Appellate court gets it wrong by invalidating a portion of health care reform law

Wednesday, Aug. 17, 2011 | 2 a.m.

The 11th U.S. Circuit Court of Appeals in Atlanta defied reason Friday in a 2-1 ruling that struck down as unconstitutional a provision of the health care reform law that would require uninsured Americans to purchase health care insurance or face financial penalties. The majority determined that Congress overstepped the Commerce Clause by approving such a requirement, but dissenting Circuit Judge Stanley Marcus made a compelling argument that lawmakers acted well within their authority to address a problem of such enormous economic magnitude.

Marcus argued that with an estimated 50.7 million Americans uninsured as of 2009, Congress crafted a law intended to end the “substantial cost shifting that occurs when uninsured individuals consume health care services ... for which they cannot pay.” The law, he added, also addressed the “unavailability of health insurance for those who need it most — those with pre-existing conditions and lengthy medical histories.” As Marcus wrote, Congress has been given broad authority over the past two centuries to create rules that are designed to regulate large segments of the nation’s economy. Such regulation obviously would include health care reform.

Individual states and the insurance industry have had ample opportunity over the years to make policies more affordable and attainable for middle- and lower-income Americans. But the states and insurers have failed miserably in this task and the economic result has been devastating. Many uninsured Americans have been driven into bankruptcy simply because they couldn’t afford their medical bills.

When individuals don’t have health insurance, they miss vital doctor’s office visits that are intended to alert patients to potential health problems and offer preventive care. Without this care, many people unnecessarily wind up in emergency rooms and their bills are paid by the likes of University Medical Center, Clark County’s only publicly funded hospital. The tab is borne by taxpayers. The Democratic majority in Congress and President Barack Obama recognized not only the moral imperative of delivering affordable and accessible health care to Americans, but also the drag on the economy created by having so many uninsured people.

Evidence that this issue hits home was delivered by Nevada’s Legislative Counsel Bureau in 2007. The bureau reported that 23.9 percent of Nevada’s adults were uninsured, the fourth-highest rate in the nation. Only three states had a higher percentage of uninsured children than the 17 percent without coverage in Nevada. More than 450,000 Nevadans were without insurance, and that was before the economic meltdown that still plagues the nation.

As Marcus observed, Congress understood that the national economic consequences of such large numbers of uninsured Americans required a national solution, one that Congress delivered. If the 11th Circuit’s ruling is upheld by the U.S. Supreme Court, this nation will be back to square one, and tens of millions of Americans will have no hope of getting health care insurance.