March 26, 2017

Health Care Law Struck Down in Florida

The likelihood of the Supreme Court hearing a case on the health care law became even higher yesterday, when a federal judge in Florida ruled the entire law unconstitutional. Judge Vinson’s ruling [.pdf] struck down the law on the basis of the individual mandate exceeding the congressional authority of the Commerce Clause (Article 1, Section 8, Clause 3). The individual mandate is found in Section 1501 of the “Patient Protection and Affordable Care Act” [.pdf] and imposes a fine on any individual who has not had health insurance for the previous 12 months beginning in 2014. For specific amounts of the fine, see this article.

Without the individual mandate, the health care law does not have a mechanism to pay for the new aspects to health care policy, such as high-risk patients who health insurance companies could previously deny coverage to, insuring young adults under their parents until the age of 26, extending health insurance to millions of impoverished Americans, and lowering the cost of prescription drugs for the elderly. Since these new services clearly require a substantial sum of money and the individual mandate is unconstitutional, Vinson ruled Section 1501 is “not severable” and the entire law is therefore void. This is on page 63 of Vinson’s ruling.

There are also a couple of distinctions between Vinson’s ruling and previous rulings on the health care law. First, Attorneys General from 26 states joined the suit. While the widespread support of this suit is only symbolical, such support arguably grants more credibility to the Florida ruling. Second, Vinson’s ruling is different from previous rulings of the health care law because it struck down the entire law as a result of the unconstitutionality of Section 1501. Though, among the four other rulings regarding the health care law, only one of them similarly found Section 1501 as unconstitutional. Other rulings of the law include:

  1. A Michigan lawsuit found Section 1501 constitutional on October 8th.
  2. On December 1st, a Virginia lawsuit found Section 1501 constitutional.
  3. On December 9th, a New Jersey lawsuit similarly found Section 1501 constitutional.
  4. In a separate Virginia lawsuit issued December 13th, a judge determined Section 1501 unconstitutional.

With the addition of the Florida ruling to these other rulings, there are now at least two federal rulings on each side of this debate. This is a prime reason why the Supreme Court will eventually hear a case about the health care law. In fact, the Supreme Court has a duty to settle such disputes, as noted in Article 3, Section 2, Clause 1. Since the highest court will eventually rule on this law, let’s consider the arguments of each side.

The Obama Administration argues Section 1501 is constitutional because the Commerce Clause gives the federal government the authority to regulate interstate commerce. Since health insurance is a nationwide service, the federal government can pass laws regarding it. Further, and perhaps the crux of the Obama Administration’s argument, is that individuals cannot guarantee they will never enter the health care system and shift the cost of the services to the rest of society.

In response to the Obama Administration, others argue the Commerce Clause gives Congress the authority to regulate interstate activity, not interstate inactivity. This is the rationale provided in both cases that found Section 1501 unconstitutional. While Congress can pass laws regarding participation in interstate commerce, Congress cannot pass laws requiring participation in interstate commerce. Vinson admits health care services are a major economic activity that Congress can certainly regulate, but the question of this case is how to exercise that regulation.

Vinson’s ruling goes on to say that people cannot guarantee they will not buy food, but just because people must buy food to live does not necessarily give Congress the authority to require people to buy food. Though, this rationale is not supported in any precedent and legal scholars even say Congress could pass such a law if it wanted. The video below shows legal scholars discussing this issue.

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When Vinson raised the argument that Congress could pass a law requiring economic activity, he concluded such a law is not “constitutionally implausible,” but it has never happened before. However, Vinson, who Ronald Reagan appointed, ultimately held such a law unconstitutional. As a result, Vinson’s ruling not only rejects the authority of the Commerce Clause to pass Section 1501, but it also rejects the “uniqueness” argument of people requiring health care. Additionally, Vinson also rejected the authority of the Necessary and Proper Clause to provide Congress with the authority to pass Section 1501, as stated on page 56 of his ruling.

To be fair, no precedent supports the rationale regarding the uniqueness argument of either side. For this reason, the Supreme Court will ultimately decide which argument is sound. In doing so, a monumental precedent will be set and either give Congress the ability to regulate nearly any economic activity or reduce the scope of authority that Congress has under the Commerce Clause. Keep in mind, though, this case is not about the ability to regulate the health care system, which is indisputable, but is only about the method of regulation.

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