Health Reform Mandate Upheld in Federal Court

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The mandate for individuals to obtain health insurance is constitutional, a federal judge in Michigan has ruled in the first court decision on the merits of the Patient Protection and Affordable Care Act.

An individual’s decision not to have health insurance has the same effect as a delberate decision to pay for medical care out of pocket, said U.S. District Court Judge George C. Steeh in a 20-page decision. It meets the standard of “activities that substantially affect interstate commerce” that the U.S. Supreme Court has set for compliance with the Commerce Clause of the Constitution.

According to the finding, “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.”

The challenge was brought by the Thomas More Law Center, a conservative Christian legal group, and several Michigan residents. Other decisions on the law are still pending.  In August, a federal judge in Virginia ruled that the  challenge to the individual mandate based on a Virginia state law could proceed. In Florida, U.S. District Court Judge Roger Vinson is considering the merits of oral arguments before returning his decision on whether to throw out the case or let it progress. That case includes challenges from an array of states to the mandate to obtain health insurance or face the penalty of a fee .

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