The improbable has happened. Healthcare reform, the legislation that US presidents have been unable to enact for decades, has finally passed. On March 23, 2010, a bill authorizing healthcare for all Americans was signed into law by our 44th President. While most Americans are scrambling to figure out whether this bill will be a benefit or a burden, the opposition to reform is scrambling to institute Plan B - challenging the constitutionality of the new law in court. The larger stack of evidence demonstrates that the law is constitutional. This leads me to ask, is this last ditch attempt to cut down universal health coverage really in the best interest of the American people, or is this a bitter swan song sponsored by the healthcare industry, a clutch of disorientated citizens, and/or a handful of deposed politicos?
Attorneys General in 13 states have filed suit against the healthcare legislation. The suit contends that the federal government does not have the right to enforce an individual mandate - in other words, citizens cannot be compelled to purchase healthcare. Virginia Attorney General Ken Cuccinelli has said, "With this law, the federal government will force citizens to buy health insurance, claiming it has the authority to do so because of its power to regulate interstate commerce... We contend that if a person decides not to buy health insurance, that person - by definition - is not engaging in commerce, and therefore, is not subject to a federal mandate." Virginia has filed suit separately because Virginia already has an anti-individual mandate law already on the books.
The logic behind these lawsuits is flawed for several reasons. First, the law does not actually require all individuals to purchase insurance. The mandate does not apply to dependents, persons receiving Medicare or Medicaid, military families, persons living overseas, persons with religious objections, or persons who already get health insurance from their employers under a qualified plan. Another way to look at this so-called mandate is that it is a tax, which people would not have to pay if they purchased health insurance. Article 1, Section 8 of the Constitution allows, "The Congress shall have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defense and general welfare of the United States; but all duties, imposts and excises shall be uniform throughout the United States." This is commonly interpreted as the Constitution giving Congress broad power to tax Americans, the individual mandate could easily be viewed as a tax serving the general welfare. Similarly, Americans pay into the social security and Medicare systems.
The argument that there is no precedent for government to order private citizens to do business with a private company is also false. States often require those who buy cars or homes to purchase insurance. In addition, the argument that Americans who choose not to have insurance aren't involving themselves in the nation's commerce is flawed. As Simon Lazarus has pointed out, people without insurance use healthcare services, and the tab is often paid by the rest of us, federal and state taxpayers. In fact, people who fail to get private insurance cost the government more than the new law requires them to pay. So this isn't a bad deal for them. It's paying part of their tab.
Historically, people that loose a battle in Congress often seek to continue their fight in U.S. courts. For example, people opposed to the regulation of child labor sued, arguing that legislating whether children could be put to work or not was beyond the power of the federal government. Franklin Roosevelt's New Deal also met with a storm of lawsuits. In the 1960's, after all manner of protests and angry speeches, Senator Strom Thurmond and many others went to court to oppose the Civil Rights Act and the Voting Rights Act. Still, both the Civil Rights Act and the Voting Rights Act remain as U.S. law.
Perhaps this attempt by the opponents of reform is the nature of the beast. Ultimately, it will be up to the courts to decide whether or not the United States steps forward or slides backward. May justice win.
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