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Appeals court strikes health insurance requirement

Fri Aug 12, 2011 1:35 PM EDT
us-news, business, health, us, barack-obama, supreme-court, overhaul
Greg Bluestein, Associated Press
< PreviousNext >
showing 1 of 2 photos
<p>FILE - In this March 23, 2010 file photo, President Barack Obama signs the health care bill in the East Room of the White House in Washington. A federal appeals court panel struck down the requirement in President Barack Obama's health care overhaul package that virtually all Americans must carry health care insurance or face penalties. (AP Photo/J. Scott Applewhite, File)</p>

FILE - In this March 23, 2010 file photo, President Barack Obama signs the health care bill in the East Room of the White House in Washington. A federal appeals court panel struck down the requirement in President Barack Obama's health care overhaul package that virtually all Americans must carry health care insurance or face penalties. (AP Photo/J. Scott Applewhite, File)

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ATLANTA — A federal appeals panel's ruling striking down the centerpiece of President Barack Obama's health care overhaul moves the question of whether Americans can be required to buy health insurance a step closer to the U.S. Supreme Court.

A divided three-judge panel of the 11th Circuit Court of Appeals ruled Friday that Congress overstepped its authority when lawmakers passed the so-called individual mandate, the first such decision by a federal appeals court. It's a stinging blow to Obama's signature legislative achievement, as many experts agree the requirement that Americans carry health insurance — or face tax penalties — is the foundation for other parts of the law and key to paying for it.

Administration officials said they are confident the ruling will not stand. The Justice Department can ask the full 11th Circuit to review the panel's ruling and will also likely appeal to the Supreme Court.

Legal observers long expected the case would ultimately land in the high court, but experts said Friday's ruling could finally force the justices to take the case.

"There needs to be a pronouncement that's nationwide," said Carl Tobias, a professor at the University of Richmond School of Law. "It would be almost impossible to implement it if we have splintered decisions from different geographic circuits. The Supreme Court may feel now it has to take it."

J. Peter Rich, a Los Angeles-based health care attorney, said the Supreme Court had never weighed in on an issue such as the provision requiring individuals to buy health insurance.

"They have never ruled on this specific issue," he said. "This really is a case of first impression, although the Obama administration may try to argue otherwise."

Rich said it's not unconstitutional for individual states to have such requirements, noting that Massachusetts has a similar law in place. However, the high court has yet to weigh in on whether a federal requirement passes muster.

In the Atlanta ruling, Chief Judge Joel Dubina and Circuit Judge Frank Hull found in a 207-page opinion that lawmakers cannot require people to "enter into contracts with private insurance companies for the purchase of an expensive product from the time they are born until the time they die."

In a lengthy dissent, Circuit Judge Stanley Marcus accused the majority of ignoring the "undeniable fact that Congress' commerce power has grown exponentially over the past two centuries." He wrote that Congress generally has the constitutional authority to create rules regulating large areas of the national economy.

Dubina was tapped by former President George H.W. Bush, a Republican, while Hull and Marcus were picks of former Democratic President Bill Clinton.

The White House argued the legislative branch was using a "quintessential" power — its constitutional ability to regulate interstate commerce, including the health care industry — when it passed the overhaul law.

"Individuals who choose to go without health insurance are making an economic decision that affects all of us — when people without insurance obtain health care they cannot pay for, those with insurance and taxpayers are often left to pick up the tab," said White House adviser Stephanie Cutter.

The 11th Circuit's ruling, which sided with 26 states that had sued to stop the law from taking effect, is the latest contradictory judicial opinion on the health care debate. The federal appeals court in Cincinnati upheld the individual mandate in June, and an appeals court in Richmond has heard similar challenges to the law. Several lower court judges have also issued differing opinions on the debate.

It's the latest hit the president's taken in what's been a rough month that's included humiliating blows on both the economy and in Afghanistan, while polls show deteriorating public support for both him and Congress.

Obama has been criticized by his Democratic base for his failures, which include dropping his push for tax increases as part of last week's compromise to raise the government's debt ceiling and his inability to let the Bush tax cuts for the wealthy to expire at the end of last year.

The Atlanta-based court is considered by many observers to be the most pivotal legal battleground yet because it reviewed a sweeping ruling by U.S. District Judge Roger Vinson, a Republican appointee from Florida who not only struck down the individual mandate but threw out other provisions ranging from Medicare discounts for some seniors to a change that allows adult children up to age 26 to remain on their parents' coverage.

His reasoning was that the insurance requirement was "inextricably bound together" with the rest of the law, but the 11th Circuit concluded Vinson went too far. The panel's ruling noted that the "lion's share of the act has nothing to do with private insurance, much less the mandate that individuals buy insurance."

The provision requiring all Americans to carry health insurance or face a tax penalty has been at the center of the legal debate. The law does not allow insurers to turn away the sick or charge them outrageous premiums. To cover their health care costs, others — particularly the young and healthy — will need to pay premiums to keep costs from skyrocketing. The potential tax penalties are meant to ensure they will do so.

The Obama Administration also has a little-known fallback if it loses the court battle. The government can borrow a strategy that Medicare uses to compel consumers to sign up for insurance.

Medicare's "Part B" coverage for doctor visits carries its own monthly premium. Yet more than nine in 10 seniors sign up. The reason: Those who opt out when they first become eligible face a lifelong tax penalty that escalates the longer they wait.

The key difference is that the Medicare law doesn't require that seniors buy the Part B coverage. Experts say Obama's overhaul could also be changed in a similar fashion.

The challenging states had urged the 11th Circuit to uphold Vinson's ruling, saying in a court filing that letting the law stand would set a troubling precedent that "would imperil individual liberty, render Congress's other enumerated powers superfluous, and allow Congress to usurp the general police power reserved to the states."

The Justice Department countered that Congress had the power to require most people to buy health insurance or face tax penalties because Congress can regulate businesses that operate across state lines, including health care providers.

The reaction was swift and celebratory from the states that filed the lawsuit.

Michigan Attorney General Bill Schuette called the decision a "huge victory in the fight to protect the freedom of American citizens from the long arm of the federal government." Alabama Attorney General Luther Strange called it a "monumental case" for individual liberty. And Texas Attorney General Greg Abbott declared: "'Obamacare' is closer to an end."

Florida Attorney General Pam Bondi issued a statement late Friday declaring that states had "prevailed in preventing Congress from infringing on the individual liberty protected by the U.S. Constitution."

A separate legal ruling Friday also buoyed critics of the law. The Ohio Supreme Court appeared to clear the way for voters there to decide whether to reject parts of the health care law in November with a unanimous ruling that rejected a liberal policy group's challenge of the so-called Health Care Freedom Amendment.

But the administration did get a small dose of good news Friday. The federal appeals court in San Francisco found that a former California lawmaker and a legal foundation could not file another challenge on the overhaul.

The 11th Circuit's ruling didn't come as a complete surprise. During oral arguments in June, each of the three judges repeatedly raised questions about the overhaul and expressed unease with the insurance requirement. And each judge worried aloud if upholding the landmark law could open the door to Congress adopting other sweeping economic mandates.

The arguments took place in what's considered one of the nation's most conservative appeals courts, but the randomly selected panel represents different judicial perspectives.

None of the three is considered either a stalwart conservative or an unfaltering liberal, but observers were quick to point out that the decisive vote came from a Democrat appointee: Hull, a former federal judge in Atlanta.

___

Associated Press Writer Ricardo Alonso-Zaldivar in Washington contributed to this report.

___

Bluestein can be reached at http://www.twitter.com/bluestein

© 2011 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed.
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  • Public Discussion (26)
AmericanMOM-598098

The individual mandate is unconstitutional. Forcing USA citizens to buy any product or service is unconstitutional. Possibly, if there was a public option attached, forcing the insurance/medical/pharmaceutical industry to better serve the people; it would have been Constitutional. This particular part of the healthcare program could be interpreted as an attempt to prop up the insurance industry. Insurance companies are almost like a union for the medical and pharmaceutical industries; except there are no opportunities for negotiation on a public forum. If medical cost were made more affordable, the consumer could deal directly with their doctor. Not only would this give the doctor more options, but the patient as well. I want the freedom to choose my doctor and the plan of treatment when needed. How many more of our freedoms will be taken away because of the policies of our "corporate owned politicians"?

  • 4 votes
Reply#1 - Fri Aug 12, 2011 2:32 PM EDT
snarky68

Forcing USA citizens to buy any product or service

That is bad enough, but then they will fine you if you dont! Nothing more than blackmail!

  • 5 votes
#1.1 - Fri Aug 12, 2011 4:12 PM EDT
zeropointfield

No argument here AmericanMOM.

  • 2 votes
#1.2 - Fri Aug 12, 2011 6:45 PM EDT
Reply
dmarrow

It seems funny that it is unconstitutional for the US government to make all American have health insurance or pay a penalty when Massachusetts requires all residents to have health insurance or pay a penalty on their state taxes. Why is it legal in Massachusetts. If the country has socialized medicine we would not have these problems because the government would regulate the prices that could be paid. People say that our health care would suffer, you would wait hours to be seen by a doctor in an emergency room. Well I don't know about other Americans but I know I already wait hours in an emergency room and that is with insurance. I have worked with numerous people who have lived in countries where they have socialized medicine and never hear complaints from people who have actually used it, not those in the US who just do so called research but actual people,when they compare it to American medical services. Everyone is treated as as equal because they receive the same amount of money whether you are rich or poor. Massachusetts also regulates auto insurance and it makes a big difference. Living in AZ now where it is not regulated by the government and if one is not carefull or does not realize they have to really shop all insurance companies the insurance companies will take you for a ride. In MA you do not have to worry you will pay the same for the same insurance from any company with exception of the extra services the insurance company provides, such as you never having to go to the MVD unless you have to take a test or have your picture taken. It is a lot better for the consumer.

    Reply#2 - Fri Aug 12, 2011 3:54 PM EDT
    ArizonaBill

    dmarrow,,,Have you ever thought about maybe just returning to your "good life" in Massachusetts ?

    That way you would not have to endure all these "Freedoms" that we in Arizona so richly enjoy.

    • 5 votes
    #2.1 - Fri Aug 12, 2011 5:09 PM EDT
    zeropointfield

    My wife and I have blue cross/blue shield. I would not like to see socialized medicine in this country.  The level of care I now receive (when I need to go) would decline substantially.  My coverage is wonderful and I pick my doctor.  Socialized medicine provides universal coverage but at a cost of the quality of coverage.   Here is a quote from an article I read about the Canadian system of health care.

    The failure of Canada's experiment with socialist medicine is readily apparent: long waiting lists and wait times for specialized services, conveyor-belt treatment for routine services, chronic shortages of family doctors and hospital beds, gross inefficiencies, slow innovation, stifling and wasteful bureaucracies, warring 'special-interest' groups, and the exodus of good doctors to greener, freer pastures.

    I have no personal knowledge if this is true or not because I don't live in Canada (although I would love to visit). From the articles I have read,however, things do not look good there.

    • 2 votes
    #2.2 - Fri Aug 12, 2011 6:57 PM EDT
    leeman1525

    Zero

    Could you provide the link i would like to read it? I would love to have a nation health care system in the US. I understand that Canada has a few problems with their system; but we have many problems with ours, for example 45,000 people die each year in the US from a lack of medical care. We spend more per capita then any country and get less care for it. We now have the advantage of seeing what works in other countries and incorporating the best from every system for our own. If a country is having problems we can fix them ourselves. Our current system is unsustainable over the long term.

    • 1 vote
    #2.3 - Fri Aug 12, 2011 7:33 PM EDT
    zeropointfield

    Sure. Here it is.

    http://www.capitalismmagazine.com/science/healthcare/4618-canada-s-healthcare-system-is-bad-medicine.html

    I think one solution is in making what we already have more efficient. I can only say that the health care I have received over my life time has been excellent. I prefer being able to keep the health insurance I have. I would not want the level of my medical care to decline with socialized medicine. I do not believe the health care system in Canada is an example of what works.

    • 2 votes
    #2.4 - Fri Aug 12, 2011 9:57 PM EDT
    leeman1525

    The care that i received in the US is fine, but the problem is i know of several people that cannot afford health insurance. I don't think that you level of care would decline with a "socialized system" If you look at world ranking the US is 37th. This was in 2000, the last time the report was done. Since 2000 the US has more people with no insurance, so the ranking may have changed. All of the countries above the US in health also have a socialized system, so your fear of medical care decline is not reasonable.

    http://www.photius.com/rankings/healthranks.html

    • 1 vote
    #2.5 - Fri Aug 12, 2011 11:38 PM EDT
    zeropointfield

    If we had socialized health care in the US would it cost less than I am paying now. Do you think that I could have the ease of access to doctors, facilities, and treatment I have now? Would I be able to chose my own doctors like I can now?

    • 2 votes
    #2.6 - Sat Aug 13, 2011 12:07 AM EDT
    leeman1525

    Countries that have socialized medical do pay less. All of the ones that i looked at lets you pick your own doctor without worrying about your insurance company. The treatment you get now is influenced by the insurance companies, they stand between you and your doctor. I was at my doctors office and before he started the test he had to go call the insurance company to get approval. In countries with socialized medicine it is just the doctors and the patient making most of the decisions.

    • 2 votes
    #2.7 - Sat Aug 13, 2011 1:04 AM EDT
    zeropointfield

    If that is true I am prepared to be open minded about this.

    • 2 votes
    #2.8 - Sat Aug 13, 2011 2:44 AM EDT
    Reply
    ArizonaBill

    Time for Obama to realized he is not the "Dictator" of America!

    If he wants to be a Dictator of a Country I would suggest he return home to Kenya.

    Oh yeah that's right they said they didn't want him and even took down the statue of him that some nut put up.

    • 4 votes
    Reply#3 - Fri Aug 12, 2011 4:59 PM EDT
    smallstuff

    ArizonaBill would you say the same thing about FDR and his Social Security Program signed into law in 1935 and Lyndon Baines Johnson's Medicare Program signed into law in 1965?

    I guess those two programs are different?

    Guess who got the first and second Medicare Identification Cards issued? Give up?

    Harry and Bess Truman.

    Real Socialists Thugs huh?

      #3.1 - Fri Aug 12, 2011 6:18 PM EDT
      Reply
      drbacon

      This will undoubtedly end up in the supreme court. With the justices that are sitting on the bench now, which way do you think this will go?

      • 1 vote
      Reply#4 - Fri Aug 12, 2011 5:58 PM EDT
      zeropointfield

      5 to 4 in favor of the states. Obamacare is essentially dead. Without the mandate the entire program fails.

      • 4 votes
      #4.1 - Fri Aug 12, 2011 7:01 PM EDT
      smallstuff

      Not true. This appeals court decision was merely on the point of the Health Care Legislation Bill being legally required for all to participate in or face penalty. No different than the federal law mandating your participation in Social Security and Medicare with penalty for failure to do so under federal law.

      The H.C. B. can still be passed in a modified format, no problem.

        #4.2 - Sat Aug 13, 2011 4:09 PM EDT
        Reply
        smallstuff

        As fellow poster dmarrow above points out about Massachusetts law on mandatory health care would this then not also call into question the federal law requiring participation in Social Security and Medicare by payroll deduction? And I am sure if I were able to block those withdraws from my payroll check I would face a federal criminal case.

          Reply#5 - Fri Aug 12, 2011 6:13 PM EDT
          VinedujourDeleted
          Roger-287Deleted
          Forest Sinclair

          I am not an expert on these issues but it DOES smack as unconstitutional to require Americans to buy something. How can we live in a free market society and be forced to buy something?! It's oxymoronic.

          • 3 votes
          Reply#8 - Fri Aug 12, 2011 9:47 PM EDT
          smallstuff

          Forest Sinclair- You are forced by law to participate in Social Security, Medicare, Medicade and pay for Social Services and Unemployment Insurance? Can you define the difference for me? Are they too not of a Socialist nature? Are they not programs forced upon you by wage deduction by the federal government? Are they not programs that you, as an individual may NOT even qualify to participate in but are forced to pay in to?

          • 1 vote
          #8.1 - Sun Aug 14, 2011 6:33 AM EDT
          drbacon

          This health care bill will probably end up going the same road as social security has as well. I worked hard for years and forced into paying into social security and now my check is a mere pittance. There hasn't even been a raise since Obama was elected. We need a wide sweeping social reform bill that includes health care and retirement assistance. But I'm afraid that what we would end up with is wide sweeping "socialist" reform.

            #8.2 - Sun Aug 14, 2011 9:19 AM EDT
            Reply
            AmericanMOM-598098

            You can avoid paying into the Social Security and Medicaid programs: Contract labor is reported on a 1099 instead of a W-2; people making over $106,000 per year have the option to opt out. Of course, people with that type of income generally have a benefit package.

            The main problems with our healthcaresystem as it currently operates is generated by the middle man; the insurance company. Keeping in mind that this industry is nothing tangible, and if you take care of yourself and are basically healthy, you're really loosing money. Then there is the "fine print" that many people are not aware of until something drastic happens and they need to use the insurance they thought they were paying into for such an occasion...just in case. It's basically the same with medicaid. Why do we keep feeding the money machine? Because medical care is something that just about everyone uses, and they are given the freedom to charge outrageously for it. Medical cost will remain high as long as the insurance companies can justify their policies and rates. The government encourages people to use medical services. For instance, in order to enroll your child in public school; they must have had their full series of shots. If no insurance orlow income, the government has programs available to pay for them. I don't know the number required to be considered an epidemic, but that is another example. It's really a "two sided coin". On one side, you have the government encouraging (some cases insisting passively) people to be vaccinated in order to prevent it from spreading, which sounds good in theory. The other side of it is; people will be congregated at clinics and hospitals possibly spreading it even further; only to receive an inoculation that know one really knows for sure what effects may develop in people. Why do other countries pay less on medical cost than the USA? If they are not receiving quality health care; why are many of the top professionals in their field from countries other than the USA? You can get a better return on your money putting it in a savings account; even with today's interest rates. Long gone are the days when an average person's insurance consisted of tangible investments, money hid in a mattress or buried, or just the history of being "good for your word". It gave too much control to the individual. Look at how much medication this country uses! Zombie Nation? If the elected officials would; for once, "step up" for the people and come up with solutions other than supporting an industry that brought our country, they said, to the brink of financial ruin in 2008.

            • 3 votes
            Reply#9 - Sat Aug 13, 2011 12:32 AM EDT
            O' Really

            AmericanMoM.. It is reasonable persons like you and I whose voices are needed in developing policy in the USA. I envy your thinking on this matter.

            Though three generations of my family have been supportive of Democratic values I must tell you about the wisdom of my grand father to me over 55 years ago. He stated to me, " Son when you become old enough to vote never vote for the incumbent but vote for change" This message rings so true today! Our career politicians, both R & D are ruining our nation. Now the Teabags are so ideological in their views nothing gets accomplished. I voted for "change" in 2008 and look what has ensued. I do not blame the POTUS but long standing career politicians in our Congress are bought and paid for.

            Yes we needed healthcare reform, but not the bat @!$%# crazy bill Nancy Pelosi forced upon us. "Have to pass it to know what is in it" Dah! The many legal challenges we are aware of certainly in my opinion are valid concerns.

            • 2 votes
            #9.1 - Sat Aug 13, 2011 5:16 AM EDT
            drbacon

            I agree with you and I think your grandfather was a wise man. But sometimes I wonder if it's health care reform we need or insurance reform. Or perhaps just reform the Medicare system.

              #9.2 - Sat Aug 13, 2011 9:45 AM EDT
              Reply
              smallstuff

              Lets look at it this way. The statistics say that there are 46 milllion Americans without any for os healthcare protection at all.

              The total population of The United States is estimated by Cencus to be 311,975,000 people. Taking that those figures are somewhere accurate, then we are talking about 14.74% of the US population that cannot afford healthcare or receive medical treatment for even the most basic forms of need.

              For the life of me, knowing how much money gets wasted in just military spending alone cannot understand why we cannot devise a way that these poor unfortunates can not be insured or cared for in their time of need medically.

              I am just baffled by the math that it cannot be done. I am for Universal Healthcare. I was NOT for the mandatory participation clause nor the penalty clause. However nearly all of us participate in Social Security and Medicare that is forced upon us with a penalty clause and yet the likes of Eric Cantor-R Virginia and John Boehner-R Ohio want us to continue to pay into those progras yet receive less and less each year even if you live long enough to qualify for newly touted dispersal ages.

              • 2 votes
              Reply#10 - Sun Aug 14, 2011 6:43 AM EDT
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