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Health Care Challenge Could Prevail

November 14th, 2010 No comments

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Home Page > Finance > Insurance > Health Care Challenge Could Prevail

Health Care Challenge Could Prevail

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Posted: Nov 08, 2010 |Comments: 0

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Health Care Challenge Could Prevail

By: Health Insurance

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Easy To Insure ME has the answers health insurance quotes / Health insurance quote / individual health insurance

(ArticlesBase SC #3628740)

Article Source: http://www.articlesbase.com/Health Care Challenge Could Prevail





When 21 states and several private groups initiated lawsuits challenging the constitutionality of the Obama health care law earlier this year, critics denounced the suits as frivolous political grandstanding. But it is increasingly clear that the plaintiffs have a serious case with a real chance of victory. Easy To Insure ME has the answers

The suits focus primarily on challenges to the new law’s “individual mandate,” which requires most American citizens to purchase a government-approved health insurance plan by 2014 or pay a fine. One of the cases was filed by 20 state governments and the National Federation of Independent Business in a federal court in Florida. Another was initiated by the Commonwealth of Virginia in a federal court in this state, and a third by the Thomas More Law Center in Michigan.

The judges considering the Florida and Virginia cases have both issued rulings rejecting the federal government’s motions to dismiss the suits and indicating that the mandate can’t be upheld based on current Supreme Court precedent. By contrast, Michigan district Judge George Caram Steeh wrote a decision concluding that the mandate is constitutional. But even he agreed that the case raises an “issue of first impression.”

In the most recent of the three rulings, Florida federal District Court Judge Roger Vinson wrote that the government’s claim that the mandate is clearly authorized by existing Supreme Court precedent is “not even a close call.” He points out that “[t]he power that the individual mandate seeks to harness is simply without prior precedent,” because no previous Supreme Court decision ever authorized Congress to force ordinary citizens to buy products they did not want.

An August ruling in the Virginia case by federal District Judge Henry Hudson reached the same conclusion. As Judge Hudson points out, “[n]o reported case from any federal appellate court” has ever ruled that Congress’ powers “include the regulation of a person’s decision not to purchase a product.”

The federal government claims that Congress has the power to impose the mandate under the Commerce Clause, the Necessary and Proper Clause, and the Tax Clause of the Constitution. On the first two claims, Judge Vinson ruled that Supreme Court precedent doesn’t clearly support the government, thereby enabling the plaintiffs’ lawsuit to go forward. He outright rejected the government’s claim that the mandate is constitutional because it is a “tax.” It is instead a financial penalty for refusing to comply with a federal regulation. As Judge Vinson pointed out, congressional leaders consistently emphasized before the law’s enactment that it was not a tax.

In September 2009, President Obama himself noted that “for us to say that you’ve got to take a responsibility to get health insurance is absolutely not a tax increase.” He was right. If the mandate qualifies as a tax merely because it punishes violators with a fine, then Congress could require Americans to do almost anything on pain of having to pay a fine if they refuse. It could, for example, force citizens to buy virtually any product, such as purchasing General Motors cars for the purpose of helping the struggling auto industry.

The government’s Commerce Clause argument is equally dubious. The Clause gives Congress authority to regulate “Commerce . . . among the several states.” But the individual mandate regulates that which is neither commercial nor interstate.

Virtually all purchases of health insurance are intrastate because a combination of state and federal law makes it illegal to purchase health insurance across state lines. Moreover, the object of the mandate isn’t even commerce at all. Instead of regulating pre-existing commerce, the bill forces people to engage in commercial transactions they would have otherwise avoided.

A series of flawed Supreme Court decisions have expanded Congress’ Commerce Clause authority well beyond what the text of the Constitution permits. These rulings allow the federal government to regulate almost any “economic activ ity.” But, as Judge Vinson emphasized, even they do not give Congress the power to regulate people “based solely on citizenship and on being alive.” Far from engaging in “economic activity,” people who decide not to purchase health insurance are actually refraining from doing so.

In his decision in the Michigan case, Judge Steeh argued that the mandate is constitutional under the Commerce Clause because deciding not to purchase health insurance is an “economic decision.”

“Economic decisions,” he reasoned, include decisions not to engage in economic activity. This approach would allow the Commerce Clause to cover virtually any choice of any kind. Any decision to do anything is necessarily a decision not to use the same time and effort to engage in “economic activity.”

If I choose to spend an hour sleeping, I necessarily choose not to spend that time working or buying products. Under Judge Steeh’s logic, the Commerce Clause authorizes Congress to force workers to get up earlier in the morning so that they would spend more time on the job.

Some defenders of the law claim that the individual mandate is similar to federal laws banning racial discrimination against customers by businesses such as motels and restaurants. But federal antidiscrimination laws apply only to existing businesses already engaged in commercial activity in the regulated industry. By contrast, uninsured individuals are not businesses and, by definition, are not participating in the insurance industry.

The federal government also argues that the mandate is authorized by the Necessary and Proper Clause, which gives Congress the power to “make all Laws which shall be necessary and proper for carrying into Execution” other powers Congress is granted by the Constitution.

Even if the mandate is “necessary,” it is not “proper” under our constitutional system of limited federal authority. If the Clause allows Congress to adopt the individual mandate, the same logic would justify almost any other requirement Congress might impose on individuals, thereby gutting the principle of limited federal power.

The legal battle over the mandate is far from over. The Florida and Virginia rulings are not final decisions. Both cases, as well as the Michigan decision, are sure to be appealed to the federal courts of appeals and, ultimately, the Supreme Court.

The anti-mandate plaintiffs still face an uphill struggle. Courts are rarely willing to strike down a law that is a centerpiece of the political agenda of the president and his party. Nonetheless, it is increasingly clear that lawsuits are far from “frivolous” and have a real chance to prevail.

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Health strategy could save W.Va. $1B

November 13th, 2010 No comments

Health strategy could save W.Va. $1B


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Home Page > Finance > Insurance > Health strategy could save W.Va. $1B

Health strategy could save W.Va. $1B

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Health strategy could save W.Va. $1B

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West Virginia’s health care system could save over $1.1 billion by going digital and centralizing patient care, according to a first-of-its-kind report presented to lawmakers Monday.

Those savings would be seen not just by government agencies, but by private insurers and policyholders, who could benefit directly in the form of lower premiums.

The report should lend urgency to some initiatives that have already begun, like electronic medical records and prescriptions, according to the groups behind its creation.

“It really is remarkable to consider the savings available from options that are, basically, low-hanging fruit,” said Perry Bryant, executive director of West Virginians for Affordable Health Care.

Lawmakers with a joint interim committee that oversees health care policy responded Monday with cautious praise for the report.

“I think it’s very positive, and certainly provocative,” said House Health and Human Resources Chairman Don Perdue, D-Wayne. “It’s gratifying to see that once again, West Virginia is ahead of the game.”

The estimates in the report, prepared by CCRC Actuaries for the West Virginia Health Care Authority, used insurance claims data from more than 800,000 West Virginia residents, including people in public plans like Medicaid and private plans like Mountain State Blue Cross Blue Shield.

Both the volume and the range of information make the report’s estimates uniquely valuable, Bryant said.

“I don’t know of any other state where private insurers have voluntarily pooled their data,” he said.

The three pieces of “low-hanging fruit” in the report are electronic prescribing, digital medical records and the so-called “medical home” concept of patient care, which prizes close relationships between patients and doctors to provide a broad spectrum of care.

West Virginia has already made steps to adopt these strategies, but the report’s estimates are based on their statewide implementation.

In the case of electronic prescriptions, the report estimates an overall savings of $164 million in 2014, including nearly $51 million in savings to private insurers and $42 million in savings to policyholders.After that, the fruit doesn’t hang quite so low. The report estimates that a statewide rollout of medical homes would cost about $45 million up front and incur ongoing costs of about $368 million.

When subtracted from the estimated 2014 savings of $643 million, though, that still means an overall break of roughly $274 million, with the report estimating that savings growing to nearly $2 billion in 2019.

The most difficult of the three measures to implement is a statewide system of electronic medical records. West Virginia has already installed digital record keeping systems at seven state hospitals, but getting private physicians on board is not so easy.

Estimates suggest that about nine in 10 health care offices still keep everything in paper. As the new report says, up front costs for physicians run from $25,000 to $45,000 and have annual costs thereafter of between $2,000 and $9,000, steep amounts for small practices.

If electronic medical records are adopted statewide in the next four years, though, the report estimates a savings of more than $317 million, including $85 million for private insurers and $84 million for policyholders.

Lawmakers at Monday’s interim meeting questioned whether the federal health care legislation in Congress might complicate the West Virginia efforts cited in the report.

“I’m concerned about the blending of the two,” Senate Health and Human Resources Chairman Roman Prezioso, D-Marion, told Bryant. “I’m glad to hear you say we’re ahead of the curve. I didn’t anticipate that.”

Bryant urged legislators to press ahead with the state’s initiatives, particularly the medical homes, whether or if something emerges from Capitol Hill.

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