Do We Really Need Health Care, After All?

Healthcare News first published this article, Do We Really Need Health Care, After All?, on January 14, 2020.

“There are no facts, only interpretations.” – Friedrich Wilhelm Nietzsche

A Decade of Reform

More than seven years ago, U.S. Supreme Court Chief Justice Roberts saved the Affordable Care Act (the “ACA”) by upholding the constitutionality of the individual mandate through Congress’s authority to “lay and collect Taxes.”  Rejecting the Commerce Clause and the Necessary and Proper Clause as a means to sustain the individual mandate, the Court acknowledged that Congress’s taxing authority can exceed its power to regulate commerce, but the power to tax affords Congress less control over individual behavior than its power to regulate commerce.  At the time Chief Justice Roberts concluded Congress can only require “an individual to pay money into the Federal Treasury, no more.”  As it turns out, Congress was unable to require an individual to pay the cost of the individual mandate, leaving the Internal Revenue Service to focus its collection efforts on the interception of refunds.

In December 2017, Congress passed the Tax Cuts and Jobs Act, setting the “shared responsibility payment” amount to the lesser of zero percent of an individual’s household income or $0.00, effective January 2019.  Following Congress’s slight modification of the ACA, a U.S. District Court in Texas held that the individual mandate was unconstitutional because it no longer was a tax, and according to Chief Justice Roberts in 2012, no other constitutional provision justified such an exercise of congressional power.  That same District Court concluded that without the individual mandate, the entirety of the ACA failed.

Last month the U.S. Court of Appeals for the Fifth Circuit agreed that the individual mandate was unconstitutional, but returned the case back to the District Court to revisit whether the ACA can stand on its own without the individual mandate.  … Read more →