DOJ Lodges First Defense of Health Care Law with High Court

January 6, 2012

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.”

The DOJ continues, “The act breaks the cycle through a comprehensive framework of economic regulation and incentives that will improve the functioning of the national market for health care by regulating the terms on which insurance is offered, controlling costs and rationalizing the timing and method of payment for health care services.”

In the fall, the Supreme Court announced it would review the constitutionality of the law. The high court has set aside three days of oral argument in March. The justices will also consider whether a federal tax law prevents the court from considering the constitutionality of the law until after the law is fully in effect and whether the law’s expansion of Medicaid is permissible.

A week before the high court announced it would review challenges to the law, the U.S. Court of Appeals for the District of Columbia ruled in favor of the law’s minimum coverage provision (or the individual mandate). Judge Laurence H. Silberman, a Reagan appointee, concluded, in part, “The right to be free from federal regulation is not absolute, and yields to the imperative that Congress be free to forge national solutions to national problems, no matter how local – or seemingly passive – their individual origins.”

For more on the constitutionality of the health care law, see this ACS Issue Brief by Simon Lazarus, the public policy counsel for the National Senior Citizens Law Center. More analysis of Judge Silberman’s opinion is here.