Moments ago, U.S. District Judge Roger Vinson — a Reagan appointee on Northern District of Florida — struck down the entire Affordable Care Act, ruling that since the individual mandate is unconstitutional, the entire law is void. “Because the individual mandate is unconstitutional and not severable, the entire Act must be declared void,” he writes. “This has been a difficult decision to reach, and I am aware that it will have indeterminable implications. At a time when there is virtually unanimous agreement that health care reform is needed in this country, it is hard to invalidate and strike down a statute titled ‘The Patient Protection and Affordable Care Act.’”
It’s the kind of over-reach that will do more to harm the Republican crusade against the law than help it. At one point, Vinson even embraces the entire Tea Party rationale against the Act and suggests that it could lead to total government domination:
If it has the power to compel an otherwise passive individual into a commercial transaction with a third party merely by asserting — as was done in the Act — that compelling the actual transaction is itself “commercial and economic in nature, and substantially affects interstate commerce” [see Act § 1501(a)(1)], it is not hyperbolizing to suggest that Congress could do almost anything it wanted. It is difficult to imagine that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place. If Congress can penalize a passive individual for failing to engage in commerce, the enumeration of powers in the Constitution would have been in vain for it would be “difficult to perceive any limitation on federal power” [Lopez, supra, 514 U.S. at 564], and we would have a Constitution in name only.
But the “activity” vs. “inactivity” distinction is hard to swallow since the actual text of the Constitution makes no mention of such a difference. The clause as written gives Congress the power to regulate economic decisions and there is a long line of Supreme Court cases that reinforce Congress’ broad power to enact laws that substantially affect prices, marketplaces, or other economic transactions. Health care comprises some 17 percent of the national economy and the failure to purchase health insurance — the very passivity that Vinson is referring to — is having a significant impact on national health care spending and growing costs.
But this too is an argument that he rejects. “If impact [of the uninsured] on interstate commerce were to be expressed and calculated mathematically, the status of being uninsured would necessarily be represented by zero. Of course, any other figure multiplied by zero is also zero. Consequently, the impact must be zero, and of no effect on interstate commerce.” Caring for the uninsured, in other words, is free and creates no cost shifts throughout the system.
That’s just not true (doctors and hospitals and treat the uninsured for free) and the argument unravels further when Vinson completely dismisses the Necessary and Proper Clause by arguing that it’s subservient to the Commerce Clause. That Clause, Vinson writes “is not really a separate inquiry, but rather is part and parcel of the Commerce Clause analysis as it augments that enumerated power by authorizing Congress ‘To make all Laws which shall be necessary and proper’ to regulate interstate commerce.”
This is the kind of distortion that really undermines the entire decision and sets Vinson apart as an activist who has decided that Congress has no power to regulate insurance companies, establish exchanges, extend drug discounts to seniors, and give small businesses tax credits to help purchase insurance are all unconstitutional. Conservatives should be outraged.