The discussion on Congress, courts, and commerce from the latest edition of the Journal of Law, Medicine & Ethics ask a hard question: is the Patient Protection and Affordable Care Act (PPACA) in violation of the constitution? The PPACA is a relatively new law (signed by president Barack Obama in 2010) which, among many others, requires American citizens to obtain health insurance by 2014 orface civil penalties ($95 of 1% of income, whichever is greater).
The PPACA, despite numerous overall improvements in the US health system, encountered many problems so far in court, over its status relative to the constitution. Essentially, the act allegedly violates the constitution, or more exactly the Congress' interstate commerce powers, because Congress lacks the power to regulate commercial "inactivity." While many courts initially dismissed the argument, federal courts in Florida and Virginia have sustained it, giving birth to what might be a long story.
The legal challenges surrounding the Patient Protection and Affordable Care Act set the stage for a long battle in courts across America, harming ultimately the average Joe. To quote from the Journal
Despite historic efforts to enact the Patient Protection and Affordable Care Act (PPACA) (1) in 2010, national health reform is threatened by multiple legal challenges grounded in constitutional law. Premier among these claims is the premise that PPACA's "individual mandate" (requiring all individuals to obtain health insurance by 2014 or face civil penalties (2)) is constitutionally infirm. (3) Attorneys General in Virginia and Florida (joined by 25 other states) allege that Congress' interstate commerce powers do not authorize federal imposition of the individual mandate because Congress lacks the power to regulate commercial "inactivity" (4) Stated simply, Congress cannot regulate individuals who choose not to obtain health insurance because they are not engaged in a commercial venture. Several courts initially considering this argument have rejected it, but two federal district courts in Virginia and Florida have concurred, leading to numerous appeals (5) and the near promise of United States Supreme Court review. (6)
In what continues, the authors offer a different interpretation, that would not have any constitutional problem. In a nutshell, the act does not refer to commercial activity per se (i.e., obtaining health insurance), but it attempts to solve the greater problem of healthcare accessibillity. More details are available in the Law & Politcs Directory. Under this interpretation, the question turns to whether:
Congress' interstate commerce power extends to commercial inactivity, but rather whether it authorizes Congress to regulate individual decisions with significant economic ramifications in the interests of protecting and promoting the public's health.
As of today, this is an open topic, to be resolved in federal courts over the next few months or years. We invite you to read the entire intepretation in the Sep 22 issue of the Journal of Law, Medicine & Ethics.