I intended to write something on the health care reform decision yesterday. I read the opinion, but it seems no one knows what the decision actually means. I’d sure like to know whether people in 26 states just lost the protections that are already in place, but I suppose I’ll have to wait until we can decipher the message in the opinion throwing the whole law out, so I’ll hold off.
In trying to determine what the judge in Florida ordered (and failing) I kept running across paragraphs like this one, in the New York Times:
The ruling by Judge Vinson, a senior judge who was appointed by President Ronald Reagan, solidified the divide in the health litigation among judges named by Republicans and those named by Democrats. In December, Judge Henry E. Hudson of Federal District Court in Richmond, Va., who was appointed by President George W. Bush, became the first to invalidate the insurance mandate. Two other federal judges named by President Bill Clinton, a Democrat, have upheld the law.
Which got me thinking. What are the names of the two federal judges who upheld the law? Why did they uphold the law? Where are the excerpts from their opinions upholding the law? Why are we only hearing from two judges, when there are four?
Two federal judges determined that the law was constitutional. One federal judge ruled that the mandate was unconstitutional and the other threw the whole thing out.
Two for to two against. But, the conservative argument on the Commerce Clause has absolutely dominated the public debate, to the exclusion of all else.
I’d like to hear from the judges who went the other way.
The district court rejected this claim and upheld the minimum coverage provision as a valid exercise of Congress’s Commerce Clause power. The court rejected the premise of that argument, explaining that the “decision whether to purchase insurance or to attempt to pay for health care out of pocket, is plainly economic.” The court explained that these decisions, “viewed in the aggregate, have clear and direct impacts on health care providers, taxpayers, and the insured population who ultimately pay for the care provided to those who go without insurance.
The court emphasized that “[t]he health care market is unlike other markets. No one can guarantee his or her health, or ensure that he or she will never participate in the health care market. Thus, [t]he question is how participants in the health care market pay for medical expenses — through insurance, or through an attempt to pay out of pocket with a backstop of uncompensated care funded by third parties. Far from ‘inactivity,’ 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. [P]laintiffs in this case are participants in the health care services market, and they have made a choice regarding the method of payment for the services they expect to receive. How participants in the health care services market pay for such services has a documented impact on interstate commerce, and this market reality forms the rational basis for Congressional action designed to reduce the number of uninsureds.
This part is interesting. I haven’ t seen it before, anywhere:
The uninsured, like plaintiffs, benefit from the ‘guaranteed issue’ provision in the Act, which enables them to become insured even when they are already sick. Without the minimum coverage provision, there would be an incentive for some individuals to wait to purchase health insurance until they needed care, knowing that insurance would be available at all times. As a result, the most costly individuals would be in the insurance system and the least costly would be outside it. In turn, this would aggravate current problems with cost-shifting and lead to even higher premiums.
I knew that people who are uninsured benefit from the national guarantee of emergency hospital care when they need care and can’t pay for it. What I hadn’t read anywhere was an explanation of the direct benefit that flows from guaranteed issue. Everyone will receive access to health insurance when and if they need it, whether they purchase it while they’re healthy, or after they get sick. That guarantee has value.
We’re hearing from the advocates who are in favor of overturning the law, the judges that found the law unconstitutional, and the Obama Administration.
Seems like there’s a glaring omission there.
Commenter SB Jules adds this:
Harris and the Democratic attorneys general of Connecticut, Delaware, Hawaii, Iowa, Maryland, New York, Oregon and Vermont planned to file their friend-of-the-court brief with the Cincinnati-based 6th U.S. Circuit Court of Appeals in the case brought by Thomas More Law Center. The lawsuit challenges the constitutionality of the law’s mandate that most people maintain a minimum level of health insurance coverage or else pay a tax penalty.
It might be nice if we were informed that there are states actively defending the law.