Appeals Court Upholds Health Reform Law's Insurance Mandate

Appeals Court Upholds Health Reform Law's Insurance Mandate

On Wednesday, a three-judge panel at the Sixth U.S Circuit Court of Appeals in Cincinnati in a 2-1 decision upheld a lower court ruling that the federal health reform law's individual mandate is constitutional, the New York Times reports (Sack, New York Times, 6/29).

Among the nearly two dozen challenges to the reform law, the decision marks the first time that a mid-level federal court ruled on the overhaul, according to the Washington Post (Markon, Washington Post, 6/29).

In addition, the Sixth Circuit's decision marks the first victory at the appeals level for the Obama administration in its defense of the law (McCarthy, National Journal, 6/29).

The lawsuit originally was filed in 2010 by the Michigan-based Thomas More Law Center and two individuals, alleging that Congress overstepped its legal authority by establishing the coverage mandate (Haberkorn, Politico, 6/29). The suit reached the appellate court after U.S. District Court Judge George Steeh in October 2010 upheld the constitutionality of the health reform law and individual mandate. Steeh also rejected the plaintiffs' motion to institute a temporary injunction against the overhaul (California Healthline, 1/21).

The Thomas More Law Center could petition the Supreme Court to overturn the Sixth Circuit panel's decision. The plaintiffs also could ask the full appellate court to consider their case, but that option is not expected, according to Politico (Politico, 6/29).

Majority Opinion Favoring the Mandate

In the majority opinion, Circuit Judges Boyce Martin and Jeffrey Sutton wrote, "We find that the minimum coverage provision is a valid exercise of legislative power by Congress under the commerce clause" (Washington Post, 6/29).

The judges added, "The activity of forgoing health insurance and attempting to cover the cost of health care needs by self-insuring is no less economic than the activity of purchasing an insurance plan."

They explained that the individual mandate is "facially constitutional" for two reasons: "First, the provision regulates economic activity that Congress had a rational basis to believe has substantial effects on interstate commerce," and "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" (New York Times, 6/29).

Sutton Becomes First GOP-Appointed Judge To Rule in Favor of Overhaul

Proponents of the overhaul and legal experts noted that in ruling in favor of the health reform law, Sutton became the first Republican-appointed federal judge to uphold the constitutionality of the individual mandate (Politico, 6/29).

According to CQ HealthBeat, Sutton -- who was appointed by President George W. Bush -- clerked for U.S. Supreme Court Justice Antonin Scalia, the most prominent conservative on the high court.

Widely considered to be "a pillar of conservative thought," Sutton's participation in the majority opinion likely deals "a blow" to opponents and challengers of the overhaul and the mandate, according to CQ HealthBeat (Norman, CQ HealthBeat, 6/29).

Proponents of the law hope that Sutton's favorable opinion of the overhaul will resonate with the conservative judges in the Supreme Court, which many expect will deliver the final decision on the constitutionality of the law and individual mandate sometime next year (Politico, 6/29). Read More