The United States Court of Appeals for the Sixth Circuit in Cincinnati has affirmed a U.S. District Court ruling in Michigan that the health care reform law's "individual mandate" on individuals to obtain health insurance is constitutional.

The district court in Michigan was one of three lower federal courts to rule the mandate as constitutional, while two other lower federal courts have ruled it unconstitutional. The ruling is the first appellate court decision on aspects of the reform law, with decisions expected soon from federal appeals courts in Atlanta and Richmond, Va., before the issues fall in the lap of the Supreme Court.

The Thomas More Law Center and four individuals appealed the Michigan ruling, arguing that Congress lacked authority under the Commerce Clause of the Constitution, which regulates activities that substantially affect interstate commerce.

In its ruling, the Appeals Court in Cincinnati noted that the Supreme Court previously has held that Congress has broad authority to regulate under the Commerce Clause. The court, citing legal precedent, further noted that, "The minimum coverage provision, like all congressional enactments, is entitled to a 'presumption of constitutionality' and will be invalidated only upon a 'plain showing that Congress has exceeded its constitutional bounds.'"

To demonstrate its belief that the Commerce Clause gives Congress broad authority, the Appeals Court asserted that it has long been established that Congress may regulate economic activity, even if wholly intrastate, if it substantially affects interstate commerce, and secondly "may regulate even non-economic intrastate activity if doing so is essential to a larger scheme that regulates economic activity."

"By regulating the practice of self-insuring for the cost of health care delivery, the minimum coverage provision is facially constitutional under the Commerce Clause for two independent reasons," the Appeals Court ruled. First, the provision regulates economic activity that Congress had a rational basis to believe has substantial effects on interstate commerce. In addition, 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."

According to the Los Angeles Times, Presidents Jimmy Carter, Ronald Reagan and George W. Bush appointed the three judges in Cincinnati.

The Appeals Court in Cincinnati's ruling in Thomas More Law Center, et al. v. Obama, et al. is available here.


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