One Year Later, PPACA Still Facing Strong Opposition

One Year Later, PPACA Still Facing Strong Opposition
Pressure Mounts for Parties to Come Together to Negotiate Issues

Congress

As part of legislation to keep the government funded through March 4, House Republicans passed a series of amendments this week aimed at defunding implementation of the health care law.  The House proposed a freeze on any money that would be used to implement the health care reform law.  Specifically, the House proposed  that there be no funding for:

• any employee of the Department of Health and Human Services, the Department of Labor to implement the health care law;
• anyone at the Internal Revenue Service to implement the individual mandate; and
• any employee to work on the health insurance exchanges or the medical loss ratios.

House Republicans dislike the law. They already voted symbolically to repeal the law but were defeated by the Democratic controlled Senate.  Now they want to make sure there is absolutely no money to fund it.  A denial of funding is also likely be defeated by the Senate.

Courts

A federal judge in Washington, D.C. became the third U.S. trial judge to uphold the constitutionality of the new health-care law’s requirement that individuals maintain health coverage or pay a penalty.

In Tuesday’s ruling, U.S. District Court Judge Gladys Kessler said Congress was within its constitutional authority under the Commerce Clause to regulate  when it chose to penalize people who forgo health insurance.  The Court  held that “Congress had a ‘rational basis’ for its conclusion that an individuals decisions not to purchase health insurance substantially affects the national health insurance market.” 

Two other judges, most recently U.S. District Court Judge Roger Vinson in Florida, have ruled the insurance mandate provision as unconstitutional. Judge Vinson, who ruled on a legal challenge brought by a group of 26 states, voided the entire law.

While trial judges continue to consider challenges to the health law, the legal fight over its constitutionality will find its way to the Supreme Court before the matter is finally resolved.

States

States have a complicated shared-power relationship with the federal government in regulating various aspects of the health insurance market and, specifically, the PPACA.

In response to the passage of the PPACA, at least 40 state legislatures proposed legislation to limit, alter or oppose selected state or federal actions that mandate a citizen’s purchase of insurance. 

Other states have sought to keep in-state health insurance optional, and instead allow citizens the opportunity to purchase any type of health services or coverage they may choose.  

In 30 of the states, the filed measures included a proposed constitutional amendment by ballot question.  In a majority of these states, their constitution includes an additional hurdle for passage–requiring either a “supermajority” of 60 percent or 67 percent for passage, or requiring two affirmative votes in two separate years, such as 2010 and 2011, for passage.♦