States file law­suits

Law­suits ques­tion con­sti­tu­tion­al­ity of new law

Modern Healthcare - - Editorial -

Just be­cause health­care re­form was signed into law last week doesn’t mean that op­po­si­tion to the mea­sure has melted away. One hospi­tal sys­tem, Well­mont Health Sys­tem, Kingsport, Tenn., said in a writ­ten state­ment shortly af­ter the U.S. House of Rep­re­sen­ta­tives ap­proved the re­form law, “The cuts in Medi­care would threaten the ac­cess to care, the qual­ity of care and sus­tain­abil­ity of the hos­pi­tals and other health­care providers in our re­gion. We agree there is a need for health­care re­form and look for­ward to work­ing with our con­gress­men on true, bi­par­ti­san re­form.” The sys­tem, which owns seven hos­pi­tals, de­clined all re­quests for in­ter­views re­lated to the state­ment last week, ac­cord­ing to a spokesman.

Two sep­a­rate fed­eral law­suits were filed last week by state at­tor­neys gen­eral against the Pa­tient Pro­tec­tion and Af­ford­able Care Act, and many state leg­is­la­tures buzzed with con­sti­tu­tional amend­ments and bills to block im­ple­men­ta­tion of the act on the state level.

Mo­ments af­ter Pres­i­dent Barack Obama signed the act into law, 13 state at­tor­neys gen­eral filed a fed­eral law­suit ques­tion­ing its con­sti­tu­tion­al­ity. Twelve of the 13 at­tor­neys gen­eral are Repub­li­cans. Louisiana At­tor­ney Gen­eral Buddy Cald­well is the lone Demo­crat to take part in the law­suit. The com­plaint was filed in U.S. District Court in Pen­sacola, Fla., ac­cord­ing to the of­fice of Florida At­tor­ney Gen­eral Bill McCol­lum.

The law­suit ar­gues that Congress ex­ceeded its con­sti­tu­tional au­thor­ity in ap­prov­ing the act, both in re­quir­ing states to ex­pand their Med­i­caid pro­grams and in the in­di­vid­ual man­date to pur­chase health in­sur­ance un­der threat of fines.

Ruthann Rob­son, a pro­fes­sor of law at City Uni­ver­sity of New York School of Law and co-au­thor of a con­sti­tu­tional law blog, said that the 13 at­tor­neys gen­eral face an up­hill bat­tle. Un­der the com­merce clause of the Con­sti­tu­tion, Congress has the right to reg­u­late in­ter­state com­merce, Rob­son said. With so many health­care providers and sup­pli­ers sell­ing across state lines, she said, “It’s pretty dif­fi­cult to say that it’s a lo­cal in­dus­try.”

Ken Cuc­cinelli, Vir­ginia’s at­tor­ney gen- eral and a Repub­li­can, al­leged in a law­suit in U.S. District Court in Rich­mond, Va., that the act’s in­di­vid­ual man­date ex­ceeds the pow­ers granted to Congress in the Con­sti­tu­tion, thereby in­val­i­dat­ing the en­tire act. Rob­son said she had not read that com­plaint.

Repub­li­can-elected of­fi­cials in Colorado, Min­nesota and Ne­vada urged their at­tor­neys gen­eral to join the Florida law­suit, ac­cord­ing to the As­so­ci­ated Press. The at­tor­neys gen­eral in Min­nesota and Ne­vada are Democrats, while Colorado’s is a Repub­li­can.

That’s not all state leg­is­la­tors have been up to. As of March 25, 36 state leg­is­la­tures had en­acted or were con­sid­er­ing mea­sures to limit, al­ter or op­pose health­care re­form, ac­cord­ing to the Na­tional Con­fer­ence of State Leg­is­la­tures. This in­cludes 29 pro­posed amend­ments to state con­sti­tu­tions and 13 pro­pos­als to change state law, three of which have been en­acted, ac­cord­ing to the con­fer­ence.

Barry Ar­buckle isn’t an op­po­nent of health­care re­form, but he is ex­act­ing about what he de­fines as health­care re­form. Ar­buckle, pres­i­dent and CEO of Me­mo­ri­alCare Health Sys­tem in Foun­tain View, Calif., was skep­ti­cal about re­form’s prospects af­ter the 2008 elec­tion (Nov. 10, 2008, p. 6). Asked what changed since then, Ar­buckle said, “ I think the def­i­ni­tion of what health­care re­form is.” He added, “We have health in­sur­ance re­form. We haven’t changed the health­care sys­tem, the de­liv­ery of health­care, one iota.”

Ar­buckle said the move to pro­vide health in­sur­ance to mil­lions of Amer­i­cans is a “big move” to­ward ad­dress­ing “one of the most un­ap­pe­tiz­ing parts of the health­care sys­tem, the unin­sured.” He also likes the law’s sup­port for ac­count­able care or­ga­ni­za­tions. “It’s tak­ing risk for a pop­u­la­tion of pa­tients,” he said. “We called it cap­i­ta­tion, and I know in a lot of parts of the coun­try it’s a four-let­ter word, but it re­ally is the best sys­tem.”<<

Ar­buckle: The re­form law “re­ally is the best sys­tem.”

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