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Published Online: 17 September 2010

Several States Ask Courts to Overturn Health Reform

Abstract

The first judicial ruling involving lawsuits filed to protest the health care reform law concluded that there were sufficient constitutional questions involved in the law's provisions to allow a Virginia suit to proceed.
The number of lawsuits filed by states, individuals, and organizations against some or all of the federal health care overhaul law enacted in the spring continues to grow, but no final judicial rulings are expected before the November elections.
The latest such suit was filed August 12 by a group of Arizona lawmakers and a conservative advocacy group. The suit challenged both the law's mandate that Americans must have health insurance and the new Independent Payment Advisory Board (IPAB) that the law placed over Medicare funding decisions, which has drawn criticism from physicians' groups such as APA.
APA had urged Congress not to include IPAB in the final measure out of concern that it would achieve future savings for Medicare chiefly through mandatory cuts in physician payments.
The Arizona lawsuit questions the legality of the law's IPAB-related timeframe that gives members of Congress just 14 business days after the IPAB begins issuing recommendations in 2017 to write and pass legislation replacing the board's cuts or forfeit the ability to ever do so. Such a provision of the health care law, according to the lawsuit, deprives the state's members of Congress of their legislative rights and duties regarding lawmaking, in this case making laws concerning Medicare policy.
The suit also charges that the IPAB's actions will deprive Medicare beneficiaries of services to which they are entitled by law. “When any of IPAB's foregoing proposals or recommendations become law, or if they are anticipated by health care providers to become law, health care providers will withdraw from participating in Medicare and reduce the availability of health care services to a greater extent than would otherwise be the case,” according to the lawsuit.

Virginia Contests Insurance Mandate

Another health care lawsuit development in August was a federal judge's decision to allow Virginia's legal challenge of the health care law's mandate that most Americans buy insurance coverage or face IRS penalties starting in 2014 to proceed.
Virginia Attorney General Ken Cuccinelli (R) filed the high-profile suit immediately after President Obama signed the health care measure into law, based on a Virginia statute that disallows government requirements that state residents must buy health insurance. U.S. District Court Judge Henry Hudson's preliminary ruling concluded that the Virginia attorney general had a right to defend that state law.
In what was widely viewed as a setback for the Obama administration, Hudson denied the Justice Department's attempt to have the suit dismissed, noting that additional hearings were needed to weigh the merits of the case.
An October 18 hearing is set on the Virginia case, but a final ruling is not expected for several months.
The other high-profile lawsuit against the health care law brought by more than a dozen other state attorneys general, which focuses on the constitutionality of the individual insurance mandate, has not yet appeared before a federal judge in Florida, where it was filed.

Missourians Vote Opt-Out Right

Another recent development regarding the health care law was the August 3 vote by Missourians in favor of a state law that allows residents to opt out of the requirements of the federal law. The 71 percent support for the opt-out measure was viewed by political observers as a sign that the Obama administration has failed so far in its efforts to promote the benefits of the measure in the months since its passage.
Additionally, Missouri Lt. Gov. Peter Kinder (R) has filed suit against the federal health care law along with three individuals who say they will have less access to affordable health care under the reform law. For instance, one plaintiff who uses a Medicare Advantage insurance plan contends that the law achieves savings by forcing many such plans out of existence—except in Florida, which the law specifically exempted from Medicare Advantage changes.
A copy of the Arizona lawsuit is posted at <www.goldwaterinstitute.org/file/4929/download/4931>. More information on legal developments affecting the health care law can be accessed by searching under “lawsuits” at <www.kaiserhealthnews.org>.

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Published online: 17 September 2010
Published in print: September 17, 2010

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