Legal Precedents to Clash as Health Care Goes to Court; Justices to Answer Questions of Federal Limits

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Byline: Paige Winfield Cunningham, THE WASHINGTON TIMES

As President Obama's health care law heads for an epic Supreme Court showdown this month, the administration and its opponents are struggling to convince the court that it can rule in their favor without upsetting years of precedent or opening the door to all sorts of mischief.

With three full days of arguments set to begin March 26, the government has the tough task of arguing that the justices can uphold the federal government's power to force all Americans to buy insurance without giving legal sanction to other mandates, such as forcing everyone to buy healthy food or join a gym.

But the more than two dozen states suing to overturn the law face a tall hurdle of their own: convincing the court that it can strike down new Medicaid rules embedded in the law without giving the states carte blanche to ignore the strings that are attached routinely to federal spending on such items as education, transportation and the legal drinking age.

The challenge for each side, analysts say, is to find a limiting principle that at least five justices will embrace. When courts consider whether the government is acting within constitutional boundaries, they want a clear limit to its powers, court watchers say.

The states say this is a unique situation, it doesn't apply anywhere else, said Timothy S. Jost, a professor at Washington and Lee University School of Law. Well, that's exactly the same argument the federal government is making to the minimum-coverage argument. I think both sides have their limiting-principle problem.

Limits of mandates

The crux of the challenge to the health care law focuses on the individual mandate, which requires every American to have health insurance or face a stiff tax penalty designed to cover the costs for being uninsured. The government argues that Congress has long had the authority to regulate health insurance under the interstate commerce clause of the Constitution, and forcing participation is just a way of bolstering that market.

The plaintiffs charge that the mandate doesn't regulate existing commerce. Instead, they say, it violates individual liberty by forcing people to engage in commerce in the first place by requiring them to purchase insurance they may not want or need. If the government can order citizens to buy health insurance, the argument goes, what is to stop Washington from mandating other healthful activities such as buying broccoli or signing up for a gym membership?

Judge Laurence H. Silberman of the U.S. Court of Appeals for the D.C. Circuit posed that very question last fall, asking the administration's attorneys whether it would be unconstitutional for the government to require Americans to buy broccoli. The attorneys said no, but added that it depends. The court ultimately upheld the law.

In arguments to the Supreme Court, the administration's attorneys have raised their own questions about the scope of the claims by leading opponents of the law, who include a majority of states and the National Federation of Independent Business, the country's top small-business lobby.

The federal law would dramatically expand coverage under Medicaid - the public health program for the poor, which is funded by federal and state governments. States have filed lawsuits arguing that they should be allowed to opt out of new requirements. The federal government can't order the states to comply, but it can condition the acceptance of vital federal money by the states on adherence to the strings attached to the money.

The Obama administration argues that if states can opt out of these requirements, there is no telling what other federal funding rules they will ignore.

Attorneys on both sides have lined up Supreme Court decisions to bolster their arguments. The administration has pointed to the 1942 case Wickard v. Filburn, in which the court said the government has the power to regulate farmers growing wheat purely for private consumption, on the theory that wheat is traded nationally. …