Benefits and Compensation

6th Circuit Upholds Health Reform’s Individual Mandate

A three-judge panel from the 6th Circuit Court of Appeals just upheld health reform’s controversial mandate that all individuals buy a minimum of health insurance or pay a penalty, saying that individual mandate is a valid exercise of Congress’ authority. This is the first appeals court ruling on such a challenge. … so 1-0 for the reformers. At the district court level, the score is 4 federal court rulings for reform to 4 rulings against.

Here is a copy of today’s ruling, which upholds the October 2010 ruling from the federal court for the Eastern District of Michigan.

The case is Thomas More Law Center, et al. v. Obama, brought by a public interest law firm and four individuals who say that being forced to purchase insurance is unconstitutional. They argued that prohibiting an individual’s choice not to buy insurance is an improper, unprecedented expansion of Congress’ authority under the Commerce Clause.

The circuit sided with government attorneys who argued that health care is different from other goods.

They said not purchasing insurance is not actually “inactivity.” Self-insuring requires saving money to cover risk responsibly and manage assets over time, while buying insurance might involve writing a check once or twice a year, or never writing one at all if the employer withholds the premiums.

They denied that a person can recuse themselves from the stream of commerce in health services, writing:

“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.”

Later, they said the individual mandate was consistent with many other federal taxation and regulatory powers over health insurance, and the aspects where it was inconsistent, those aspects may have been disputable on consistency or fairness grounds, but not on constitutional grounds.

The judges shared the plaintiff’s concerns about this being a slippery slope: if today the government can mandate one kind of purchase, tomorrow it can mandate another:

“If Congress can require Americans to buy medical insurance today, what of tomorrow? Could it compel individuals to buy health care itself in the form of an annual check-up or for that matter a health-club membership? Could it require computer companies to sell medical-insurance policies in the open market in order to widen the asset pool available to pay insurance claims?”

But, the court noted that two U.S. States have mandated purchases of health insurance and virtually all states require people to carry auto insurance.

This is the first of three rulings that will come from the appeals courts. Other challenges are Virginia v. Sebelius — which garnered a victory for anti-reformers from the federal court for the eastern district of Virginia — and Florida v. HHS, brought by 22 states’ attorneys general and four governors, which yielded another favorable opinion for the challengers.

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