First health law appeal rejected

WASHINGTON -- The U.S. Supreme Court on Monday refused to revive a challenge to President Barack Obama's health care overhaul, leaving intact a ruling that said a California man and an interest group filed their lawsuit prematurely.

The case marks the first time that the high court has been called upon to act on the health care law, which is also being challenged by 20 states in 2 lawsuits.

In rejecting the appeal, the justices dropped a hint that all 9 of them will take part if they ultimately consider the law's constitutionality. Two justices whose participation has been the subject of discussion -- Elena Kagan and Clarence Thomas -- both took part in Monday's action.

Justice Kagan, who served as Mr. Obama's top courtroom lawyer before he appointed her to the Supreme Court, was pressed by Republican senators considering her nomination this year to say whether she would disqualify herself from disputes over the health care law.

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Ruling on Health Law Is Due by End of Year

RICHMOND, Va. — A federal judge said Monday that he would rule by the end of the year on the constitutionality of the new health care law, as lawyers for the Obama administration and the Commonwealth of Virginia debated whether the entire 2,700-page act should be invalidated if a key provision is struck down. 

In a nearly three-hour hearing, a lawyer for the commonwealth argued that if Judge Henry E. Hudson of Federal District Court finds unconstitutional the provision that requires Americans to have health insurance, he should declare the entire law void until the Supreme Court can review it. The lawyer noted that in writing the legislation, Congress failed to include “severability” language to specify that the rest of the law would survive.

The Justice Department concedes that some of the most essential insurance changes, including requiring insurers to cover those with pre-existing conditions, will have to be scrapped if the coverage requirement loses in the courts. The administration maintains that the regulations can work only if everyone is required to have coverage, so people will not simply wait until they get sick to buy policies.

But the federal government’s lawyers argued on Monday that other provisions, like the vast expansion of Medicaid eligibility, could survive, and that the judge should keep the law in effect during the appeals process.

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State workers feeling pain of implementing health-care law

Even as President Obama prepares to acknowledge the six-month mark since he signed his health-care overhaul into law, the legislation remains something of a mystery for patients and politicians alike. Its impact is instead being felt largely by state workers nationwide whose job is to implement the law - and thus begin the mammoth task of transforming the care Americans receive.

For legions of men and women such as James Focht, who coordinates health information technology for the District, that means longer hours and extra work.

When Focht's alarm clock screeched at 3:45 one recent morning, he pulled himself out of bed in the dark, switched on a computer and started tapping out a proposal for a federal grant that would make it easier for hospitals, doctors and other providers to share electronic patient records. He hurried to finish his draft, take a shower and get to work at the D.C. Department of Health Care Finance by 8:15 a.m. so that other executives could edit the proposal and send to the Department of Health and Human Services by 5 p.m.

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