Iowa reaction to ruling striking down health insurance reform

U.S. District Court Judge Roger Vinson struck down last year’s health insurance reform law yesterday, backing the lawsuit filed by Florida’s attorney general and joined by 25 other states. Vinson’s 78-page opinion can be read in full here. David Kopel summarized the key points at the Volokh Conspiracy blog:

1. The 26 states lose on the argument that the mandate for drastically increased state spending under Medicaid is unconstitutional. State participation in Medicaid always has been voluntary, and remains so. […]

2. The plaintiffs win on the individual mandate. The individuals plaintiffs, and the National Federation of Independent Businesses have standing to challenge the mandate. So do Utah and Idaho, at the least, because of state statutes forbidding health insurance mandates. According to original meaning, “commerce” was trade. Citation to Randy Barnett. Even the modern precedents require “activity” as a predicate for commerce clause regulation.[…]

3. Necessary & proper does not save the mandate. […]

4. The mandate is not severable from the health control act. Defendants themselves have argued forcefully that the mandate is absolutely essential to the entire regulatory scheme. There is no severability clause. The mandate is tightly integrated into the entire act. […]

6. The entire act is declared void. […] Of course the 11th Circuit might grant a stay, and Judge Vinson might also do so, but as of right now, there is no stay.

The White House immediately made clear that the federal government will continue to implement the Affordable Care Act. I would be shocked if the U.S. Court of Appeals doesn’t grant a stay of Vinson’s ruling, especially since two other U.S. district court judges ruled last year that the individual mandate is constitutional. Vinson’s ruling went further than U.S. District Court Judge Henry Hudson’s decision in December, which struck down the federal requirement that individuals purchase health insurance but let the rest of the law stand. Click here for links to numerous reactions to Vinson’s ruling. Legal analyst Ilya Somin finds the judge’s reasoning persuasive, while Orin Kerr argues that Vinson erred by going against precedent (Supreme court case law). Dave Weigel explains how Congressional Democrats failed to include a standard severability clause in this legislation. Brian Beutler notes that U.S. Supreme Court Chief Justice John Roberts (one of the most conservative members of the high court) recently struck down a single provision of a law that lacked a severability clause.

Representative Steve King (IA-05), a champion of efforts to repeal health insurance reform, was jubilant about yesterday’s news: “Many of us opposed ObamaCare in part because of our oath to the Constitution. Any member who had reservations should now be empowered to vote with those of us who will cut off all funding to ObamaCare starting with the continuing resolution.” The full text of King’s press release is after the jump.

Iowa State Senator Jack Hatch blasted Vinson’s “blatant judicial overreach” and expressed confidence that courts will ultimately uphold the federal law. Hatch chairs the Working Group of State Legislators for Health Reform and joined more than 70 state lawmakers who filed a “friend of the court” brief in the Florida case supporting the constitutionality of the law. The full press release from Progressive States Network and the Working Group of State Legislators for Health Reform is after the jump.

Senators Tom Harkin and Chuck Grassley didn’t release any statement on Vinson’s ruling, which surprised me, since both quickly reacted to Hudson’s ruling against the individual mandate in December. Yesterday Harkin publicized the first in a series of Senate HELP Committee hearings about “the tangible, positive impact that [health insurance] reform is having on Americans’ lives.”

Governor Terry Branstad joined the plaintiffs in the Florida lawsuit two weeks ago (disregarding Iowa Attorney General Tom Miller’s opinion). I was surprised not to see any statement from the Branstad administration on Judge Vinson’s ruling yesterday. I will update this post with further Iowa reaction as it becomes available.

UPDATE: Through the governor’s Twitter account, Branstad’s communications director Tim Albrecht said released this statement:

“This health care law is clearly not sustainable nor is it affordable for the long-term. I believe it would be appropriate for both parties to start over and advance a plan that is more workable.”

When I asked how questions about whether the law is sustainable or affordable related to the constitutional matters at hand (judge rejecting argument against Medicaid expansion but accepting case against individual mandate), Albrecht added, “The governor continues to believe the individual mandate is unconstitutional.” To my knowledge, Branstad has not publicly acknowledged that a few years ago he supported a state mandate to purchase health insurance.

Steve King press release of January 31:

Washington D.C.- Congressman Steve King (R-IA) released the following statement after United States District Court Judge Roger Vinson struck down ObamaCare in its entirety. Vinson ruled today that the “individual mandate” provision of the law is unconstitutional and that since it cannot be severed from the rest of the law, the entire act must fall.

“Two weeks ago, the House of Representatives passed language I authored repealing ObamaCare ‘as if such act had not been enacted,’ and now Judge Vinson has similarly ruled that the entire act must be struck down,” said King. “Today’s ruling is important not only because it backs up the earlier decision in Virginia declaring the ‘individual mandate’ to be unconstitutional, but also because it goes one step further by declaring all of ObamaCare to be void. Many of us opposed ObamaCare in part because of our oath to the Constitution. Any member who had reservations should now be empowered to vote with those of us who will cut off all funding to ObamaCare starting with the continuing resolution.”

Progressive States Network press release of January 31:

STATEMENT: PROGRESSIVE STATE LEGISLATORS BLAST “JUDICIAL OVERREACH” OF FLORIDA HEALTH CARE RULING

New York, NY – Today, leaders representing Progressive States Network and the Working Group of State Legislators for Health Reform issued the following statements in reaction to the ruling of U.S. District Judge Roger Vinson in Florida:

“Today’s ruling was not unexpected, but is still terribly distressing to millions of American families who are seeing their health security threatened by this kind of blatant judicial overreach,” said State Senator Jack Hatch (IA), Chair of the Working Group of State Legislators for Health Reform. “Despite the conflicting opinions that have been issued in lower courts in recent weeks and months, we remain very confident that the health care law will ultimately be judged constitutional, that Americans will continue to be protected from insurance company abuses and that our states’ health care systems will be strengthened.”

“This ruling puts us one step closer to the Supreme Court, where this issue will ultimately be resolved,” said State Representative Garnet Coleman (TX), Chair of the Board of Progressive States Network. “Through this lawsuit, right-wing Attorneys General have been actively working to dismantle a law that is improving health coverage for families in all 50 states and is helping countless others afford coverage. State lawmakers in every region of the country agree that the law will ultimately stand up in court, which is why they are now working on implementing the Affordable Care Act in almost every state. Progressive state lawmakers in particular remain focused this year on improving the health security of families in our states through implementing strong state health exchanges.”

In November 2010, a group of over 75 state lawmakers from 27 states working with Progressive States Network and the Constitutional Accountability Center filed a “Friend of the Court” brief defending the constitutionality of the health care law — specifically against one claim by the plaintiffs that the law violated state sovereignty in requiring states to pay for a share of the Medicaid expansion scheduled for 2014. Today’s opinion by Judge Vinson acknowledged that this provision was indeed constitutional.

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  • Conservatives should be careful

    what they wish for. The reality is, any kind of meaningful insurance reform that relies on the private insurance market must have a mandate of some sort – assuming the goal is to get to something that’s even close to “universal” coverage. – If the mandate is ruled unconstitutional, all meaningful insurance reform options are much more socialist in nature (single payer, Medicare for all, etc.).

    • And naturally

      we should not forget that this whole private insurance solution with a mandate was very much a Republican idea.

    • you are assuming

      they care about solving the problems. If the law is struck down, they won’t try to pass something that gets us to universal coverage. They will respond with their usual wish list of tort reform, selling insurance across state lines and other things that will make a bad situation worse.

      It is hard for me to imagine Congress passing single-payer in my lifetime. A Medicare expansion (say, for people over 50 or over 55) is only possible if the insurance industry decides it’s better to dump those people onto state plans.

      • You are absolutely right

        about people not being interested in solving the problems and covering all people. I’m really thinking of this as a possible silver lining way down the line. Probably 15-20 years at a minimum, as things would really need to get bad for people to get serious about another major reform effort. (That’s why I think the health care victory was a big deal, even with all its flaws and inadequacies.) On the other hand, as my better half often points out, things could change very quickly if we were to have some sort of a major pandemic that could be blamed on 40-50 million people going without insurance and preventive care. Not an implausible scenario.

      • Single payer

        A year or two ago I wrote our two senators and my (Demo) representative, telling each of them that my preference was for them to produce nothing other than a simple single-payer system. No opt-outs, no loopholes, no nothing except that all medical business in America be billed and paid with a single payer. I added that I expected the single payer to be my Uncle Sam.

        I received zilch recognition from old chuckie for my effort. It’s as if he never received it.

        Harkin’s office sent me a boilerplate response that was better than ol chuckies only because they at least did it.

        My representative sent me a very nice note with the usual platitudes of course, but then went on to tell me in some detail, that there was no support for single payer and that it was not going to be happening.

        I know/knew as much before writing, but at least all three of their staffs got to learn that at least one constituant is in favor of SP.

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