While the seemingly endless health insurance reform debate ostensibly ended last Tuesday when President Obama signed reform legislation into law, opponents of the new law immediately initiated a campaign to repeal the legislation. The debate will not be disappearing any time soon, as the law will undergo a variety of political and legal challenges before the majority of its provisions are fully implemented in 2014.
The crux of the legal case against the health reform law is the
individual mandate, requiring nearly every American to buy insurance.
Opponents claim the mandate is a violation of the U.S. Constitution’s commerce clause.
The key question is whether the commerce clause allows Congress to
require individuals to purchase a product, in this case, health
insurance. Senator Jeff Sessions (R-AL), the senior Republican on the Senate Judiciary Committee, said the mandate raises “very serious constitutional questions.”
Top legal officials from fourteen states have filed lawsuits challenging the legislation on that basis. More than 250 people rallied in Alabama on Tuesday as well, calling for amendments to their state constitution to supersede the federal requirement. Virginia already has such a law: Virginia attorney general Ken Cuccinelli filed a separate suit that attacked health reforms, arguing that the law’s requirement that most Americans buy health coverage conflicted with an existing state law that exempts Virginia residents from federal fines to be imposed for not owning health insurance.
Florida’s attorney general, Bill McCollum, is leading the larger effort. In an interview with PBS, McCollum stated that “the freedoms of Americans, and particularly in my state of Florida, were impaired by this bill. And it forces people to do something in the sense of buying a health care policy, or pay a penalty, a tax or a fine, that simply, the Constitution doesn’t allow Congress to do.” The suit asks the trial court to declare that the federal government is violating the sovereignty of the states and to bar federal agencies from enforcing the new law.
When President Lyndon B. Johnson signed the Medicare program into law 45 years ago, it faced strong opposition from the states, in some cases because it required racial integration of publicly funded hospitals. As PBS notes, those challenges failed, and numerous analyses in the past week state that these lawsuits will fare no better. Robert Gibbs, the White House press secretary, stated “For many decades, the Supreme Court has recognized Congress’s authority, under the Commerce Clause, to regulate activities relating to interstate commerce. My advice from counsel is that we will win these – we will win these lawsuits.”
There has of course been defense of the reform law and pushback from within some state governments. Michigan governor Jennifer Granholm thinks opposition is drawn from lack of knowledge and understanding of what is in the complicated bill. In Louisiana, state representative Cedric Richmond is wary of taking away new health benefits or funding a long legal battle when state budgets are already tight: “Why don’t we let our Louisiana citizens start to benefit from this legislation?”
The bottom line? Health insurance reform is now law. Putting the plan into action will still be no easy task even though most legal experts agree that McCollum and the other state officials’ arguments are unlikely to prevail in the courts. Ultimately more than 30 million more Americans will have health insurance coverage, and insurance will be more accessible and more affordable nationwide. Decades of failed attempts at reform testify to the difficulty of this task; this law is a victory for the American people.