Health care fight's Round II

With a ruling Monday finding a key portion of the nation's new health care law unconstitutional, the smoldering battle over reform has now been joined in the federal courts.

U.S. District Court Judge Henry E. Hudson in Virginia was the first to find that Congress overreached when it mandated that everyone has to buy private medical insurance or pay a fine. Two other judges have ruled it constitutional. Unfortunately the rulings so far have a partisan cast. The judges who supported the mandate were appointed by a Democratic president, Hudson by a Republican.

The health care reform battle was bitterly partisan. If it appears that judges also choose sides for that reason, it will damage the credibility of the federal courts for decades. That's why it would also be a mistake to bypass intermediate appeals courts and seek expedited review by the U.S. Supreme Court.

The legal process shouldn't be rushed. The coverage mandate raises legitimate questions about the reach of powers to regulate interstate commerce that the Constitution gives Congress. A similar lawsuit filed in Florida by 20 states has yet to be decided. Allowing the issues to ripen, and more courts to weigh in, will better focus the constitutional questions, educate the public and enhance the courts' credibility as honest arbiters of the law.

Nothing will change immediately as a result of Monday's ruling. The mandate, like many of the law's provisions, isn't due to take effect until 2014. But striking it down risks gutting the law by causing interrelated provisions to unravel. The mandate is the key to popular reforms that will force insurers to cover people with pre-existing conditions, eliminate lifetime caps and stop canceling the policies of sick people.

Those changes increase costs for insurers. To absorb them without jacking up premiums, insurers need the new revenue that would be generated by additional healthy people buying insurance. The mandate would make sure that happens.

The courts must decide whether Congress' authority to regulate interstate commerce extends to an individual's decision not to buy private insurance. Virginia won Monday after arguing that if such economic inactivity can be regulated, then nothing is beyond the government's reach. The U.S. Justice Department countered that a decision not to buy insurance affects interstate commerce by driving up costs for the rest of us who pick up the tab when uninsured people get sick.

The legislative fight was clouded by wild distortions of what was in the bill and cheapened by cynical deals for votes. Republicans campaigned this year on a promise to repeal reform and President Barack Obama's relection in 2012 could hinge on the outcome.

The best resolution in the courts will be one that finds judges standing above the political fray, parsing what the Constitution may mean for the future of health care. hN