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Thursday, February 03, 2011

Legal Complications of Healthcare Reform

It seems that the issue of the legality of the mandatory coverage provisions of the Patient Protection and Affordable Care Act, aka health care reform, is not as simple as I thought.

Responding to my posting of January 25 on the subject, Jim Walworth points out a number of complications.

For one, the constitutional grant of authority to the federal government is over interstate commerce, not commerce in general.

For another, it is not clear whether, from the legal standpoint, health insurance and health care are related ‘commercial’ activities or separate. It was only with the advent of HMO’s that organizations were created to do both.

Thirdly, the courts have long held that insurance is a state function and not interstate commerce. Hospitals, doctors and other providers of health care are also licensed and regulated by states and not by the federal government.

Jim, now retired, spent the closing years of his career as head of Health Alliance Plan, a large HMO that operates as part of Henry Ford Health System in Detroit. So he knows what he is talking about.

The law is clearly headed for the Supreme Court and if the decision is that the federal government does not have the authority to regulate health insurance, it will knock a big hole in the federal health care reform effort and send the whole issue back to the states.

Jim’s comments can be seen in the original by going to the January 25th posting and clicking on ‘comments.’

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