Just because healthcare reform was signed into law last week doesn't mean that opposition to the measure has melted away.
The fight against reform
Lawsuits question constitutionality of new law
One hospital system, Wellmont Health System, Kingsport, Tenn., said in a written statement shortly after the U.S. House of Representatives approved the reform law, “The cuts in Medicare would threaten the access to care, the quality of care and sustainability of the hospitals and other healthcare providers in our region. We agree there is a need for healthcare reform and look forward to working with our congressmen on true, bipartisan reform.” The system, which owns seven hospitals, declined all requests for interviews related to the statement last week, according to a spokesman.
Two separate federal lawsuits were filed last week by state attorneys general against the Patient Protection and Affordable Care Act, and many state legislatures buzzed with constitutional amendments and bills to block implementation of the act on the state level.
Moments after President Barack Obama signed the act into law, 13 state attorneys general filed a federal lawsuit questioning its constitutionality. Twelve of the 13 attorneys general are Republicans. Louisiana Attorney General Buddy Caldwell is the lone Democrat to take part in the lawsuit. The complaint was filed in U.S. District Court in Pensacola, Fla., according to the office of Florida Attorney General Bill McCollum.
The lawsuit argues that Congress exceeded its constitutional authority in approving the act, both in requiring states to expand their Medicaid programs and in the individual mandate to purchase health insurance under threat of fines.
Ruthann Robson, a professor of law at City University of New York School of Law and co-author of a constitutional law blog, said that the 13 attorneys general face an uphill battle. Under the commerce clause of the Constitution, Congress has the right to regulate interstate commerce, Robson said. With so many healthcare providers and suppliers selling across state lines, she said, “It's pretty difficult to say that it's a local industry.”
Ken Cuccinelli, Virginia's attorney general and a Republican, alleged in a lawsuit in U.S. District Court in Richmond, Va., that the act's individual mandate exceeds the powers granted to Congress in the Constitution, thereby invalidating the entire act. Robson said she had not read that complaint.
Republican-elected officials in Colorado, Minnesota and Nevada urged their attorneys general to join the Florida lawsuit, according to the Associated Press. The attorneys general in Minnesota and Nevada are Democrats, while Colorado's is a Republican.
That's not all state legislators have been up to. As of March 25, 36 state legislatures had enacted or were considering measures to limit, alter or oppose healthcare reform, according to the National Conference of State Legislatures. This includes 29 proposed amendments to state constitutions and 13 proposals to change state law, three of which have been enacted, according to the conference.
Barry Arbuckle isn't an opponent of healthcare reform, but he is exacting about what he defines as healthcare reform. Arbuckle, president and CEO of MemorialCare Health System in Fountain View, Calif., was skeptical about reform's prospects after the 2008 election (Nov. 10, 2008, p. 6). Asked what changed since then, Arbuckle said, “I think the definition of what healthcare reform is.” He added, “We have health insurance reform. We haven't changed the healthcare system, the delivery of healthcare, one iota.”
Arbuckle said the move to provide health insurance to millions of Americans is a “big move” toward addressing “one of the most unappetizing parts of the healthcare system, the uninsured.” He also likes the law's support for accountable care organizations. “It's taking risk for a population of patients,” he said. “We called it capitation, and I know in a lot of parts of the country it's a four-letter word, but it really is the best system.”
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