Health care reform, barely hours old, has begun its way into the legal system. It is a process that could take years. Attorneys general from 12 states are planning to challenge key portions of the bill. The new legislation will force all Americans to have health care. Virginia AG Kenneth Cuccinelli II, a founder of Fairfax, Va.-based firm Cuccinelli & Day, said that “just being alive is not interstate commerce,” reports the Richmond Times-Dispatch. “If it were, Congress could regulate every aspect of our lives.” Aside from Virginia, attorneys general from Florida, South Carolina, Alabama, Nebraska, Texas, Oklahoma, Pennsylvania, Washington, Utah, North Dakota and South Dakota say they will challenge the new health care bill in court. The states, they argue, can block the right of the federal government to mandate who must have insurance and what type they must have.
The states’ suits is only the beginning of a long path filled with resistance that health care reform must run before it goes into effect. The federal bureaucracy, particularly the Health and Human Services Department, will have to turn the law into rules and regulations that can be monitored by the government. It is too early to tell how each of the 32 million Americans without health insurance will be enrolled in the new system. Equally complex is the method whereby citizen’s who do not make enough money to cover their premiums will get supplemental payments.
It is now clear either which branch of the federal government will decide whether drug companies and insurance firms are charging rates that conform to the health care reform package. No penalties have been determined yet. Early word out of Washington says that the IRS, of all agencies, will enforce many of the regulations. According to The Washington Examiner, “health care reform, as currently envisioned by Democratic leaders, would be built on the foundation of an expanded and more intrusive IRS.” The tax collection agency will examine and decide, among other things, which people are in compliance with the new regulations. What data it may collect from health care providers is still unclear. It is also unclear whether the charter of the IRS will even allow it to perform these tasks, although the mandate of charter was expanded as part of the legislation. The agency may ask people to list the nature of their insurance on their 1040 tax returns.
Some portions of Americans do not pay their taxes. People with incomes below a certain level are not always required to file with the IRS on an annual basis at all. The use of the IRS as a health care monitoring agency is imperfect at best.
So, health care reform, which was created by one of the landmark pieces of legislation, now gets thrown into the crucible of the real world where lawsuits and enforcement often override the best of legislators’ intentions. And, as Social Security, civil rights, environmental reform, and other broad programs that have passed Congress and been signed into law show, the slip between the cup and the lip can be a big one.
Douglas A. McIntyre
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