This article was published by Florida Progressive Coalition Blog
It’s worth remembering during this season of giving and charity that the USA remains the only industrialized nation on earth that doesn’t provide access to health care coverage for all its citizens. But it’s against the law for hospital emergency rooms and ambulance services to deny care to those without insurance. What that adds up to is over forty billion dollars a year in “uncompensated” health care costs, which instead of getting paid mostly by insurance companies, get paid for by working and middle class families through higher taxes, higher individual & group premiums, higher employee cost-sharing, deductibles and co-payments. Yesterday in Pensacola, Florida, the first law in American history to lay a foundation for fixing that broken-down and brazenly unfair system faced its latest and so far greatest legal challenge.
Virtually moments after the Patient Protection and Affordable Care Act was passed by Congress and signed into law by President Obama, FL Attorney General Bill McCollum announced he was suing the federal government, claiming it’s unconstitutional to require a state’s citizens to buy health insurance. But the economic reality is that this “individual mandate” is the only way the new law can ever achieve its goal of insuring the uninsured, thereby halting the vicious cycle of soaring prices and chaotic cost-shifting.
Simply put, without a mandate, many younger and healthier people choose to remain uninsured and insurance companies end up with a “bad risk pool”, covering far more sick people than well people; which means big losses for them, which means they find ways to recover their losses, including wiggling out of universally popular but very costly reforms, like ending pre-existing condition exclusions and prohibiting policy cancellations due to high benefit usage. As leading health care financing expert, Dr. Jonathan Gruber, Economics Professor at the Massachusetts Institute of Technology said in a conference call with the press after today’s ruling:
“You can’t have insurance market reform without broad participation…you can’t do that without the individual mandate.”
Based on repeated failures of private sector, “free-market” solutions to the health care crisis, like the embarrassing “Cover Florida” flop that has been foisted off as real reform by outgoing Governor Charlie Crist, many see this lawsuit to upend federal reform as just another in a series of purely partisan attempts to stick it to President Obama and the Democratic Party, at the expense of the American people.
Note that in an Op-Ed column by Bill McCollum in today’s Washington Post, the Attorney General refused to call the fairly enacted law of the land by its actual name, showing the same preference for overblown rhetoric that he did when he tried to impeach President Clinton in the 1990?s:
“…until struck down, ObamaCare will be a disaster for our Constitution.”
Florida is joined as plaintiff in this lawsuit by 19 other states, almost all of which also have Republican attorney generals and/or governors leading the way. Rather than having the suit heard in a Tallahassee court as would be customary, it was instead argued in the District Court of Pensacola, where the two senior judges are George W. Bush and Ronald Reagan appointees. The latter, Judge Roger Vinson, is going to decide this case in the coming months, after having heard oral arguments from both sides today.
Much was made earlier this week out of the ruling by a Virginia District Court judge who concluded that the insurance purchase requirement was unconstitutional. No other aspect of the overall law, however, was called into question. Around the country, two earlier District Court decisions have supported the entire law’s constitutionality, while no less than 14 other judges nationwide have refused to even hear the case based on what they deemed a lack of merit. The bottom line is that by sometime in 2012-2013, this will all be decided by the United States Supreme Court.
Meanwhile in Florida, lame duck McCollum is in a matter of days turning over his job to another conservative Republican, AG-elect Pam Bondi; confident that the torch meant to send health reform up in flames will be passed and carried on with all due diligence. He showed clear pride in today’s editorial that his lawsuit is special and different from those others, because it challenges the legality not only of the individual mandate, but:
“…also the massive Medicaid expansion that places state budgets and taxpayers in peril…The Obama law unconstitutionally coerces states to provide health services to those who are not poor, infirm or children – at a cost of billions of residents’ tax dollars.”
What he’s referring to is the fact that roughly half of the 32 million uninsured Americans to be covered by the new law will be covered by the federal-state Medicaid program, through very moderate expansion in its eligibility requirements. Regarding poverty issues in Florida, note that 2.7-million citizens, or roughly 1 in 7 people, are living under the poverty level. Florida has had the largest increase in that statistic of any state in the country since 2007. Ron Pollack, Executive Director of the national advocacy organization, Families USA, had a few other interesting facts to share with reporters in today’s conference call:
* To qualify for Medicaid coverage currently in FL, a 3-person family (which must include at least one dependent child) cannot have a combined annual income of more than $9,700.
* An individual with no dependent children cannot currently qualify for FL Medicaid coverage, regardless of income.
* For years 2014, 2015, and 2016, the federal government will pick up 100% of the cost of every one of the state’s newly eligible Medicaid recipients who qualify as a result of the new rules. In following years, Florida will never have to pick up more than a dime out of every dollar in those costs, and there will be a gradual rise to that cap.
And yet Blaine Winship, Special Counsel to the FL Attorney General who co-argued the plaintiff’s case yesterday, called the new expansion plans “Medicaid on steroids“.
Then again, the name of today’s outrageous editorial by Florida’s very soon-to-be ex-Attorney General is “The wrong way to reform health care”. Apparently, for partisan defenders and protectors of giant private health insurer profits, there will never be a morally, ethically or even economically “right” way to reform health care, or Medicaid. A right-wing way, yes. A right way, no.
As summed up by Patrick Cannon, Advocacy director for the Florida Health Care consumer interest group, Florida CHAIN:
“This lawsuit would overturn 75 years of legal precedent, deprive health coverage to 30 million Americans, and remove many new protections that make quality coverage more affordable for all Americans.”
