Health Care Law

by Jeremy Leaming

The Supreme Court has set aside a large chunk of time later this month to hear argument over the constitutionality of the health care law’s integral provision, but the primary argument against the minimum coverage provisions has been loudly and repeatedly bandied about since the law’s enactment.

The law’s minimum coverage provision requires people who can afford it to obtain a minimum coverage of health insurance or pay a penalty when filing their income tax returns. It’s not the only provision being challenged by the states, but it is the one that has largely driven the right-wing argument that if the federal government can force some people to purchase health care insurance, there’s no limit to what Congress will be able to require individuals to purchase. (Maybe Congress will require everyone to purchase a gun, to protect their lives, from predators. While becoming a target of crime is obviously something that does and can happen anywhere in the world, it is not as certain as humans’ need for medical treatment due to many other causes, many natural.)

As noted on ACSblog numerous times, the liberty argument is not only wobbly, but hypocritical. A former U.S. Solicitor General Walter Dellinger noted at last year’s ACS Convention that many of the folks complaining about the minimum coverage provision are also supporters of laws requiring women to undergo sonograms and listen to propaganda from doctors before receiving an abortion.

In a March 7 piece for The Nation, Georgetown University law school professor and constitutional law expert David Cole provides, as usual for the professor, an accessible explanation about why the argument against the minimum coverage provision is unlikely to be invalidated by the high court.

Not only is the argument against the minimum coverage provision on flimsy ground, it’s also not conservative. The argument is, in reality, “radically libertarian,” Cole writes.

Cole states:

We’ve seen this kind of libertarian constitutional argument before. In the early twentieth century, after the Industrial Revolution had concentrated economic power in employers’ hands, Congress and the states passed many laws designed to protect workers from exploitation. Time and again, the Supreme Court invalidated these statutes. It deemed the federal laws beyond Congress’s power to regulate interstate commerce because they were said to regulate the terms of production, manufacture or mining, all of which were said to precede interstate commerce. And it invalidated state labor laws as infringements on the “freedom of contract” protected by the due process clause.

After the Depression, however, the court “overruled both lines of precedent it abandoned altogether the due process notion that economic regulation infringes on ‘freedom of contract,’” and “it has never since invalidated any law on that ground. And it ruled that in our integrated national economy, Congress is entitled to regulate on the presumption that all economic activity, not matter how local, affects interstate commerce.”

by Jeremy Leaming

The Obama administration’s signature domestic achievement, the Patient Protection and Affordable Care Act, which requires many people to purchase health care coverage in 2014, is a reasonable and constitutional means to provide millions of uninsured with health care coverage, the Department of Justice argues in a brief lodged today with the Supreme Court.

The brief “arguments track the Obama administration’s arguments before lower courts,” Brian Beutler reports for TPM, which also provides access to the 130-page document.

As Beutler notes, the DOJ explains why the law’s so-called individual mandate is a constitutional means to help millions of Americans afford health insurance. The law bars insurance companies from denying coverage or charging more to people who have pre-existing medical conditions. For that provision of the law to work, however, the law must require individuals who can afford health insurance to obtain minimum coverage or pay a penalty via their annual income tax returns.

The DOJ’s brief argues that the law is a permissible regulation under its constitutional authority to regulate commerce and its taxing power.

The federal government already regulates the health care market – Medicare and Medicaid are examples. However, millions of people, because of a lack of additional regulation have been unable to afford health care insurance or been denied it because of preexisting conditions.

The DOJ argues that the law’s so-called individual mandate will bridge the gap.

“The uninsured shift tens of billions of dollars of costs for the uncompensated care they receive to other market participants annually,” the brief states. “That cost-shifting drives up insurance premiums, which, in turn, makes insurance unaffordable to even more people.”