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U.S. Makes Its Case for Health Care Law U.S. Makes Its Case for Health Care Law

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U.S. Makes Its Case for Health Care Law


The U.S. filed the first brief in the Supreme Court's review of challenges to the 2010 health care law.

The Obama administration kicked off the Supreme Court case on health care reform by submitting a brief on Friday defending the 2010 law's most controversial feature -- its requirement that individuals buy health insurance.

As they have argued in the lower courts, the government's lawyers say the mandate is constitutional because the law is permitted under the Constitution's Commerce Clause. They argue that because health care is a national market that everyone enters at some time, Congress should have the power to regulate the way that people finance the use of health care services. The mandate, they argue, is a "necessary and proper" part of that regulatory scheme, since other features of the law would not work without it. 


"The Act closes a gap that has undermined Congress's longstanding system of regulation and financial incentives in the health care market and that has impeded the ability of millions of Americans to obtain services in that market," the brief says. "The minimum coverage provision is key to the insurance reforms that were designed to fill that gap."

They also argue that Congress's power to tax covers the penalty the law imposes on those who do not buy insurance.

Opponents of the law also submitted their first arguments to the court, arguing that the entire health care reform law must rise or fall with the individual mandate. Briefs from the National Federation of Independent Business and the attorneys general of 26 states agree that the mandate is so essential to the law that it cannot be severed from other provisions.


Both challengers, in separate briefs, argued that Congress would have never passed the health reform law without an individual insurance requirement, because it would’ve been far too costly to enact.

"Congress considered the individual mandate essential to the Act's functioning, to its passage, and to its ability to achieve Congress' goal of near-universal helath insurance," the brief from the states says. "This Court cannot remove the hub of the individual mandate while leaving the spokes in place without violating Congress' evident intent."

The challengers say that without a requirement for individuals to buy health insurance, the health care law’s insurance regulations would cause premium costs to increase dramatically, forcing health care providers and state governments to bear the burden of higher costs. That's a position the government also holds, though it has not yet filed a brief on the issue. The court had to seek an independent lawyer to argue that the mandate could be separated from other provisions in the law.

In addition to the government and the challenger's briefs, a lawyer appointed by the Court submitted a brief arguing that an old tax law called the Anti-Injunction Act prevents most of the case from moving forward until after individuals who fail to buy insurance have paid penalties under the law. Three federal Appeals Court judges have agreed that this law means that the courts can't decide the case now, but neither the government nor the law's challengers agree.


Outside parties who have an interest in the outcome of the case also began filing briefs on Friday. Court watchers anticipate that the health care case could generate a record number of these "friend of the court" briefs. One filed Friday came from the health insurance industry; the brief of America's Health Insurance Plans focused on the question of severability, saying that insurance market regulations in the law should rise or fall with the mandate.

Thirty-four Senate Republicans also filed an amici brief arguing the health care law could not stand if the court finds the insurance requirement unconstitutional. The brief includes quotes from several Democratic legislators that the Republican senators say proves Congress believed the insurance requirement was central to the health reform law when it was passed in 2009.

Eleven Senate Republicans did not sign the amici agreement, running the spectrum of moderate to very conservative members of the party. For example, Sen. Scott Brown, R-Mass., facing a tough reelection challenge from the left, did not sign the amici brief. Nor did Tea Party favorite Sen. Jim DeMint, R-S.C.

The initial brief on the fourth big question before the Court -- whether the law's expansion of the federal-state Medicaid program unconstitutionally coerces the states -- is due next week.

Friday's filings will kick off a process of written argument and counterargument that will run through early March. The parties will then present their arguments in person over three days in late March.

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