Protesters object to state’s role in case

OLYMPIA – As the U.S. Supreme Court questioned lawyers about the constitutionality of making Americans buy health insurance Tuesday, a liberal group that supports the rule protested outside the offices of a business group and a state official who oppose it.

About 100 demonstrators, including several who drove across the state from Spokane, demonstrated outside the Washington office of the National Federation of Independent Business, then marched through downtown Olympia to the office of Attorney General Rob McKenna.

“We need to change things for the next generation, so they don’t get worse,” said Aaron Kathman, a community organizer from Spokane.

The NFIB filed the first legal challenge to the Affordable Care Act, arguing the federal government has no authority to require people to buy health insurance, and because of that the entire law must be struck down. In a separate suit, McKenna added Washington to the 26 states challenging the law. While he says his main objection is that “individual mandate,” that lawsuit, too, asks to abolish the entire law.

Protesters from the Main Street Alliance, a group of small businesses primarily in the Puget Sound, said the NFIB doesn’t speak for them, despite its claim to be the “voice of small business.”

Don Orange, a Vancouver tire and auto shop owner, called health care reform “the best thing that’s happened to small business in a long time.” Opposing the law now is like opposing Social Security in the 1930s or Medicare in the 1960s, he added.

Patrick Connor, state director of NFIB, said the organization probably doesn’t speak for members of the alliance who aren’t part of the federation, but does speak for its dues-paying members. The federation polled its membership before filing the suit, and they were opposed to the mandate. Many members support some elements of the act, including tax breaks for small business health insurance expenses that are similar to what larger companies receive, he said.

Congress wrote the law in such a way that the individual mandate can’t be split out, Connor said. “They (Congress) have to go back to the start.”

McKenna contends that much of the law can survive without the mandate, which he believes is unconstitutional. He supports keeping rules that say a person can’t be denied coverage for pre-existing medical conditions and that young adults can stay on their parents’ insurance until they are 26.

But protesters said he was “saying one thing and doing another” because the suit asks to strike down the entire law. They chanted for him to “drop the lawsuit now,” even though several protesters acknowledged that wouldn’t keep the other 25 states from continuing the challenge.

Justin Ellenbecker, who works as a patient advocate at the Spokane Veterans Center, said McKenna should never have drawn Washington into the court challenge. An Iraq war veteran, Ellenbecker likened the individual mandate to the military ideal that “you leave no man behind.”

“This is not a right-wing or a left-wing issue,” he said. “The solution is somewhere in the middle.”

State Insurance Commissioner Mike Kreidler, who was monitoring Tuesday’s court arguments closely, said if the individual mandate is struck down but the rest of the act is left standing, several elements will eventually fail. Among them would be the requirement that insurance companies offer insurance to everyone, regardless of pre-existing medical conditions.

“That doesn’t work if you have lots of people outside the system,” Kreidler said.

Washington state currently has an estimated 1 million people without health insurance, Kreidler’s office said. If the Affordable Care Act is upheld, more than half of those will be eligible for some kind of coverage. The number of uninsured people in the state will never drop to zero, because it includes about 130,000 illegal immigrants who won’t qualify for coverage, and as many as 70,000 who may choose not to buy insurance. Some have religious objections and are exempt from the mandate; others can afford it but refuse. The state currently has an estimated 100,000 people who earn more than $100,000 but do not have health insurance.

One part of the Affordable Care Act already in place could also be eliminated if the Supreme Court strikes down the whole act, Kreidler said. That’s a provision that allows persons under 26 to remain on their parents’ insurance if they don’t have a job that provides coverage. An estimated 52,000 young adults are covered under that provision, he said.