for the privilege of being treated just like they believe the gov't will treat them under this plan.  Think the gov't will have death panels?  Apparently, you have not been through the denial/appeal process with an insurance company.  Right now, I can afford to pay a bit more to assist my fellow American get the care they need.  This won't always be the case. I fear I will be on the other side of the coin one day and hope others will feel the same.

[Bill Peckham]

This judge and this court were hand picked because both are straight up Republican.  It really wasn't in the Judge's abilities to make the WHOLE law unconstitutional.  He could rule that forcing everyone to buy insurance was unconstitutional.  The Health care package is a bit far reaching, but should be fixed, not thrown out.

The judge had throw out the whole law, because Congress failed to include a severability clause in the Affordable Healthcare Bill.  Most legislation has this clause added so that if the rest of the law would remain in force is any portions of it are deemed unconstitutional.  However, this massive bill was rushed through Congress, so somebody forgot to include the severability clause.  The judge had no choice but to throw out the whole thing.

If mandating Heath care insurance is illegal... then why do I have to buy Car Insurance in NJ??? That should be unconstitutional too!!
(not that I am advocating  getting rid of car insurance)

Car insurance laws are mandated by the individual states; the Healthcare requirement is an attempt to federally mandate coverage.  The Constitution doesn't give the Federal Government such authority. 

The Founding Fathers never intended for our country to have a powerful, central government.  Rather, they envisioned a bunch of separate, independent nations (states), united for mutual defense and commerce.  The Federal Government was to have minimal say-so in how each of these states were to function.  We've gotten so far away from this concept that most people aren't even aware of this.  However, situations like this occasionally come up and remind us how the US government's supposed to work.

The Healthcare Law was hastily written by a single political party (the Democrats).  There was no attempt at creating a bipartisan bill.  It's a 3,000-page monstrosity that will never stand. The good thing is that once the bill is officially deemed as unconstitutional by the Supreme Court (and it will be), Congress will have to sit down and come up with another solution.  Fortunately, the power structure in Congress has shifted, so both parties will have to come to an agreement on how to fix the healthcare mess. No telling what we'll end up with, but I hope it's better than the nightmare that was ram-rodded through Congress last year.

You can read today's testimony of Reagan's Solicitor General on the constitutionality of the law
http://www.talkingpointsmemo.com/documents/2011/02/reagans-solicitor-general-testifies-that-obamacare-is-constitutional.php?page=1

In his prepared remarks, Fried said the argument that the health care regulation is not regulation of commerce because it requires an economic act (instead of prohibiting or limiting an economic activity) is "entirely wrong and even worse quite confused."

That's pretty much in keeping with the other legal analysis I've seen, I've not seen a legal analysis to the contrary that makes a lot of sense but would read it if someone has a link.

In other news a Ga. Lawmaker Proposes Doing Away With Driver's Licenses because drivers licenses are unconstitutional in his reckoning


EDITED TO ADD  I learn something new every day on the internets. Back in the early days of this country, Congress passed and Washington signed the Militia Act of 1792, which provided for universal military training to be conducted at the state level.

http://www.constitution.org/mil/mil_act_1792.htm

The law required citizens to buy a gun! and back then low wage earners didn't automatically get subsidies to buy guns, like the Affordable Care Act does with health insurance. Instead, people were faced with an unfunded individual mandate!

[Genlando]

Bill Peckham, as I mentioned earlier, the Founding Fathers intended for the states to have most of the power, while the Federal Government was to have very limited powers.   The Militia Act of 1792 fits that narrow reach of power.  The Constitution clearly gives the Federal Government authority to make laws concerning national defense. The same Founding Fathers were very uncomfortable with the Federal Government maintaining a large standing army.  They therefore felt that a "well-regulated militia," which would be controlled by each state, would serve the same purpose.  This concept was both constitutional and respected each states' rights. 

The Affordable Heathcare Act doesn't meet either of these tests.  If people want to give Congress the authority to control national healthcare, they'll need to ratify a Constitutional Amendment.  As a patient with ESRD, I'd love to see something done to make healthcare more affordable.   However, the Affordable Healthcare isn't constitutional, and I never felt that it would ever be enacted. Hopefully, Congress will try to come up with a truly constitutional solution before too long.

[Bill Peckham]

The Constitution our founding fathers left us with was deeply flawed, but thankfully it allowed amendment and as amended, with the Commerce Clause, the Affordable Care Act isn't obviously unconstitutional. Just stating that it is, isn't very persuasive.


As I think Reagan's Solicitor General laid out and as literally decades of legal precedents support, it isn't obvious that healthcare is outside the government's ability to regulate. That said we live in strange times and the Supreme Court can change their interpretation of the Commerce Clause any time five justices agree, but it would be a new direction if they held the mandate unconstitutional.