This is an early skirmish in what will be a protracted war over the Affordable Health Care Act, but a federal judge has ruled that the law’s requirement that all Americans purchase health insurance does not violate the US Constitution. From The NYT:
Two other cases with higher profiles, one in Florida and one in Virginia, are headed toward hearings on the issues that were decided in Michigan. The central question, which may ultimately fall to the Supreme Court, is whether the Commerce Clause of the Constitution gives Congress the authority to require citizens to obtain a commercial product, namely health insurance. . .
Judge George C. Steeh of Federal District Court in Detroit ruled that choosing not to obtain insurance qualified as an example of “activities that substantially affect interstate commerce.” That is the standard set by the Supreme Court for Congress’s compliance with the Commerce Clause.
Judge Steeh, who was appointed by President Bill Clinton, agreed with the federal government that not obtaining health coverage is effectively an active decision to pay for medical care out of pocket. “These decisions, viewed in the aggregate,” Judge Steeh wrote, “have clear and direct impacts on health care providers, taxpayers and the insured population who ultimately pay for the care provided to those who go without insurance.”
While conservatives around the country are rallying to have the law tossed out in court, most legal experts believe the requirement to purchase health insurance is perfectly legal. You’ve no doubt heard about the case in Tennessee where a fire department allowed a family’s house to burn down because they had not purchased fire protection, a form of insurance. My colleague Jay Bookman and other bloggers have compared that to the requirement for health insurance:
The situation is in many ways analogous to the health care debate, where folks skate without insurance until something goes wrong and they show up in an emergency room, where the law says they have to be treated.
Do we instead do what the South Fulton fire chief did, refusing available treatment to fellow human beings even in life-threatening situations, because they gambled and didn’t buy insurance?
No, we don’t. At least not yet. Instead, the solution implemented in President Obama’s health-care reform — a solution initially proposed by conservatives — is to require that everyone carry insurance, so that the “free riders” are eliminated. That way everyone is covered, much like, in the example above, everyone in the city limits of South Fulton is required to pay taxes to support fire protection. (Again, the Cranicks live in unincorporated Obion County, where such coverage is optional.)