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Pennsylvania Federal Judge: Individual Mandate In Health Care Act Violates Constitution

HARRISBURG, Pa. -- A Pennsylvania federal judge on Sept. 13 held that the individual mandate contained in the Patient Protection and Affordable Care Act (PPACA) is an unconstitutional extension of authority granted to the federal government under the U.S. Constitution's commerce clause (Barbara Goudy-Bachman, et al. v. United States Department of Health and Human Services, et al., No. 10-763, M.D. Pa.).

Barbara Goudy-Bachman and Gregory Bachman sued the U.S. Department of Health and Human Services, Kathleen Sebelius, in her official capacity as secretary of Health and Human Services, the U.S. Department of the Treasury and Timothy Geithner, in his official capacity as secretary of the Treasury, in the U.S. District Court for the Middle District of Pennsylvania, alleging that Section 1501 of the PPACA, which requires all people to purchase and maintain qualifying health insurance, is an unconstitutional exercise of Congress' authority under the commerce clause.  The Bachmans say the individual mandate has caused them current economic and noneconomic harm, and they seek an order to enjoin enforcement of the individual mandate.

The federal government moved to dismiss the case or, alternatively, for summary judgment, saying Congress acted within its authority in passing the provision.  The plaintiffs also moved for summary judgment.

In granting summary judgment in favor of the plaintiffs, Judge Christopher C. Conner said the case is not about the need to address the country's health care system but instead concerns precise parameters of Congress' enumerated authority under the commerce clause and whether Congress can invoke its power under that clause to compel individuals to buy insurance as a condition of lawful citizenship or residency.

Congress exceeded its power under the commerce clause in enacting the mandate because the "power to regulate interstate commerce does not subsume the power to dictate a lifetime financial commitment to health insurance coverage," Judge Conner said.

"Without judicially enforceable limits, the constitutional blessing of the minimum coverage provision would effectively sanction Congress's exercise of police power under the auspices of the Commerce Clause, jeopardizing the integrity of our dual sovereignty structure," Judge Conner said.

In reaching the decision, Judge Conner rejected arguments relating to the distinction between activity and inactivity, saying such wordplay "is imprecise and unhelpful."

The extension of commerce clause power to the pre-transaction stage would eliminate "judicially enforceable boundaries," Judge Conner said.  The mandate regulates people who have not yet entered the market in anticipation of their entrance into the health care services market, and, to date, all exercises of commerce clause authority have proscribed activity by individuals already engaged in commerce who are active in the relevant interstate market.

"Congress may lawfully regulate the interstate market for health insurance and health services, but Congress cannot require individuals who choose not to purchase health insurance or individuals who are not currently seeking or receiving services in the health care market to purchase health insurance in order to stabilize the health insurance market.  Congress cannot mandate or regulate in anticipation of conduct that may or may not occur in the future," Judge Conner said.

[Editor's Note:  Full coverage will be in the Sept. 21 issue of Mealey's Managed Care Liability Report.  In the meantime, the order is available at or by calling the Customer Support Department at 1-800-833-9844.  Document #31-110921-007Z.  For all of your legal news needs, please visit]

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