Federal Court in Pennsylvania Strikes Down Individual Mandate of U.S. Health Care Reform Law

Today a federal judge in Harrisburg, Pennsylvania found unconstitutional 26 U.S.C. § 5000A, the individual mandate provision of the federal Patient Protection and Affordable Care Act. Goudy-Bachman v. United States Department of Health and Human Services, No. 1:10-cv-763 (M.D. Pa. Sept. 13, 2011).  In a 50 page opinion, the court concluded that the mandate–which requires most Americans to purchase health insurance in 2014 or be subjected to a fine–exceeded the power of the U.S. Congress under the Commerce Clause of the U.S. Constitution. That provision of the Constitution, in Article 1, Section 8, declares in relevant part that Congress has the power to “regulate commerce . . . among the several States . . . ”

In response to the government’s argument that the mandate merely regulates the timing and method of payment individuals use to pay for health care services which they will almost certainly receive at some point, the court opined that “the Supreme Court has never sanctioned, under the auspices of the Commerce Clause, the enactment of a broad scale economic mandate of a probable but uncertain future transaction.” Observing that “[t]he minimum coverage provision regulates now for a future contingent event,” the court characterized the mandate as an attempt to regulate people’s behavior “in anticipation of the receipt of health care services that forces individuals to become market participants prior to entering the market or engaging in any conduct, activity or transaction in that market.”

The court also rejected the government’s contention that the uniqueness of the market and nature of insurance–which “necessarily entails payment for services in advance of receipt of services”–supported the expansion of the Commerce Clause power to permit Congress “to regulate individuals prior to their entry into the market.” In addition, the court found that Congress’s action was not justified by the Necessary and Proper Clause of the Constitution, which endows Congress with power “[t]o make all laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the government of the United States, or in any department or officer thereof.”

The court found that 26 U.S.C. § 5000A could not be severed from the remainder of the health care reform act without also severing the guaranteed issue and preexisting conditions health insurance reforms. However, the court held that the remainder of the Act should “be left intact to function in accordance with the intent of Congress.”

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