The Washington Post
Twenty states are squaring off against the Obama administration on Tuesday in a lawsuit seeking to nullify the sweeping new health-care law.
The suit - originally filed by Florida Attorney General Bill McCollum (R) and the Republican attorneys general of 12 other states within hours of the law's adoption last March - quickly became the most prominent of several pending legal challenges as seven more states signed on. Two individuals and the National Federation of Independent Business, a small-business association that lobbied vigorously against the law, have also joined. (Virginia has filed a separate lawsuit that awaits a judge's decision on whether it can move forward.) The lawyers will make their case before a federal judge in Pensacola, Fla.
In addition to Florida, the states now party to the multi-state suit are South Carolina, Nebraska, Texas, Utah, Louisiana, Alabama, Michigan, Colorado, Pennsylvania, Washington, Idaho, South Dakota, Indiana, North Dakota, Mississippi, Arizona, Nevada, Georgia and Alaska.
Technically, Tuesday's oral arguments presented to Judge Roger Vinson of the U.S. District Court for the Northern District of Florida will be limited to the government's argument that the case should be dismissed because neither the states nor the other parties have standing to pursue it. But the lawyers are also bound to clash over the question at the heart of the suit: Does the new health-care law violate the Constitution?
In particular the states argue that Congress exceeded its constitutional authority by requiring that virtually all Americans obtain health insurance or pay a tax penalty.
For instance, although the Constitution grants Congress power to regulate interstate commerce, attorneys for the states argued in legal briefs that the failure to buy insurance in the first place is a form of "inactivity" that "by its nature cannot be deemed to be in commerce."
Indeed, "to do so would arm Congress with unbridled top-down control over virtually every aspect of persons' lives." And the attorneys contend there is absolutely no legal precedent for regulating such "inactivity."
The Obama administration has countered that because "virtually everyone at some point needs medical services," choosing not to purchase insurance is merely a decision on whether to pay for those services in advance through insurance, or later, out of pocket. Either way it's an economic decision that falls within the scope of the commerce the law seeks to regulate.
The administration further argues that because the uninsured generally cannot be turned away from emergency rooms, they often end up passing on a substantial share of the cost of their care to third parties - hospitals and local governments, for example. Americans who wait until they are older and sicker to get insurance also end driving up premiums for everyone else by skewing the risk pool toward the unhealthy.
Unless the risk is spread evenly, it would also be impossible for insurers to comply with the law's requirements that they cease practices such as discriminating against people with preexisting conditions. So the administration argues that the requirement that everyone obtain minimum insurance "forms an essential part of a comprehensive interrelated regulatory scheme" well within the scope of Congress's power.
Also at issue is the law's expansion of the eligibility requirements for Medicaid to include low-income individuals on top of the poorest of the poor. Although the federal government will initially fund the entire cost of the newly eligible, by 2020 states will have to foot 10 percent of the bill - an amount that Florida predicts will reach more than $1 billion annually.
Medicaid is a voluntary program. If states don't wish to spend the extra money necessary to expand coverage, they can simply pull out. However, the states argue that because doing so would force them to give up a huge cash infusion from the federal government and leave millions of their poorest citizens without insurance, the government has them over a barrel. Therefore, they are effectively being coerced to increase their spending - a violation of their sovereignty under the Constitution.
Administration attorneys have countered that this line of reasoning would make it impossible for Congress to make any changes to Medicaid - and they point to court decisions that have upheld such changes in the past.
The courtroom drama comes as polls suggest Americans remain profoundly ambivalent about the health-care law.
But efforts to overturn the law might also be politically fraught: Notwithstanding his highly publicized leadership role in the suit, McCollum's bid for Florida's governorship was cut short in GOP primaries last month.
The suit - originally filed by Florida Attorney General Bill McCollum (R) and the Republican attorneys general of 12 other states within hours of the law's adoption last March - quickly became the most prominent of several pending legal challenges as seven more states signed on. Two individuals and the National Federation of Independent Business, a small-business association that lobbied vigorously against the law, have also joined. (Virginia has filed a separate lawsuit that awaits a judge's decision on whether it can move forward.) The lawyers will make their case before a federal judge in Pensacola, Fla.
In addition to Florida, the states now party to the multi-state suit are South Carolina, Nebraska, Texas, Utah, Louisiana, Alabama, Michigan, Colorado, Pennsylvania, Washington, Idaho, South Dakota, Indiana, North Dakota, Mississippi, Arizona, Nevada, Georgia and Alaska.
Technically, Tuesday's oral arguments presented to Judge Roger Vinson of the U.S. District Court for the Northern District of Florida will be limited to the government's argument that the case should be dismissed because neither the states nor the other parties have standing to pursue it. But the lawyers are also bound to clash over the question at the heart of the suit: Does the new health-care law violate the Constitution?
In particular the states argue that Congress exceeded its constitutional authority by requiring that virtually all Americans obtain health insurance or pay a tax penalty.
For instance, although the Constitution grants Congress power to regulate interstate commerce, attorneys for the states argued in legal briefs that the failure to buy insurance in the first place is a form of "inactivity" that "by its nature cannot be deemed to be in commerce."
Indeed, "to do so would arm Congress with unbridled top-down control over virtually every aspect of persons' lives." And the attorneys contend there is absolutely no legal precedent for regulating such "inactivity."
The Obama administration has countered that because "virtually everyone at some point needs medical services," choosing not to purchase insurance is merely a decision on whether to pay for those services in advance through insurance, or later, out of pocket. Either way it's an economic decision that falls within the scope of the commerce the law seeks to regulate.
The administration further argues that because the uninsured generally cannot be turned away from emergency rooms, they often end up passing on a substantial share of the cost of their care to third parties - hospitals and local governments, for example. Americans who wait until they are older and sicker to get insurance also end driving up premiums for everyone else by skewing the risk pool toward the unhealthy.
Unless the risk is spread evenly, it would also be impossible for insurers to comply with the law's requirements that they cease practices such as discriminating against people with preexisting conditions. So the administration argues that the requirement that everyone obtain minimum insurance "forms an essential part of a comprehensive interrelated regulatory scheme" well within the scope of Congress's power.
Also at issue is the law's expansion of the eligibility requirements for Medicaid to include low-income individuals on top of the poorest of the poor. Although the federal government will initially fund the entire cost of the newly eligible, by 2020 states will have to foot 10 percent of the bill - an amount that Florida predicts will reach more than $1 billion annually.
Medicaid is a voluntary program. If states don't wish to spend the extra money necessary to expand coverage, they can simply pull out. However, the states argue that because doing so would force them to give up a huge cash infusion from the federal government and leave millions of their poorest citizens without insurance, the government has them over a barrel. Therefore, they are effectively being coerced to increase their spending - a violation of their sovereignty under the Constitution.
Administration attorneys have countered that this line of reasoning would make it impossible for Congress to make any changes to Medicaid - and they point to court decisions that have upheld such changes in the past.
The courtroom drama comes as polls suggest Americans remain profoundly ambivalent about the health-care law.
But efforts to overturn the law might also be politically fraught: Notwithstanding his highly publicized leadership role in the suit, McCollum's bid for Florida's governorship was cut short in GOP primaries last month.
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