The Caesars Palace, Las Vegas
nd
th
November 2 – 6 , 2013
www.EmployerHealthcareCongress.com
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2012 Employer Healthcare & Benefits Congress
An Examination of the Landmark Supreme
Court Decision on PPACA
Donald Jones
Professor of Law
University of Miami
Images of Obamacare
Article 1—Section 8
Alexander Hamilton
The Constitution is itself,
in every rational sense,
and to every useful
purpose, A BILL OF
RIGHTS.”
The Federalist No. 84, p. 515 (C.
Ros- siter ed. 1961)
Enumerated Powers
Rule 1 -Federal power limited to
enumerated powers.
Corrollary-Pre-existing state power
unlimited.
Rule 2-Where enumerated federal power is
supreme
Enumerated Powers in Issue
• Commerce Clause
• Necessary and Proper Clause
• Power to Tax
The Commerce Clause
Article I , section Eight, clause
threeCongress shall have power to
regulate commerce with foreign
nations, and among the several
states, and with the Indian
tribes…
Judicial Deference
• “The peculiar circumstances
of the moment may render a
measure more or less wise,
but cannot render it more or
less constitutional.”
•
Chief Justice John Marshall, A Friend of the Constitution No. V, Alexandria Gazette, July 5, 1819, in
John Marshall’s Defense of McCulloch v. Mary- land 190–191 (G. Gunther ed. 1969).
The Scope of the Commerce Clause Power
• [T]he power of Congress over interstate
commerce is not confined to the regulation of
commerce among the states,” but extends to
activities that “have a substantial effect on
interstate commerce.”1
Commerce Clause Test
• Where economic activity substantially affects
interstate commerce, legislation regulating
that activity will be sustained.
Framing the Issue
• Activity v. inactivity
• Collective control/individual control
• Coercion/ freedom
Scope of the Commerce Clause
Pro: “The Free Rider Problem”
“With rare exception, at some point every individual
will require health care services. Therefore, the
decision of many individuals not to purchase
coverage…presents a free rider problem. ..For those
individuals for whom health coverage is unaffordable,
there is a societal obligation to create remedies. On
the other hand, for those individuals who could afford
to purchase coverage, yet choose not to…"free riding"
cannot be sanctioned.”
Justifying “Activity”
• Individual decisions not to buy insurance will
effect interstate commerce.
• Individuals who do not purchase insurance
will become “free riders” and obtain unjust
enrichment.
• Individuals who do not have health care need
to be provided for.
The Scope of the Commerce Clause
• CON:
• Yet if the federal government can require people
to buy insurance in order to keep [health
insurance] premiums affordable, could it also
require people to buy baby aspirin or a gym
membership to keep those premiums affordable
on the theory that using these products reduces
the use of health care services and thus insurance
costs.
The Responsibility of Citizenship
• [S]acrifice of liberty could be demanded of the
individual by the state in the interest of
furthering the social compact, specifically in
the context of health.
• Motor cycle helmets
• Vaccines
The “Temporal” Objection
• because “[e]veryone subject to this regulation
is in or will be in the health care market,” they
can be “regulated in advance.” Tr. of Oral Arg.
109 (Mar. 27, 2012).
Anticipating effects v. anticipating activity
• Everyone will likely participate in the markets
for food, clothing, transportation, shelter, or
energy; that does not authorize Congress to
direct them to purchase particular products in
those or other markets today. The commerce
clause is not a general license to regulate an
individual from the cradle to the grave.
Justice Roberts
• The proximity and degree of connection
between the mandate and the subsequent
commercial activity is too lacking…. The
individual mandate forces individuals into
commerce precisely because they elected to
refrain from commercial activity. Such a law
cannot be sustained under a clause
authorizing Congress to “regulate Commerce.”
Precedent
• [T]o register for the draft, to purchase
firearms in anticipation of militia service, to
exchange gold currency for paper currency,
and to file a tax return--are based on
constitutional provisions other than the
Commerce Clause. See Art. I, § 8, cl. 9