The federal government can force its citizens to purchase a minimum level of health insurance coverage.
That’s the bottom line of a 2-1 decision issued yesterday by the 6th Circuit — the first federal appeals court to address the constitutionality of the Patient Protection and Affordable Care Act.
“Congress had a rational basis for concluding that the minimum coverage provision is essential to the Affordable Care Act’s larger reforms to the national markets in health care delivery and health insurance,” wrote the Judge Boyce Martin Jr. for the majority in Thomas More Law Center v. Obama.
President Barack Obama signed the Patient Protection and Affordable Care Act into law in 2010. Section 1501 of the Act, known as the Minimum Essential Coverage Provision, imposes a tax penalty on those who fail to purchase a minimum level of health insurance beginning in 2014.
In the case before the 6th Circuit, the Thomas Moore Law Center, a public interest law firm, and several taxpayers sued to enjoin the implementation of the Act, arguing that the individual mandate violated the Commerce Clause.
U.S. District Judge George Steeh for the Eastern District of Michigan decided that the individual mandate was constitutional in a ruling issued last October.
Yesterday’s decision by the 6th Circuit affirmed the lower court and featured Judge Jeffrey Sutton as the first Republican-appointed judge to side with the Obama Administration in its fight to defend the landmark legislation.
Sutton, an appointee of President George W. Bush, joined Martin — an appointee of President Jimmy Carter — in the majority.
In a concurring opinion, Sutton addressed the concerns of those who contend that the Act regulates “inactivity” and that letting the individual mandate stand sets a dangerous precedent for the federal government’s interference with individual rights.
“Regulating how citizens pay for what they already receive (health care), never quite know when they will need, and in the case of severe illnesses or emergencies generally will not be able to afford, has few (if any) parallels in modern life,” wrote Sutton.
“Not every intrusive law is an unconstitutionally intrusive law. And even the most powerful intuition about the meaning of the Constitution must be matched with a textual and enforceable theory of constitutional limits, and the activity/inactivity dichotomy does not work with respect to health insurance in many settings, if any of them.”
The third member of the panel, Judge James Graham, is an appointee of President Ronald Reagan and a senior judge for the U.S. District Court for the Southern District of Ohio.
In his dissent, Graham argued that the individual mandate constituted a dangerous overstepping of congressional authority.
“If the exercise of power is allowed and the mandate upheld, it is difficult to see what the limits on Congress’s Commerce Clause authority would be. What aspect of human activity would escape federal power? The ultimate issue in this case is this: Does the notion of federalism still have vitality? …
“To approve the exercise of power would arm Congress with the authority to force individuals to do whatever it sees fit (within boundaries like the First Amendment and Due Process Clause), as long as the regulation concerns an activity or decision that, when aggregated, can be said to have some loose, but-for type of economic connection, which nearly all human activity does,” Graham wrote.
The 6th Circuit case is one of a number of challenges to the Act working through the federal courts on their way to an ultimate showdown in the Supreme Court — perhaps as early as next term.
The 11th Circuit heard oral arguments in Florida v. U.S. Department of Health and Human Services on June 8. In that case, a federal judge in Florida declared the individual mandate unconstitutional.
In May, the 4th Circuit heard oral arguments in a pair of cases — Liberty University v. Geithner and Virginia v. Sebelius — to resolve a conflict between the Eastern and Western Districts of Virginia as to the constitutionality of the Act.
In February, a federal judge in the District of Columbia decided that the federal health care mandate is constitutional.
— Pat Murphy