Judge Hears Arguments In Va. Health Care Lawsuit

A federal judge in Richmond, Va., on Thursday heard the first arguments in the first of several lawsuits challenging the constitutionality of the federal health overhaul law. Michele Norris talks to NPR's Julie Rovner, who is at the courthouse in Richmond.

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MELISSA BLOCK, host:

This is ALL THINGS CONSIDERED from NPR News. I'm Melissa Block.

MICHELE NORRIS, host:

And I'm Michele Norris.

Today a law went into effect in Virginia that seeks to exempt it citizens from the new federal health care law. In addition, the state has filed suit claiming the federal law is unconstitutional. The Obama administration was in court today to get that suit dismissed.

And NPR's Julie Rovner is at the courthouse in Richmond and she joins now. Julie, tell us what this case is all about.

JULIE ROVNER: Well, it's basically about what all the cases against the new law are about. It's the single-most controversial feature of the new federal health care law, the so-called individual mandate that requires everyone to have health insurance starting in the year 2014.

Now, Virginia was the first state to pass a law saying its citizens can't be forced to buy health insurance if they don't already have it. Its legislature did it about two weeks before the federal health bill became law. Now, two other states have passed similar laws and several others are considering similar types of legislation.

NORRIS: So why does Virginia say this law is unconstitutional? What's the basis for that argument?

ROVNER: Well, the heart of its argument is that the federal government can't regulate inaction. In this case, the act of not having health insurance. While the Constitution does give the federal government the authority to regulate interstate commerce, Virginia says not having health insurance isn't commerce, and if this law is upheld there'd be no limit to what the federal government could require people to purchase - whether it's cars or gym memberships or whatever.

This is the argument that's also being made by the 20 other states that have filed suit against the health law.

Virginia has a second line of argument that the other states don't, of course, and that's that their state law conflicts with the federal law that exempts Virginia residents from having to buy insurance.

NORRIS: And what's the federal government's response to Virginia's claims?

ROVNER: Well, first of all, it says the case shouldn't even be allowed to proceed. In fact, what was argued today was a preliminary motion to dismiss the case. The government says Virginia lacks standing to sue because the insurance mandate doesn't apply to the state, it applies to individual citizens. So therefore, only individual citizens have a right to sue over it.

But there was also quite the discussion about the merits of the case. Basically the Justice Department's lead attorney argued that people without insurance aren't inactive, as Virginia claims. The uninsured, as a group, consume an estimated $43 billion a year in medical care that doctors and hospitals write off and then pass on in higher costs to everyone else.

So the insurance mandate really just requires people who currently don't have insurance to pay up front, rather to try to pay after they get sick or hit by a bus or whatever.

NORRIS: Did the government comment specifically on Virginia's law?

ROVNER: Yes, it basically said if Virginia could pass a law exempting its citizens from having to buy health insurance, then what was to stop another state from passing a law to prevent its citizens from having to register for the draft or having to pay the federal estate tax?

Basically this is what's known as a nullification law, and it has long been not allowed by the Supreme Court.

NORRIS: What happens next?

ROVNER: Well, the judge in this case, Henry Hudson, said he expected to have a written opinion on whether to allow the suit to proceed within 30 days. Meanwhile, the bigger case, the one filed by 20 state attorneys general down in Florida is expected to have its first hearing sometime in the fall.

NORRIS: Thank you, Julie.

ROVNER: Thank you, Michele.

NORRIS: That's NPR's Julie Rovner, speaking to us from Richmond, Virginia.

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