Wednesday, February 2, 2011

Health Care and Federalism

"[The Congress shall have Power] To regulate Commerce with foreign Nations, and among the several States, and with the Indian tribes;"
~Article I, Section 8, Line 3 of the U.S. Constitution
In 2010, the United States Congress passed landmark health care reform. Among the law's intentions is the closing of the "uninsured gap" that sees nearly 50 million Americans living without health insurance.

From the outset, this legislation has been controversial - not a single Republican voted for the law that President Obama signed in late March. Democrats have pushed for some version of national health insurance since the presidency of Harry Truman, and in recent decades, Republicans have stood staunchly against most attempts at reforming the national health care system.

What mostly divides the parties on the health care issue is a question of federalism: does the Constitution provide the power to Congress to regulate the health care industry?

More than 20 states (most with Republican governors or attorneys general) have joined various lawsuits against the new law. These suits take aim at the so-called individual mandate, a requirement that all Americans buy health insurance or pay a fee. Critics of the mandate claim the national government does not have the power to require individuals to purchase health coverage.

In the months since the suits were filed, judges in federal courts have ruled for both sides, likely foreshadowing an eventual decision by the Supreme Court.

This week, Judge Roger Vinson of Federal District Court in Pensacola, Fla., concluded that "It would be a radical departure from existing case law to hold that Congress can regulate inactivity under the Commerce Clause.” The plaintiffs that brought the case claim the mandate is an unprecedented effort to regulate inactivity because citizens would be fined for NOT participating in commerce (purchasing health insurance).

Whether Congress has the power under the commerce clause to require citizens to purchase health insurance will likely remain an issue for debate until the Supreme Court decides. For AP U.S. Government students, it's important to understand this issue as part of the ongoing debate over federalism.

PBS NewsHour covered the issue in some depth tonight:

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