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Can the States Nullify Health Care Reform? (Commiecare™ on the ropes)
NEJM ^ | 3/11/10 | Timothy S. Jost

Posted on 03/10/2010 7:00:39 PM PST by Libloather

Can the States Nullify Health Care Reform?
Timothy S. Jost, J.D.
March 11, 2010

On February 1, the Virginia Senate passed a bill stating that "No resident of this Commonwealth . . . shall be required to obtain or maintain a policy of individual insurance coverage." In considering this legislation, Virginia joins numerous other states with pending legislation aimed at limiting, changing, or opposing national health care reforms (see map).1 What is going on here?

Whereas states generally adopt laws to achieve a legal effect, nullification laws are pure political theater. On its face, the Virginia bill exempts residents of the Commonwealth from having to comply with a law requiring the purchase of health insurance. Although the bill is phrased in the passive voice, its intent is clearly to block the implementation of a federal mandate requiring all individuals to carry health insurance. But achieving this aim is constitutionally impossible.

The Supremacy Clause of the United States Constitution (article VI, clause 2) states, "This Constitution, and the Laws of the United States . . . shall be the supreme Law of the Land; . . . any Thing in the Constitution or Laws of any State to the Contrary notwithstanding." Indeed, one of the primary reasons for adopting our Constitution in place of the Articles of Confederation was to establish the supremacy of national over state law. Our only civil war was fought over the question of whether national or state law was ultimately supreme.

Within the past 60 years, the most important confrontation between federal law and states' rights concerned school desegregation. Faced with federal law commanding the desegregation of its schools, Arkansas amended its constitution to prohibit integration. In Cooper v. Aaron (1958), the only Supreme Court opinion I know of that was signed individually by each of the Court's nine justices, the Court decisively reaffirmed the supremacy of federal law and rejected the state's claimed right to nullification. More recently, a number of federal courts have rejected claims that a state could refuse Medicaid coverage of abortions in cases of rape and incest after the Hyde amendment (which originally prohibited the use of federal funds for coverage of abortion except when the mother's life was at risk) was changed to permit federal funding for abortions under these circumstances.2 These decisions held that state constitutional provisions must yield even to federal regulations. State law cannot nullify federal law. This principle is simply beyond debate, and state legislators, many of them lawyers, know that.

The purpose of these laws, therefore, is not legal but rather political. The Virginia bill is a second-generation nullification statute. Earlier proposals in other states, including a constitutional amendment proposed by the Arizona legislature, are worded differently. These bills protect a right to pay health care providers directly for services and to purchase private health insurance. In other words, they were proposed to oppose a single-payer system or mandatory public option, neither of which has ever been part of the current federal reform legislation. These antireform bills were based on model legislation put forward by the American Legislative Exchange Council, an organization funded by wealthy right-wing foundations to support conservative state legislative causes, which was reportedly aided in this endeavor by the insurance industry.3 Because these bills were not aimed at any actual federal legislation, they seem to have simply been part of a larger campaign to mischaracterize federal legislative efforts and stir up opposition to any federal health care reform.

The Virginia bill, in contrast, is aimed at an actual provision of the federal health care reform bill — the individual mandate. As the legislative findings that accompany the individual mandate in the Senate bill emphasize, the mandate is fundamental to the legislation. The government cannot require insurers to take all comers, regardless of health status and preexisting conditions, unless the healthy as well as the unhealthy are required to purchase health insurance. We will not be able to reduce providers' burden of uncompensated care or the alarming rate of medical bankruptcies unless all Americans who can afford health insurance buy it.

The individual mandate, however, is uniquely vulnerable. First, it is strongly opposed by conservatives and libertarians. The fact that five of the Virginia Senate's Democrats voted for the state senate bill sends a clear message to Virginia's congressional delegation that a federal bill containing such a mandate is going to be very unpopular with many of their constituents.

Second, the individual mandate is somewhat vulnerable constitutionally. Although the argument that the mandate is constitutional is overwhelming, as Balkin noted in a recent issue of the Journal,4 it is hard to think of a direct precedent for it. And the argument against it is not frivolous, unlike most of the other constitutional arguments that have been raised against the pending legislation. The state bills can be read as briefs to the Supreme Court on this issue.

Third, the mandate is particularly vulnerable from an enforcement perspective. It essentially imposes a tax penalty (to begin in 2014 and to be fully phased in by 2016) on uninsured individuals who do not purchase health insurance, subject to a number of exceptions for those who cannot afford health insurance or who oppose it for religious reasons. Individuals are supposed to pay this penalty with their annual income taxes, but the Senate bill waives criminal penalties and prohibits the Internal Revenue Service (IRS) from imposing liens or levies on a taxpayer's property for failure to pay. Compliance will, therefore, be largely voluntary (although the IRS can still make a tax resister's life miserable, whether or not it can ultimately collect). The state bills can thus be seen as invitations to civil disobedience that counsel state citizens to "violate the federal law, wave this statute in their face, and dare them to come after you."

I know of two other significant state campaigns — one ongoing, one historical — to rally or support state citizens in resisting federal law. In the ongoing effort, more than a quarter of the states have now legalized medical marijuana in the face of a federal prohibition. Although the Supreme Court has emphatically upheld the authority of the federal government to outlaw medical marijuana, the Justice Department announced last fall that the prosecution of users of medical marijuana was not "an efficient use of limited federal resources."5 It is possible that the federal government will eventually conclude that it is not possible to enforce the individual mandate for health insurance. But if individuals successfully resist accepting responsibility for being insured, there will be no way of expanding affordable coverage in a system that depends on private insurers. If government funding of health care must therefore be increased, it may not be the result resisters want.

In the historical effort, demagogues such as the late Senator Harry Byrd (D-VA) mounted the Campaign for Massive Resistance to school desegregation in Virginia and other states during the 1950s and 1960s. Virginia passed a series of statutes intended to maintain the strict segregation of its schools, even going so far as to close the public schools in one county for 6 years. The legislation was held unconstitutional by the federal courts, and the campaign eventually collapsed. Today, most Virginians regard the whole episode as an embarrassment. The state legislature has even adopted reparations legislation to help people who were denied an education during the campaign. Perhaps if health care reform is successfully implemented and Americans come to fully appreciate its benefits, they will look back at the current efforts with similar embarrassment.

These resistance efforts are not about law — they are about politics. But of course at this point, health care reform is only about politics, except insofar as it is still about the morality of equal treatment for all.


TOPICS: Crime/Corruption; Editorial; Government; News/Current Events
KEYWORDS: healthcare; obamacare; reform; states
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From today -

Va OKs 1st bill banning mandated health coverage

1 posted on 03/10/2010 7:00:39 PM PST by Libloather
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To: Libloather

Tim you ignorant putz. The 10th Amendment nullfies your entire arguement.


2 posted on 03/10/2010 7:08:31 PM PST by DarthVader (Liberalism is the politics of EVIL whose time of judgment has come.)
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To: Libloather; ForGod'sSake

An earlier thread today wondered when Virginia was going to join in. Good to see they have started.


3 posted on 03/10/2010 7:08:52 PM PST by dynachrome (Barack Hussein Obama yunikku khinaaziir!)
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To: Libloather
a lot of us would not look good with this kind of close up..but love Drudge putting it up...nancy is melting

4 posted on 03/10/2010 7:09:48 PM PST by RummyChick
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To: devolve; Libloather; ntnychik; PhilDragoo
Someone posted to me on another thread about this, pretty much saying the states could do what they please. I tried doing a little research on it.

Don't know just HOW it presently stands. Some of this stuff was interesting;

Do federal laws override state laws when the two are in conflict?

This decision of 1842 seems pretty conclusive:

[sorry, this link no longer works]
http://law.jrank.org/pages/13486/Prigg-v-Pennsylvania.html

"The ruling upheld the Supremacy Clause of the Constitution in which federal laws take precedence over state laws when regulating the same activity. The Commerce Clause of the Constitution is one major avenue for the national government to exercise its authority over states.

From the 1930s New Deal era through the 1970s the federal government significantly grew by increasingly regulating many facets of life.

By the 1980s states' rights proponents began to reverse the trend. Debates over federal controls continued into the late 1990s focused on proposed national health care reforms.

At the center of issues intensively debated by the founders of the United States was federalism, the distribution of power between the federal and state governments. Dispute over the degree of centralization of political power in the United States highlighted by debates between Alexander Hamilton and JamesMadison led to formation of the first political parties in the nation.

>>>>>>>> LINK

As a result, the Supremacy Clause was written into Article IV of the Constitution providing the primary basis for the federal government's power over states. The article states the "acts of the Federal Government are operational as supreme law throughout the Union . . . enforceable in all courts of the land. Thestates have no power to impede, burden, or in any manner control the operation of" federal law."

5 posted on 03/10/2010 7:11:36 PM PST by potlatch (- What a co-inky-stink!)
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To: RummyChick

Melt. Wicked Witch of the West, Commies!


6 posted on 03/10/2010 7:16:09 PM PST by Texas Fossil (Government, even in its best state is but a necessary evil; in its worst state an intolerable one.)
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To: potlatch

.

Excellent post potlatch


7 posted on 03/10/2010 7:16:10 PM PST by devolve ( . . . . . . . . . Sarah Palin can spell corpsmen . . . . . . .)
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To: RummyChick

After seeing this pic, I think I am going to invest in whatever cosmetic company she uses...from this close up, it looks like she smears @ 50 bucks worth of crap on her face everyday...


8 posted on 03/10/2010 7:16:10 PM PST by Fedupwithit ("The welfare of humanity is always the alibi of tyrants" -Albert Camus)
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To: Libloather
it is still about the immorality of equal mistreatment for all
9 posted on 03/10/2010 7:17:24 PM PST by outofstyle (Resistance to tyrants is obedience to God)
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To: Libloather
These resistance efforts are not about law...

Think again.

It is impossible to introduce into society a greater change and a greater evil than this: the conversion of the law into an instrument of plunder. - "The Law" Frederic Bastiat 1801-1850

10 posted on 03/10/2010 7:21:31 PM PST by PGalt
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To: potlatch

It is the X Amendment that gives States the right, but this is going to have to play out in the courts. It is a good thing the States are doing this because it is sending a message that the States are going to challenge this in court. Thankfully, Obama has already p*ssed off the Supreme Court, and although Justices supposed to be impartial, I don’t think Obama will do well in court against the States.


11 posted on 03/10/2010 7:21:58 PM PST by Sarah-bot (Palin is spry.)
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To: outofstyle
...it is still about the immorality of equal mistreatment for all...

All depends on which state you live in. I heard Floriduh seniors will get gold-plated care compared to the rest of us schlubs.

12 posted on 03/10/2010 7:23:20 PM PST by Libloather (Tea totaler, PROUD birther, mobster, pro-lifer, anti-warmer, enemy of the state, extremist....)
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To: devolve
Thanks devolve. Some things in that that were very interesting to me.

I did a lot of reading and it's a tangled web in who supersedes who between state and federal law.

13 posted on 03/10/2010 7:23:52 PM PST by potlatch (- What a co-inky-stink!)
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To: Libloather

Well, if one single small state was to stand up to the Federal government, they’d have a tough time. A state like Maryland or New Hampshire, you know what I mean.

But if it was a state like Texas or Ohio or one of the biggies, the feds wouldn’t stand a chance. Not a chance.


14 posted on 03/10/2010 7:27:07 PM PST by djf (Who says "The stuff of life" is not stuff? Mostly it's people who have the most stuff.)
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To: potlatch

Would you agree that it is a good thing that the States are doing this because it gives the States standing in court, and now this issue can be revisited?


15 posted on 03/10/2010 7:29:54 PM PST by Sarah-bot (Palin is spry.)
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To: Sarah-bot

People are starting to get fed up with the courts. The courts get paid for by the federal government.

How can you say in any way you can get a fair trial when one of the parties is paying off the ones who will make the decision?

You can’t. It’s not possible. It is IMPOSSIBLE for a federal court to give a fair, unbiased verdict if one of the parties is the United States government.


16 posted on 03/10/2010 7:30:26 PM PST by djf (Who says "The stuff of life" is not stuff? Mostly it's people who have the most stuff.)
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To: djf

The Supreme Court has been making good decisions in regard to gun rights. There is no reason to believe that the court would not make the right decision in the case. I am still willing to give checks and balances a chance.


17 posted on 03/10/2010 7:32:39 PM PST by Sarah-bot (Palin is spry.)
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To: Libloather
Hypothetical federal legislation -- Senate Bill #S666:

Henceforth every American citizen or resident or person domiciled in the United States will have to bow before an image of Barack Obama, burn incense in front of such image and swear total love for and loyalty to Barack Obama. Images allowed will be either color photographs or statues of Barack Obama. A member of ACORN, SEIU, AmeriCorps or the Department of Justice or other designated Democrat Party official or federal government official will be present to verify that the oath is taken properly. All persons refusing to take such an oath will be fined $5,000 (five thousand US dollars) every time they refuse to take the oath. The oath must be taken once a year on April 16th.

To remain in good standing as US citizens or residents of the US, all persons must take the oath and affix their signature and fingerprints to a document that confirms that the oath was taken. The Congress shall have the power to enact measures to collect the fine and enforce the oath. "All persons" shall mean all persons at or over the age of 18.


If the "Health Reform" bill is legal then so is my hypothetical Senate bill S666. And the States won't have any say about this either. Was this what the "war between the states" was about -- the federal government as our Lord and Master?
18 posted on 03/10/2010 7:34:27 PM PST by StormEye
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To: potlatch

.

State residents are likely to get their backs up against the Feds - esp. with Dick Durbin saying Obama’s promise of lower premiums was not thue - that it really only meant ‘slowing the increase of rising premiums’

More taxes - higher premiums - not a a way to keep liberal liberals - or convert others


19 posted on 03/10/2010 7:36:39 PM PST by devolve ( . . . . . . . . . Sarah Palin can spell corpsmen . . . . . . .)
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To: Sarah-bot

Yes, sorry I got behind and didn’t get to your first post. I agree this is a good thing.

I’m in Texas and surprised we haven’t signed on yet. Texas was a Republic before it was a state, lol, we could stand alone!


20 posted on 03/10/2010 7:37:03 PM PST by potlatch (- What a co-inky-stink!)
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