Striking down mandate would be 'devastating'

A day after a Virginia judge struck down the healthcare reform law's individual mandate, Obama administration officials warned in a Tuesday op-ed that there would be "devastating consequences for everyone with health insurance" if the ruling is upheld.

"Without an individual responsibility provision, controlling costs and ending discrimination against people with preexisting conditions doesn't work," Health and Human Services Secretary Kathleen Sebelius and Attorney General Eric Holder wrote in a Washington Post op-ed.

A federal judge in Virginia ruled Monday that the reform law's requirement that everyone purchase insurance by 2014 is unconstitutional because Congress can't regulate an individual's failure to purchase health insurance under the pretense that it is an economic activity that affects interstate commerce. The Obama administration has argued that choosing not to purchase health insurance is an economic activity, because everyone will need healthcare at some point in his or her life.

Sebelius and Holder pointed to federal judges in Virginia and Michigan who had already upheld the individual mandate before Monday's ruling. Those judges wrote that failure to purchase health insurance has a negative impact on the rest of the insurance market because the cost of uncompensated care is passed on to care providers, businesses and individuals with insurance.

"As two federal courts have already held, this unfair cost-shifting harms the marketplace," Sebelius and Holder wrote. "For decades, Supreme Court decisions have made clear that the Constitution allows Congress to adopt rules to deal with such harmful economic effects, which is what the law does — it regulates how we pay for health care by ensuring that those who have insurance don't continue to pay for those who don't."

A federal court in Florida will hear oral arguments Thursday on a 20-state lawsuit that also challenges the individual mandate. Both the Florida lawsuit and latest Virginia ruling are expected to wind up before the Supreme Court.