(Originally posted on the National Physicians Alliance Virginia Local Network page, May 15, 2011)
Last week, two Virginia lawsuts against the Patient Protection and Accountable Care Act (PPACA) were heard in the United States Court of Appeals for the Fourth Circuit. The 3-judge panel heard appeals for two different cases: one case brought forward by Liberty University (in which the PPACA was upheld), and one case brought forward by Virginia's Attorney General Ken Cuccinelli (in which the PPACA was found unconstitutional). This is the next step on what will be the PPACA's inevitable review by the United States Supreme Court. Last Tuesday's hearing begins a string of appeal hearings across the United States.
As of right now, it does not sound as though the hearings went very well for AG Cuccinelli. Kaiser Health News summarized much of the news coverage of the hearing, and most analysis indicated that the panel appeared inclined to uphold the PPACA. Some of the news reports indicate that the panel might even determine that the Commonwealth of Virginia has no standing to sue the Federal government regarding the PPACA. Despite this apparently unfavorable early response from the court, AG Cuccinelli is making no indication of changing his approach even though the panel seemed to reject his claim that not buying insurance was inactivity (as opposed to activity) and therefore could not be regulated.
Obviously, every single person (unless incredibly lucky) will need to access health care during our lives, so this is a necessity and not a commodity. So long as healthcare expensive (which it is) and largely paid for by for-profit insurance companies (which it is), people will need to have access to health insurance. And as long as we require Emergency Departments to provide treatment for everyone, regardless of their insurance status (which we do), then it is fair to ask everyone to pay into the system that will pay for their care when they need it. Currently, it is estimated that $1,000 of each family's health insurance policy costs result from cost-shifting for uncompensated care. It is reasonable to expect all of us to pay our share, and to help those who seek insurance but cannot afford it.
A decision from the 3-judge panel is expected in the next few months; whatever happens, another appeal will follow.