Peltier column: Capital showdown for health care reform

MICHAEL PELTIER

— Combatants in the fight over national health care reform squared off last week in a federal court in the Florida panhandle, the latest battleground over national health insurance that will ultimately be decided by the U.S. Supreme Court.

Attorneys representing 20 states faced off with Department of Justice lawyers for the Obama administration over whether the president’s sweeping insurance package oversteps constitutional limits of federal power.

The states’ lawsuit claims the sweeping reform, pushed through by Obama’s fellow Democrats in the U.S. Congress after months of bitter partisan wrangling, violates state sovereignty and will force massive new spending on hard-pressed state governments.

The arguments came days after a federal judge in Virginia threw out a key component of the Affordable Care Act. In his ruling U.S. District Judge Henry Hudson said Congress did not have the power to require individuals to carry health insurance or face a fine.

Florida’s case includes a challenge to the individual mandate, but also charges that the expansion of Medicaid, which plaintiffs contend could add 18 million to the Medicaid roles — an increase by 30 percent — is an unconstitutional expansion of the federal/state program that will cost states billions more to put in place.

Though originally crafted as a voluntary program, attorneys for the states told U.S. District Judge Roger Vinson that Medicaid has become so large that states, in practical terms, have no alternative but to participate.

The federal program, which on average pays about 55 percent of Medicaid costs, now pumps $251 billion a year to the states, the largest single federal grant and aid program.

Attorneys for the federal government argued that Congress has been given the authority to regulate the parameters of the Medicaid program and who qualifies for coverage. Since its creation, the courts have never struck down expansions of the original safety net program.

The new health care law is a cornerstone of Obama’s domestic agenda and aims to expand health insurance for millions more Americans while curbing costs. Obama officials have insisted it is constitutional and necessary to stem huge projected increases in health care costs.

In regard to the individual mandate, plaintiffs contend that requiring individuals to obtain medical coverage would be a “radical interpretation” of federal powers by allowing individuals to be punished for not doing something.

Attorneys defending the federal plan counter that the nation’s $2.5 trillion health care market is unique in that unlike other economic decisions, participants receive health care whether they pay for it or not. By choosing not to fund their health care up front through insurance, individuals have acted by choosing to pay cash or rely on other taxpayers to finance their care.

Vinson repeatedly returned to what has become the central and most fundamental issue in the case — whether Congress can force individuals, in essence, to purchase a product or face penalties if they don’t.

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