Judge's decision on health law conflicts with other cases

By Joan Biskupic and Richard Wolf, USA TODAYWASHINGTON — A U.S. district judge's ruling Monday that overthrows a key portion of President Obama's health care law conflicts with other lower-court rulings and centers on a thorny area of the law at the Supreme Court.At issue in the latest ruling on the health care initiative is a provision that requires most Americans to buy health insurance. The legal question is whether a person's decision not to buy coverage is economic activity that affects interstate commerce and can be regulated by Congress.

U.S. District Court Judge Henry Hudson ruled Monday that the decision to forgo insurance does not affect interstate commerce. Hudson said the law would penalize a person for not acting, rather than for voluntarily taking part in some economic activity.

Last month, U.S. District Court Judge Norman Moon, also in Virginia, ruled the opposite, saying a decision to opt out is an "economic" one that ends up affecting the whole system, for example, "by collectively shifting billions of dollars on to other market participants and driving up the prices of insurance policies."

At the Supreme Court, where the ultimate fate of the health care overhaul probably rests, the justices' recent rulings on the power of Congress have been marked by narrow votes and shifting majorities. Yet in one of the most significant disputes, a 2005 case testing federal anti-drug law, the high court broadly interpreted congressional power.

In that dispute, the justices expansively defined the "economic" activities that Congress could control in the states, over protests from dissenters that the decision was "irreconcilable" with past court principles.

Obama administration lawyers defending the individual-insurance mandate have stressed that the uninsured affect the system for all. They say the uninsured consume "tens of billions of dollars in uncompensated care each year." Those costs — $43 billion in 2008 — are borne by doctors, hospitals, insured individuals, taxpayers and small businesses.

Virginia officials challenging the insurance requirement in Monday's case counter that when someone doesn't buy insurance, the required "economic activity" is lacking.

Siding with Virginia, Hudson said no court had ever extended the commerce power "to compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market."

He minimized the reach of the high court's 2005 ruling, Gonzales v. Raich, in which the justices affirmed Congress' power to prohibit the local cultivation of marijuana for medicinal purposes and broadly interpreted activities Congress could regulate.

The 6-3 decision in Gonzales v. Raich was written by liberal Justice John Paul Stevens yet joined by conservative justices Anthony Kennedy and Antonin Scalia.

Scalia, who in past cases had sided with state interests at the expense of Washington, wrote a separate opinion to explain his stance and stress that Congress has authority to control activity that might not be directly "economic" but is an essential part of a larger regulatory scheme.

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