This afternoon, the District Court for the Middle District of Pennsylvania became the latest court to strike down the Patient Protection and Affordable Care Act’s (Obamacare) individual mandate, holding that “[t]he power to regulate interstate commerce does not subsume the power to dictate a lifetime financial commitment to health insurance coverage.” The challenge was brought by a Barbara Goudy-Bachman and Gregory Bachman, who are both self-employed and have chosen to drop their health insurance because it exceeded their monthly mortgage payments. Instead, Bachmans opted to pay for health care out of pocket. The Administration, unless it wants to concede that Obamacare is unconstitutional, will have to appeal to the U.S. Court of Appeals for the Third Circuit.
Adopting much of the reasoning of the Judge Vinson’s district court opinion and the Eleventh Circuit three-judge panel decision, Judge Christopher Conner rejected the government’s position that the Commerce Clause could be extended to the “pre-transaction stage”— that is, regulation of the possibility that an individual would seek medical services and then fail to pay for them. The judge noted that allowing such a use of the Commerce Clause was unprecedented and would eradicate previous judicially enforceable boundaries. Judge Conner continued, “[u]nless and until [nonpayment of services occurs], an individual’s status as uninsured…has no effect whatsoever on interstate commerce.”
Judge Conner further found that the individual mandate provision is severable from the larger law, except for three other provisions (the minimum-coverage provision, the guaranteed issue and preexisting conditions reforms, 42 U.S.C. §§ 300gg-(1)(a), 300gg-3) that must be struck down as well.
In closing, Judge Conner stated that “[t]he nation undoubtedly faces a health care crisis…the federal government, however, is one of limited enumerated powers.” Congress’s attempts to “remedy the ailing health care and health insurance markets must fit squarely within the boundaries of those powers.” With challenges working their way up a number of circuit courts and one petition for certiorari already pending before the Supreme Court, the only question remaining is one of timing.