As soon as the Patient Protection and Affordable Care Act â€” the health care reform bill â€” was signed into law on March 23, 2010, Republicans vowed they would repeal the law or block its implementation somehow. Hereâ€™s what theyâ€™ve been up to:
To date, the attorneys general, mostly Republican, of 14 states have filed lawsuits challenging the Act. Most of these argue the â€œindividual mandateâ€ provision of the bill is unconstitutional. This provision requires that people must purchase individual insurance policies if they donâ€™t get insurance through employee benefits or other group plans.
As of this writing, none of these suits have gone past the filing stage. Many legal experts say the suits donâ€™t have a legal leg to stand on; see, for example, Steven D. Schwinn, Associate Professor of Law at the John Marshall Law School. Remarkably, lawyers who work for the several conservative â€œthink tanksâ€ (such as Randy Barnett, a senior fellow at the Cato and Goldwater institutes) came to a different conclusion.
Republicans in more than 35 state legislatures have proposed bills or constitutional amendments that would block all or part of the federal law at the statesâ€™ borders. Most of these provisions declare that citizens of that state cannot be compelled by the federal government to purchase individual policies.
A few bills go further. Republicans in the California legislature want to prohibit enforcement of most of the Actâ€™s provisions, including the one that says health insurers canâ€™t refuse to insure people because of a pre-existing condition. The California bill also contains a pre-emptive ban of a â€œsingle-payerâ€ health care system, just in case the federal government creates one in the future.
Most of these bills are still in committee. Some have already failed and have been dropped. However, at least three of these state laws â€” in Idaho, Utah, and Virginia â€” have been signed into law. Note that all three of these states have Republican governors, and Republicans are the majority party in the Idaho and Utah legislature. In Virginia, Republicans are the majority in the House of Delegates but not the Senate. Virginia Democrats, such as Former DNC Chairman Terry McAuliffe, claim that the Republicans are essentially playing games with healthcare reform.
â€œThis is all bogus,â€ McAuliffe said recently. â€œItâ€™s nothing more than pure politics. These lawsuits will not be successful. â€œThis is more about playing to their own political base.
The new Idaho and Virginia laws attempt to nullify the federal mandate to purchase insurance. The Utah law is more extensive and declares that several aspects of the federal Act would not apply to Utah unless the state legislature votes to accept them.
Whether a state can nullify a federal law is an old and not entirely resolved question in the U.S., however. About the last time it was tried, President Andrew Jackson got permission from Congress to take military action to compel South Carolina to accept federal tariff law. A compromise was worked out before the shootinâ€™ started.
Beyond these legal maneuvers, the GOPâ€™s best shot at killing health care reform is to continue to stir up public opinion against it, moving toward an eventual repeal at the federal level. Itâ€™s going to be a long-term struggle to keep them from succeeding.