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Since the enactment of health reform legislation in March, several state Attorneys General and others opposed to the law have filed lawsuits challenging the constitutionality of the Affordable Care Act. Legal challenges like this are nothing new. Challenges to the Social Security Act, the Civil Rights Act, and the Voting Rights Act all failed.
Now, challenges to the health care law are failing in court. In October, a federal judge in Michigan found that the Affordable Care Act is constitutional. Today, a federal judge in Virginia dismissed a lawsuit brought by Liberty University that challenged the constitutionality of the health reform law. The judge upheld the law and said that the requirement that individuals maintain health insurance is constitutional, writing:
“I hold that there is a rational basis for Congress to conclude that individuals’ decisions about how and when to pay for health care are activities that in the aggregate substantially affect the interstate health care market…Nearly everyone will require health care services at some point in their lifetimes, and it is not always possible to predict when one will be afflicted by illness or injury and require care…Far from ‘inactivity,’ by choosing to forgo insurance, Plaintiffs are making an economic decision to try to pay for health care services later, out of pocket, rather than now, through the purchase of insurance. As Congress found, the total incidence of these economic decisions has a substantial impact on the national market for health care by collectively shifting billions of dollars on to other market participants and driving up the prices of insurance policies.”
The judge’s ruling today only underscores the importance of the law’s individual responsibility provision. In order to make health care affordable and available for all, the Act regulates how to pay for medical services – services that account for more than 17.5% of the national economy. This law came into being precisely because of the interconnectedness of our health care costs. People who make an economic decision to forego health insurance do not opt out of the health care market, but instead shift their costs to others when they become ill or are involved in an accident and cannot pay.
We do not leave people to die at the emergency room door – whether they have insurance or not. Those costs – $43 billion in 2008 alone – are borne by doctors, hospitals, insured individuals, taxpayers and small businesses. According to a recent study, this cost-shift added on average $1,100 to family premiums in 2009 and roughly $410 to an individual premium.
In the weeks ahead, there will be additional court cases examining this matter and the health reform law. We can’t predict the outcome of each case, but we are confident that we will ultimately prevail in court and continue to deliver the benefits of reform to the American people.
Stephanie Cutter is Assistant to the President for Special Projects