Last month, the first judge ever to consider the issue reached the obviously correct conclusion that the Affordable Care Act is constitutional. Today, a second federal judge reached the same conclusion. The lengthy opinion by Judge Norman Moon of the Western District of Virginia gives several reasons why the Act’s provision requiring all Americans to either carry insurance or pay slightly higher income taxes easily fits within Congress’ broad authority to regulate the national economy, including the fact that striking down this provision would make it impossible to prevent insurance companies from denying coverage to persons with preexisting conditions:
The conduct regulated by the individual coverage provision is also within the scope of Congress’ power under the Commerce Clause because it is rational to believe the failure to regulate the uninsured would undercut the Act’s larger regulatory scheme for the interstate health care market. The Act institutes a number of reforms of the interstate insurance market to increase the availability and affordability of health insurance, including the requirement that insurers guarantee coverage for all individuals, even those with preexisting medical conditions. As Congress stated in its findings, the individual coverage provision is “essential” to this larger regulatory scheme because, without it, individuals would postpone health insurance until they need substantial care, at which point the Act would obligate insurers to cover them at the same cost as everyone else. This would increase the cost of health insurance and decrease the number of insured individuals—precisely the harms that Congress sought to address with the Act’s regulatory measures.
Today’s decision is just another nail in the coffin of the many meritless lawsuits challenging health reform. While conservatives have touted a pair of procedural victories they won in two high-profile lawsuits, the fact remains that every single judge to consider merits of these challenges has upheld the law. Indeed, even ultra-conservative Justice Antonin Scalia has indicated that he agrees with today’s decision. As Scalia wrote in Gonzales v. Raich, “where Congress has the authority to enact a regulation of interstate commerce, it possesses every power needed to make that regulation effective.”