New York Healthcare Law Blog

Efforts to block a key provision of the new healthcare reform law are blooming in 33 states. A growing number of mostly Republican officials are mounting legal and legislative challenges to the new law's requirement that, starting in 2014, all Americans buy health insurance or pay a penalty tax.

The challengers contend that Congress lacks the constitutional authority to mandate an individual citizen's participation in an insurance plan and that it has infringed on states' rights by requiring them to extend coverage to low-income residents without fully funding the associated cost. One of the complaints, filed by a conservative public interest law firm in the United States District Court for the Eastern District of Michigan on the same day as the Patient Protection and Affordable Care Act became law, alleges that "The Health Care Reform Act imposes unprecedented governmental mandates that restrict the personal and economic freedoms of American citizens in violation of the Constitution."

The Department of Justice (DOJ), in defending the constitutionality of the healthcare reform law, argues that Congress had a rational basis for the provision, as an individual decision to purchase healthcare insurance, collectively, substantially affects interstate commerce. In addition and apart from its power under the Commerce Clause, Congress, DOJ's lawyers claim, has authority to enact the new law under its power to tax and spend to provide for the general welfare.

Many constitutional scholars have stated that the new law is likely to withstand the challenge, pointing out to Supreme Court's long record of upholding congressional authority to regulate the economy by imposing taxes, to restrict personal freedoms in the national interest and to supersede conflicting state laws. There are many, however, who feel that we are now seeing only the first set of a complex web of lawsuits, which are likely to pose a serious threat to survival of the new law. Beyond all disputes is the fact that the determination of the constitutionality of such severe governmental coercion and such a serious intrusion into personal freedom, will have a profound impact on the political future of our nation.