WASHINGTON, D.C. - (Mealey's) A District of Columbia federal judge on Feb. 22 dismissed a challenge to the Patient Protection and Affordable Care Act (PPACA), finding that Congress did not exceed its power in enacting the individual mandate provision and that the act did not violate the plaintiffs' religious freedom (Margaret Peggy Lee Mead, et al. v. Eric H. Holder Jr., et al., No. 10-950, D. D.C.).
U.S. Judge Gladys Kessler of the District of Columbia dismissed a challenge to the PPACA brought by Margaret Peggy Lee Mead, Charles Edward Lee, Susan Seven-Sky, Kenneth Ruffo and Gina Rodriquez. The plaintiffs contend that they can afford health insurance coverage but that they have chosen not to purchase insurance in the past and do not wish to purchase it in the future. Ruffo and Rodriquez contend that they would prefer to pay for medical services out of pocket. Mead, Lee and Seven-Sky allege that they will refuse all medical services for the remainder of their lives.
The plaintiffs allege that by requiring most people to purchase health care insurance or pay a penalty, Congress exceeded its powers under and violated the Religious Freedom Restoration Act.
After finding that the plaintiffs do have standing to sue, Judge Kessler granted the defendants' motion to dismiss, saying Congress acted within its authority under the commerce clause in enacting the individual mandate.
A person's decision to purchase or not to purchase health insurance is an "economic" decision, and in the aggregate, the decisions of people to forgo health insurance substantially affect the national health care market, Judge Kessler said. Because Congress had a rational basis for finding that the aggregate of individual decisions not to purchase health insurance substantially affects the national health insurance market, Congress acted within its power under the commerce clause in enacting the individual mandate, she added.
Having already rejected the premise that people can opt out of the health care market indefinitely, Judge Kessler also rejected the plaintiffs' argument that Congress cannot subject them to the regulation because they will never consume medical services.
Even if the plaintiffs do refuse medical care for the remainder of their lives, Congress may still regulate the larger class of people when it "decides that the total incidence of a practice poses a threat to a national market," Judge Kessler said.
Also, Congress did not violate the Religious Freedom Restoration Act in enacting the individual mandate because the alleged conflict between the provision's requirements and the plaintiffs' Christian faith does not rise to the level of a substantial burden, the judge said.
Further, it is unclear how the provision puts substantial pressure on the plaintiffs to modify their behavior and to violate their beliefs because the act permits them to pay a shared responsibility payment in lieu of actually obtaining health insurance and the plaintiffs have alleged that they intend to do this, Judge Kessler said.
Already the "plaintiffs routinely contribute to other forms of insurance, such as Medicare, Social Security and unemployment tax, which present the same conflict with their belief that God will provide for their medical and financial needs," Judge Kessler said.
[Editor's Note: Full coverage will be in the March 2 issue of Mealey's Managed Care Liability Report. In the meantime, the opinion is available at www.mealeysonline.com or by calling the Customer Support Department at 1-800-833-9844. Document #31-110302-017Z. For all of your legal news needs, please visit www.lexisnexis.com/mealeys.]
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