Radnofsky: AG Turns His Back on VA Hospital South of San Antonio

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2 May 2010

The Texas Attorney, finishing his second four year term, has made headlines for his letters, lawsuits, and press releases criticizing the federal government for its health care reforms.

If he really had the power to reverse Congressional actions and require fair treatment of Texans, he should have filed suit long ago for a VA hospital south of San Antonio.

For many, many years Texas has ranked among the worst states for veterans' care. During the incumbent Attorney General's long reign, Texas ranked near the bottom of the barrel, with huge numbers of wounded, injured or sick veterans denied VA medical care. The distance our South Texas veterans must travel for VA hospital care represents a national shame.

The Attorney General has spent our tax dollars and his official time and energies claiming that Congress has no constitutional authority to implement the health care reform law recently passed. The legal decision on constitutionality will turn on whether or not Congress has a “rational basis” for the law. The courts won't ask if the law is the best solution, but rather whether the law promotes a legitimate government end, with a reasonable and not arbitrary basis for doing so. The Attorney General claims his lawsuit is legally valid. If so, he'd have a much easier time showing massive unfairness and harm to Texas' veterans.

In December 2009, prior to the health care law passage, Texas Attorney General threatened suit by press release and correspondence asserting Texans' individual rights and limits on constitutional authority. Why has he not asserted the rights of Texas veterans to health care? In truth, our State Attorney General lacks the Constitutional power to assert Texans' individual rights; a state and its agencies are not "persons" with rights to assert due process. If he had such power, it should first be used for the individuals with superb claims to federally promised medical and dental care: our veterans. The Texas Attorney General should have sued on behalf of our deserving veterans treated so poorly relative to other states, and relative to veterans outside South Texas.

On December 30, 2009, the Texas Attorney General co-signed a letter to Congressional leaders protesting political horse trading. Yet he never objected when, in 2006, politically powerful Nevada received a firm commitment for a new Las Vegas medical center to "enhance veterans’ access to VA's world-class health care in the area." The year prior, the VA spent nearly $700 million to serve Nevada's 245,000 veterans. Nevada already had significant facilities in the form of Las Vegas clinics and the Reno medical center and nursing home. The much greater needs of Texas went unmet. Why did the Texas AG stand idly by and not challenge the federal decision-making?

Texas Attorney General Greg Abbott claims he can prevent Congress from requiring, subsidizing and exempting people who do not buy health insurance. The Attorney General forgets history in claiming that Congress cannot rationally require certain action, when inaction harms people. In the case of insurance, we all pay more for health care when folks are uninsured on a large scale. Other cases have not involved economic harm. The Heart of Atlanta Motel refused to rent rooms to African Americans in violation of the Civil Rights Act of 1964 ban on racial discrimination. The motel owners claimed many defenses, including a right to refuse service, just as Lester Maddox claimed rights to refuse service on the basis of race at his restaurant. The business owners claimed their conduct in not doing something didn't affect interstate commerce. The business owners lost. Congress could constitutionally mandate they serve African Americans, the U.S. Supreme decided, in the historic Heart of Atlanta Supreme Court decision.

Under the Constitution, individuals do not make the decision as to whether they affect commerce. The independent judiciary makes that decision in a country where we have rule of law, not rule by princes and kings.

The Attorney General's claim ignores the impact of the choice to not (or in many cases, economic or medical reasons a person wants to but cannot) buy insurance. Congress provided massive evidence that remaining "uninsured" affects commerce. The Senate Committee on Finance found that "health reform is an essential part of restoring America's overall economy and maintaining our global competitiveness." The Report detailed the 93 percent increases in average family premiums from 2000 to 2009. Rising health care costs have played a huge role in bankruptcies affecting millions of people each year. Hospitals and clinics provide tens of billions of dollars each year in uncompensated care for the uninsured. Americans pay a “hidden health tax” in the form of higher medical costs and larger premiums for the insured. The "hidden health tax" cost to the average family paying premiums: $1,000. Uninsured, ill people, regardless of pre-existing condition, accident or source of problem are entitled in emergency situations under the federal EMTALA law to treatment and stabilization at hospitals and in ambulances. This is the well-known, most expensive kind of health care. And this is another mandate: federal law mandates health care providers to give care, but the law provides no funding, no source of reimbursement for the overwhelming costs.

The Texas Attorney General cannot replace elected, Congressional decision-making with his personal, partisan or political opinion on what is best. Congress must have a "rational basis," for the way it seeks to meet lawful goals. Constitutional law gives this role to our elected Congress, not the Texas Attorney General. If the Texas Attorney General was serious about challenging federal unfairness to Texas and convinced of his legal correctness, he should have and still can sue for a VA Hospital south of San Antonio.

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Barbara Ann Radnofsky is the Texas Democratic Party nominee for Attorney General. She graduated with honors from the University of Houston and the University of Texas School of Law. She was honored as the Outstanding Young Lawyer of Texas in 1988 and for the past 17 years she has been listed in "Best Lawyers in America." Prior to 2006, she was a partner at the law firm of Vinson & Elkins in Houston, where she served as head of the Alternate Dispute Resolution Section.