Health-care reform: Is it unconstitutional?

Does President Obama’s health-care reform violate the Constitution? asked Peter Suderman in Reason.com. That momentous question is clearly headed for the U.S. Supreme Court, now that a federal judge in Florida has opened the door to the biggest Republican legal challenge of the law. The central issue is whether the federal government has constitutional authority to require virtually all Americans to have health insurance or pay a penalty. Judge Roger Vinson, a Reagan appointee, ruled that a lawsuit by 20 states’ attorneys general could go forward, agreeing that the “individual mandate” to buy health insurance is an “unprecedented” exercise of federal authority. Vinson made it clear he sees merit in the lawsuit, but in a similar lawsuit filed in Michigan two weeks ago, a federal judge who was appointed by Bill Clinton came to the opposite conclusion, ruling that health-care reform—and the individual mandate—was clearly constitutional. In the end, opponents of health-care reform “face long odds,” because the Supreme Court isn’t likely to overturn a landmark piece of legislation passed by Congress.

Actually, the case for overturning the law is pretty strong, said The Wall Street Journal in an editorial. In a historic first, Obamacare’s mandate essentially places a tax on “economic inactivity.” You’re required to purchase car insurance, for example, based on your decision to buy and drive a car. But requiring you to buy health insurance is “based solely on citizenship and on being alive,” as Judge Vinson pointed out. As he also noted, the government doesn’t typically “require Americans to purchase particular goods or services from private parties.”

What that argument fails to consider, said Garrett Epps in The Atlantic.com, is that health care isn’t something you can choose not to consume. Some people get by without driving a car, but someday we all “end up in the emergency room, hospital, or hospice.” That care costs money. People without insurance stick other citizens with the bill; their selfish decision not to buy health insurance “has a huge impact on their neighbors and on the nation.” To petulantly insist that it doesn’t is to engage in a conservative game of “let’s pretend,” with Americans still living in cabins out in the frontier, completely isolated from one another and the health-care system. If some Grizzly Adams somewhere will swear he’ll never, ever see a doctor or visit a hospital, we can let him out of the mandate. Now, can the rest of us please grow up?

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