February 3, 2011—The Democratic-controlled U.S. Senate yesterday defeated a Republican-sponsored amendment to an aviation bill that would have repealed last year’s health care reform law, including its expansion of the 340B drug discount program and gradual elimination of the “donut hole” in Medicare beneficiaries’ Part D prescription drug benefits.
The vote came two weeks after the GOP-controlled House passed its own repeal measure and just two days after a federal district judge in Florida declared the entire Affordable Care Act (ACA) unconstitutional.
Senate Republicans have said they will try again to repeal and replace health reform. This will be difficult, however, as they would need a super majority of 60 votes to overcome Democratic opposition.
Ruling’s Effect Unclear
The immediate effect of U.S. District Judge Roger Vinson’s Jan. 31 decision to strike down health reform is unclear. Because he declined to issue an injunction barring the law’s implementation, questions have risen about the law’s status. Officials from some of the 26 states that brought the suit have declared the law dead and have indicated they will cease carrying it out. Obama administration officials say they are appealing Judge Vinson’s decision to the 11th U.S. Circuit Court of Appeals, investigating whether they need to seek a stay, and continuing to put the law into effect. The case appears destined for U.S. Supreme Court review.
“We strongly disagree with the court’s ruling,” the U.S. Justice Department said, “and we are confident that we will ultimately prevail on appeal.”
Judge Vinson is the first of four federal judges who have ruled on the constitutionality of health care reform to the strike down the entire law. A Virginia federal district judge ruled in December that only the law’s so-called individual mandate for the purchase of health insurance was unconstitutional. Two other federal district judges, in Virginia and Michigan, have dismissed challenges to the law’s constitutionality.
Unlike the judge in Virginia who struck down the individual mandate only, Judge Vinson declared the entire health care reform law void.
“A Defectively Designed Watch”
“The act, like a defectively designed watch, needs to be redesigned and reconstructed by the watchmaker,” he wrote.
Although the judge agreed with the states that brought the suit that the individual mandate was unconstitutional, he rejected their argument that the law also violated the Constitution by requiring them to pay part of the cost of Medicaid’s expansion. The states, he said, had the option of withdrawing from the program.
In addition to voting to repeal health care reform, the GOP-controlled House instructed four committees to begin crafting a replacement. One of those committees has indicated that it might examine the budget and functions of the Health Resources and Services Administration (HRSA) in conjunction with a review of the Department of Health and Human Services’ $80 billion discretionary budget. HRSA is the parent of the Office of Pharmacy Affairs (OPA), which oversees the 340B program.