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Court ruling calls key portion of health care law into question

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mandating insurance in health care law might be unconstitutionalThe U.S. Constitution does not support a provision of the landmark health care law passed this year that would require most people to get health insurance, according to a Monday ruling by a federal judge in Virginia.

Lack of health insurance leads to 44,789 excess deaths in the U.S. each year, a 2009 study estimated. And annual medical costs that go unpaid added up to about $43 billion in 2005, according to a study published that year.

The ruling is the first to overturn the Patient Protection and Affordable Care Act, which was signed into law in March.

Henry E. Hudson, the U.S. District judge in Richmond who made the ruling, wrote that the health care law violates the Tenth Amendment of the Constitution, which states that anything not specifically designated for federal control is "reserved to the States respectively, or to the people." Health care—and more specifically the decision to purchase health insurance, known as the Minimum Essential Coverage Provision—falls under that clause and thus new federal rules are "in direct conflict" with the 2010 Virginia Health Care Freedom Act, Hudson concluded in his decision [pdf].

Many of those who support the health care law‘s insurance provision point to the increased use of primary and preventive care among people who have affordable health insurance. And many studies have pointed to primary care as a way to overcome key disparities in health care—as well as reduce ballooning medical costs over the coming years.

Some 20 states are involved in a separate lawsuit currently pending in Florida, the Richmond Times-Dispatch reported. And two other U.S. District cases—from Michigan and previously from Lynchburg, Va.—have sided with the federal government’s right to require most Americans to obtain health insurance or face a penalty, NPR noted.

The case ruled upon Monday was brought against the government by Virginia Republican Attorney General Kenneth Cuccinelli. Hudson noted in his decision that the government’s case "holds the weaker hand." He emphasized, however, he is not opining on "the wisdom of Congress or the public policy implications of the [Affordable Care Act]," but rather "solely on the constitutionality of the enactment." He declined a request for an injunction that would further halt the Act’s implementation.

The issue is expected to wind up in the U.S. Supreme Court in the next couple years, The New York Times reported. The ruling is not expected to have an immediate effect on the Affordable Care Act, as many of the provisions are not set to take effect until 2014. Nevertheless, "you might see some air taken out of the balloon nationwide," Jason Helgerson, the Medicaid director in Wisconsin, told the Times about the push for broader health insurance coverage.

Image courtesy of iStockphoto/alexskopje





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  1. 1. c100lan 7:53 am 12/14/2010

    How much will it take to administer, enforce and litigate on an annual basis if this law holds up in the supreme court? Is this supposed to reduce healthcare costs? Staff HealthcareReviews.com

    Link to this
  2. 2. hsr0601 8:16 am 12/14/2010

    The Republicans are the ultimate hypocrites!

    How do we pay for health care reform ?

    ** How do you pay for tax cuts for the wealthy ?

    1. First attempt : threatening Social Security and Medicare Cut through the deficit panel.

    2. Second attempt : holding the desperate Hostage, say, by the Ransom.

    ** Inaction cost, $9trillion over the next decade, ((Some of CBO analysis : While the costs of the financial bailouts and economic stimulus bills are staggering, they are only a fraction of the coming costs from Social Security, Medicare, and Medicaid. Over the next decade, the Congressional Budget Office (CBO) projects that each year Medicaid will expand by 7 percent, Medicare by 6 percent, and Social Security by 5 percent. These programs face a 75-year shortfall of $43 trillion–60 times greater than the gross cost of the $700 billion TARP financial bailout)).

    Over the duration of healthcare debate, using the preliminary cost analysis of CBO, the reps opposed the public option stubbornly, but after the release of final score, they have been defiant on the referee.

    The nonpartisan Congressional Budget Office estimates that :
    Inaction cost in relation to health care reform totals $9trillion over the next decade.
    Reform will reduce the federal deficit by $143 billion over the next 10 years and as much as $1 trillion during the following decade.

    Link to this
  3. 3. JamesDavis 8:18 am 12/14/2010

    Giving credit where credit is due… The forced purchase of health care from a private insurer is part of the republican agenda. The republicans said that they would "stall" the bill forever without that clause. Removing the public option from the health care bill is also a republican move. They said that option would take jobs away from the private sector and put private insurers out of business because private insurers cannot compete with a government ran health care policy that provides health care for poor people and they would "stall" the bill if it is left in. 36 million people in America cannot afford to purchase health insurance from a private insurer because of their high premiums and high deductibles – it is out of reach of the common person and without the public option in the health care bill that would provide affordable health insurance to people who cannot afford to purchase from a private insurer, those 36 million people will still be without health insurance and with the forced purchase from a private insurer those people will now be fined for not having health care insurance.

    As soon as the health care bill left the house, private health care insurance companies skyrocketed their premiums and deductibles where the uninsured could not but insurance from them because the uninsured are the ones who always have preexisting conditions and the insurance companies do not want those preexisting sick people biting into their profits.

    If you are going to force people by law to have health care insurance, you have to provide a way for those people to afford health insurance. Put the "public option" back in the health care bill and that will solve the problem. Take the part out of the bill where it says you have to purchase from a private insurer and the whole mess is solved. With the public option, the uninsured can pool their purchase of health care insurance and the ones who need health care can use it and afford it.

    The republicans do not have the interest of America or the interest of the American people in mind, but their own "defeat the "Obamacare" at any cost agenda and they are hurting America.

    Link to this
  4. 4. sparcboy 3:41 pm 12/14/2010

    FYI…the CBO, by law, can only use numbers supplied to it by Congress. Congress supplies the CBO with numbers it needs to get the answer Congress wants.

    CBO data is worthless.

    Medicare cost many more times than the CBO originally predicted. It currently has many trillions of dollars in unfunded liability, as does Social Security. Obamacare will be no different.

    Regardless of ones opinion on Obamacare, the bill, as written is unconstitutional.

    Link to this

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