Health care reform is in the cross-hairs at the U.S. Supreme Court this week. In this Health & Wealth update, as the nine justices hear oral arguments on Obama's 2010 health reform, implementation of some aspects of the law are on hold in Missouri.
Outside the Supreme Court supporters and opponents rallied and counter-rallied, and politicians held press conferences, including Missouri's Republican Senator Roy Blunt. Blunt has long been a vocal opponent of "Obamacare" -- in fact, he helped coin that usually derogatory term, according to the New York Times.
"Whether it's constitutional or not, I'm still equally and adamantly opposed to moving forward with this view of health care, where government makes too many decisions, runs health care in too dramatic a way, and I think most Americans agree."
Just over half of Americans think the health care law's individual mandate is unconstitutional, while just over a quarter think it is constitutional, according to the latest poll from the Kaiser Family Foundation. This, despite wide support for other aspects of the law, like tax credits for small businesses to buy health insurance (80 percent in favor), and expanding Medicaid (70 percent in favor).
Inside the court on Tuesday, justices on the court's conservative majority grilled the federal government's lawyer, pressing him to define the limits of federal power. If the federal government can require people to buy health insurance, what else can the feds make you buy? A cell phone? Broccoli? A car? Burial insurance?
Missouri's Attorney General, Chris Koster, had a similar--if more literary--question for the court in a brief he filed last month, opposing the health reform law as unconstitutional:
"When Henry Thoreau set about to idly chronicle the summer of 1845 alongside Walden Pond, could the United States Congress assert that Thoreau's season of reflection was, in fact, an active decision under the Commerce Clause, and thereafter penalize his failure to fish under the theory that everyone has to eat?"
(The federal government argues that since everyone will purchase health care at some point--whether in the E.R. or earlier--Congress has the authority to regulate that purchase under the commerce clause of the Constitution, and require health insurance.)
While justices and lawyers sparred in the Supreme Court on Tuesday, the Missouri House heard a bill that has already passed in the Senate, that would prevent Governor Jay Nixon from implementing elements of health reform at the state level, without legislative approval.
The bill is sponsored by Republican Senator Rob Schaaf, who said he wants to prevent the governor from setting up a state-run health insurance exchange under the Affordable Care Act.
"It may be that the governor doesn't have the same sentiment as the people of Missouri," said Schaaf. "I think the people pretty much stated their opinion on Prop C: 71 percent is a huge margin that said they didn't want a health insurance mandate and bigger government."
Prop C was passed by Missouri voters in 2010, banning the federal government from requiring Missourians to purchase health insurance. Last week, a House committee approved another bill that goes even further, creating criminal penalties for any federal agent who tries to enforce health care reform in the state.
"My hope is that the Supreme Court will rule 'Obamacare' unconstitutional, and my bill will be superfluous," said Republican Representative Kurt Bahr, the bill's sponsor. "I want to keep our state from implementing it, because there are parts of 'Obamacare' that require our acquiescence."
Governor Nixon, for his part, said the state should hold off on implementing a health insurance exchange until after the Supreme Court issues its decision.
"I think everybody is clearly waiting to see what action happens at the federal level. You have five and a half hours of argument at the Supreme Court. It's really not something we've focused a lot of attention on, until our federal partners decide what the proper policy should be."
That decision is not expected until late June.