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Fact Check: On health care ruling, Obama ignores broader power of the states

In his first public comment on last week's federal court ruling that declared the centerpiece of the health care law unconstitutional, President Obama today defended the law as good public policy but sidestepped, or chose to ignore, the legal issues at the core of the decision.

"It should not be controversial, but it has become controversial," the president said at a stop in Cannon Falls, MN.

"You've got a governor who's running for president right now who instituted the exact same thing in Massachusetts. This used to be a Republican idea, by the way, this whole idea of the individual mandate, and suddenly, it's like they got amnesia," he said, in a reference to Mitt Romney, the former Massachusetts governor.

But in invalidating the requirement that virtually all Americans buy health insurance, the 11th Circuit Court of Appeals explicitly noted that the Constitution gives states much broader powers than the federal government to regulate health care.

The health care industry "falls within the sphere of traditional state regulation," last Friday's ruling said.

"A state's role in safeguarding the health of its citizens is a quintessential component of its sovereign powers. The Supreme Court has declared that the 'structure and limitations of federalism ... allow the States great latitude under their police powers to legislate as to the protection of the lives, limbs, health, comfort, and quiet of all persons,'" the court said, quoting from a 2006 US Supreme Court decision on the limits of Congressional power.

Obama also said the individual insurance mandate is essential to the other features of his health-care reform plan.

"You can't not have health insurance, then go to the emergency room, and each of us, who've done the responsible thing and have health insurance, suddenly we now have to pay the premiums for you. That's not fair," he said.

It may not be fair, but that doesn't make the individual mandate constitutional, last week's appeals court ruling said.

Under the Obama administration's theory, the court said, "There is no reason why Congress could not similarly compel Americans to insure against any number of unforeseeable but serious risks. High costs and cost-shifting in premiums are simply not limited to hospital care, but occur when individuals are disabled, cannot work, experience an accident, need nursing care, die, and myriad other insurance-related contingencies."

The only other federal appeals court to consider the constitutionality of the health-care law came to the opposite conclusion. The Sixth Circuit Court of Appeals upheld the individual mandate in late June.

The losing sides in both cases could ask the full appeals courts to take up the question, or they could go directly to the U.S. Supreme Court.