Legal Challenges

Retired Justice John Paul Stevens tells Bloomberg the Supreme Court's ruling in favor of a federal law banning marijuana suggests it would also uphold the healthcare reform law.

House Budget Committee Chairman Paul Ryan (R-Wis.) is dusting off a proposal to replace employers' healthcare tax exemption with a tax credit for all, reports Inside Health Policy (subscription required).

Children's hospitals are facing a leaner fiscal climate, Kaiser Health News writes in Part 3 of its series on kids' care.

The Obama administration signaled Monday that it wants the Supreme Court to rule before the next election on the individual coverage mandate in healthcare reform.

The administration will likely go straight to the Supreme Court to appeal a ruling that the mandate is unconstitutional. That decision was handed down last month by a three-judge panel of the 11th Circuit Court of Appeals. The Justice Department could have appealed to the full circuit before the Supreme Court, but it decided not to seek the "en banc" hearing.

Although the request might not have been granted, and wasn't guaranteed to prevent the high court from ruling before November 2012, it was the administration's best chance to slow down the legal proceedings, if it had wanted to.

Healthwatch's Sam Baker has more on the timing — and another upcoming deadline that could indicate which lawsuit the White House wants the Supreme Court to take.

Critics happy: The National Federation of Independent Business, a co-plaintiff in the suit, praised the administration's decision.

"NFIB is excited that all indications point to the government going directly to the Supreme Court to hear our case and commends the administration on their decision," NFIB Small Business Legal Center executive director Karen Harned said in a statement. "The uncertainty created by the healthcare law on small businesses and other job creators is an immeasurable and burdensome effect on the economy. We are hopeful that the Supreme Court will take our case immediately."

Merger maker: Express Scripts has hired a former top staffer to House Judiciary Committee Chairman Lamar Smith (R-Texas) to help assuage the panel's concerns over the pharmacy benefit manager's pending merger with MedCo Health Solutions. Healthwatch's Julian Pecquet has the story.

The decision? Asking an appeals court to review its challenge or fast-tracking the decision to the Supreme Court.

The Obama administration's decision today on whether to appeal the 11th Circuit Court's ruling on the healthcare law to the full court could determine whether the Supreme Court weighs in before the 2012 elections, reports the Los Angeles Times.

Kaiser Health News partners with McClatchy to examine the rise of children's hospitals in the first of a three-part series on the "big-money world of kids' care."

Advocates are worried that autism won't make the list of federally approved "essential health benefits" under the healthcare reform law, writes Kaiser Health News.

Politico Pro reports on the four questions to ask about the healthcare law waivers (subscription required).

A sprawling, $25 million Miami-Dade home healthcare racket fueled by bribes and kickbacks has implicated 54 doctors, nurses, operators and recruiters, reports the Miami Herald.

Another TV segment for Prostate Cancer Awareness Month gets a failing grade from HealthNewsReview.org.

A federal judge in Pennsylvania walked onto new ground Tuesday in a ruling that said parts of the healthcare reform law are unconstitutional.

The decision’s impact is limited because it comes from a federal district court; three federal appeals courts have already ruled on the healthcare law’s requirement that most people buy insurance. But Judge Christopher Conner carved out a new approach to the question of severability — whether the rest of the law can be left intact if the coverage mandate is unconstitutional.

He’s the only judge, at either level, to strike the mandate, as well as a select few other provisions. When other courts have found the mandate unconstitutional, they’ve either struck it down on its own or invalidated the entire healthcare law.

In addition to the mandate, Conner struck down provisions that require insurance companies to cover everyone who wants to buy a policy and prohibit discrimination against people with pre-existing conditions.

The 4th Circuit dismissed both suits without ruling on the merits of whether the mandate is constitutional.

A federal appeals court ruled Virginia does not have the right to sue over the insurance mandate.

The lawsuits over healthcare reform aren't just about the reform law, but a referendum on liberty and the scope of government's police power, Virginia Attorney General Ken Cuccinelli says in a law review article.

Cuccinelli was the first state attorney general to sue over the healthcare law, and his challenge has proceeded separately from the 26-state suit in which a federal appeals court ruled last week. Although Cuccinelli's political opposition to the healthcare law has always been clear, he lays out a scathing critique in the current issue of the Texas Review of Law and Politics.

"The battle for liberty is never over," Cuccinelli wrote. "The challenges to the health care law are our generation’s battle field in that ceaseless struggle."

The 46-page article details the progressive legal doctrine that the Supreme Court applied under President Franklin Roosevelt, describing it as "experiment" in radically expanding the federal government's power. Cuccinelli says the healthcare reform law — the Patient Protection and Affordable Care Act, or PPACA — is an extension of that experiment and an effort to bestow new powers to the government.

"Acknowledging the legitimacy of that newly claimed power would fundamentally alter the relationship between government and the American citizen," he wrote. "For the first time in American history, government would become Hobbes’ Leviathan," referring to philosopher Thomas Hobbes.

Pharmacy groups are calling on the Supreme Court to give patients and healthcare providers the right to challenge Medicaid cuts. Read more...

The 3rd Circuit Court of Appeals on Wednesday upheld a lower court's decision to toss out a healthcare reform challenge from a New Jersey doctor and one of his patients.

The lawsuit, filed the day after the law was enacted last year, argues that Dr. Mario Criscito and an anonymous "Patient Roe" would be harmed by the law because the patient pays directly without relying on insurance. The law's individual mandate requiring that most people have insurance or pay a penalty, the complaint alleges, "will have a direct, substantial impact upon Dr. Criscito's medical practice, the manner in which he may, or may not, seek payment for his professional services and the manner in which he may render treatment to his patients."

The appeals court, however, ruled that the doctor and patient failed to show they would suffer "an actual or imminent 'concrete and particularized' injury."