Tuesday, February 22, 2011

The Constitution and Your Health Care

Opponents of the new health care law are trying to stop it by any means necessary. A number of states have filed objections to the law on constitutional grounds, and a number of courts have handed down a number of conflicting rulings.

Today, a federal district judge in Virginia ruled that a part of the law is unconstitutional. This is the first federal court to do so, according to the New York Times. Two other federal judges had already found the same part of the law to be constitutional. So, off to appeals court it goes. No doubt eventually the Supreme Court will have to decide.

The part of the law being challenged is crucial to providing affordable health insurance for most of us, especially for Americans old enough to have “pre-existing conditions” but not old enough to be on Medicare. This is the requirement, to go into effect in 2014, that most Americans obtain health insurance.

Why is this important? Also beginning in 2014, private insurance companies will no longer be able to refuse to insure someone because of a pre-existing condition. This means younger, healthier people can simply wait to purchase health insurance until they get sick or injured.

Or, people can simply not buy insurance and not pay their bills, either, and then doctors and hospitals must pad everyone else’s bills to make up the lost revenue. This is a big reason health care costs keep going up. As insurance costs go up, people are priced out of buying insurance, and then when they can’t pay medical bills, insurance costs go up more.

By the time we reach 50, nearly all of us have “pre-existing conditions.” Some of  those conditions can be devastating –  mesothelioma, for example, is rarely diagnosed in patients younger than 50.  But if the only people in the insurance risk pool are older, or sicker, than means the cost of insurance will go up. It also means that the cost of medical care for uninsured people will be made up by padding other peoples’ medical bills.

The legal question of the legal case rests on an interpretation of the “commerce clause.” The U.S. Constitution gives to Congress the power to regulate commerce “among the several States.” The question is, does that clause give Congress the power to require individual citizens to purchase something, such as health insurance?

Very basically, previous court decisions have ruled that Congress can regulate just about any commercial activity that has a substantial effect on interstate commerce. The Justice Department argues that when people choose to not purchase health insurance, these decisions, in aggregate, shift billions of dollars in uncompensated care costs to taxpayers, hospitals, and those who do pay for their own health insurance. So, such decisions have a big impact on commerce.

Two other federal judges have agreed with the Justice Department. But the Virginia judge decided that the Constitution does not give Congress the power to tell people to buy something. The controversy continues.

This entry was posted on Monday, December 13th, 2010 at 3:16 pm and is filed under Uncategorized. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.


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