Health News and Scoops

A federal judge has ruled that the health care reform bill signed into law by President Barack Obama in March is unconstitutional.

Judge Roger Vinson, a Reagan appointee serving in Pensacola, Florida, ruled that key components of the law are unconstitutional and that the entire law “must be declared void.”

In the decision, Vinson writes:

“… I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the Act with the individual mandate. That is not to say, of course, that Congress is without power to address the problems and inequities in our health care system. The health care market is more than one sixth of the national economy, and without doubt Congress has the power to reform and regulate this market. That has not been disputed in this case. The principal dispute has been about how Congress chose to exercise that power here.

Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void.”

You can read the decision here.

Today’s decision is the second ruling by a federal judge against the constitutionality of the health care legislation. Two other federal courts have upheld the constitutionality of the law, including its requirement that most Americans buy health insurance or pay a penalty.

While the lawsuit addressed in Vinson’s ruling is the largest of its kind – with 26 states having signed on – today’s decision is likely just one more step in the law’s march to the United States Supreme Court.

But this is the biggest court victory yet for opponents of the law’s requirement that all Americans buy health insurance.

*** UPDATE *** NBC’s Pete Williams has more:

A federal judge in Florida has declared the new health care law unconstitutional, ruling in a lawsuit brought by 26 states against the federal government. It’s the biggest court victory yet for opponents of the law’s requirement that all Americans buy health insurance.

Judge Roger Vinson found the entire law unconstitutional, after declaring that its key element — the health insurance mandate — was a law Congress did not have the power to enact.  Opponents of the law claimed that while the government can regulate the activities of people engaged in commerce, like the insurance industry, it cannot regulate someone’s inactivity — that is, someone’s refusal to buy insurance.  It’s an argument the judge found persuasive. 

“It would be a radical departure from existing case law to hold that Congress can regulate inactivity under the Commerce Clause,” he said.  If that were true, he said, “it is not hyperbolizing to suggest that Congress could do almost anything it wanted.”  If Congress could reach so broadly, “we would have a Constitution in name only,” he said.

Judge Vinson rejected the Obama administration’s argument that no one truly opts out of the health care system, because everyone eventually needs medical attention.  In that sense, the judge said, health care is no different than many human activities.

“There is quite literally no decision that, in the natural course of events, does not have an economic impact of some sort. The decisions of whether and when (or not) to buy a house, a car, a television, a dinner, or even a morning cup of coffee also have a financial impact that — when aggregated with similar economic decisions — affect the price of that particular product or service
and have a substantial effect on interstate commerce. To be sure, it is not difficult to identify an economic decision that has a cumulatively substantial effect on interstate commerce; rather, the difficult task is to find a decision that does not,” he said.

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Washington (CNN) — A federal judge in Florida has ruled unconstitutional the sweeping health care reform law championed by President Barack Obama, setting up what is likely to be a contentious Supreme Court challenge over the legislation in coming months.

Monday’s sweeping ruling came in the most closely watched of the two dozen separate challenges to the law. Florida, along with 25 other states, filed a lawsuit last spring seeking to dismiss a law critics labeled “Obamacare.”

Judge Roger Vinson, in a 78-page ruling, dismissed the key provision of the Patient Protection and Affordable Care Act: the “individual mandate” requiring most Americans to purchase health insurance by 2014 or face stiff penalties.

“I must reluctantly conclude that Congress exceeded the bounds of its authority in passing the Act with the individual mandate. That is not to say, of course, that Congress is without power to address the problems and inequities in our health care system,” wrote Vinson.

“Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void. This has been a difficult decision to reach, and I am aware that it will have indeterminable implications,” Vinson wrote, adding, “At a time when there is virtually unanimous agreement that health care reform is needed in this country, it is hard to invalidate and strike down a statute titled ‘The Patient Protection and Affordable Care Act.’ “

The states bringing suit in this appeal are Alabama, Alaska, Arizona, Colorado, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin and Wyoming.

Virginia and Oklahoma have filed separate challenges, along with other groups and individuals opposed to the law.

A federal judge in Virginia has also found the health care law unconstitutional, while two other judges have ruled just the opposite. Such disagreements almost ensure the high court will take up the issue. The various cases will likely have to go separate federal appeals courts before the justices would take up one or more of the cases.

There was no indication of when the Supreme Court would take the case, although it could be as soon as later this year.

In the Florida case, opponents were targeting not only that individual mandate, but also the law’s requirement that each state expand Medicaid to cover more of the low-income uninsured.

“It’s an enormous burden on the states that they never agreed to,” then-Florida Attorney General Bill McCollum said last month after oral arguments. The Medicaid expansion, he said, amounts to “the compulsion and coercion of the states, in violation of the 10th Amendment.”

Under the law, the federal government is supposed to pay states for most of the cost of the Medicaid expansion — an estimated 95 percent over the first five years, according to an analysis by the Kaiser Family Foundation. But Texas Attorney General Greg Abbott estimated that the expansion could cost his state up to $25 billion over 10 years.

In his ruling, Vinson seemed almost apologetic that he had to rule against the government on an issue he repeatedly referred to as monumental. But he said that forcing Americans to buy a product like health care insurance that they may not want or need clearly violates the Constitution.

“I will simply observe, once again, that my conclusion in this case is based on an application of the Commerce Clause law as it exists pursuant to the Supreme Court’s current interpretation and definition,” he wrote. “Only the Supreme Court (or a Constitutional amendment) can expand that.”

Obama has said the requirement is justified for the overall good.

“All we’ve said is, everybody has to get some basic insurance, so that we’re not paying for you when you get sick,” he said last month. “It’s the right thing to do, and I’m confident that the courts will uphold it.”

The mandate on individuals to buy insurance is not scheduled to go into effect until 2014. But if that portion of the law is ultimately struck down, analysts say it would make it difficult to pay for the law’s other, more popular provisions.

In the meantime, the public will already benefit from several other provisions of the law, according to White House health care policy director Nancy-Ann DeParle. Those include requirements that insurers offer coverage to children of beneficiaries until age 26; not deny coverage for pre-existing conditions; and not place a lifetime cap on benefits.

The case is Florida v. U.S. Department of Health and Human Services (3:10-cv-91-RV/EMT).

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Here are some of the latest health and medical news developments,
compiled by the editors of HealthDay:

Chinese Drywall Not Linked to Deaths:
CDC

There is no link between tainted Chinese-made drywall and the deaths of
11 people living in homes with the defective drywall, says the U.S.
Centers for Disease Control and Prevention.

All of the 11 people in Louisiana, Florida and Virginia died due to
“preexisting chronic health conditions unrelated to imported drywall
exposure,” according to a CDC report released Monday, said the
Associated Press.

The CDC conclusion supports a previous finding by the U.S. Consumer
Product Safety Commission.

The defective Chinese-made drywall has been linked to corrosion in
thousands of homes in the U.S., mostly in Alabama, Florida, Louisiana,
Mississippi and Virginia, the AP reported. The drywall was imported
during a past housing boom and after a series of Gulf Coast hurricanes
five years ago.

—–

Drug Maker Settles First Avandia Lawsuit
Before Trial

A lawsuit involving the diabetes drug Avandia was settled just before
it was scheduled to go to trial this week in Philadelphia federal court,
says drug maker GlaxoSmithKline PLC.

The lawsuit by the family of James Burford of North Carolina alleged
that his fatal heart attack in 2006 was caused by Avandia, which he took
for 15 months. The company settled the case to avoid the risks and costs
of litigation, Glaxo spokeswoman Mary Anne Rhyne said in an e-mailed
statement Sunday, Bloomberg news reported.

The company did not provide details of the settlement’s terms.

The lawsuit was the first of 2,000 cases heading to court alleging that
U.K.-based Glaxo hid Avandia’s health risks, Bloomberg reported.
The remaining lawsuits in the include at least 1,600 cases filed in
Philadelphia and another 400 in state courts across the U.S.

European regulators ordered the drug off the market and Glaxo has
restricted U.S. sales of Avandia and said it would stop promoting the drug
worldwide. Last September, Glaxo agreed to pay about $460 million to
resolve about 10,000 lawsuits alleging that the company hid the drug’s
heart attack risks.

In the past 12 months, Glaxo has set aside $6.4 billion for legal costs
associated with Avandia, Bloomberg reported.

—–

Artifical Pancreas Benefits Pregnant Women
With Diabetes: Study

Using an artificial pancreas to maintain normal sugar levels in
pregnant women with diabetes could benefit both mother and child,
according to a new study.

U.K. researchers fitted artificial pancreases to 10 pregnant women with
type 1 diabetes. A sensor sent continuous readings of blood sugar levels
to a computer, which instructed a pump to inject required amounts of
insulin when needed, BBC News reported.

The system maintained normal sugar levels in the pregnant women,
according to the study published in the journal Diabetes Care.

“For women with type 1 diabetes, self-management is particularly
challenging during pregnancy due to physiological and hormonal changes,”
said Dr. Helen Murphy of Cambridge University, BBC News
reported.

“These high blood glucose levels increase the risk of congenital
malformation, stillbirth, neonatal death, preterm delivery, macrosomia
[oversized babies] and neonatal admission. So to discover an artificial
pancreas can help maintain near-normal glucose levels in these women is
very promising,” Murphy said.

—–

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PENSACOLA, Fla. – A federal judge declared the Obama administration’s health care overhaul unconstitutional Monday, siding with 26 states that argued people cannot be required to buy health insurance.

U.S. District Judge Roger Vinson agreed with the states that the new law violates people’s rights by forcing them to buy health insurance by 2014 or face penalties. He went a step further than a previous ruling against the law, declaring the entire thing unconstitutional if the insurance requirement does not hold up.

Attorneys for the administration had argued that the states did not have standing to challenge the law and that the case should be dismissed.

Justice Department spokeswoman Tracy Schmaler said Monday the department strongly disagrees with Vinson’s ruling and intends to appeal.

“There is clear and well-established legal precedent that Congress acted within its constitutional authority in passing this law and we are confident that we will ultimately prevail on appeal,” she said in a statement.

The final step will almost certainly be the U.S. Supreme Court. Two other federal judges have already upheld the law and a federal judge in Virginia ruled the insurance mandate unconstitutional but stopped short of voiding the entire thing.

At issue was whether the government is reaching beyond its constitutional power to regulate interstate commerce by requiring citizens to purchase health insurance or face tax penalties.

Vinson said it is, writing in his 78-page ruling that if the government can require people to buy health insurance, it could also regulate food the same way.

“Or, as discussed during oral argument, Congress could require that people buy and consume broccoli at regular intervals,” he wrote, “Not only because the required purchases will positively impact interstate commerce, but also because people who eat healthier tend to be healthier, and are thus more productive and put less of a strain on the health care system.”

Obama administration attorneys had argued that health care is part of the interstate commerce system. They said the government can levy a tax penalty on Americans who decide not to purchase health insurance because all Americans are consumers of medical care.

But attorneys for the states said the administration was essentially coercing the states into participating in the overhaul by holding billions of Medicaid dollars hostage. The states also said the federal government is violating the Constitution by forcing a mandate on the states without providing money to pay for it.

Opponents of the health overhaul praised the decision within minutes of its release Monday afternoon. House Speaker John Boehner said it shows Senate Democrats should follow a House vote to repeal the law.

“Today’s decision affirms the view, held by most of the states and a majority of the American people, that the federal government should not be in the business of forcing you to buy health insurance and punishing you if you don’t,” he said in a statement.

Florida’s former Republican Attorney General Bill McCollum filed the lawsuit just minutes after President Barack Obama signed the 10-year, $938 billion health care bill into law in March. He chose a court in Pensacola, one of Florida’s most conservative cities. The nation’s most influential small business lobby, the National Federation of Independent Business, also joined.

Officials in the states that sued lauded Vinson’s decision. Almost all of them have Republican governors, attorneys general or both.

“In making his ruling, the judge has confirmed what many of us knew from the start; ObamaCare is an unprecedented and unconstitutional infringement on the liberty of the American people,” Florida GOP Gov. Rick Scott said in a statement.

Other states that joined the suit are: Alabama, Alaska, Arizona, Colorado, Georgia, Indiana, Idaho, Iowa, Kansas, Louisiana, Maine, Michigan, Mississippi, Nebraska, Nevada, North Dakota, Ohio, Pennsylvania, South Carolina, South Dakota, Texas, Utah, Washington, Wisconsin and Wyoming.

___

Associated Press Writer Curt Anderson in Miami contributed to this report.

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Connecting struggling veterans to the mental health services
they need is an ongoing challenge. Now, a new study finds that the process could
start with a sympathetic bartender.

The exploratory study found that bartenders at Veterans of
Foreign Wars (VFW) clubs could help identify veterans in trouble and direct
them to mental health professionals. Brief and inexpensive training for these
bartenders would widen the safety net for veterans
in need of care, said study researcher Keith Anderson, a professor of
social work at Ohio State University.

“We found that the VFW bartenders were quite close to
the veterans,” Anderson told LiveScience. “In many cases they saw the
veterans as both friends and even like family.”

Bartending gatekeepers

More than 23 million veterans live in the United States,
according to 2009 data from the Department of Veterans Affairs. Veterans are at
higher risk than the general population for depression and post-traumatic
stress disorder (PTSD), a fact that has led the Veterans Health
Administration to intensify its focus on mental health services. But many
veterans still fall through the cracks.

That’s where community members can come through, Anderson
said. Doctors may miss symptoms, because they typically only see patients once
a year, he said. In contrast, a grocery store clerk or a mail delivery person
may see the veteran weekly or daily.

“Bartenders, we tend to look at them as confidants and
counselors in certain instances, so I naturally thought of them as someone who
could serve as a gatekeeper” to mental health services, Anderson said.

To find out how prepared and willing VFW bartenders might
be, Anderson and his colleagues sent out questionnaires to 300 VFW halls.
Seventy-one bartenders from 32 halls responded.

Because VFWs are private clubs where regulars are common, 54
percent of the bartenders reported feeling “close” to their clients.
Another 18.6 percent said they were “very close.” On average, the
bartenders had worked at their VFW hall for seven years, and 73 percent said
they felt as though the veterans
were family.

“It’s not just a job here; it is a second home with an
extended family,” one bartender wrote on the survey.

About 55 percent of bartenders said their clients shared
problems with them often, and another 15.5 percent said they “always”
heard about veterans’ struggles with family, work, finances and other personal
problems. Slightly more than 65 percent of bartenders ranked themselves as
moderately able to identify signs of depression, and 42.8 percent said they
were moderately familiar with symptoms of PTSD. Another 34 percent said they
were highly familiar with depression symptoms, and 14 percent said they were
well acquainted with PTSD symptoms.

Willing to help

Bartenders weren’t as comfortable with the services offered
by veterans’ hospitals. Only 43 percent were familiar or very familiar with the
types of mental
health benefits available to veterans. But the key, Anderson said, was that
80 percent of respondents were willing to refer veterans to professional help,
and 60 percent were willing to get extra training to help them do so, according
to the study detailed in the current issue of the Journal of Military and
Veterans’ Health.

The goal isn’t to turn bartenders into social workers or
psychiatrists, Anderson said, but a 20-minute online training mandated by the
VFW could give workers the information they need to identify and refer
struggling veterans. The idea is “beginning to work its way through some
of the bureaucratic levels” of the VA and VFW, Anderson said.

There’s no telling when such a program might be implemented,
but Anderson says the idea is cheap, easy and has potential.

“If it helps one veteran, then it’s
cost-effective,” he said.

You can follow LiveScience Senior Writer Stephanie Pappas on Twitter @sipappas.

• Original Story: For Veterans, Road to Mental Health May Begin at the Bar

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