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KBIA’s Health & Wealth Desk covers the economy and health of rural and underserved communities in Missouri and beyond. The team produces a weekly radio segment, as well as in-depth features and regular blog posts. The reporting desk is funded by a grant from the University of Missouri, and the Missouri Foundation for Health.Contact the Health & Wealth desk.

Health Reform Moves Toward the Supreme Court

ltgov.mo.gov

Missourians have never been in love with health reform. A year ago, Missouri was the first to pass a state law prohibiting an individual insurance mandate. It was a largely symbolic rejection of the Affordable Care Act, but now, more serious obstacles are looming. Missouri Lieutenant Governor Peter Kinder is one of dozens of officials from around the country challenging "Obamacare" in the courts.

In this weekly Health & Wealth update, the Affordable Care Act moves toward the U.S. Supreme Court. 

As early as next week, Supreme Court justices will decide which of six legal challenges they'll hear. Currently Kinder's suit is not among them. It was tossed out by a federal judge back in April, but now Kinder is appealing that ruling, and hopes to be included as a plaintiff in the case filed by Florida, whose suit is under consideration by the court (25 other states have already glommed on).

Kinder's suit is a bit unusual compared tothe others. In other state challenges, attorneys general filed in their official capacity, on behalf of the state. Kinder tried that too, but Missouri's attorney general, Chris Koster, jumped in to point out the Lieutenant Governor does not have that authority. 

So Kinder filed as an individual, which is a bit awkward as he already has health insurance, provided by his employer, the state of Missouri.

District Judge Rodney Sipple found the plaintiffs did not have standing to sue. To have standing they would need to show they had suffered some injury that was: "(A) concrete and particularized, and (B) actual or imminent, not conjectural or hypothetical." The judge found the harms listed in the suit were hypothetical, based on what might or might not happen in 2014 when the Affordable Care Act takes full effect.

In an appeals hearing on October 20th, lawyers sparred over many of thecontroversial elements of the health care reform law. Regardless or whether Kinder's suit ends up before the Supreme Court, many of these arguments will.

At the heart of these is whether Congress has the power, under the commerce clause of the Constitution, to require people buy health insurance. At the appeals hearing, Kinder's lawyer, Thor Hearne, said the case is not actually about health care. "The fundamental constitutional issues at issue in this case concern the most basic principles of federalism and individual liberties that underlie our national order."

That kind of rhetoric certainly won't hurt Kinder's political career, which has been floundering after this summer's "stripper scandal." Kinder has been talking about running since early this year, and now says he'll decide for sure later this month.

Meanwhile, if the Supreme Court takes up the health reform question in the the coming days, justices will likely hear oral arguments in the spring, and make a final ruling by early summer.

In this video, Kinder announces his original suit, and introduces his co-plaintiffs: 

http://www.youtube.com/watch?v=n4R7zKRIw7g