Among the measures that Liberty University challenged was the imposition of a financial penalty upon persons who failed to purchase health insurance. Although the court rejected the government's argument that the so-called insurance mandate constituted a permissible tax, it held that the provision was a valid exercise of the Commerce Power.
Dissenting Justice has analyzed the relationship between health care reform and the Constitution in several previous blog posts. The court's analysis of the Commerce Clause substantially mirrors the conclusions that those essays reach.
In particular, the court rejects the argument that a decision to remain uninsured cannot constitute economic activity -- which Congress can regulate -- because it simply represents a decision to refrain from commerce, or merely to exist. The court, however, held that the failure to purchase health insurance is not merely a passive, noncommercial act. Instead, it represents a decision by consumers to self-finance their inevitable use of health care. The court found that Congress could rationally assume that the consumption of medical services by uninsured individuals substantially impacts the market for health care in the nation.
In addition to upholding the penalty, the court rejected plaintiff's argument that the law would unconstitutionally require individuals to pay for abortion, regardless of their religious beliefs, and that law violated the Tenth Amendment. These arguments are inconsistent with Supreme Court precedent in this area. The court rightfully rejected them.