Iowa reaction to federal ruling against health insurance mandate

U.S. District Court Judge Henry Hudson ruled today that the individual mandate to purchase health insurance is unconstitutional. The mandate, scheduled to go into effect in 2014, is a key provision in the Patient Protection and Affordability Act, which President Barack Obama signed in March. The mandate creates a guaranteed increased market for private insurers in exchange for new regulations, such as ending discrimination based on pre-existing conditions. Most of the two dozen lawsuits filed against the federal health insurance reform law have challenged the individual mandate. Judges dismissed several of those cases earlier this year, but Virginia Attorney General Ken Cuccinelli found a somewhat sympathetic ear in Judge Hudson, who wrote, “No specifically constitutional authority exists to mandate the purchase of health insurance. […] Salutatory goals and creative drafting have never been sufficient to offset an absence of enumerated powers.”

Hudson arguably should have recused himself from this case, since he owns a significant share in the Republican consulting firm Campaign Solutions, Inc. That firm has worked against health care reform and for various Republicans, including Cuccinelli. But in fairness to Hudson, he rejected the plaintiff’s call to strike down the entire health insurance reform law, or to issue an injunction against implementing that law. In any event, legal challenges to the mandate are bound to work their way up to the U.S. Supreme Court one way or another. (The Justice Department will appeal Hudson’s ruling.)

Senator Chuck Grassley’s office released this statement:

As Ranking Member of the Senate Committee on Finance, in 2008 and 2009, Senator Grassley participated in the bipartisan effort for health care reform that could secure support across the political spectrum.  In September 2009, that effort was thwarted by Democratic leaders in Washington.  From 2007 through 2009, there was a rigorous debate over the individual mandate.  President Obama staunchly opposed it as a candidate for President.  The concerns he raised then became more clear as the reform debate unfolded, including enforcement.  Health insurance companies lobbied for the mandate, which drives billions of tax dollars in new subsidies directly to them.

Senator Grassley’s comment:

“The nonpartisan Congressional Research Service called requiring people to buy a good or service or be penalized a ‘novel issue,’ and now a federal court has ruled it unconstitutional.  The ruling is likely to be appealed, but it’s a clear signal that the constitutionality of the law, which was moved through Congress with a lot of controversy and partisanship, isn’t as certain as its supporters have argued.”

Hmmm, something seems to be missing from that statement. Oh, now I remember: Grassley supported an individual health insurance mandate in 1993 and 2007, and said in June 2009 that “there is a bipartisan consensus [in Congress] to have individual mandates.”

Senator Tom Harkin, a key author of the health insurance reform law, didn’t think much of the judge’s reasoning:

“On the merits, the Virginia Attorney General’s suit is clearly wrong.  When people seek medical care without health insurance and don’t pay for it, they aren’t ‘opting out’ of the health care market.  Instead, it adds more than $1,000 per year to the premiums of American families who act responsibly by having coverage.  This clearly affects interstate commerce and is thus within Congress’ power to regulate.  

“Two federal courts in Michigan and Virginia have already dismissed similar cases, and the Virginia court should have followed their lead.  I’m confident that the appellate courts and the Supreme Court will find the Affordable Care Act constitutional and in doing so, ensure that Americans keep crucial new protections against the unfair practices of insurance companies.”

I will update this post as other Iowa politicians comment on Hudson’s ruling.

UPDATE: From Representative Steve King, a leading Republican advocate of repealing the health insurance reform:

“With Judge Hanson’s decision, a federal court has now ruled in accordance with what I have always said – Obamacare’s requirement that Americans purchase health insurance or pay a fine is unconstitutional. Obamacare’s ‘individual mandate’ always restd on the absurd premise that the Commerce Clause empowered the federal government to regulate Americans’ decisions not to engage in commercial activity… With the ‘individual mandate’ that lies at the heart of the legislation ruled unconstitutional, the badly-flawed Obamacare law is now completely dysfunctional, further accelerating the need for Congress to repeal it.”

Governor-elect Terry Branstad hasn’t commented on this lawsuit, but he announced today that Brenna Findley will be his legal counsel. Findley was King’s chief of staff for seven years before running unsuccessfully for Iowa attorney general. She made challenging health insurance reform (specifically the individual mandate) a major issue in her campaign. Branstad promoted her candidacy at virtually every campaign stop and appeared in one of Findley’s television commercials.  

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desmoinesdem

  • In the very long term,

    a Supreme Court rejection of the mandate could be the only possible way to achieve a single-payer or some other truly public health care system.  Without any reform, 15-20 years down the line our current system could be such a mess that there could be political will for true reform.  Some sort of a mandate is probably necessary for any market-based universal healthcare solution.  But if the mandate is rejected by the courts, then a true public system could be the only way to achieve meaningful reform.

    I know this is a very unlikely scenario.  But one can always dream.

    • a more likely outcome

      is that striking down the individual mandate would prompt the federal government not to enforce any of the new regulations on insurance companies, because our government exists to protect the profits of corporate interest groups, as opposed to people with chronic health conditions.

      The administration acknowledges that if the insurance requirement falls before taking effect in 2014, related changes would necessarily collapse with it, most notably provisions that would prevent insurers from denying coverage to those with pre-existing conditions or charging them discriminatory rates.

      But officials said other innovations, including a vast expansion of Medicaid eligibility and the sale of subsidized insurance policies through state-based exchanges, would withstand even a Supreme Court ruling against the insurance mandate.

      Seeing a Democratic-controlled Congress on the verge of passing what will amount to a permanent extension of all Bush tax cuts, I am not up to dreaming about any future progress on any issue. I think I need to find a new hobby.

      • I think you are much more likely

        to be right on this one.  Mine is more like the ultimate be-careful-what-you-wish-for scenario for health reform opponents.  But, I do think that in the very long term and if no meaningful change happens, our current health system will become such a financial and public health monstrosity (even worse than what it is now) that it will collapse from within.  

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