Patient Protection And Affordable Care Act Constitutional, Cincinnati Appeals Court Finds

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Main Category: Public Health
Also Included In: Health Insurance / Medical Insurance;  Medicare / Medicaid / SCHIP
Article Date: 01 Jul 2011 - 7:00 PDT


The Obama administration won a political victory over the Republican opposition when a federal appeals court in Cincinnati found the Patient Protection and Affordable Care Act constitutional - i.e. it upheld the 2010 health-care law - and with Judge Jeffrey Sutton, who was appointed by George W. Bush in 2003, concurring.

The issue was regarding Congress' constitutional authority. Requiring most Americans to have health insurance, does Congress have interstate commerce authority? The majority of the judges said that in this case it does.

Both Judge Jeffrey Sutton and Judge Boyce Martin (appointed by Carter in 1979) upheld the law, while James L. Graham (appointed by Reagan) dissented.

The Justice Department believes that pending appeals court cases in Atlanta, Washington D.C., and Richmond (Va.) will go the same way.

President of the Thomas More Law Center, Richard Thompson, who filed the suit said they plan to appeal to the Supreme Court.

The court's lead opinion was written by Judge Martin. However, Judge Sutton's agreement will attract the most interest among politicians and strategists. He rejected the notion that a person who does not take out health insurance is not participating in commerce and falls beyond the federal power to regulate commerce.

In 2014 it will be mandatory for Americans to have health insurance. This will be acquired either through Medicaid or a similar government program, through their employers, or through a private purchase. Some people will be exempt.

Judge Sutton wrote that Congress has been given wide berth in regulating commerce ever since the Great Depression of the 1930s - the Constitution allows Congress to create laws that are proper and necessary to implement its powers. He added that even activities of a non-commercial nature, such as cultivating marijuana for personal medical purposes can "substantially affect interstate commerce" when authorized by the state law, and therefore fall under Congress' authority.

Judge Martin wrote:

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."

Judge Graham, who dissented, wondered "What aspect of human activity would escape federal power (if the majority was correct)? The uniqueness that justifies one exercise of power becomes precedent for the next contemplated exercise"

Judge Sutton wrote:

"Call this mandate what you will - an affront to individual autonomy or an imperative of national health care - it meets the requirement of regulating activities that substantially affect interstate commerce."

Lawyers on both sides expect the Supreme Court to take at least one of the cases, possibly in October, at the start of the coming term. The speed of the current appeals could help ensure that timing.

Written by Christian Nordqvist
Copyright: Medical News Today
Not to be reproduced without permission of Medical News Today

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