Health-Care Reform Faces Long Legal Fight12/14/10
TUESDAY, Dec. 14 (HealthDay News) -- A federal judge's ruling
Monday that struck down a key component of the new U.S. health-care
reform law -- that nearly all Americans carry health insurance --
marks the first successful challenge to the controversial
But the battle over the law, which has pitted President Barack
Obama and fellow Democrats against Republicans, will continue to be
fought in the federal court system until it finally reaches the
U.S. Supreme Court, perhaps as early as next year, experts
Tuesday afternoon, the U.S. Justice Department said it planned
to appeal the decision to an appellate court,
Fox News reported.
During an interview with a Tampa, Fla., TV station on Monday,
Obama said: "Keep in mind this is one ruling by one federal
district court. We've already had two federal district courts that
have ruled that this is definitely constitutional."
"You've got one judge who disagreed. That's the nature of these things," he said.
Earlier Monday, a federal judge sitting in Richmond, Va., ruled
that the health-care legislation, signed into law by Obama in
March, was unconstitutional, saying the federal government has no
authority to require citizens to buy health insurance.
The ruling was made by U.S. District Judge Henry E. Hudson, a
Republican appointed by President George W. Bush who had seemed
sympathetic to the state of Virginia's case when oral arguments
were heard in October, the
Associated Press reported.
But as the
Washington Post noted, Hudson did not take two additional
steps that Virginia had requested. First, he ruled that the
unconstitutionality of the insurance-requirement mandate did not
affect the rest of the law. And he did not grant an injunction that
would have blocked the federal government's efforts to implement
White House officials had said last week that a negative ruling
would not affect the law's implementation because its major
provisions don't take effect until 2014.
Just two weeks ago, a federal judge in nearby Lynchburg, Va.,
upheld the constitutionality of the health insurance requirement,
The New York Times reported. "Far from 'inactivity,'" said
Judge Norman K. Moon, who was appointed by President Bill Clinton,
"by choosing to forgo insurance, plaintiffs are making an economic
decision to try to pay for health care services later, out of
pocket, rather than now, through the purchase of insurance." A
second federal judge appointed by Clinton, a Democrat, has upheld
the law as well, the
In the case decided Monday, Virginia Attorney General Kenneth
Cuccinelli, a Republican, had filed a lawsuit in defense of a new
Virginia law barring the federal government from requiring state
residents to buy health insurance. He argued that it was
unconstitutional for the federal law to force citizens to buy
health insurance and to assess a fine if they didn't.
The U.S. Justice Department said the insurance mandate falls
within the scope of the federal government's authority under the
Commerce Clause. But Cuccinelli said deciding not to buy insurance
was an economic matter outside the government's domain.
In his decision, Hudson agreed. "An individual's personal
decision to purchase -- or decline to purchase -- health insurance
from a private provider is beyond the historical reach of the
Commerce Clause," the judge said.
Jack M. Balkin, a professor of constitutional law at Yale
University who supports the constitutionality of the health-reform
package, told the
Times that "there are judges of different ideological views
throughout the federal judiciary."
Hudson seemed to reflect that reality when he wrote in his
opinion that "the final word will undoubtedly reside with a higher
Hudson's decision was not unexpected, and both supporters and
opponents of the legislation anticipate that its fate will be
decided by the Supreme Court.
Hudson became the first federal judge to strike down a key part
of the health law, which had been upheld by federal judges in
Virginia and Michigan. Several other lawsuits have been dismissed
and others are pending, including one filed in Florida by 20
states, according to the
By 2019, the law, unless changed, will expand health insurance
access to 94 percent of non-elderly Americans.
Advocates say that between now and then, the law will also
provide consumers with many new rights and protections.
Key provisions include:
- Health insurance plans may no longer deny coverage to adults
based on pre-existing health conditions. This provision is
scheduled to take effect in 2014.
- Health plans that cover dependents must permit children to stay
on a parent's family policy until age 26. This provision took
effect in September.
- Insurers may no longer place lifetime dollar limits on
essential benefits. This provision took effect in September.
- New health plans must offer preventive services such as
mammograms and colon cancer screenings without charging a
deductible, co-payment or coinsurance. This provision took effect
in September, but does not apply to existing plans that are
Reaction to the judge's ruling Monday was divided, with
opponents of the law pleased while backers were dismayed.
The mandate that consumers buy insurance or pay a penalty marked
the first time Americans have been required by the federal
government to purchase a commercial product, said Devon Herrick, a
senior fellow at the National Center for Policy Analysis in
Requiring people to carry insurance takes away an individual's
freedom of choice, he said, agreeing with the judge's decision to
strike down that provision of the law.
"According to the judge, this dispute is about an individual's right to choose to participate," Herrick said. "One reason why individual choice is important is that the health insurance policies individuals will be required to purchase are saddled with mandated benefits and mandated providers that drive up the cost of coverage," he added.
"Moreover, the cost of this mandated health coverage will grow at twice the rate of the nation's income. It doesn't make sense to require individuals to purchase a product they cannot afford and fine them when they fail to purchase it," he stated.
DeAnn Friedholm, director of Consumers Union's health reform
campaign, said: "This is a case that will likely wind up in the
Supreme Court, since other courts have ruled in favor of the new
health law. This law, while not perfect, finally protects American
consumers against the worst practices of the health insurance
industry. Until there is a final decision, we will continue to work
hard to educate consumers about what is really in the health law
and how they can get the best benefits from the system for their
family's health and pocketbook."
To learn more about the impact of the Affordable Care Act, visit
U.S. Department of Health and Human Services Web
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