At a panel discussion sponsored by the North Carolina Institute for Constitutional Law
(NCICL), Adam Linker of the NC Justice Center was hesitant to say the health
law passed in March would provide everybody adequate insurance. Groups had
previously given up on claims of lowering health care costs and reducing the
deficit, but this is only the second time I have seen a supporter give up on
the bill’s ability to guarantee universal health insurance coverage. The first
time was U.S. Sen.
Ben Nelson (D – Cornhusker
Kickback) who did so to downplay the cost of Medicaid expansion to states.

Linker’s comments were in response to claims that ObamaCare’s guarantee of adequate insurance to everybody in America meant that North Carolina would not have to continue central planning of
capital investments in health care with certificates of need (CON). Also on the panel were Jason Kay of NCICL, Noah Hufstetler of Nelson Mullins LLP, and Duke University professor Clark Havighurst.

Despite a lack of evidence
that CON regulations lower health care costs and strong
evidence that competition does, both Kay and Hufstetler were hesitant to end CON on its own.
Havighurst was more comfortable with the idea.

Linker, on the other hand, completely ignoring economics and
common sense, sounded like Yogi Berra in his defense of the regulations for
rural hospitals in particular. In short he said that rural hospitals need
certificate of need to protect them from competition because nobody is seeking
to challenge their local monopolies. As recently as 2000, just 18 of 100
counties had more than a single hospital system.

ObamaCare Challenge Proceeds
Last week, a federal judge allowed the multi-state lawsuit
against ObamaCare to go forward on two challenges — the ability of the federal
government to force people into commerce and whether the federal government is
coercing and commandeering states to expand Medicaid. On the Medicaid question,
Judge Roger Vinson wrote,

Congress
does not really anticipate that the states will (or could) drop out of the
Medicaid program. To be sure, since the Act seeks to reduce costs, reduce
uncompensated care, and reduce the number of uninsured, it would make little
sense for Congress to expect that objecting states would opt out of Medicaid
and leave millions of the country’s poorest citizens without medical coverage,
and thus make each of those stated problems significantly worse.

On the individual mandate, Vinson cited the Congressional Budget
Office in 1994 as saying a mandate was "unprecedented" in its
requirement of action "as a condition of lawful residence in the United
States." Vinson added,

Of course, to say that something is "novel" and "unprecedented" does not
necessarily mean that it is "unconstitutional" and "improper." There may be a first
time for anything. But, at this stage of the case, the plaintiffs have most
definitely stated a plausible claim with respect to this cause of action.