A three-judge panel of the 11th U.S. Circuit Court of Appeals in Atlanta ruled Friday that the individual mandate in the federal health care reform law violates the Commerce Clause of the U.S. Constitution. The 11th Circuit’s opinion conflicts with a separate federal appellate court decision upholding the law, all but guaranteeing that the U.S. Supreme Court will review the legislation.
The lawsuit before the 11th Circuit was filed by 26 states and a number of other parties, and state Attorney General Roy Cooper refused to join it.
Moreover, Gov. Bev Perdue vetoed legislation passed by the General Assembly that would have exempted North Carolinians from the individual mandate and required Cooper to join that lawsuit.
The panel also said striking down the mandate did not invalidate the rest of the law. Since the mandate was not scheduled to take effect until 2014, implementation of the law can proceed.
State of Florida vs. U.S. Dept. of HHS challenges the Patient Protection and Affordable Care Act, a bill passed in 2009 with no Republican support and signed into law by President Barack Obama. In the lawsuit, the plaintiffs made two main charges: The law’s requirement that every person who is not covered by a public health care program purchase insurance from a provider approved by the federal government exceeds the power of Congress to regulate interstate commerce; and that an expansion of Medicaid included in the law illegally compelled states to take on new health care costs for the poor that they might not want to pay.
The majority included Chief Judge Joel Dubina, appointed by President G.H.W. Bush, and Judge Frank M. Hull, selected by President Clinton. Hull is the first federal judge appointed by a Democrat to strike down the mandate. Another Clinton appointee, Judge Stanley Martin, wrote the dissent.
(For a PDF download of the 304-page opinion, click here.)
The judges unanimously upheld the expansion of Medicaid. But by a 2-1 vote, the panel concluded that the individual mandate went beyond the enumerated powers of the legislative branch that are spelled out in the Constitution.
“This economic mandate represents a wholly novel and potentially unbounded assertion of congressional authority: the ability to compel Americans to purchase an expensive health insurance product they have elected not to buy, and to make them re-purchase that insurance product every month for their entire lives,” the majority stated. “The statutory language of the mandate is not tied to health care consumption—past, present, or in the future. Rather, the mandate is to buy insurance now and forever. The individual mandate does not wait for market entry.”
Even during the Great Depression and the two world wars, the panel said, “Congress never sought to require the purchase of wheat or war bonds, force a higher savings rate or greater consumption of American goods.”
In his dissent, Martin said, “when measured against the kinds of sweeping changes we have seen in the past, the individual mandate is far from a cataclysmic expansion of Congress’ commerce power.” He found the requirement to purchase insurance acceptable because everyone will need health care at some point in their lives, and purchasing insurance gives individuals the capacity to pay for what they consume.
Moreover, Congress imposed the mandate to prevent individuals from waiting until they become sick to purchase coverage. This cost-saving measure, Martin said, is another proper use of congressional power.
In June, the 6th U.S. Circuit Court of Appeals in Cincinnati turned back a challenge to the health care law. The government is expected to ask the full 11th Circuit to review today’s decision; even if the full circuit reverses, an appeal to the Supreme Court is certain.
When Perdue vetoed House Bill 2, she called the bill “superfluous,” and said “This issue will reach the Supreme Court in a timely manner without North Carolina spending money and energy on it.”
Perdue’s office did not respond to an email asking if the governor had any comment about today’s court ruling.
Rick Henderson is managing editor of Carolina Journal.
Editor’s note: This story was updated after initial publication.