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The wrong way to reform health care

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By Bill McCollum
Friday, December 17, 2010

On Thursday, 20 states argued in a Pensacola, Fla., courtroom against not only the individual mandate in the federal health-care law but also the massive Medicaid expansion that places state budgets and taxpayers in peril. Our suit differs from that brought by the state of Virginia, but we agree that the health reform law crosses legal boundaries. The Obama administration has threatened that court rulings against this legislation will devastate efforts to provide universal health care. Yet until struck down, ObamaCare will be a disaster for our Constitution.

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Health-care reform is critical - but it should not come at the expense of our citizens' individual rights nor by jeopardizing the role of the states in our system of federalism.

Congress has limited, enumerated powers under the Constitution and cannot make law beyond those specific powers. All powers not specifically granted to Congress by the Constitution are left for the states, which have equal sovereignty to make their own laws.

When Congress has invoked the commerce clause in the past, it has regulated only those individuals who voluntarily engaged in commercial activities. This law would compel the purchase of insurance and fine those who do not comply. If Congress has the power to force Americans to buy goods and services, where is the limit?

Our Constitution ensures that the federal government cannot bully states by forcing them into a no-win decision, like the massive expansion of the Medicaid entitlement program ObamaCare has imposed. The Obama law unconstitutionally coerces states to provide health services to those who are not poor, infirm or children - at a cost of billions of residents' tax dollars.

Medicaid is a critical component of states' health-care coverage for poor and needy residents. The March legislation fundamentally transforms this long-established program without consulting the states; under the new Medicaid program, childless adults with incomes at 138 percent above the poverty level are eligible for coverage. States could not have foreseen that Congress would impose this radically altered program when they originally agreed to a partnership role and a financial commitment.

Furthermore, the very structure of the federal health law directly depends on the individual mandate and the expanded Medicaid; without these tenets, it fails along with its goal of universal coverage. The Justice Department has argued that states could withdraw from Medicaid, but Congress passed this legislation counting on states staying in the program and knowing that withdrawal is costly and virtually impossible.

We expect that our lawsuit and Virginia's will eventually end up before the Supreme Court. The stakes could not be higher: ObamaCare is public policy at its worst, in violation of the U.S. Constitution. We can and should support a health-care overhaul; it is up to our leaders in Congress to both do those reforms and protect the Constitution.

The writer is attorney general of Florida.


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