When Federal Judge Henry E. Hudson declared the portion of the health care reform law mandating that all Americans be covered by health insurance in 2014 to be unconstitutional, a part of me approved. Now, granted, his decision, made on December 13, is going to be widely appealed. The Obama administration stands by its legislation and I stand by the goal of the effort. Health care is too expensive in this country. But then so is insurance. The relationship between the world of medicine and the world of coverage is just out of hand.
One thing Judge Hudson said, really stuck in my mind. The crux of his argument was that the provision violates the Commerce Clause of the Constitution. He wrote, “Neither the Supreme Court not any federal circuit court of appeals has extended Commerce Clause powers to compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market.”
We can be required to insure our cars because we are *not* required to own and drive cars. It’s our choice and it’s within the government’s powers to insist we operate them safely for the greater public good. The health insurance requirement basically says we have to have to have health insurance because we’re alive. I’m a Southerner. I have a nasty little states rights streak. I don’t like having those kind of requirements put on my existence. Apparently neither does Hudson. “At its core,” wrote Hudson, “this dispute is not simply about regulating the business of insurance — or crafting a scheme of universal health insurance coverage — it’s about an individual’s right to choose to participate.”
This is a conundrum with which many, many Americans are struggling. We know health care and insurance needs to be reformed, but we’re not sure we want to be compelled to carry coverage we may not be able to necessarily afford. So, what to do in the interim, while the appellate courts debate? Accept that expenses are out of hand. Accept that you likely need some degree of protection. And shop as intelligently as you can for health insurance using the best tools at your disposal to find affordable coverage.
Has the health care and insurance issue been solved by health care reform? No. I’m afraid the real debate is just getting started.