To no one's surprise, the U.S. Supreme Court said Monday it will decide the fate of health care reform that holds so much promise and already has helped millions of Americans. Federal appellate courts are divided on whether the federal law is constitutional, and the nation needs clarity that only the nation's highest court can provide. The court should uphold the law, and Florida and Congress should focus on carrying out the reforms rather than undermining them.
The court will hear a lawsuit filed by Florida and 25 other states that argues the federal law is unconstitutional. It is as much a political attack on President Barack Obama as a legal attack on health care reform. A panel of the 11th U.S. Circuit Court of Appeals ruled in August that a key provision that would require people to have health insurance by 2014 or pay a penalty is unconstitutional — and upheld the rest of the law. Two other appellate courts have upheld the law, and two others dismissed challenges for other reasons. The law's opponents have raised what-if scenarios about the federal government's authority to require purchase of a product (buy broccoli? Buy a GM car?). But there is a strong argument that health care is unique and choosing not to purchase health insurance is an economic decision that affects everyone else as costs for treating the uninsured are passed on to taxpayers and those with private insurance.
In addition to that pivotal question, the Supreme Court will decide whether other parts of the law can remain if the individual mandate is found unconstitutional. It also will consider whether Congress is illegally coercing the states to extend Medicaid to more people, as the states claim, and whether the issues are even ripe for a decision since the penalty for not having insurance does not take effect until 2015. Congress routinely attaches strings to federal money for other programs ranging from education to road construction, so the coercion claim by the states appears to have little merit.
This is the court's highest-profile case since the justices decided the 2000 election with Bush vs. Gore, and the stakes are enormous. The Patient Protection and Affordable Care Act already has produced substantial benefits, including allowing tens of thousands of young adults to continue to be covered by their parents' health insurance. Florida is dragging its feet and has declined millions in federal money to help implement health care reform. And after oral arguments, the court's decision will come by late June in the midst of the presidential campaign. It will not be the final word on health care, but it will provide welcome clarity on how Florida and the nation should proceed.