South Dakota and 25 other states won their challenge to the new health care reform law Monday when a Florida judge said Congress cannot force individuals to buy health insurance.
The ruling sets up a legal appeal but also intensifies the debate about how far the government may reach into private lives.
“There is a point where Congress overreaches its authority,” Attorney General Marty Jackley said. “Today, at least on a federal level, a judge has said the individual mandate went too far.”
The Florida ruling, by U.S. District Judge Roger Vinson in Pensacola, strikes what would be an essential source of money to pay for the reform package Congress passed last March. But it’s only the latest twist in the events now reshaping government’s role in health care.
“All of this will ultimately be decided by the U.S. Supreme Court. Until that happens, the rest of this is just theater,” said Dave Hewett, president of the South Dakota Association of Healthcare Organizations.
Four judges now have ruled on the law – two for and two against. Congress also is split. The House of Representatives, with its new Republican majority, voted in January to repeal the law. Democrats leading the Senate are ignoring the House action.
Monday’s ruling only sets up the inevitable, Hewett said.
“People can keep score, but it will ultimately depend on how the nine justices on the Supreme Court vote,” he said.
The health bill would require all Americans to carry health insurance by 2014 or face a penalty. Most Americans already have insurance, including coverage under group plans with their employers. But millions do not, including many healthy young adults who see no need for it. They would be forced to buy coverage at perhaps $2,000 to $3,000 a year and thus help pay for medical care for people in poorer health. Advocates on both sides call the individual mandate the linchpin to the entire reform package.
“If we do not have a large population of folks with insurance coverage, it’s unsustainable,” said Sam Wilson, associate state director for advocacy for AARP in South Dakota.
Congress has authority to regulate interstate economic activity, but the issue pivots on whether Congress also has power to regulate inactivity such as a disinterest in buying insurance.
“This case is not about whether the act is wise or unwise legislation, or whether it will solve or exacerbate the myriad problems in our health care system,” Judge Vinson said, according to court papers. “In fact, it is not really about our health care system at all. It is principally about our federalist system, and it raises very important issues regarding the constitutional role of the federal government.”
Jackley has budgeted $25,000 for South Dakota’s role in the suit but predicted last year that actual costs would not reach $1,000. He said Monday the cost to South Dakota has been more like “$200 and change,” for expenses the 26 states have shared for witnesses and copying services. He was ready to testify by video hookup from Pierre at a December hearing, but that proved unnecessary, he said.
The issue divides South Dakotans. In Congress, Republican Rep. Kristi Noem voted last month for repeal. “The health care law should have never been passed in the first place … and now the courts are exposing the law’s unconstitutionality,” she said Monday.
Republican Sen. John Thune said: “I applaud today’s federal court ruling declaring the new health care law unconstitutional. South Dakotans should not face financial penalties for making personal health care decisions.”
Democratic Sen. Tim Johnson has supported reform. “This ruling is not the final word on this issue,” he said. “Two other federal judges have issued rulings upholding the constitutionality of the individual responsibility provision, and this matter could potentially end up before the Supreme Court.”
The law phases in over several years, with certain benefits already in place. “We expect the Supreme Court will make the final decision. Until that time, we’ll treat it as the law of the land,” Wilson said.
Jackley said striking the individual mandate should force Congress to take a different approach.
“I like certain portions of the health care bill … but it’s not up to attorneys general and the courts to determine what a health bill should look like. My focus has always been has it gone too far at the expense of states’ and individuals’ rights,” he said.