Sunday night, 219 House Democrats voted to approved the Patient Protection and Affordable Care Act that has been the subject of contentious political debate since the beginning of the Obama presidency, despite bipartisan efforts to kill the legislation.   House Speaker Nancy Pelosi ( D-CA) proclaimed the legislation an historic victory 

“on a par with passing Social Security and Medicare

while  President Obama stated that

“this government — a government of the people and by the people — still works for the people.”  

Yet support for this legislation by the people was sorely lacking, and states are lining up to file lawsuits challenging the legislation before the President’s signature is dry.  Officials in at least eleven states already have plans to challenge the constitutionality of mandating that all Americans have some form of health insurance, including Virginia, Texas, Alabama, Florida, South Carolina, Nebraska, North and South Dakota, Pennsylvania, Utah and Washington.  These state sovereignty claims will be met with Commerce Clause assertions by supporters of the legislation, though one has to wonder what interstate commerce is being conducted by those citizens who choose not to purchase health insurance.  In addition, at least three dozen state legislatures are weighing possible challenges to the legislation, changes to state law and amendments to their constitutions. 

Florida Attorney General Bill McCollum said  

“The health care reform legislation passed by the U.S. House of Representatives this last night clearly violates the U.S. Constitution and infringes on each state’s sovereignty.” 

Nebraska Attorney General Jon Bruning said the measure 

“tramples on individual liberty and dumps on the states the burden of an unfunded mandate that taxpayers cannot afford.” 

So now we turn to the courts.  Will the legislation survive state challenges, which are certain to increase over the coming weeks and months.  While legal challenges are heard, will the courts stay implementation of the Act?  How will states already on the verge of bankruptcy pay for the increase in their share of Medicare?  And what will be the impact on the House and Senate come November?  Will the American people soon forget those in Washington who chose to ignore them for the sake of another “We Won” moment?

Where Do We Go From Here?

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