Written by 2:27 pm Opinions • 9 Comments

On the Constitutionality of Healthcare Reform

Last week, the House of Representatives passed the Senate’s healthcare reform bill, sending it to President Obama for his signature or veto. As the President was signing the document into law, however, the Attorneys General of twelve states filed a joint lawsuit against the national government. They claim that, in passing the healthcare law, Congress exercised a power it is not granted in the Constitution, and thus violated its constitutional obligations. The Attorneys General are correct.

Their entire case against the new law is built upon the claim that the so-called “individual mandate”—which requires all citizens of the United States to purchase health insurance, and all businesses employing more than fifty employees to purchase insurance coverage for their employees—has no grounding in the Constitution. Let’s examine that claim.
The Constitution grants Congress the power “To regulate Commerce with foreign Nations, and among the several States,” but no part of the above clause implies that Congress has the power to force an individual or group of individuals to engage in commerce. The similar language used regarding both inter-state and inter-national commerce implies that Congress has the same power to regulate commerce over state boundaries as it does to regulate it over national boundaries—Congress may, of course, enact tariffs and restrictions on international commerce, and thus has the power to do the same over interstate commerce.

No one, however, claims that Congress has the power to force a person to engage in inter-national commerce; and if Congress does not have this power, then surely it does not have the power to force a person to engage in inter-state commerce.

In any case, the current nature of health insurance commerce makes the inter-state commerce clause moot to the issue: people may not, under the laws of the fifty states, buy insurance over state boundaries—a plan sold in one state can not be freely sold in another state. Congress has no power over intra-state commerce; since most, if not all residents of each state can only engage in intra-state commerce to buy health insurance coverage, Congress has no constitutional power over their decisions regarding the purchase and sale of health insurance.

Within the new law, however, the requirement has been framed as a tax, and not a mandate. So instead of forcing people to purchase insurance, at penalty of a fine, the law taxes people who choose not to purchase insurance. Supporters of the new law claim that, since Congress of course has the constitutional power to tax commerce, this tax is therefore constitutional. But if you fail to see a difference between a tax and a fine, you are not alone. A tax is a fine, plain and simple.

But does that make it unconstitutional? Let’s presume that it does not.

If Congress has the power to enact this particular tax, then logically it has the power to enact a tax structured in the exact same way, but infinitely steeper. After all, the Constitution mentions nothing of the degree to which Congress may exercise its powers, but only which powers Congress may exercise.

Now, if Congress has the power to tax a person for choosing not to buy health insurance coverage, it logically also has the power to tax a person for failing to engage in any other kind of commerce—and to tax them to any degree of magnitude for such a failure. So, if the health insurance tax is indeed constitutional, then Congress therefore has the power also to tax a person, at any rate or lump sum amount, for failing to: purchase an automobile, purchase a hat, install and annually maintain cable television service, purchase a dryer machine, set up and maintain a credit card or mutual fund account, donate to a religious organization annually, donate to a political cause annually, subscribe to a magazine annually, purchase a gas-powered oven, purchase an annual membership to a fitness center, annually purchase any mandated amount of energy drinks, or organically-grown food, or inorganically-grown food, subscribe annually to a weight-control program, purchase bullet-proof windows, purchase cameras and microphones to be installed in one’s place of residence or engage in any other activity in which money changes hands.

Some of the above examples may seem ridiculous, and certainly unconstitutional, because any law regarding them would violate the treasured “right to privacy.” But the Constitution does not explicitly deny Congress the power to infringe on citizens’ privacy, and does not specify any right of privacy for the people of the United States. And Congress, in specifying what actions people must take regarding their health, has demonstrated a lack of concern with any “right to privacy.”

It might appear, by my reasoning, that I believe all taxes to be unconstitutional. As the Constitution specifically grants Congress the “Power To lay and collect Taxes,” it is obvious that many taxes are indeed constitutional. The difference between the health insurance tax and the taxes allowed under the Constitution is that the taxes allowed under the Constitution are those that taxes engagement in a specified activity, while the health insurance tax taxes non-engagement in a specified activity.

A tax on engagement in an activity still allows a great degree of freedom of choice—for example, if Congress were to tax the purchase of health insurance coverage at an exorbitant rate, one could join a health savings pool instead. The tax on refraining from purchasing health insurance coverage, however, leaves no freedom to choose—instead of “you must not,” the law says “you must,” funnelling everyone into, instead of pushing them away from, a single specific outcome: the purchase of health insurance coverage.

If Congress has the power to force people to buy any service or good, at penalty of a tax of any rate or lump sum amount, in any way not explicitly denied it by the Constitution, then what powers does Congress not have at its disposal? Is there anything that Congress may not do?

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