Florida Attorney General Bill McCollum says Congress is unfairly coercing states to expand Medicaid roles.
Florida Attorney General Bill McCollum says Congress is unfairly coercing states to expand Medicaid roles. Steve Cannon/AP
Twenty states asked a federal judge in Florida Thursday to find the federal health care overhaul unconstitutional.
It was part of the states' attempt to get U.S. District Judge Roger Vinson to strike down the health care law in a summary judgment without a full trial.
Vinson welcomed the states' attorneys to his Pensacola, Fla., courtroom with a reminder that they were there to argue issues of "significant constitutional interest."
"We're down to a precious two," he said.
Those two issues are whether Congress can force everyone to buy health insurance, and whether the federal government can force states to pay for an expansion of Medicaid, the health care program for the poor.
The Power Of Congress
An attorney for the states, David Rivkin, argued that the overhaul pushed by President Obama is a "radical interpretation of congressional power."
Outside the courthouse, state officials called it an unprecedented federal reach.
"This ultimately is about freedom," said Republican Attorney General Greg Abbott of Texas. "This is the biggest encroachment upon our freedom that Congress has ever levied. And if Congress has the power to force Americans to go out and buy something, Americans will lose their freedom. It's liberty and freedom which is being fought for in this courthouse today."
During the oral arguments, Vinson, a Reagan appointee, had some pointed questions about the power of Congress. He asked, if the federal government has the authority to mandate individuals to buy health insurance, then could Congress deem that broccoli is healthful and mandate everyone eat broccoli once a week?
Deputy Assistant Attorney General Ian Gershengorn argued the health care law is different because it's making people pay now through insurance rather than "externalizing" their costs to the rest of the health care market.
The government's position is that it's appropriate for Congress to regulate that kind of "economic decision" under the commerce clause of the Constitution.
But in Virginia this week, that argument didn't work. U.S. District Judge Henry Hudson struck down the individual mandate. Two other federal courts have upheld the new law.
Cost An Undue Burden?
The other issue in the Florida case is extending Medicaid coverage to more people. Florida Attorney General Bill McCollum says Congress is unfairly coercing states to expand Medicaid roles.
"The question with regard to Medicaid is a violation of state sovereignty," he says.
But case law doesn't bear that out, says Ron Pollack, executive director of Families USA. The advocacy group filed a friend-of-the-court brief in support of the Medicaid expansion.
"Never in the history of the Medicaid program — and all the various expansions that have occurred — has there ever been a successful challenge to any expansion," he says. "And what makes this so ridiculous, frankly, is in this case the expansion is going to be paid for almost exclusively by the federal government."
Initially the federal government will pick up the tab for extending Medicaid, and it will ultimately bear 90 percent of the cost. Still, these 20 states say that's an undue burden in tight budget times.
Vinson did not give a timetable for when he will rule on the case. Whatever he decides, it seems clear the fate of the Affordable Care Act is likely to end up before the U.S. Supreme Court.