Iowa Senator Tom Harkin, a Democrat, is standing behind the federal healthcare reform law. Federal lower court rulings have split on whether the law is unconstitutional, so the issue will likely be decided at the highest level.

Harkin says it looks the issue will make its way to the U.S. Supreme Court. Harkin says he has no idea how the Supreme Court might rule, but he believes “there’s a strong case to be made that under the commerce clause of the constitution that Congress can mandate or regulate certain things.”

The courts that have ruled against the reform say it cannot mandate that people not covered by another plan buy government health insurance. Harkin says everyone eventually pays for the healthcare of the uninsured. Harkin says when the 30-million people who don’t have health insurance will get healthcare at some point. He says when they show up at the emergency room they are not told to “get out on the street and die,” they are given care at the most expensive point in the system and everyone else is forced to pay more to cover their care.

Harkin says the current system is a sort of mandate already. “We’re mandated right now, so this is just a mandate to say that everybody has to have insurance, and if you can’t afford it, the government and the rest of the people else will pick it up and pay for your insurance,” Harkin says. He says that has a “demonstrable and logical impact on lowering healthcare costs.” Harkin says the Congressional Budget office estimates repealing the health care mandate will cost $240-billion in the first decade.