Health care bill under review

Health care bill under review

It's high noon at the high court as the justices wrestle with the legal questions raised by President Obama's national health care reform bill.

The atmosphere Monday at the U.S. Supreme Court was rife with possibilities, but the justices devoted themselves to narrow procedural issues surrounding the 2,700 page Obamacare bill — whether the core issues it raises should be addressed now or in a couple of years.

The consensus among court watchers is that the justices appeared almost unanimously in agreement that this issue should be quickly resolved. So over the next two days, the justices will hear arguments about the meat of the issues surrounding Obamacare — whether the individual mandate that requires all Americans to buy health insurance is constitutional, whether the entire bill should be struck down if the mandate is stricken because it lacks a severability clause and whether the federal government has exceeded its authority by ordering the states to vastly expand their Medicaid rolls as part of Obamacare.

Public opinion polls in recent weeks indicate that Obamacare, particularly the health insurance mandate, is extremely unpopular with voters. But it's Congress, located across the street from the high court, where public opinion drives policy. All that's supposed to matter in the Supreme Court is the law.

Consequently, the arguments surrounding the mandate will focus solely on whether the legal requirement ordered by Congress exceeds its authority under the U.S. Constitution's commerce clause.

Supporters of the mandate say it is a reasonable expansion of federal authority justified by the need to address a national goal — expanding health insurance coverage to as many Americans as possible. But opponents contend this proposed expansion of federal authority is without limit. They say it is not so much about regulating interstate commerce as it is about compelling people not otherwise inclined to do so to participate in interstate commerce.

While supporters contend that the health mandate reflects a rare use of federal authority, opponents claim it would open the door to allowing the government to order people to engage in all kinds of conduct the government deems beneficial.

The court, of course, has heard many cases involving the limits of the commerce clause, but none involving a law that would allow the federal government so much unbridled authority over so many people. That's why the public policy consequences of this case are enormous.

Following arguments on the mandate, the court will hear more arguments on whether the entire bill should be stricken if the mandate is deemed unconstitutional. Supporters of the law say that stripping the mandate from the bill leaves it a mere shell, but the fact is that the legislation contains hundreds of pages requiring the federal government to take action not directly related to the health mandate.

This issue relates to what is known as severability clause, a common legislative tool that states the legislature's intent to see the rest of the bill remain law even if one provision is declared unconstitutional. Incredibly, Congress passed Obamacare without a severability clause, a gaffe that prompted one lower court judge to order the entire bill be struck down because of its absence.

One final issue is the federal government's requirement that states vastly expand their Medicaid rolls to cover people unable to obtain insurance under the new law. This is a question of the limits of federal authority in a federal/state system under which states establish their own requirements for enrollment in Medicaid, a health insurance program for low-income people.

This issue has profound financial implications for states like Illinois. Already effectively bankrupt because of costly programs like Medicaid, the state will face dire financial consequences if it is forced to expand an already costly program as the federal government has ordered.

Under Obamacare, the federal government would pay for the expansion requirement for a couple of years but then it would force states to pick up new costs.

The high court has scheduled an unprecedented three days of oral arguments to consider these issues, and it's been deluged with roughly 140 friend-of-the-court briefs from interested parties. A ruling is expected sometime in June — right in the middle of the presidential election campaign. Whatever the court decides, the consequences will be enormous.

Sections (2):Editorials, Opinion
Categories (2):Editorials, Opinions

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