Judge Rules Individual Mandate Is Constitutional

In the first decision of its kind, a federal judge in Michigan has ruled that the individual mandate included in the Affordable Care Act is constitutional. Ben Smith at Politico posted a crucial piece of the judge’s ruling, which states that the federal government has power – via the Commerce Clause – to require Americans to maintain insurance:

The health care market is unlike other markets. No one can guarantee his or her health, or ensure that he or she will never participate in the health care market. Indeed, the opposite is nearly always true. The question is how participants in the health care market pay for medical expenses – through insurance, or through an attempt to pay out of pocket with a backstop of uncompensated care funded by third parties.

This phenomenon of cost- shifting is what makes the health care market unique. Far from “inactivity,” by choosing to forgo insurance plaintiffs are making an economic decision to try to pay for health care services later, out of pocket, rather than now through the purchase of insurance,collectively shifting billions of dollars, $43 billion in 2008, onto other market participants….

The plaintiffs have not opted out of the health care services market because, as living, breathing beings, who do not oppose medical services on religious grounds, they cannot opt out of this market. As inseparable and integral members of the health care services market, plaintiffs have made a choice regarding the method of payment for the services they expect to receive. The government makes the apropos analogy of paying by credit card rather than by check. How participants in the health care services market pay for such services has a documented impact on interstate commerce. Obviously, this market reality forms the rational basis for Congressional action designed to reduce the number of uninsureds.

Lawsuits elsewhere are ongoing, but this is a significant win for the Obama Administration.

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  • nflfoghorn

    …a significant win that now has to pass legal muster because the losers are so sore they sue.

  • deconstructiva

    Kate, do your tea leaves see a brewing battle at SCOTUS over Commerce Clause™ (as here) vs. 10th Amendment (if conservative judges dissent and claim it’s a state issue) over this with early round win to CC? Or do you guess that most other judges will fall into line follow new precedent (even if SCOTUS eventually has to settle this)?

  • http://phd9.blogspot.com Paul Dirks

    The judge mentions the elephant in the room. People who can’t pay already routinely get health care anyway.

  • textee

    The case is styled Thomas More Law Center vs. Barack Hussein Obama.

    “Barack Hussein Obama”?

    Didn’t every identically minded political activist in the Washington/New York/American/European/Arab press corps declare that mentioning Obama’s middle name is “racist”?

  • Exiled_At_Home (formerly Neo)

    That’s not a constitutional argument. Reasonable? Yes. Constitutional? Cleverly avoided.

  • shepherdwong

    Constitutional?

    Well, my friend, if the Constitution says corporations are persons and that the government can secretly collect your electronic communications or declare you a terrorist and throw you in jail forever without due process, that ship has sailed.

  • 53_3

    No, it’s not racist textee. No more racist than Beck’s parody of Obama’s daughter asking about why daddy “…hates white people..”.
    .
    It’s simply a case of attempting to fan the flames of Islamaphobia. Beck fanned the flames of Blackaphobia. Nothing racist in that whatsoever.
    .
    And of course, let’s not forget the fanning of the flames of hatred that led to Rosewood.
    .
    Not racist in the least…

  • diecash1

    Well, my friend, if the Constitution says corporations are persons and that the government can secretly collect your electronic communications or declare you a terrorist and throw you in jail forever without due process, that ship has sailed.

    True that shepherd……..

  • 53_3

    Shepherd:
    .
    You should google ‘Crossroads GPS’ and see just what the First Amendment hath wrought for our newest corporate “citizens”…

  • Exiled_At_Home (formerly Neo)

    First, that unconstitutional actions have been declared constitutional by the courts is hardly just cause for continued disregard for the constitution. That’s either a defeatist sentiment, one felt by someone who is fully willing to allow any and all governmental action henceforth, or it is the position of someone looking for any excuse to defend something which is constitutionally indefensible. In other words, someone more loyal to partisan agenda than continuity of principle.
    .
    Secondly, and less consequentially, your aforementioned examples were at least defended based on “constitutional” justifications -read, exemptions- albeit misguided interpretations of the constitution. With regard to the individual mandate, I don’t even see the slightest application of so-called constitutional principles.

  • 53_3

    Oops. Guess I walked into that one.
    .
    Oh well. At least I can take solace in the fact that I’m only partly wrong.
    .
    Where I’m right is people like textee do indeed have a different agenda than case law and form…

  • 53_3

    FYI all:
    .
    I plan to celebrate by enrolling my two sons when open enrollment begins in November.
    .
    According to Crossroads GPS, in their newest ad attacking Patty Murray, I’m actually threatening peoples lives!
    .
    Go figure. Guess our newest corporate “citizens” are really showing their more responsible side.
    .
    “Democratic” oligarchy, here we come…

  • 53_3

    Exiled:
    .
    I actually agree with you. I don’t like to, and I don’t want to, but I have to.
    .
    I’m wondering though, though those more “misguided exemptions” have caused harm to American citizens, I don’t see too much harm in applying an exemption to this. There are parallels with auto insurance.
    .
    We do have a health care problem, and as I agree with you on this, I don’t think I’d lay the blame for the flaws in HCR at the feet of the Dems alone…

  • shepherdwong

    That’s either a defeatist sentiment, one felt by someone who is fully willing to allow any and all governmental action henceforth, or it is the position of someone looking for any excuse to defend something which is constitutionally indefensible.
    .
    Color me “defeatist” then. BTW, what do you think makes the mandate “unconstitutional” in the way that giving corporations Bill of Rights protections or, certainly, the naked violations of Bill of Rights protections for individual citizens done in the name of the national security police state?

  • shepherdwong

    …and do you think Medicare is “unconstitutional” as well?

  • carol2000

    http://www.mied.uscourts.gov/News/Docs/09714485866.pdf

    The judge is lying for pretending that it’s merely necessary to claim that something has economic ramifications in order to be justified under the Commerce Clause. He lied by omission in the Filburn case, by leaving out the key fact that Filburn was in fact a farmer engaged in interstate commerce, who had chosen to participate in the commodity program, and the wheat in question was in addition to his allotment. His invoking of the Raich decision is ludicrous, like pretending that the government has the right to regulate people for NOT wanting to grow or buy marijuana!!!

    http://www.heritage.org/Research/Reports/2009/12/Why-the-Personal-Mandate-to-Buy-Health-Insurance-Is-Unprecedented-and-
    Unconstitutional

    His claim that the uninsured are a burden to the insured which would magically disappear if they’re forced to buy health insurance is a filthy Big Lie! The cost of insurance is even higher than the health costs they can’t pay for!

    “People uninsured for any part of 2008 spend about $30 billion out of pocket and receive approximately $56 billion in uncompensated care while uninsured. Government programs finance about 75 percent of uncompensated care. If all uninsured people were fully covered, their medical spending would increase by $122.6 billion. The increase represents 5 percent of current national health spending and 0.8 percent of gross domestic product.” (Covering The Uninsured In 2008: Current Costs, Sources Of Payment, And Incremental Costs of Expanding Coverage. J Hadley, J Holahan, T Coughlin, D Miller. Health Affairs 2008;27(5):w399-w415.) Page 56, “Even if all private funding for uncompensated care were recouped from private insurance payments, this would still amount to only 1.7% of private insurance premiums.” (Covering the Uninsured in 2008: A Detailed Examination of Current Costs and Sources of Payment, and Incremental Costs of Expanding Coverage. J Hadley, J Holahan, T Coughlin, D Miller. Kaiser Commission on Medicaid and the Uninsured, Aug. 2008.) Also in this report, it says that full-year uninsured people on average received $1,686 in health care, compared with $3,915 for insured people, and paid for a larger proportion of it out of their own pockets, page 15. The Obama plan is to force them to buy health insurance, with an average subsidy of $6,000, for those average expenses of less than $2,000! (Reid Letter, Mar. 18, 2010.) WHAT A BARGAIN – FOR THE INSURANCE COMPANIES!

    http://www.kff.org/uninsured/upload/7809.pdf“>http://www.kff.org/uninsured/upload/7809.pdf

    Meanwhile, those with health insurance have inflicted a burden of $246 billion in lost federal tax revenues due to the exclusion of employer-provided health insurance from taxable income. This exclusion is the nation’s COSTLIEST tax subsidy, and the expense of making up for these lost revenues is distributed across everyone, including the uninsured (Van de Water, 2009).

    http://www.cbpp.org/cms/index.cfm?fa=view&id=2832

    And, most importantly, the Supreme Court has invalidated congressional action on the ground that it employed unconstitutional means to an end that it could have constitutionally accomplished in another manner. Congress could have funded health care for those who can’t pay simply by expanding existing programs.

  • kbanginmotown

    Hear, hear! About f#cking time!

  • kbanginmotown

    fitty: re: Crossroads GPS.
    .
    I listened to Fresh Air today about the “shadow RNC” that groups like Crossroads GPS, Americans for Prosperity, and the US CoC are funding. Frightening.
    .
    The Dems are fools if they don’t strangle this baby in its cradle. 2010 is a dry run for 2012.
    .
    More at:
    http://www.npr.org/blogs/itsallpolitics/2010/10/07/130399554/fresh-air

  • http://patricksartor.wordpress.com patricksartor

    I see no difference between the income tax and the individual mandate for health insurance.

    Both require individuals to give money to something they may or may not have individually chosen to do, but, is, by a majority of the people elected by the majority of the citizens on their behalf chosen as a national priority.

    This not an opt out government.

    Just as I may find many parts of our defense budget (Star Wars, some of the money spent on maintaining ICBMs, some of the money spent on submarines, battle ships and some of the money spent on the Armored Cavalry and the Iraq War) and can not cherry pick what I pay for, if the government, through a majority of the representatives chosen by a majority of voters determine the expenditure of money is needed for the public good, I can not opt out of it, either.

    The opposite decision would have opened the doors to a flood of lawsuits against the government for every mandate of every kind.

  • Exiled_At_Home (formerly Neo)

    The constitutional questions surrounding extending civil liberties to corporations and allowing otherwise unlawful policing powers under the guise of national security are so fundamentally indistinguishable from the issues raised by the personal mandate as to make any attempted comparison or parallel discussion an exercise in futility, or distraction. Not yet sure which is your intended goal. As for Medicare, again, entirely and absolutely different than personal mandates. In the former, collective pools of taxpayer funds are used to provide necessary services for the disenfranchised; in the latter, individuals are mandated to purchase a product from private companies, ostensibly to what, balance market participation? And any allusions to auto insurance are, likewise, wholly irrelevant. Driving is a risky endeavor in and of itself a privilege, one which imposes risks on individuals other than those actually driving. Auto insurance is necessary. Living, which is a right, is not in and of itself a dangerous activity that endangers the public at large. Health insurance should be willingly participatory.

  • shepherdwong

    As for Medicare, again, entirely and absolutely different than personal mandates. In the former, collective pools of taxpayer funds are used to provide necessary services for the disenfranchised; in the latter, individuals are mandated to purchase a product from private companies.
    .
    So the important difference that makes the HCR law unconstitutional is that you’re mandated to buy medical services through an insurance company, rather than through a program administered by the government? That’s the most objectionable part of the legislation for me as well, but for policy, moral and political reasons. What I’d like to know is what is less Constitutional about a mandated social insurance program administered by a private market vs. a government agency? (Again, have I mentioned how much I hate the invividual mandate without a public insurance plan option for policy, moral and political reasons)?

  • Exiled_At_Home (formerly Neo)

    I object to any mandate to buy health insurance either from a government administered agency or from the private market. The state, in my reading of governmental limitations in our republic, is prohibited from forcing its citizens into purchasing such a commodity. While you and I both find the current mandate to be objectionable, I also object to the public option. Ideally, universal health-care would be implemented, freeing all Americans from insurance schemery, providing all with adequate and equal access to health-care, all of which provided for through progressive taxation. This is the only instance in which I find progressive taxation to be morally acceptable and socially viable.

  • Exiled_At_Home (formerly Neo)

    I object to any mandate to buy health insurance either from a government administered agency or from the private market. The state, in my reading of governmental limitations in our republic, is prohibited from forcing its citizens into purchasing such a commodity. While you and I both find the current mandate to be objectionable, I also object to the public option. Ideally, universal health-care would be implemented, freeing all Americans from insurance schemery, providing all with adequate and equal access to health-care, all of which provided for through progressive taxation. This is the only instance in which I find progressive taxation to be morally acceptable and socially viable.

  • stuartzechman

    Neorationalist86:
    .
    You sound like a hardcore conservative…in Europe!

  • stuartzechman

    Very interesting arguments.

  • apr2563

    textee: Context is everything.

  • stuartzechman

    patricksartor:
    .
    if the government, through a majority of the representatives chosen by a majority of voters determine the expenditure of money is needed for the public good, I can not opt out of it, either.
    .
    That’s an interesting line of thought.
    .
    Are there no constitutional limits on what the majority can compel individuals to purchase from private entities?
    .
    Can the federal government require individuals to purchase cable television, if a majority in Congress were persuaded that such a scheme would be for the public good, or do we need a Constitutional amendment passed to stop such laws from being upheld by courts?
    .
    If a Congressional majority and the President got it into their heads some day that the way to help poverty-level families afford baby formula was to pass regulations that compelled baby formula retailers to lower prices to what extremely low-income families could afford, and, in order to help those retailers continue to be profitable, then simultaneously require every family to purchase baby formula, thus keeping federal spending on baby formula subsidies from severely impacting the deficit, would that be constitutional, according to you?
    .
    If it was accepted that infant nutrition is an important public good, and Congress and the President were strange ideologues who resisted the idea of the government just helping families who needed help via subsidies paid for with a highly progressive federal income tax, and came up with this crazy “moderate” scheme that was “market-oriented” and “uniquely American,” could they do that, patricksartor?
    .
    I mean, they could, but would it be constitutional?
    .
    If not, then why not?

  • herby002

    4.1- 53_3
    No, it’s not racist textee. No more racist than Beck’s parody of Obama’s daughter asking about why daddy “…hates white people..”.

    Maybe it was Beck, but Rush Limbaugh did that parody for at least two weeks on his radio show – then proudly said he wasn’t racist, or making fun of lttle girls – he was just jousting with the (liberal) mainstream media to see who would bite, and attack him for his “jokes”.

  • ricardo4max

    Interesting that NOWHERE in this propaganda post by Kate is the Judge’s name (George Steeh) or background. He is another U of Michigan left wing Clinton appointee. Why do Democrat leftist judges always ignore the Constitution and operate as ideologues? We must be ever vigilant because the neoCommunist left will take over the govt by any means, including stacking the courts with judges like this.

  • ricardo4max

    Great post but facts logic and reason will neither convince nor sway the hard core useful idiots that post here.

  • kathy

    Well reasoned argument from the judge. Too bad the Democrats weren’t so adept when explaining the law.

    I have a Republican friend who, when health care was being argued for last fall, kept saying there needed to be an individual mandate, for just this reason. But most Republicans have been content to oppose it just because Obama was for it.

    Besides that, as Lawrence O’Donnell read from the law some months ago, there is no enforcement provision for fines. In fact, enforcement is prohibited. So in fact there really isn’t an enforceable mandate. So for that reason this will also be found to be constitutional.

  • allthingsinaname

    “Ideally, universal health-care would be implemented, freeing all Americans from insurance schemery, providing all with adequate and equal access to health-care, all of which provided for through progressive taxation. This is the only instance in which I find progressive taxation to be morally acceptable and socially viable.”
    .
    I do not know about the rest of your argument and why you bothered with it when the above statement is all that is required.

  • 53_3

    Exiled:
    .
    I am forced to agree.
    .
    I’ve never liked the mandate. Personally, I preferred UHC because it would not only supplant Medicare, it would become a fee for services proposition like Medicare.
    .
    However, and herein lies the rub and my exposure to criticism for being a hypocrite:
    .
    HCR in it’s present form occurred because there were two nearly equal political forces. Health care, being 1/6 of the American economy, would be in dire straits without it, so it is a choice of the lesser of two evils.
    .
    However, in making that choice (for HCR in it’s current form), the Constitution has been violated.
    .
    The only plea I can make for innocence is that unconstitutional ploys are a mainstay of American politics…

  • allthingsinaname

    Your post seem to indicate that those with insurance receive more care then those without.

  • 53_3

    Lately, I’ve noticed that Rush has been trying to show a “human” side, with his persona appearing in Family Guy and other attempts to polish his image.
    .
    I wonder if it has to do with his wife. Maybe she’s slowly leading him over to Sacred’s dark side.

  • shepherdwong

    The state, in my reading of governmental limitations in our republic, is prohibited from forcing its citizens into purchasing such a commodity.”
    .
    “That’s not a constitutional argument. Reasonable? Yes. Constitutional? Cleverly avoided.”

    .
    I’m sorry neo, you’ll need to be more specific to back up your claim that the mandate violates the Constitution. Perhaps you could start with the opinion of the federal judge who says that it doesn’t.

  • nathan7777

    Stuart,
    .
    Price controls are constitutional, unfortunately. The government can legally set a price ceiling on infant formula. Requiring every family to buy formula, however, is different from requiring citizens to maintain health insurance. Not all families use formula, but everyone uses the health care system. As the Judge said:

    The health care market is unlike other markets. No one can guarantee his or her health, or ensure that he or she will never participate in the health care market.

    Therefore, requiring citizens to maintain health insurance is more like requiring families to adequately budget for their infant’s nutritional needs. For those unable to do so, the government will provide subsidies. Some families may choose to breast feed and some may choose to use formula, but everyone will have to feed their child in some manner. Requiring everyone to purchase health insurance is simply a requirement to provide for one’s own health with one’s own funds (or through help from the government).

  • stewartiii

    NewsBusters| TIME Magazine: Court Ruling on ObamaCare ‘Significant Win’; But Is It?
    http://newsbusters.org/blogs/ken-shepherd/2010/10/08/time-magazine-court-ruling-obamacare-significant-win-it

  • thomasrial

    To all of you who fail to “accept” this very adept ruling on the appropriate use of Congressional power under the Commerce Clause, please refrain from deriding this Judge as “just a liberal Clinton appointee” as if the judge is some political hack rather than a true legal scholar. Further, I suggest that if you “just don’t like the mandate” that if it were removed from HCR, that you forgo your right to claim bankruptcy when your “I’ll just pay cash for my healthcare” doesn’t cut it when serious illness strikes, or simply stay out of the health care system until you have enough cash in your piggy-bank. If you aren’t willing to play by this game, then your selfishness becomes an economic burden on me and my tax-paying friends and health care providers who do see this as an economic issue covered by the Commerce Clause. Plain and simple.

  • thomasrial

    Please tell us exactly where in the Constitution you found a “prohibition” on Congress from requiring by law our purchase of “this type of commodity.”

    I can’t find it and you don’t provide the details. Thank you in advance!

  • Exiled_At_Home (formerly Neo)

    First, the idea that a constitutional argument is only valid once it has been articulated by a federal judge is absurd. That is a statist mentality if there ever was one. With that said, here is my rationale.
    .
    Any and all powers of the US government must be enumerated in the Constitution. Therefore, the right of the government to impose a mandated purchase of a private commodity must fall within the realm of explicit federal power. This judge invoked the Interstate Commerce Clause as evidence of the constitutionality of the personal mandate. Article I, Section 8, Clause 3 of the Constitution grants Congress the right to “regulate” industries that affect interstate commerce, such as the health-insurance industry. If Congress wishes to pass regulations and impositions on the insurance industry, it may, and it has. Regulation of an industry, however, is not the same thing as impositions on consumers of that industry. Therefore the Commerce Clause does not apply to we the people in regard to mandated participation in the health-insurance industry.
    .
    Oddly enough, Congress would be constitutionally sanctioned in a personal mandate if health-insurance were federally administered because the mandate could be argued to fall under the Taxing and Spending Clause. As it currently is, though, the mandate requires the purchase of a commodity from private companies and hence cannot be classified as taxes, duties, imposts, or excises, despite the fact that it is for the general welfare of the nation.
    .
    Since neither of these clauses are valid, absent another enumerated power which would be applicable to the personal mandate, the right to be free of such an imposition is “reserved to the States respectively, or to the people” (10th Amendment).

  • Exiled_At_Home (formerly Neo)

    See post 5.16…
    ~
    All governmental action is unconstitutional unless explicitly enumerated. Congress has the right to “regulate” industries involved in interstate commerce, not the right to mandate consumer participation in such industries, nor the right to levy funds on behalf of private corporations. All rights not expressly granted to the federal government are reserved to the states or to the people.

  • shepherdwong

    Your arguments are well-reasoned and I wouldn’t try to hang the mandate on the Commerce Clause either. Suffice to say, like Medicare, it falls within the government’s authority to tax to promote the general welfare – in this case, preventing lots of unnecessarily sick, bankrupt or dead people. However, this is just your assertion:

    As it currently is, though, the mandate requires the purchase of a commodity from private companies and hence cannot be classified as taxes, duties, imposts, or excises, despite the fact that it is for the general welfare of the nation.

    Nothing in the Constitution says what a particular tax must purchase and the reason Medicare is more efficient than most private insurance is because it provides a more seamless pass-through from government collection to private, for-profit (in most cases) provider. Again, I’m against the mandate as it is constructed for policy, political and moral reasons but, constitutionally, your just making that last part up.

  • Exiled_At_Home (formerly Neo)

    Medicare is appropriate use of the Taxing and Spending Clause in that taxes are levied from the public to be used for general welfare, i.e. medical coverage for the disenfranchised. The mandate, though, requires individuals to purchase coverage for themselves. That’s stretching the definitional boundaries of taxation to the surreal. In my (imaginary? fictitious?) opinion, that cannot be considered a government tax and thus cannot be supported by the Taxing and Spending Clause. Were the entire system one of Medicaresque structure it would be sanctioned. Taxation for UHC would be sanctioned. But this, forced direct remuneration to a private company? Not seeing that in Congress’ explicit powers.

  • Exiled_At_Home (formerly Neo)

    By the way, thanks for the response. I sometimes come off a little too matter-of-fact. And certainly I am more charged up for a rebuttal than a ‘thank you,’ so I generally neglect the pleasantries. I should try to remember that we both find this objectionable, we only disagree on its admissibility.

  • shepherdwong

    That’s stretching the definitional boundaries of taxation to the surreal.
    .
    Point taken. I’m sure that The Founders would also have found life in 21st Century America to be…surreal.

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