United States District Court Judge Roger Vinson has struck down the entirety of the National Health Care law (The Patient Protection and Affordable Care Act) as unconstitutional. What is most interesting is his decision that the entire act had to be struck down because of the individual mandate provision’s unconstitutionality. Vinson grants declaratory relief but declines to grant injunctive relief.
Joined by governors and attorneys general from 26 states, the Florida challenge was broader than the recent Virginia challenge — that led to the striking down of the individual mandate provision. I have previously written about my own concerns over the constitutionality of that provision.
The decision of Judge Vinson will only increase the already high likelihood that the Supreme Court will review the controversy. The two major decisions in Virginia and Florida will be reviewed by two different courts of appeal. Two other rulings (supporting the law) are also moving toward the Supreme Court.
The rule also represents a rejection of the Administration’s effort to avoid review by challenging the standing of the state attorneys general. Ironically, I reviewed the Bond v. U.S. (09-1227) case in my Supreme Court class today. That case involves a woman who challenged her conviction on federalism grounds. The Third Circuit ruled that only states and state officials could challenge federal laws on federalism grounds. The Obama Administration (correctly in my view) switched sides before the Court and ended up arguing for the Bond that she did have standing. This could prove an important term on standing doctrine. The conservatives justices have been generally hostile to standing and have gradually carved out individuals and groups who can seek review of some laws.
Judge Vinson ruled that he could not treat the individual mandate provision as severable and thus (after agreeing with Judge Hudson in Virginia that the provision is unconstitutional) he struck down the entire act. He stated: Judge Roger Vinson said as a result of the unconstitutionality of the “individual mandate” that requires people to buy insurance, the entire law must be thrown out:
“I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the Act with the individual mandate. That is not to say, of course, that Congress is without power to address the problems and inequities in our health care system. The health care market is more than one sixth of the national economy, and without doubt Congress has the power to reform and regulate this market. That has not been disputed in this case. The principal dispute has been about how Congress chose to exercise that power here.”
The court notes that Congress elected not to include a severability clause despite the fact that one was in an earlier version of the law — setting itself up for such a total rejection of the law.
The decision is a strong expression of federalism, starting with Madison’s famous statement from the Federalist Papers 51:
If men were angels, no government would be necessary. If angels were to govern men, neither external nor internal
controls on government would be necessary. In framing a government which is to be administered by men over
men, the great difficulty lies in this: you must first enable the government to control the governed; and in the next
place oblige it to control itself.
The problem is the lack of a limiting principle in the arguments in favor of the law. Vinson notes:
The problem with this legal rationale, however, is it would essentially have unlimited application. There is quite literally no decision that, in the natural course
of events, does not have an economic impact of some sort. The decisions of whether and when (or not) to buy a house, a car, a television, a dinner, or even a
morning cup of coffee also have a financial impact that — when aggregated with similar economic decisions — affect the price of that particular product or service
and have a substantial effect on interstate commerce. To be sure, it is not difficult to identify an economic decision that has a cumulatively substantial effect on
interstate commerce; rather, the difficult task is to find a decision that does not.
He notes the political pressure in the case: “Because the individual mandate is unconstitutional and not severable, the
entire Act must be declared void. This has been a difficult decision to reach, and I am aware that it will have indeterminable implications. At a time when there is
virtually unanimous agreement that health care reform is needed in this country, it is hard to invalidate and strike down a statute titled “The Patient Protection and
Affordable Care Act.”
In rejecting an injunction, the court indicates that declaratory and injunctive relief should be essentially fungible:
The last issue to be resolved is the plaintiffs’ request for injunctive relief enjoining implementation of the Act, which can be disposed of very quickly. Injunctive relief is an “extraordinary” [Weinberger v. Romero-Barcelo, 456 U.S. 305, 312, 102 S. Ct. 1798, 72 L. Ed. 2d 91 (1982)], and “drastic” remedy [Aaron v. S.E.C., 446 U.S. 680, 703, 100 S. Ct. 1945, 64 L. Ed. 2d 611 (1980) (Burger, J., concurring)]. It is even more so when the party to be enjoined is the federal government, for there is a long-standing presumption “that officials of the Executive Branch will adhere to the law as declared by the court. As a result, the declaratory judgment is the functional equivalent of an injunction.” See Comm. on Judiciary of U.S. House of Representatives v. Miers, 542 F.3d 909, 911 (D.C. Cir. 2008); accord Sanchez-Espinoza v. Reagan, 770 F.2d 202, 208 n.8 (D.C. Cir. 1985) (“declaratory judgment is, in a context such as this where federal officers are defendants, the practical equivalent of specific relief such as an injunction . . . since it must be presumed that federal officers will adhere to the law as declared by the court”) (Scalia, J.) (emphasis added). There is no reason to conclude that this presumption should not apply here. Thus, the award of declaratory relief is adequate and separate injunctive relief is not necessary.
I doubt the Administration will view it that way. They have two decision upholding the law and two rejecting the law on the district level. They are not likely to view themselves constructively enjoined.
Here is the entire decision by Judge Vinson: Vinson
Jonathan Turley
[youtube=http://www.youtube.com/watch?v=sgpa7wEAz7I&w=480&h=390]
Dr Rosemary:
After you are done waving your magic wand over the wishing well, consider this. Where in the Constitution does it say the government has power to do Obamacare?
And you do realize that what you are suggesting is that government go to your neighbor’s house, stick a gun in his face, and demand money to pay for someone elses health care?
How did you come up with such a crazy idea?
Did you parents ever teach you that stealing was wrong?
Sometimes it is useful to step back and look at first principles so that one is forced to look at the implications of one’s opinions. Dr. McHugh’s comment reflects her view that society should recognize health care as a legal right. I agree with her. The health care reform efforts of the Obama administration have sought to implement that right through legislation. Those who have opposed the legislation have primarily couched their opposition in ideological, rather than policy, terms. Loaded phrases like “government control” and “socialized medicine” are useful for gaining the attention of the fearful, but add nothing to the debate.
Unless one is of the belief that the uninsured and the indigent should be permitted to die when they become ill, we are faced with the question of how to pay for health care. The so-called “free market” has not solved the problem because insurers will not sell protection to those most likely to need medical care. In addition, for-profit insurance companies will inevitably trade off coverage for profits. Therefore, tax dollars have to be committed in one way or another to cover what insurance does not. The mandatory purchase requirements in the current law are unwise not so much because they are mandatory, but because they do nothing about the problem of increasing health care costs.
I believe that we will eventually adopt a single-payer system in this country because that will be the most efficient and cost-effective method for providing universal coverage. And I have yet to hear conservatives suggest concrete alternatives that will achieve that goal.
Mike:
The feds have NO authority to run loans for scholarships. Find it in the Constitution and site the clause, please.
And I lived without health care insurance for about ten years during which time I also dipped below the poverty line. We paid out of pocket.
rcampbell:
You wrote:
“The reality is that Tootie wants to continue the socialism of having everyone else paying for the healthcare for the 40 million uninsured through billions in extra taxes each year instead of being personally responsible by carrying one’s own.”
Uh, some of the mains reasons we all have to pay for 40 million uninsured are:
1) government forces hospitals to treat all patients
2) greedy Democrats refuse to donate to these needy people (George Soros and Warren Buffet alone could cover most of these costs).
Tootie,
Your blanket statements place you in an incredibly difficult position to defend.
Not everything the government touches gets more expensive: I couldn’t afford any of my education without government-backed loans, and your statement that just about anyone can afford an x-ray out of pocket shows me that you have never been faced with the problem of having to do so.
Dr Rosemary Eileen McHugh
Life is full of choices. How long have you been practicing if may I ask.
Well said, Dr.McHugh.
Government doesn’t do shit to protect his customers.
They try but it’s the other way up the food chain.
Remember red dye #5 is bad for hot dogs.
As a family physician, I see the need for everyone to have healthcare coverage as a right and as a privilege.
Why is healthcare reform being presented as healthcare coverage being forced on the American people? It makes common sense that every American needs to have healthcare coverage.
Why is healthcare reform being seen as a mandate to have insurance, rather than a need that we all have in case we become ill?
To me, it seems that some people are under the illusion that they will never become sick and never need healthcare.
No one can be sure that they will not need healthcare. Life is full of surprises.
For the common good and for the good of individuals and families, it makes sense that everyone should have the right and duty to get healthcare coverage.
Judge uses Obama’s words against him
udge Vinson used Mr. Obama‘s campaign words from an interview with CNN to show that there are other options that could fall within the Constitution — including then-candidate Obama‘s plan.
During the presidential campaign, one key difference between Mr. Obama and his chief opponent, then-Sen. Hillary Rodham Clinton, was Mrs. Clinton‘s plan required all Americans to purchase insurance, and Mr. Obama‘s did not.
New York Times columnist Paul Krugman predicted Mr. Obama‘s opposition to an individual mandate could come back to haunt him: “If Mr. Obama gets to the White House and tries to achieve universal coverage, he’ll find that it can’t be done without mandates — but if he tries to institute mandates, the enemies of reform will use his own words against him.”
http://www.washingtontimes.com/news/2011/jan/31/judge-uses-obamas-words-against-him/
Buddha:
“Owners and shareholders, who by the way, do not give a flying rat’s ass about people dying if they can profit from it.”
how do you know that? Yesh, talk about me making unsubstantiated statements.
But it seems to me that an investor would want to make money. So they would want a company that took care of their patients/clients. Because if they don’t and cause people to die needlessly they would be sued and that would be bad for business. Especially in light of the multi-million dollar judgements.
So I disagree with your assertion.
Self interest protects more than just self. As I said on the Rush thread my friend keeps a tight ship because he wants to keep selling his hot dogs. If he makes someone sick, he could go out of business and then where would he be? Government doesn’t do shit to protect his customers, he does because he knows it is in his self interest to do so. And so his self interest protects his customers.
Now there are plenty of stupid people who think they are putting something over on their customers but they don’t last long and the health department only gives them a patina of respectability.
bdaman,
First, learn to differentiate between “insurance companies” and “hospitals”. The problem in this country isn’t hospitals per se but rather the insurance companies.
Second, “not-for-profit” means exactly what you think it means: surplus funds at year end are reinvested into infrastructure and – in this case, patient services – instead of distributed to owners or shareholders. Owners and shareholders, who by the way, do not give a flying rat’s ass about people dying if they can profit from it.
What does a not for profit hospital mean?
What it means is close to the end of the year, if they show any monetary gain that money must be spent as to not be seen as making a profit. So lets say a non profit hospital is 3 million in the black at some point in the year. That money is then spent say on new equipment, raises, new wing ect ect.
Just because they are not for profit doesn’t mean they don’t make one.
A judge who understands the Constitution, wonder of wonders. You go Judge Vinson.
Hey, Obama, here’s why appointing judges matters
A Reagan appointee rules the entire healthcare reform act unconstitutional — and praises the Boston Tea Party
Florida District Court Judge Roger Vinson has ruled that the individual mandate provision of the Affordable Care Act is unconstitutional. Of the four judges who have decided so far on the constitutionality of healthcare reform, Vinson is the second to deem the mandate out of bounds. But in distinction to his Virginia counterpart, Henry Hudson, Vinson also took the “radical” step of ruling that since the ACA included no “severability” clause that would leave the rest of the act intact, even if one part was struck down, the entire law was unconstitutional.
That sound you hear is the flutter of million ecstatic tweets of joy from conservatives, even if, in the short term, nothing substantive changes today. The legal status of the Affordable Care Act won’t be decided until the Supreme Court makes its own determination, a point that is at least a year or two away.
Legal analysis aside, the most obvious thing about the four rulings that have been made so far is that two Clinton appointees have found the law constitutional, while Henry Hudson, a George W. Bush appointee, and Vinson, a Reagan appointee, have not. Correlation is not causation, but Slate’s Dave Weigel spotted a paragraph in Judge Vinson’s opinion that seems more than a little resonant of current political fashions.
It is difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place.
Continue reading
A Tea Party shout-out in a legal opinion on healthcare reform? Seems just a little bit obvious. Not to mention activist. And it further emphasizes the profound importance of the fight to determine who gets appointed to the federal judiciary, a fight Republicans have been winning for decades.
And a fight that Obama has been losing to a spectacular, unprecedented degree. The Prospect’s Jamelle Bouie and the New Republic’s Jonathan Bernstein make a compelling case: Yes, Obama has been fighting the most obstructionist opposition party in modern history, but at the same time, he has let down his side by not being aggressive enough in both nominating judges and pushing for their appointment. Even if healthcare reform makes it past the current Supreme Court unscathed, the path for any future socially beneficial legislation will just get harder and harder, as the scales of justice get increasingly stacked.
UPDATE: Just got off a conference call with “senior administration officials” who made the case that, in their opinion, Judge Vinson’s ruling was an “outlier.” But there was some dancing around the question of whether the individual states party to the lawsuit could choose to interpret the decision as permitting them to drag their feet on implementation of the law. Two reporters on the call said that lawyers for the plaintiffs had made that claim. We’ll watch that closely.
http://www.salon.com/news/healthcare_reform/index.html?story=/tech/htww/2011/01/31/healthcare_reform_and_the_federal_judiciary
Bob,
In re proper application of Commerce Clause.
No. In this instance, it is a clear overreach to mandate purchasing a private for-profit product. I’ve called this what it is all along: the health insurance company bailout. It’s not “reform”. It’s certainly not universal single-payer coverage – which makes the most sense economically and structurally and could be accomplished legally. But it is propping up the same robber barons, er, insurance company executives, who are currently denying coverage for their personal profits. “Health care reform” is simply more corporatist protectionism by people bought out of their loyalty to the American people by industry driven graft. It does little if anything about the problem of the uninsured other than attempt to penalize them for not being good lil’ blind consumers and doing what they are told. Obama is as big a fascist asshole as Bush. He just works for the insurance lobby instead of the family oil business. His “health care reform” is simply icing on the cake. Have you tried the cake? Marie says it’s DEEE-lish!
Rafflaw because Obama did exactly what he said he would not and thats favors special interest groups. Obama is a Union payback man, a big government type of guy. Ask yourself who has benefited the most from the waivers and there you shall find the answers you seek.
Tootie
1, January 31, 2011 at 3:28 pm
If the feds can do this (force us to have health care) it can force us to do just about anything
The reality is that Tootie wants to continue the socialism of having everyone else paying for the healthcare for the 40 million uninsured through billions in extra taxes each year instead of being personally responsible by carrying one’s own.
No one in their right mind would want this law repealed. And no one in their right mind does.
@Tootie: Yes, I advocate a national health care system. Increasing profit is not the only possible motivation for streamlining or efficiency. My wife works at a non-profit hospital; one I briefly worked at as a consultant, and they are efficient, and save money, and nobody there is earning a fortune. A governmental motivation can be to make as big a difference as possible with the budget they have. You are mistaken if you believe that money is the only thing that motivates people, or healthcare workers.
In fact, in the vast majority of companies the vast majority of employees are not motivated by profits at all, their hourly wage or yearly salary does not change at all if they are more efficient or less so. People are motivated by trying to please their bosses, from the line managers on up. My niece is an executive secretary; her salary doesn’t change by a dime if her employer is profitable or loses money, and neither does her manager’s salary or compensation: Nobody gets bonuses there.
So if the government runs the organization, it should be Congress or the President making demands to get more efficient and provide more services for citizens with less money. That is their job in “congressional oversight” and in being the “chief executive.”
So yes, let the government have the monopoly, they don’t need to make a profit, and healthcare would cost us about 30% less, because that is what we learned, in 2009, the insurance companies are siphoning off the top. Or we’d get about 50% more benefits than we are getting now.