While many provisions of the Patient Protection and Affordable Health Care Act of 2010, as amended by the Health Care and Education Reconciliation Act of 2010 (otherwise referred to as the "Health Reform Bill") have already taken effect, one important provision may never be implemented.
On December 13, 2010, a federal district court in Richmond, Virginia ruled that Section 1501 of the Health Reform Bill was unconstitutional. The ruling was issued by Judge Henry E. Hudson and is the first ruling on several challenges to the Health Reform Bill to render the statute unconstitutional.
Section 1501 of the Health Reform Bill mandates, with a couple of exceptions, that every United States citizen obtain and maintain at least a minimum level of health insurance coverage by 2014. Failure to maintain such coverage will result in a penalty administered under the Internal Revenue Code. In adopting this provision, Congress stated within the Bill that "the requirements, together with other provisions of this Act, will add millions of new consumers to the health insurance market, increasing the supply of, and demand for, health care services, and will increase the number and share of Americans who are insured...By significantly reducing the number of the uninsured, the requirement, together with the other provisions of this Act, will lower health insurance premiums…By significantly increasing health insurance coverage, the requirement, together with the other provisions of this Act, will improve financial security for families."
The Virginia suit was filed by the Commonwealth of Virginia, through the Attorney General, and alleged that Section 1501 of the Health Reform Bill exceeded Congress' powers under the Commerce Clause and the General Welfare Clause of the United States Constitution. In defending the lawsuit, the Department of Health and Human Services stated that the Health Reform Bill was within Congress' powers to regulate interstate commerce.
The Court ruled that Section 1501 exceeded the Commerce Clause by compelling individuals to "involuntarily enter the stream of commerce" through the requirement that individuals purchase health insurance. Section 1501 regulates a person's decision not to participate in interstate commerce, which the Court concluded was beyond Congress' delegated power to regulate interstate commerce. Judge Hudson found that the insurance mandate was "neither within the letter nor the spirit of the Constitution."
The Court, however, did not rule that the entire Health Reform Bill was unconstitutional, and did not force State and Federal officials to stop efforts designed to put the Health Reform Bill into effect. While many believe the Section 1501 mandate is essential to healthcare reform, by only ruling this individual provision of the Health Reform Bill unconstitutional, the Court left room for flexibility with regard to the implementation of healthcare reform in other areas.
The Obama Administration plans to appeal the Court's decision to the Fourth Circuit Court of Appeals. Justice Department spokeswoman Tracy Schmate stated, "We are disappointed in today's ruling but continue to believe -- as other federal courts in Virginia and Michigan have found -- that the Affordable Care Act is constitutional....we are confident that we will ultimately prevail." Many believe that the appeal will eventually reach the United States Supreme Court.
As of the date of this article, two other federal judges (in Detroit, Michigan and Lynchburg, Virginia) have ruled on the merits of the Health Reform Bill and have deemed it to be constitutional. One major pending challenge to the Health Reform Bill is being led by the State of Florida, who has been joined by nineteen other states, including Alabama. Many analysts expect the Florida court will also deem the insurance mandate unconstitutional.
This recent decision in Virginia signals that the legal challenges to the Health Reform Bill are far from over. It may be years before all the dust settles and a final version of healthcare reform is fully implemented. In the meantime, Americans can decide where they fall on this heated debate. So I ask you, mandated insurance coverage - constitutional or unconstitutional?
Kelli Fleming is an associate with Burr & Forman LLP and practices exclusively within the firm's Health Care Practice Group.
