Health Reform: Not a Done Deal?
Challenges seek to erase the law's mandate to buy coverage.
The ink wasn't yet dry on the Patient Protection and Affordable Care Act before cries went up for repeal. Minutes after the historic health-care-reform legislation was signed into law in March, more than a dozen state attorneys general filed suit, challenging the law's constitutionality; the suits now number more than 20. So far, legislatures in 39 states, from Virginia to Utah, have adopted or are considering measures to nullify the federal mandate that their citizens obtain health insurance by 2014.
Two bills have been introduced in the House of Representatives and one in the Senate to repeal the law altogether. Idaho's governor has called for an amendment to the U.S. Constitution that would prohibit Congress from mandating insurance. Class-action lawsuits are brewing. And polls show that Americans are deeply divided about health-care reform and its repeal.
As the challenges mount, it's fair to ask: Is health-care reform here to stay? The political challenges, at least for now, are more symbolic than threatening. Federal law trumps conflicting state laws, so legislation to nullify reform for citizens of a given state seems futile. And without a veto-proof majority in Congress, federal repeal legislation is unlikely to survive. But major provisions of the law won't even be implemented until 2014. "You could get a whole new balance of power in 2013," says Wake Forest University law professor Mark Hall. "A new Congress could derail the whole thing."
Sign up for Kiplinger’s Free E-Newsletters
Profit and prosper with the best of expert advice on investing, taxes, retirement, personal finance and more - straight to your e-mail.
Profit and prosper with the best of expert advice - straight to your e-mail.
The more pressing challenges to reform are the legal ones, which for the most part hinge on four key issues. The first is whether Congress's right to regulate commerce among the states extends to people who choose not to buy health insurance -- in other words, who aren't actively engaging in economic activity. "Congress has never used the commerce power to mandate that individuals enter into a transaction with a private company," says constitutional-law professor Randy Barnett, of Georgetown University.
Another issue is whether states are being coerced into compliance with the law as a condition of federal funding of states' Medicaid programs. A third legal aspect involves whether Congress appropriately structured the tax penalty for failing to obtain insurance. And here's one more, a biggie: Some say the mandate to buy insurance would deprive citizens of life, liberty or property without due process of law.
Will the Supreme Court settle health-care reform for good? So many challenges make it more likely that the Court will hear a case. The safe bet is that it will uphold an act of Congress, but a lack of precedent for parts of the sweeping law means that it's not a sure thing. "These challenges are not frivolous," says Barnett. "Supporters will need some fancy footwork to show why Congress can do something that's never been done."
Meanwhile, expect some foot-dragging. Some 19 states so far have refused to operate a high-risk insurance pool designed to provide temporary coverage for the uninsured until 2014, when the new law bars insurers from turning customers with preexisting conditions away. In those states, the feds will run the pools instead.
To continue reading this article
please register for free
This is different from signing in to your print subscription
Why am I seeing this? Find out more here
Anne Kates Smith brings Wall Street to Main Street, with decades of experience covering investments and personal finance for real people trying to navigate fast-changing markets, preserve financial security or plan for the future. She oversees the magazine's investing coverage, authors Kiplinger’s biannual stock-market outlooks and writes the "Your Mind and Your Money" column, a take on behavioral finance and how investors can get out of their own way. Smith began her journalism career as a writer and columnist for USA Today. Prior to joining Kiplinger, she was a senior editor at U.S. News & World Report and a contributing columnist for TheStreet. Smith is a graduate of St. John's College in Annapolis, Md., the third-oldest college in America.
-
Markets Post Broad-Based Gains Thanks to Mega-Cap Tech
Stocks get help from a couple of laggard Magnificent 7 stocks.
By Dan Burrows Published
-
How to Assess the Impact of Your Charitable Giving
Here are five simple ways to 'do this, not that' when trying to find out from a nonprofit what kind of impact your donations are having.
By Catherine Crystal Foster Published
-
403(b) Contribution Limits for 2024
retirement plans Teachers and nonprofit workers can contribute more to a 403(b) retirement plan in 2024 than they could in 2023.
By Jackie Stewart Published
-
Roth IRA Contribution Limits for 2024
Roth IRAs Roth IRA contribution limits have gone up for 2024. Here's what you need to know.
By Jackie Stewart Published
-
Four Tips for Renting Out Your Home on Airbnb
real estate Here's what you should know before listing your home on Airbnb.
By Miriam Cross Published
-
Five Ways to a Cheap Last-Minute Vacation
Travel It is possible to pull off a cheap last-minute vacation. Here are some tips to make it happen.
By Vaishali Varu Last updated
-
How Much Life Insurance Do You Need?
insurance Instead of relying on rules of thumb, you’re better off taking a systematic approach to figuring your life-insurance needs.
By Kimberly Lankford Published
-
When Is Amazon Prime Day?
Amazon Prime In 2023 Amazon had two Prime Day events — one in July and another, called Big Deal Days, in October. We expect 2024 to follow the same schedule.
By Bob Niedt Last updated
-
How to Shop for Life Insurance in 3 Easy Steps
insurance Shopping for life insurance? You may be able to estimate how much you need online, but that's just the start of your search.
By Kaitlin Pitsker Published
-
5 Ways to Shop for a Low Mortgage Rate
Becoming a Homeowner Rates are high this year, but you can still find an affordable loan.
By Daniel Bortz Published