Yesterday a three-judge panel from the United States Court of Appeals for the Sixth Circuit became the first appellate court to uphold the constitutionality of the minimum coverage provision of the Patient Protection and Affordable Care Act (the "Act"), requiring that Americans obtain health insurance. Opinions are expected from the Fourth and Eleventh Circuits later this summer.
The Act, passed by Congress last year, contains five essential
components designed to make significant changes to public and
private health insurance and extend medical coverage to
approximately 30 million uninsured Americans. By far, the most
contested provision is the individual mandate, which requires every
"applicable individual" to obtain "minimum essential
coverage" of health insurance starting in 2014 or pay a tax
penalty.
The plaintiffs, a conservative public interest law firm from
Michigan and four individuals, argued that the minimum coverage
provision compels, rather than simply regulates, economic activity,
and is therefore unconstitutional. On these grounds, the plaintiffs
"sought a declaration that Congress lacked authority under the
Commerce Clause to pass the minimum coverage provision, and
alternatively a declaration that the penalty is an unconstitutional
tax." The district court found the provision to be authorized
by the Commerce Clause.
The overriding question on appeal was whether a person's
decision to self-insure for the cost of healthcare is a type of
economic activity that constitutes commerce or a kind of inactivity
that is beyond congressional regulation. Judge Boyce F.
Martin, a Carter appointee, ruled that the mandate was
"facially constitutional under the Commerce Clause"
because "the provision regulates economic activity that
Congress had a rational basis to believe has substantial effects on
interstate commerce." Judge Martin also explained that
"Congress had a rational basis to believe that the provision
was essential to its larger economic scheme reforming the
interstate markets in health care and health
insurance."
Although lower court decisions on the individual mandate have
ostensibly split along partisan lines, this is the first ruling
where a Republican appointee has voted to uphold the
constitutionality of the law. Judge Martin was joined in this 2-1
decision by Judge Jeffrey Sutton, a George W. Bush appointee. This
ruling, along with others expected later this year, will likely be
further appealed to the Supreme Court.
The content of this article is intended to provide a general guide to the subject matter. Specialist advice should be sought about your specific circumstances.