Judge Vinson Rules Health Care Reform Unconstitutional

Judge Vinson (N.D. Fla.) ruled today in State of Florida v. U.S. Dep't of Health and Human Services that the Patient Protection and Affordable Health Care Act was unconstitutional--in its entirety.  The ruling declared that the individual health insurance mandate exceeded congressional authority under the Commerce Clause and the Necessary and Proper Clause.  Judge Vinson wrote that because the mandate cannot be severed from the rest of the Act, the whole thing was unconstitutional.  We posted previously on the case--which was brought by governors or AGs in 26 states, two private citizens, and a business association--here and here.

In striking down the mandate, Judge Vinson ruled that the Commerce Clause only authorizes Congress to regulate activity, that failure to purchase health insurance is not an activity, and that there's nothing inherent or unique in the health care market or in the decision not to purchase health insurance that ties the failure to purchase health insurance to interstate commerce.

Judge Vinson emphasized throughout his analysis that the question--whether Congress can regulate a non-"activity"--was novel.  This alone, he ruled, did not make it unconstitutional.  But it seemed to put a heavy thumb on the scale in his analysis.  (He didn't seem troubled that other congressional acts upheld under the Commerce Clause were also "novel" when they first came to the courts: wheat production for home use in Wickard v. Filburn and home production and use of marijuana in Gonzales v. Raich, just to name two.  But he did write this about Wickard: "[B]efore Wickard was decided, it is likely that most people (including legal scholars and judges) would have thought it equally "ridiculous" to believe that Congress would one day seek (and be permitted) to regulate (as interstate commerce) the amount of wheat that a farmer grew on a small private farm for his personal consumption."  Op. at 47, n. 20.)

He also emphasized the unbridled power that would result if Congress could require individuals to purchase health insurance: if Congress could do this, he wrote, Congress could do anything--require us to buy certain cars, to buy certain bread, and even to buy broccoli.  These kinds of regulations exceed congressional authority, he wrote, because they run counter to the Framers' intent and to precedent and practice.

Judge Vinson was perhaps most emphatic in writing that the non-act of not purchasing health insurance had no effect on interstate commerce:

If impact on interstate commerce were to be expressed and calculated mathematically, the status of being uninsured would necessarily be represented by zero.  Of course, any other figure multiplied by zero is also zero.  Consequently, [even the aggregate] impact must be zero, and of no effect on interstate commerce.

Op. at 50.  According to Judge Vinson, it would require "pil[ing] inference upon inference" to get from not insuring to the interstate economy, thus running afoul of the principle in U.S. v. Lopez. 

Judge Vinson wrote separately about the Necessary and Proper Clause.  He wrote that this Clause also failed to support the individual mandate, largely because the Commerce Clause didn't support the mandate:

The Necessary and Proper Clause cannot be utilized to "pass laws for the accomplishment of objects" that are not within Congress' enumerated powers.  As the previous analysis of the defendants' Commerce Clause argument reveals, the individual mandate is neither within the letter nor the spirit of the Constitution.  To uphold that provision via application of the Necessary and Proper Clause would authorize Congress to reach and regulate far beyond the currently established "outer limits" of the Commerce Clause and effectively remove all limits on federal power.

Op. at 62.

Judge Vinson ruled that the Medicaid expansion portion of the Act did not violate the Spending Clause.  He ruled that it clearly met the standards under South Dakota v. Dole and that it didn't unconstitutionally "coerce" the states.  (The states argued that the expansion coerced them into continuing their participation in Medicaid, even as the cost of participating became unsustainable.)

But he nevertheless ruled the entire Act unconstitutional, because, he wrote, the individual mandate wasn't severable from the rest of the Act.

Judge Vinson's ruling is now the second federal district court ruling that the individual mandate is unconstitutional.  (Judge Henry Hudson (E.D. Va.) issued the first ruling last month.)  There are also two federal court rulings upholding the constitutionality of the mandate.

SDS