Posts Tagged ‘health care law’

CD3 Candidate John Oceguera Side Steps Question Of Support For Federal Health Care Law, Offers No Plan on Key Issues

By Sean Whaley | 9:10 pm May 7th, 2012

CARSON CITY – Assembly Speaker and 3rd Congressional District candidate John Oceguera, D-Las Vegas, declined today to say whether he supports the federal health care law now under review by the U.S. Supreme Court.

Oceguera, who is termed out of office in the Assembly, said it is premature to comment on the law given the fact that it is awaiting a decision on its constitutionality by the nation’s high court.

CD3 candidate John Oceguera.

“What I say is, if we can make health care more transparent, make insurance companies more transparent, and get the cost of health care down, then I’m for that.”

Oceguera, interviewed on Jon Ralston’s Face To Face television program, repeatedly declined to state a position on the law. Oceguera is challenging Rep. Joe Heck, R-Nev., in a race that has attracted several other candidates as well.

Heck won the seat in 2010 after defeating then-Rep. Dina Titus, D-Nev., who voted for the health care law. Titus was one of many Democrats in Congress who was defeated after voting for the controversial health care legislation. Titus is now a candidate for congress in the 1st Congressional District.

Heck, a physician, opposes the health care law.

Asked about comments by Mike Willden, director of the state Department of Health and Human Services, that Nevada will have to add 150,000 people to the Medicaid program and spend $574 million between now and 2020 if the health care law is upheld, Oceguera offered qualified support for increased access to health care.

Willden made the comments in an interview televised today on Nevada NewsMakers and reported by the Nevada News Bureau.

“I think that if we can make health care more accessible, that is a laudable goal and we ought to do that,” Oceguera said.

A now retired North Las Vegas firefighter, Oceguera said he knows firsthand that for many people, it was dialing 911 that was their option to gain access to medical care.

“I don’t think that is the way it should work,” he said.

Oceguera pushed for a bill in the 2011 legislative session that would have imposed more transparency on rate increases sought by health insurance companies. Assembly Bill 309 passed the Legislature but was vetoed by Gov. Brian Sandoval.

In his veto message Sandoval said the goals of the measure were laudable, but that the bill “does more harm than good and seems to impose duplicative regulatory requirements.”

Oceguera took the opportunity during the interview to criticize Heck for what he said were comments that minimized Nevada’s foreclosure crisis in 2008 by calling it a blip on the radar and for not being proactive in dealing with the problem.

A House committee held a hearing on the crisis in Las Vegas in March at Heck’s request.

Oceguera said job creation is the key to the foreclosure crisis.

“You fix this economy, you get it back on track, you balance the budget the right way,” he said. “That helps put people back to work. If they’ve got a job they can make their house payment.”

But Oceguera offered few specifics on how to end the foreclosure crisis or protect Medicare. He also declined to take a position on the federal stimulus bill.

Oceguera also responded to questions about a column written by Las Vegas Review-Journal Glenn Cook last month calling him a “world class hypocrite” for championing the middle class after retiring at age 43 to collect a lifetime public pension.

Oceguera said he was fortunate to be a firefighter and that he “did it by the book.”

The election is about priorities and getting the economy back on track, he said.

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Audio clips:

Congressional candidate John Oceguera says he is for more transparency to get the cost of health care down:

050712Oceguera1 :08 I’m for that.”

Oceguera says getting people back to work is key to solving the foreclosure crisis:

050712Oceguera3 :14 their house payment.”

Medicaid Caseload Will Expand By 150,000, Cost Nevada $574 Million if Federal Health Care Law Is Implemented

By Sean Whaley | 2:51 pm May 7th, 2012

CARSON CITY – The head of Nevada’s Department of Health and Human Services said today that as many as 150,000 more residents will be eligible for Medicaid coverage if the federal health care law is found constitutional by the U.S. Supreme Court.

Bringing new residents onto the rolls is expected to cost the state an estimated $574 million between now and 2020, said HHS Director Mike Willden in an interview on the Nevada NewsMakers television program broadcast today.

The estimate, which is about two years old, includes the cost to the state of serving new Medicaid eligibles, the cost of new information technology needed to implement the law and some increased payments to primary care physicians, he said.

The U.S. Supreme Court is expected to rule on the constitutionality of the health care law by June.

U.S. Supreme Court.

Nevada was one of more than two dozen states to challenge the constitutionality of the new law. Even so, Gov. Brian Sandoval has moved forward with implementation because it is the law of the land.

Willden said the new rules say that every man, woman and child living under 138 percent of the federal poverty level will be eligible for Medicaid, the cost of which is shared by the states and federal government.

“Our estimate in Nevada is, as I indicated, we have about 325,000 people on Medicaid or our Checkup program now, and we may see upwards of 150,000 more people eligible for Medicaid,” Willden said. “Because we pick up a group that we’ve never covered in Nevada, and that’s what we call childless adults. Nevada has never served childless adults.”

The other part of the expansion will come as Nevadans now eligible for Medicaid but who have not enrolled in the program will participate because of the individual mandate to have health insurance, he said.

Willden said he does not believe Nevada’s medical provider community will be able to accommodate the increased population seeking health care.

“As you know we’re one of the worst in the nation when it comes to primary care physicians ratios to population, specialists of various kinds ratios to population, and you bring in many, many more on Medicaid I don’t think there will be what we call adequate networks to provide that, so that will be a challenge,” he said.

Nevada will need to bring more physicians into the state, but will have to compete with other states to do so, Willden said. It could also lead to an examination and potential expansion of what types of medical care nurses and physician assistants are able to provide to patients, he said.

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Audio clips:

DHHS Director Mike Willden says about 150,000 more Nevadans may be eligible for Medicaid:

050712Willden1 :22 served childless adults.”

Willden says Nevada’s medical community may not be able to handle the increase in the Medicaid eligible population:

050712Willden2 :23 be a challenge.”

 

Nevada Among States With Lowest Spending On Health Care And Least Number Of Insured

By Sean Whaley | 2:35 pm December 20th, 2011

CARSON CITY – Nevada ranks 46th among states on spending on health care per capita, according to a report released this month by the Centers for Medicaid & Medicare Services.

Nevada spends $5,735 per person on total personal health care as of 2009, the report says. The national average is $6,815. The highest per capita spending was found in Massachusetts at $9,278.

Larry Matheis, executive director of the Nevada State Medical Association, said Nevada’s low spending on health care is a reflection of the large number of residents who don’t have health insurance.

U.S. Census data released in October shows that Nevada is the third most uninsured state per capita in the U.S as of 2009.

“On first blush it’s good news that we’re not on the high end of spending per person,” Matheis said. “But a more balanced look at the data says we have a lot of warning signs in this pool of data. It renders a number that looks like we’ve got costs under control. It actually just means we have a big access problem.”

The report found that eight of the ten top states for total health care spending per capita, including Massachusetts, Connecticut, and New York, are also ranked in the top third in the nation for annual personal income per capita.

Photo by James Gathany, Centers for Disease Control and Prevention.

“Income appears to have an important and positive relationship with health spending,” the report said.

Matheis said the study provides much-needed information as the country moves forward with full implementation of the national health care law.

“They need much better baseline information about how much they are spending and on what with every population and in every part of the country, because a big part of the reform proposals are aimed at trying to, if not reduce costs, reduce the things that lead to higher costs,” he said.

Report also looks at Medicare and Medicaid spending

The report shows that Nevada is in the middle of the pack in terms of Medicare spending per enrollee at $9,692, and ranks toward the bottom of the states on Medicaid spending per enrollee at $6,003. The national averages are $10,365 and $6,826, respectively.

But in terms of the percentage of health care dollars spent on Medicaid, Nevada is lowest among all states at only 8.6 percent. Nevada is the only state where spending is in the single-digits. The highest is New York, where 29.2 percent of all personal health care spending is via Medicaid.

Medicaid is the health care program for low income seniors, disabled and families, the cost of which is shared by states and the federal government.

Charles Duarte, administrator of the state Division of Health Care Financing and Policy, which oversees the Medicaid program, said Nevada’s spending is low because of the policy decision to restrict eligibility. The program also doesn’t offer many optional services that can increase costs.

“We’ve made decisions as a state that we’re not going to expand the program from an eligibility perspective,” he said. “And so in other states Medicaid makes up 14, 15, 16 percent of coverage for people in the state. In some states it is as high as 30 percent.

“We don’t cover as many people in our public programs, but our employers are kind of right in the middle there, slightly above the national average,” Duarte said. “And what the means is the uninsured group are those that could be covered by Medicaid if our rules allowed it.”

Federal health care law expected to affect Nevada Medicaid spending

This situation is expected to change as the Medicaid program expands beginning in 2014 as part of the implementation of the federal health care law, he said. As many as 100,000 new residents could be eligible for Medicaid. There are residents eligible for Medicaid now who are not participating in the program who will have to be covered as well, Duarte said.

The cost of the newly eligible residents will be covered almost entirely by the federal government, but the state will share in the cost of those who are eligible now but who have not signed up for the program, he said.

This Medicaid expansion is one reason Nevada joined with many other states in challenging the constitutionality of the health care law. The U.S. Supreme Court has agreed to review the law. Former Gov. Jim Gibbons in 2010 estimated the Medicaid mandate will cost Nevada $613 million over six years beginning in 2014. Gibbons initiated Nevada’s participation in the challenge to the law which is being continued by Gov. Brian Sandoval.

Matheis said there is a strong feeling in the Nevada medical community that the state is under-spending on this population, which will have to change with the implementation of the health care law.

“Nevada is going to go from where we are now, which is a very low spending per Medicaid patient; we’re going to jump a huge amount because there are going to be so many people that will be identified for the new Medicaid expansion that is coming under the Affordable Care Act,” he said.

This rapid expansion will create budget challenges for state lawmakers, Matheis said.

Policy-makers need to seriously consider the data and build it into the state’s planning efforts, he said.

“At some point we do have to invest in a health care system that we want,” Matheis said. “Right now we’re doing that in Nevada minimally and that’s what this report really shows.”

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Audio clips:

Larry Matheis, executive director of the Nevada State Medical Association, says the report provides much needed baseline information:

122011Matheis1 :24 to higher costs.”

Matheis says Nevada will see a big jump in Medicaid spending because of the new health care law:

122011Matheis2 :25 Affordable Care Act.”

Matheis says the news looks good at first, but it suggests there are concerns:

122011Matheis3 :19 pool of data.”

Charles Duarte, administrator of the state Division of Health Care Financing and Policy, says Nevada’s Medicaid spending is low because eligibility is restricted:

122011Duarte1 :15 high as 30 percent.”

Duarte says the uninsured group in Nevada are those who could be covered by Medicaid if eligibility was expanded:

122011Duarte2 :18 rules allowed it.”

 

Las Vegas Attorney Readies Nevada For U.S. Supreme Court Review Of Federal Health Care Law

By Sean Whaley | 2:43 pm November 15th, 2011

CARSON CITY – The Las Vegas attorney representing Nevada in the 26-state challenge to the new federal health care law says the case is critically important because of the mandate for people to purchase health insurance.

“Never before in our nation’s history has the federal government required its citizens to purchase a product or service as a condition of citizenship in this country,” said Mark Hutchison, who is representing Nevada without charge in the case. “This case is of high importance to all Nevadans, because if the federal government can require us to purchase health insurance, then they can require us to purchase anything they choose.”

Hutchison, in a statement issued Monday when the U.S. Supreme Court agreed to hear the case, said the initial written briefs are due Dec. 29. Oral arguments are expected to be in March. The court will issue a decision in the case before its term expires at the end of June 2012.

U.S. Supreme Court.

First appointed by Gov. Jim Gibbons, and then re-affirmed by Gov. Brian Sandoval, Hutchison was named to serve as lead special counsel for the state when Attorney General Catherine Cortez Masto declined to represent the state in the federal litigation.

In addition to the 26 states, the National Federation of Independent Business (NFIB) is a party to the challenge.

Randi Thompson, Nevada state director for the NFIB, said in a statement Monday: “This act is already increasing the cost of health care on Nevadans, increasing costs to Nevada taxpayers for Medicaid and Medicare coverage, and causing business owners to even drop coverage for their employees. Health care needs to be more accessible and affordable, but this act is not the way to reach that goal.”

Others also weighed in on the decision.

White House Communications Director Dan Pfeiffer issued this statement: “Earlier this year, the Obama Administration asked the Supreme Court to consider legal challenges to the health reform law and we are pleased the court has agreed to hear this case.

“Thanks to the Affordable Care Act, one million more young Americans have health insurance, women are getting mammograms and preventive services without paying an extra penny out of their own pocket and insurance companies have to spend more of your premiums on health care instead of advertising and bonuses. We know the Affordable Care Act is constitutional and are confident the Supreme Court will agree,” he said.

U.S. Sen. Dean Heller, R-Nev., said in a statement: “Nevada families and businesses are already struggling in this current economic environment, and the president’s job killing health care law is making a difficult situation worse. The law’s excessive taxes, expensive regulations and questionable constitutionality are stripping businesses of the certainty they need to hire at a time when Nevadans and the rest of the country are desperate for jobs.

“While the Supreme Court considers this case, the president should work with Congress to find real solutions to health care reform so the excessive mandates in this law do not add to our national debt or hurt our struggling economy,” he said.

U.S. Senate Majority Leader Harry Reid, D-Nev., said in a statement: “Families, seniors and small businesses in Nevada and across the country are reaping the benefits of health insurance reform. Prescription drug costs for seniors are falling as the Medicare ‘donut hole’ closes, insurance companies can no longer deny coverage to children with pre-existing conditions, and business owners are taking advantage of tax breaks.

“Just last week, a conservative judge appointed by President Reagan ruled that this legislation is constitutional, and I am confident the high court will do the same,” he said.

Rep. Mark Amodei, R-Nev., said in a statement: “I believe that the individual mandate is unconstitutional and it is my hope that the Supreme Court will overturn it. Already, during my short time in Congress, I voted to repeal a provision of the president’s health care law that raised eligibility for Medicaid far beyond the intended poverty level. This correction is estimated to save taxpayers at least $13 billion over 10 years.

“I eagerly await the court’s decision and from there we’ll be able to assess the path for repealing what amounts to government control of 16 percent of our economy,” he said.

A number of federal courts have weighed in on the law with sometimes contradictory rulings on the constitutionality of the law and the individual mandate. President Obama signed the Patient Protection and Affordable Care Act into law in March 2010.

The U.S. Supreme Court decided to use the case filed by the states, including Nevada, and the NFIB, to determine the constitutionality of the law.

Nevada and the other states challenged the law in federal court in the Northern District of Florida. U.S. District Court Judge Roger Vinson ruled in the states’ favor and declared the individual mandate in the federal health care law unconstitutional. He declared the entire law unconstitutional without the mandate.

The 11th U.S. District Court Appeals then upheld Vinson’s ruling on the individual mandate but said the rest of the law could stand.

The U.S. Supreme Court will now take up the issues of whether the individual mandate is constitutional and whether the entire law is unconstitutional if the individual mandate is unlawful.

The individual mandate requires all U.S. citizens and residents to purchase health insurance from a private company or face government-imposed penalties enforced by the Internal Revenue Service.

“We are pleased that the highest court in the country will make a final decision about the constitutional fate of the healthcare legislation,” Hutchison said. “The states are confident that the U.S. Supreme Court will determine that the law is unconstitutional.”

Gov. Sandoval Makes Appointments to Health Insurance Exchange Board

By Nevada News Bureau Staff | 3:44 pm September 23rd, 2011

Dr. Ronald Kline.

CARSON CITY – Gov. Brian Sandoval announced today his appointments to the Silver State Health Insurance Exchange Board.

Sandoval has appointed Elsie Lavonne Lewis, Leslie Ann Johnstone, Dr. Ronald Kline, Barbara Smith Campbell and Marie Kerr. Each of the appointees will be voting members of the board.

“While Nevada remains a partner in challenging the constitutionality of the federal health care law, we are mandated to move forward with its implementation,” Sandoval said.  “Each member of the board will bring a distinctive perspective to the table to help Nevada formulate the most effective exchange.”

Lewis, chief operating officer of the Clark County Urban League, will serve until June 30, 2013. Johnstone, executive director of the Health Services Coalition in Clark County, will serve until June 30, 2014. Kline, a physician with Comprehensive Cancer Centers of Nevada in Clark County, will serve until June 30, 2012. Smith Campbell, a Washoe County resident and former chairwoman of the Nevada Tax Commission, is the founder of Consensus, a tax consulting firm, will serve until June 30, 2014. Kerr, an attorney in Reno, will serve until June 30, 2012.

Reno attorney Marie Kerr.

Created by Senate Bill 440, the Exchange is required to:

-          Create and administer a state-based health insurance exchange;

-          Facilitate the purchase and sale of qualified health plans;

-          Provide for the establishment of a program to assist qualified small employers in Nevada in facilitating the enrollment of their employees in qualified health plans;

-          Make only qualified health plans available to qualified individuals and qualified small employers on or after January 1, 2014; and

-          Unless the federal health care law is repealed or is held to be unconstitutional or otherwise invalid or unlawful, perform all duties that are required of the exchange to implement the requirements of the law.

The bill creating the exchange passed both houses of the Legislature unanimously with four members of the Assembly not present for the vote. While lawmakers questioned the effect of the act being found unconstitutional on the operation of the exchange, there was no testimony in opposition to the measure.

The exchange is governed by the Board of Directors, consisting of five voting members appointed by the governor, one voting member appointed by the Senate majority leader and one voting member appointed by the speaker of the Assembly.

Senate Majority Leader Steven Horsford has appointed Dr. Judith Ford with Canyon Gate Medical Group in Las Vegas, and Assembly Speaker John Oceguera has appointed Lynn Elkins.

Affordable Health Care Insurance Now Available To Nevadans With Pre-Existing Medical Conditions

By Sean Whaley | 3:38 pm July 1st, 2011

CARSON CITY – Officials with the U.S. Department of Health and Human Services put out the word today that a new affordable health insurance plan is available for Nevadans with pre-existing medical conditions.

The plan, offered through the new federal Patient Protection and Affordable Care Act, will serve as a bridge to cover this group of people between today and Jan. 1, 2014, when the major provisions of the law take effect, said Herb Shultz, regional director of HHS for Nevada.

The rates for Nevadans who are eligible for the coverage have also been reduced by 37.5 percent, making the insurance even more affordable, he said.

“Both kids and adults, who have pre-existing medical conditions – cancer, diabetes, asthma – many for the first time will be able to get comprehensive health care coverage because the affordable care act makes it able for people who have been denied health insurance before to now be eligible to get affordable quality health insurance,” Shultz said.

Health care coverage is now available for Nevadans with pre-existing medical conditions / James Gathany @ Wikimedia Commons

David Sayen, Medicare’s regional administrator for Nevada, said the comprehensive health care plan includes access to 8,800 physicians, 480 pharmacies and 57 hospitals. It is operated by GEHA, a nonprofit organization that provides health care coverage to federal employees and retirees.

The coverage is available to U.S. citizens and legal residents who have a pre-existing medical condition and who have not had insurance for the six months prior to filing an application. Barriers to enrollment have also been eased, Sayen said.

“This is historic and groundbreaking,” Shultz said. “And this will not only give peace of mind to individuals and families and to communities, it is what is important about this law – is that people with pre-existing conditions can get access to affordable, quality health insurance.”

More information about the program can be obtained at the website: www.pcip.gov. Nevada’s Office of Consumer Health Assistance can also provide help.

Information about the Pre-Existing Condition Insurance Plan can also be obtained by calling 1-866-717-5826; (TTY: 1-866-561-1604). Hours of operation are Monday to Friday, 8 a.m. to 11 p.m., Eastern Time.

Nevada Gov. Brian Sandoval has opted to prepare for the implementation of the new health care law even though the state is one of 26 involved in a joint legal challenge to it. Various legal challenges to the law are making their way through the federal courts and are expected to end up before the U.S. Supreme Court.

The pre-existing insurance plan is being operated by the U.S. Department of Health and Human Services on behalf of the state, however.

Audio clips:

Herb Shultz, regional director of HHS for Nevada, says those with pre-existing conditions will be able to get affordable health insurance for the first time:

070111Shultz1 :22 quality health insurance.”

Shultz says the new coverage is historic and groundbreaking:

070111Shultz2 :20 quality health insurance.”

 

Federal Appeal In States’ Challenge To National Health Care Law Set For June 8 In Atlanta

By Sean Whaley | 2:17 pm April 28th, 2011

CARSON CITY – Oral arguments in the ongoing legal challenge of the national health care law by 26 states including Nevada are set for June 8 before the 11th U.S. Circuit Court of Appeals in Atlanta, Ga.

Lead Special Counsel for Nevada, Mark Hutchison, will represent the state at the hearing, which will consider the federal government’s appeal of a lower federal court ruling out of Florida which found a key provision of the health care law unconstitutional.

Florida Judge Roger Vinson ruled Jan. 31 that the provision of the law that requires all U.S. citizens and residents purchase a private health insurance policy is unconstitutional.

“The federal government’s appeal was expected,” Hutchison said. “We are confident that Judge Vinson’s decision is sound and that at the end of the day the states will prevail. Congress exceeded its authority under the Constitution by compelling Americans to purchase a product, in this case a health insurance policy, from a private company.”

In Vinson’s original ruling he reasoned: “It is difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place. If Congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the Constitution would have been in vain for it would be ‘difficult to perceive any limitation on federal power,’ and we would have a Constitution in name only. Surely this is not what the Founding Fathers could have intended.”

The federal lawsuit was originally filed in federal court in the Northern District of Florida on Mar. 23, 2010. Nevada joined the lawsuit on May 14, 2010 at the direction of former Gov. Jim Gibbons.

Gov. Brian Sandoval supports Nevada’s legal challenge of the law as well.

The state of Virginia filed a separate lawsuit in U.S. District Court in Virginia on Mar. 23, 2010, making a total of 27 states challenging the constitutionality of the Patient Protection and Affordable Care Act.

Public court documents about the case can be found at www.hutchlegal.com/healthcare. Nevadans can also visit Hutchison’s blog for regular updates and information at www.obamacarelitigation.blogspot.com.

 

Nevada Gov.-elect Brian Sandoval Pleased With Federal Court Ruling Against Health Care Law

By Nevada News Bureau Staff | 2:19 pm December 13th, 2010

CARSON CITY – Gov.-elect Brian Sandoval said today he is pleased with the ruling by a federal judge in Virginia finding a key element of the new national health care law unconstitutional.

In a statement, Sandoval said: “As I’ve noted before, I see the constitutional question created by the health care bill as monumental in all future matters involving state’s rights. Today’s ruling provides support for the claim that the federal health care legislation is at least, in part, unconstitutional. I believe the constitutional questions involved in the federal health care legislation deserve a hearing by the United States Supreme Court.”

Sandoval’s comments came after U.S. District Judge Henry Hudson ruled today the individual mandate to buy health insurance is unconstitutional because it “exceeds the constitutional boundaries of congressional power.”

Nevada is involved in a separate legal challenge to the health care law as well, along with 19 other states. A federal judge in Florida is scheduled to hear arguments in the case on Thursday.

Nevada’s Challenge To Health Care Law Could See Ruling By January But Appeal Certain

By Sean Whaley | 1:45 pm November 8th, 2010

CARSON CITY – The private attorney working on Nevada’s challenge to the new national health care law says a federal judge in Florida should rule on the case by January, setting the stage for an appeal that ultimately is expected to reach the U.S. Supreme Court.

U.S. District Judge Roger Vinson gave Nevada and 19 other states a victory in October when he rejected the federal government’s efforts to get the lawsuit thrown out of court.

“I think by mid-January we will have a decision out of Judge Vinson,” said Las Vegas attorney Mark Hutchison, representing Nevada without charge in its challenge to the constitutionality of the Patient Protection and Affordable Care Act.

Vinson is now scheduled to hear arguments on Dec. 16 on two major legal issues: whether Congress can mandate individuals to purchase insurance coverage, and whether the law oversteps the federal government’s authority to tell states how to run their budgets by mandating an expansion of the Medicaid caseload.

The mandate by Congress to individuals to purchase insurance is a key element of the legal challenge, Hutchison said.

“He (Vinson) will decide whether or not, through the commerce clause, Congress can essentially regulate inactivity; that is, my decision or your decision not to purchase insurance,” Hutchison said.

The other issue is whether the mandate that states expand Medicaid coverage under the new law violates the 10th Amendment giving states authority over their own budgets and programs.

The mandate by the federal government is putting tremendous financial burdens on the state, he said.

Gov. Jim Gibbons has estimated the Medicaid mandate will cost Nevada $613 million over six years beginning in 2014 when a three-year federal payment to cover the cost of an increased Medicaid caseload goes away.

While the lawsuit remains active, Hutchison said actions by the next Congress could potentially make the legal challenge moot.

The Democratic majority in the House of Representatives was swept away on Tuesday, and the new Republican majority has made repealing the health care law a top priority.

A repeal of the law would make the challenge moot, Hutchison said. If, in the alternative, Congress refuses to fund the implementation of the law, that too could sideline the challenge, he said. The argument could be made that the states would not have standing to challenge the law because it is not being put into effect, he said.

In his October ruling allowing the case to proceed, Hutchison said Vinson gave some hints about how he may rule. Vinson noted the Congressional mandate is unprecedented, saying in a footnote in his ruling there have been at least six attempts by Congress to implement universal health care in the past 90 years but that this is the first effort at a mandate.

Vinson said there may be a presumption that the mandate under the commerce clause is unconstitutional because it has never been used before despite claims by the U.S. Justice Department that Congress has the authority to do so.

“While the novel and unprecedented nature of the individual mandate does not automatically render it unconstitutional, there is perhaps a presumption that it is,” Vinson said in footnote 21.

“So I think that gives us a clue,” Hutchison said.

The ruling is also interesting in that it rejects an alternative effort by the federal government to justify the mandate under its taxing authority, Hutchison said. The penalty for not purchasing health insurance has always been defined as a penalty, not a tax, he said.

In his ruling, Vinson said: “Congress should not be permitted to secure and cast politically difficult votes on controversial legislation by deliberately calling something one thing, after which the defenders of that legislation take an ‘Alice-in-Wonderland’ tack and argue in court that Congress really meant something else entirely, thereby circumventing the safeguard that exists to keep their broad power in check.”

The opposing motions for summary judgment that will be filed by the states and the U.S. Department of Justice will both say there is no need for a trial, only a ruling on the merits of the case.

Whichever way Vinson rules, the case will be appealed to the 11th Circuit Court of Appeals and ultimately to the U.S. Supreme Court, Hutchison said

Other challenges, by states and individuals, are proceeding in other jurisdictions. The challenge by Nevada and the other states also includes the National Federation of Independent Business and two individuals.

Hutchison agreed to represent Nevada in the case after Democratic Attorney General Catherine Cortez Masto declined to file suit on behalf of the state. The election of GOP candidate Brian Sandoval as Nevada’s next governor ensures the challenge on behalf of the state will continue.

“He (Sandoval) welcomes with open arms the state’s continuing involvement in this litigation,” Hutchison said.

Hutchison said Masto’s argument for declining to challenge the law – that it was frivolous – has been repudiated by Vinson’s ruling allowing the case to proceed.

He called Masto’s decision, “a poor exercise of professional judgment.”

“Now Nevada is one state that is right in the hunt on a very important issue that is going to be proceeding up the process ultimately to the U.S. Supreme Court,” Hutchison said.

Asked for a response, Masto said: “It sounds like Mr. Hutchinson is still trying to justify his involvement in this case. I can understand his concerns considering that two separate federal courts have already dismissed similar actions against the health care law and the judge in the Florida action has dismissed four of the six claims and will make a decision on the remaining claims sometime in December.”

Audio clips:

Las Vegas attorney Mark Hutchison says key question is whether Congress can mandate the purchase of insurance:

110510Hutchison1 :32 on its constitutionality.”

Hutchison says mandate violates 10th Amendment:

110510Hutchison4 :22 without federal interference.”

Hutchison says  Gov.-elect Sandoval wants the challenge to continue:

110510Hutchison3 :18 happy with that.”

Hutchison says Attorney General Masto should have challenged the health care law:

110510Hutchison2 :42 U.S. Supreme Court.”

Nevada Insurers Stop Offering Child-Only Policies Due to Uncertainty Over Federal Health Care Law

By Sean Whaley | 2:05 am September 24th, 2010

CARSON CITY – A Nevada insurance broker today said families seeking health care coverage for a child only can no longer purchase such policies because of uncertainty over the effects of the national health care reform law.

Phil Randazzo, chief executive officer of Nevada Benefits Corp. said uncertainty about how the Patient Protection and Affordable Care Act will affect these types of polices has led the companies offering health care coverage in Nevada to independently decide to no longer offer such coverage.

Nevada Benefits is one of the state’s leading brokerages of individual and group medical and life insurance.

“What happened was that children now are allowed to purchase health care insurance with no preexisting conditions,” Randazzo said. “Which sounds good, but the problem is the insurance companies don’t know how to underwrite that or handle that because it is an unknown.”

Regulations have not yet been generated for insurance companies to know the ramifications of the change, he said.

Elements of the federal health care law, including provisions prohibiting insurance companies from turning down children with preexisting conditions, took effect today. Other states have seen the same effect as companies decide to no longer offer the policies.

“The insurance companies made a business decision, which I totally understand, to not offer child only insurance policies,” Randazzo said. “So now if you live in Nevada, and you want to buy insurance for your child, you can’t buy one.”

One alternative would be for parents to cover their children under a health plan offered by an employer, he said.

Randazzo said the situation “is a big mess.” Nevada’s Congressional delegation has been contacted but is unaware of how this situation will be resolved, he said.

Randazzo said he is now turning down such coverage requests because he can longer sell such policies.

Ethan Rome, executive director of the liberal group Health Care for America Now (HCAN), issued a statement criticizing the decision of the insurance companies to drop the coverage.

“The latest announcement by the insurance companies that they won’t cover kids is immoral, and to blame their appalling behavior on the new law is patently dishonest,” he said. “Instead, they should reverse their actions immediately and follow the spirit of the law, instead of exploiting loopholes.”

Nevada is one of several states challenging the constitutionality of the health care law.

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Audio clips:

Phil Randazzo said child-only insurance policies are no longer available in Nevada due to the new health care law:

092310Randazzo1 :18 been put out.”

Randazzo said insurance companies had to make a business decision:

092310Randazzo2 :13 can’t buy one.”

Randazzo describes the situation as a big mess:

092310Randazzo3 :18 vote right now.”