Case 3-4-1-7-04

Petitioner sought nullification of the lower courts’ decisions finding that termination of his insurance coverage by the South Estonian division of Health Insurance Fund was lawful and that § 28 of the Constitution did not guarantee the right to any type of free health care.

The South Estonian division of Health Insurance Fund sent a notice to Petitioner on December 6, 2002 informing Petitioner that his insurance coverage would expire the following month under § 89(4) of the Health Insurance Act (“HIA”). Among other provisions, the HIA excluded from the pool of insured persons anyone with up to five years left until attaining a pensionable age who was maintained by an insured spouse, including those persons who could not find or had not refused a job.

Petitioner filed suit in the Tartu Administrative Court, seeking a declaration that the South Estonian division of Health Insurance Fund’s termination of his insurance coverage was unlawful and that the Health Insurance Act was unconstitutional. The Tartu Administrative Court dismissed the lawsuit, stating that the Constitution did not guarantee the right to any type of health care free of charge. Petitioner appealed to the Tartu Circuit Court, which also dismissed the case, stating that § 89(4) of the HIA did not conflict with the Constitution and that solidarity-based health insurance meant only that those who were unable to pay insurance premiums themselves shall have insurance cover, not that all persons should have insurance cover.

Petitioner subsequently appealed in cassation to the Administrative Law Chamber of the Supreme Court, which remanded to the Tartu Administrative Court for a new hearing. The Tartu Administrative Court declared the South Estonian division of Health Insurance Fund’s actions unlawful and § 89(4) of the HIA unconstitutional. The Administrative Court petitioned the Constitutional Chamber of the Supreme Court to review the constitutionality of § 89(4).

Among other submissions, Petitioner argued that it was unlawful to confine health insurance to insured persons only, to limit the duration of health insurance coverage, or to establish an age-related condition to the dependent spouse of an insured person. HIA argued that the under international law the guarantee of social rights was dependent on the state’s economic capabilities, that the question of how to guarantee necessary medical care to the unemployed should be a political decision, and that the principle of solidarity did not require coverage of persons who did not make insurance premium payments.

The Constitutional Review Chamber of the Supreme Court dismissed the petition of the Tartu Administrative Court on the grounds that § 89(4) of the HIA was not a relevant provision for the adjudication of the case under the specified facts.

The Court held that, in order for it to review the constitutionality of a given provision, the provision must be relevant to the adjudication of the case at hand. This requirement was satisfied if the provision was of decisive importance to the case, that is, if a court would make different judgments where the provision is constitutional vs. unconstitutional.

The Court noted that the HIA, which entered into force October 1, 2002, provided that only persons with up to five years left until attaining pensionable age were considered equal to insured persons. However, § 89(4) created a transitional period by stating that until January 1, 2003, the dependent spouse of an insured person would also be deemed equal to insured persons.

The Court noted that if § 89(4) were declared unconstitutional, Petitioner’s health coverage would be deemed to have expired on October 1, 2002 (under the prior health act) rather than January 1, 2003, thus leaving the Petitioner in a worse position than if § 89(4) were considered to be constitutional. The Court concluded that because Petitioner would not obtain health insurance cover regardless of whether or not the contested provision were declared unconstitutional, § 89(4) was not a relevant provision for the adjudication of the case, and the Court therefore could not review the constitutionality of the provision. The Court furthermore rejected the suggestion that the Court could consider the constitutionality of other relevant provisions of the HIA, noting that, although the Court was not limited by the arguments used in the judgments of the lower courts, the Court was generally bound by the petition for constitutional review and should not search for an unconstitutional provision on its own initiative.

The Constitutional Review Chamber of the Supreme Court therefore dismissed the petition of the Tartu Administrative Court.

"In the case of conflict of § 89(4) of the Health Insurance Act with the Constitution the court would not have to adjudicate the matter differently than in the case of constitutionality of § 89(4) of the HIA. If the contested provision were declared unconstitutional J. Toom would, nevertheless, not obtain health insurance cover. Thus, § 89(4) of the HIA is not a relevant provision for the adjudication of this case, and the constitutionality thereof can not be reviewed in this proceeding. That is why the Constitutional Review Chamber of the Supreme Court shall dismiss the petition of the Tartu Administrative Court.” Para. 21.

“Pursuant to § 14(1) of the Constitutional Review Court Procedure Act the Supreme Court is not bound by the reasoning of a court’s judgment when rendering its own judgment. This means, first and foremost, that the Supreme Court is not bound by the arguments used in the judgment of the court who initiated a constitutional review proceeding. It does not proceed from § 14(1) of the Constitutional Review Court Procedure Act that the Supreme Court is in no ways bound by the constitutional review petitions and that it may form a totally new object of proceeding for constitutional review. It unambiguously proceeds from § 1(1) of the Constitutional Review Court Procedure Act that upon reviewing the constitutionality of legislation of general application the Supreme Court shall be bound by petitions.” Para. 23