Court Fight Over Health-Care Reform Shifts to
THURSDAY, Dec. 16 (HealthDay News) -- A federal judge in Florida
will start hearing arguments Thursday in the latest legal challenge
to the constitutionality of a key provision of the nation's new
health-care reform law -- that nearly all Americans must carry
health insurance or face a financial penalty.
On Monday, a federal judge in Virginia sided with that state's
attorney general, who contended that the insurance mandate violated
the Constitution, making it the first successful challenge to the
The dispute over the constitutionality of the insurance mandate
is similar to the arguments in about two dozen health-care reform
lawsuits that have been filed across the country. Besides the
Virginia case, two federal judges have upheld the law and 12 other
cases have been dismissed on technicalities, according to
What makes the Florida case different is that the lawsuit has
been filed on behalf of 20 states. It's also the first court
challenge to the new law's requirement that Medicaid be expanded to
cover Americans with incomes at or below 133 percent of the federal
poverty level (about $14,000 in 2010 for someone living alone).
That Medicaid expansion has unleashed a series of protests from
some states that contend the expansion will overwhelm their
ABC News reported.
The federal government is supposed to pick up much of the
Medicaid tab, paying $443.5 billion -- or 95.4 percent of the total
cost -- between 2014 and 2019, according to an analysis by the
non-partisan Kaiser Family Foundation, the news network
The Florida lawsuit has been filed by attorneys general and
governors in 20 states -- all but one represented by Republicans --
as well as the National Federation of Independent Business, an
advocacy group for small businesses,
The federal government contends that Congress was within its
legal rights when it passed President Barack Obama's signature
legislative goal in March.
But the battle over the law, which has pitted 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 predict.
During an interview with a Tampa, Fla., TV station on Monday,
after the Virginia judge's decision, 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
"You've got one judge who disagreed," he said. "That's the nature of these things."
Earlier Monday, the 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.
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
By 2019, the law, unless changed, will expand health insurance
access to 94 percent of non-elderly Americans.
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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