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.
