Newspapers Adding Voice of Support to Health Care Reform Law’s Mandate

The New York Times provides a robust defense of the Affordable Care Act's so-called individual mandate, which is the target of many of the lawsuits aimed at scuttling the Obama administration's landmark health care reform law.

The Times' editorial follows one from the Los Angeles Times, which called the mandate the most divisive, but "crucial" component of the law. The health care reform law's provision requires persons to obtain health care insurance starting in 2014 or pay a tax.

The Times states:

A mandate is key for reducing the ranks of the uninsured, who often turn to emergency rooms for care, driving up everyone's costs. Spreading the costs - among healthy and sick - is also the only way to make many of the most popular reforms work, including those that bar insurers from denying coverage to people with pre-existing conditions or from setting annual limits on benefits.

Lawsuits lodged in Virginia and Florida by state attorneys general, and similar ones filed by conservative groups, argue that Congress exceeded its constitutional powers on several fronts. The individual mandate, however, is a major target of the opponents, who argue that Congress cannot force people to buy health care insurance, or that so-called inactivity, not purchasing insurance, cannot be regulated by Congress.

As noted on this blog, numerous times, constitutional law experts have repeatedly said the opponents' arguments are wobbly, and as maintained by the National Senior Citizens Law Center's Simon Lazarus, the rhetoric used to advance those arguments is misleading. As Lazarus wrote in a piece for the Newsweek, the proper question is whether Congress can "ensure that all persons have access to affordable health care insurance, even if they have preexisting conditions?" Instead, opponents repeatedly ask whether Congress can require individuals to enter the health care insurance market or purchase a commercial product. It's the wrong question advancing a weak legal argument, Lazarus, author of an ACS Issue Brief on the constitutionality of the mandate, says.

As noted by The Times editorial, the only federal judge to rule on the constitutionality of the health care reform law's mandate is U.S. District Judge George Steeh, who dismissed the opponents arguments. Instead Steeh wrote that the uninsured actively add to the nation's high cost of health care for everyone. The judge concluded in Thomas More Law Center v. Obama that individuals who put off buying health care insurance are "making an economic decision to try to pay for health care services later, out of pocket, rather than now through the purchase of insurance, collectively shifting billions of dollars, $43 billion in 2003, onto other market participants."

The Times editorial concludes:

We agree. Most uninsured people who are badly injured or come seriously ill cannot afford to pay their medical bills. Their tab is picked up - some $43 billion in 2008 - by others, including federal, state and local governments and their taxpayers, health care providers, and people who are insured.