The Social Security Act, the Voting Rights Act, the Civil Rights Act and the Minimum Wage Act were all landmark laws that changed our country for the better. They secured essential freedoms for all Americans and improved our quality of life. All were initially struck down by lower court judges unwilling politically or unable intellectually to embrace the fact that our Constitution permits that kind of progress. An activist conservative lower court federal judge in Pensacola, Florida, has now made his contribution to this history.
U.S. District Judge Roger Vinson ruled this week that the Affordable Care Act's (ACA's) provision requiring most Americans to obtain private health insurance, or else face a modest tax penalty, was unconstitutional. He is the only judge to be so aggressively activist as to strike down the whole law. Like a Virginia judge, Judge Vinson found the law's "individual mandate" to be unconstitutional. The Virginia judge confined his ruling to that one issue and refused the invitation to void the whole law. Judge Vinson could not resist; he took the wild step of holding that the individual mandate was so intertwined with the rest of the law that it could not be "severed" from it, and so he invalidated the whole law. In the opinion, he does not note that eight of the nine titles of the law have nothing to do with the mandate. Essentially, he notes that the defense and members of Congress have stated that the individual mandate is "important" to the statutory scheme. If you say the mandate is so important, the court argues, then the whole law has to fall if it falls. Lame.
The Justice Department immediately announced that it plans to appeal the decision to the U.S. Court of Appeals for the 11th Circuit. The score in the cases challenging the law now stands as follows: two judges have upheld the individual mandate and two have ruled it unconstitutional, while in numerous other cases either provisions of the law have been upheld or the challenges have been dismissed. So far, judges appointed by Republican presidents have ruled consistently against the ACA, while Democratic judicial appointees have ruled for it. And in the most recent case, all but one of the state officials who filed suit are Republican.
At the heart of these lawsuits is the individual responsibility provision. This part of the ACA says that most individuals who can afford it will be required to obtain basic health insurance coverage or else pay a fee to help offset the cost of providing medical care to uninsured individuals. If affordable coverage is not available to an individual, he or she will be eligible for an exemption. The individual responsibility provision is an extremely important tool to help ensure that healthy people have health insurance policies, too; otherwise, only the sick or old may choose to have coverage, which would drive up costs for consumers and insurers alike. Every insured family pays an average of $1,000 more a year in premiums to cover the care of those who have no insurance, and the cost of uncompensated care was an estimated $43 billion in 2008.
In a side show in the case, Judge Vinson rejected a constitutional challenge to the part of the ACA that will expand Medicaid in 2014 to individuals with household incomes under 133 percent of the poverty level. The plaintiff state officials had argued that this expansion unlawfully imposes on their sovereignty; however, Judge Vincent held that there is no infringement because a state can choose whether to participate in the Medicaid program. But never mind, the Medicaid expansion falls with everything else under the judge's ultimate ruling.
Judge Vinson's ruling invalidating the whole law (as "un-severable" from the individual mandate provision) means that the state officials who are plaintiffs in the case are in an ambiguous position as to whether they will continue implementation activities in their states. They might gamble that the ruling of this fringe judge will hold up on appeal. Wisconsin officials, reacting to the ruling, have said that state will stop implementing the law (although at this writing they had begun backtracking on that position). That would be unfortunate for the people who live in Wisconsin and in any other state where a governor decides to exalt his or her ideology over the needs of the citizens that are being addressed by the ACA.
Americans--including lots of them who live in Wisconsin--cannot afford to lose the benefits already flowing from provisions of the Affordable Care Act that have nothing to do with the individual mandate, including discounts for seniors struggling with the cost of lifesaving prescriptions, tax credits for small businesses that need help to provide coverage for employees, protections for children who have pre-existing conditions, and coverage for young adults up to age 26.
In the midst of our nation's jobs crisis, Americans are counting on the Affordable Care Act to put them back in control of their own health care, stop insurance company abuses, and lower escalating health care costs. Judge Vinson and at least some of the state officials in the case have other priorities.