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Affordable Care Act ‘Ultimately Will Be Upheld in Its Entirety’

By Ron Pollack,


This blog was originally posted on the Huffington Post.

There’s encouraging news out of Atlanta today for all Americans. The third hearing before the court of appeals left me feeling optimistic about the future of the Affordable Care Act.

But let’s start from the beginning. There have been approximately two dozen suits filed against the Affordable Care Act’s individual responsibility provision. All but two of the cases decided so far by federal district courts threw out those challenges, most on procedural grounds but several on the constitutional merits.

But Florida judge Roger Vinson, weighing in on a 26-state lawsuit against the new law, took his anti-health reform stance to the extreme. In February, he ruled that because he found the individual responsibility provision unconstitutional, the entire law should be thrown out with it.

Roger Vinson’s ruling is simply conservative judicial activism run amok. Long-standing judicial principles make clear that courts should deal with constitutional challenges as narrowly as possible — a principle Judge Vinson cited in his opinion and then did the exact opposite. Additionally, experts from both sides of the aisle have said his ruling goes too far.

Just a few days after Judge Vinson’s extreme ruling, the Obama administration appealed his decision, which leads us to round two: Arguments at the 11th circuit court in Atlanta, Georgia. And this morning, three judges heard oral arguments to determine whether Judge Vinson’s ruling can stand or whether it should be overturned.

The arguments put forward today by the federal government illustrate why the Affordable Care Act is both constitutional and good policy. As most courts have found, the individual responsibility provision challenged by the Attorneys General is easily within Congress’s constitutional commerce clause powers.

All three judges remarked at some point that health care is a “unique” part of commerce. And they’re right. Three aspects make it unlike any other part of the economy. First, everyone seeks health care — even when they don’t expect to (such as after an accident, heart attack, stroke, or other unexpected problem). Second, for those needing such care, it must be provided; hospitals and doctors can’t turn someone down who is at risk of losing life or limb. Third, when an uninsured person receives such care but cannot pay for it, this results in a direct and substantial cost shift to others with insurance — a premium add-on that averages over $1,000 for family coverage. This makes health care unique and — unlike a requirement to purchase any other product — makes it constitutionally appropriate for Congress to establish a personal responsibility provision.

It seems that the lawyer for the states even understands this fact. He conceded that Congress can require people to buy health insurance when they are at a hospital — but he said that they could not force someone to buy insurance before then. According to that logic, it’s just a timing thing.

The fact of the matter is the individual responsibility provision is good policy. It protects the overwhelming majority of Americans who have insurance. They will no longer have to pay higher premiums to cover the costs of caring for those who refuse to purchase insurance.

To throw out the entire law would do a great disservice to American families, who, for far too long, have been trapped in an unfair system. Thanks to the Affordable Care Act, children can no longer be denied access to insurance because they have a pre-existing condition. Seniors and people with disabilities can receive preventive care services free-of-charge. And insurance companies cannot arbitrarily jack up premiums just to increase their profit margin.

To suggest that Americans are better off without these new rights is ludicrous. Were the court to uphold the District Court’s decision striking down the entire law, it could have devastating consequences for America’s families.

After hearing today’s arguments, however, I am feeling optimistic that this court will reject the Attorneys’ General arguments in their entirety and leave the new law in place.

We’ve taken big strides forward with the Affordable Care Act, now is not the time to take a giant leap back.