This week, the Sixth Circuit Court of Appeals upheld the
Affordable Care Act as constitutional (including the key individual
responsibility provision) infusing a large dose of rational thinking into the
highly polarized world that surrounds the health reform law.
In fact, the majority opinion used the word “rational” several times in rejecting the challenge by the conservative Thomas More Law
Center.
“By regulating the practice of self-insuring for the cost
of health care delivery, the minimum coverage provision is facially
constitutional under the Commerce Clause for two independent reasons. First,
the provision regulates economic activity that Congress had a rational basis to
believe has substantial effects on interstate commerce. In addition, Congress
had a rational basis to believe that the provision was essential to its larger
economic scheme reforming the interstate markets in health care and health
insurance.”
A prominent conservative and proponent of state’s rights,
Judge Jeffrey Sutton, joined the majority. Sutton was appointed to the bench by President George W. Bush and
clerked for Supreme Court Justice Antonin Scalia. He is the first Republican appointee on the federal bench to
rule in favor of the individual responsibility provision requiring people to
purchase health insurance or face a penalty.
“No one is inactive when deciding how to pay for
healthcare,” Sutton wrote, rejecting the argument by opponents of the Affordable Care Act that Congress could not regulate “inactivity” such as the decision
not to buy health insurance. “Self insurance and private insurance are two forms
of action for addressing the same risk,” he wrote. “Each requires
affirmative choices.”
Legal challenges are still pending in three other federal
appeals courts: the Fourth Circuit Court of Appeals based in Richmond, Virgina
(in a case brought by Virginia Attorney General Ken Cuccinelli) the Eleventh
Circuit Court of Appeals based in Atlanta, Georgia (in case brought by over two
dozen GOP state officials), and the District of Columbia Circuit Court of
Appeals (in a case brought by several private individuals).
The Supreme Court will likely make the final decision on
the constitutionality of the health reform law sometime next year. Let’s hope the Justices read the rationale for this decision and make a rational decision.