Federal Court Upholds Constitutionality Of Health Insurance Mandates

The new health care law's individual mandate has survived it's first legal challenge, and that's not really a surprise.

A Federal District Court in Michigan has issued the first ruling on the merits challenging the constitutionality of the individual health insurance mandates in the new health care reform law, and it was a defeat for the opponents of ObamaCare:

A federal judge in Detroit today upheld key provisions of President Barack Obama’s Health Care Reform Act of 2010.

In a 20-page decision, U.S. District Judge George Steeh refused to issue a preliminary injunction to halt preparations for putting federal health reforms into full effect in 2014. He also dismissed the key points of the suit — requiring Americans to buy health insurance and penalizing those who don’t starting in 2014.

He is the first judge nationally to rule on the key criticisms of the law.

The Thomas More Law Center, which sued along with four plaintiffs, said it plans to appeal the decision.

In the opinion, which I’ve embedded below, Judge Steeh bases his ruling entirely on Congressional power under the Interstate Commerce Clause and does not rule at all on the additional ground raised by the Federal Government that the mandate is a proper exercise of the power to tax and spend for the General Welfare.

The money quote from the decision:

The health care market is unlike other markets. No one can guarantee his or her health, or ensure that he or she will never participate in the health care market. Indeed, the opposite is nearly always true. The question is how participants in the health care market pay for medical expenses – through insurance, or through an attempt to pay out of pocket with a backstop of uncompensated care funded by third parties. This phenomenon of costshifting is what makes the health care market unique. Far from “inactivity,” by choosing to forgo insurance plaintiffs are making an economic decision to try to pay for health care services later, out of pocket, rather than now through the purchase of insurance, collectively shifting billions of dollars, $43 billion in 2008, onto other market participants.

As this cost-shifting is exactly what the Health Care Reform Act was enacted to address, there is no need for metaphysical gymnastics of the sort proscribed by Lopez. The plaintiffs have not opted out of the health care services market because, as living, breathing beings, who do not oppose medical services on religious grounds, they cannot opt out of this market. As inseparable and integral members of the health care services market, plaintiffs have made a choice regarding the method of payment for the services they expect to receive. The government makes the apropos analogy of paying by credit card rather than by check. How participants in the health care services market pay for such services has a documented impact on interstate commerce. Obviously, this market reality forms the rational basis for Congressional action designed to reduce the number of uninsureds.

The Supreme Court has consistently rejected claims that individuals who choose not to engage in commerce thereby place themselves beyond the reach of the Commerce Clause. See, e.g., Raich, 545 U.S. at 30 (rejecting the argument that plaintiffs’ homegrown marijuana was “entirely separated from the market”); Wickard, 317 U.S. at 127, 128 (home-grown wheat “competes with wheat in commerce” and “may forestall resort to the market”); Heart of Atlanta Motel v. United States, 379 U.S. 241 (1964) (Commerce Clause allows Congress to regulate decisions not to engage in transactions with persons with whom plaintiff did not wish to deal). Similarly, plaintiffs in this case are participants in the health care services market. They are not outside the market. While plaintiffs describe the Commerce Clause power as reaching economic activity, the government’s characterization of the Commerce Clause reaching economic decisions is more accurate.

Based on the current state of Commerce Clause jurisprudence, which goes back to a case called Wickard v. Fillburn in which the New Deal era Court held that a farmer growing wheat on his own farm for his own use could still be subject to regulations of the Agricultural Adjustment Act of 1938, this is not at all a surprising decision. In fact, it’s fairly clear that if the mandate is to be declared unconstitutional, it would require a Court to determine that 6o-plus years of Commerce Clause case law was wrongly decided. That isn’t something that Court’s do on a whim, and even a Justice like Antonin Scalia is unlikely to throw out a half century’s worth of case law without a very good reason.

It’s unclear what impact this decision will have on the cases pending in Virginia and Florida. Since it comes from a District Court, it isn’t considered binding precedent of any kind, however it’s a certainty that the Federal attorneys assigned to those cases will be incorporating this decision into their pleadings.

The next step for this case would be the Sixth Circuit Court of Appeals. However, in one way or another, it’s fairly clear that this case is head to the Supreme Court.

Thomas More Law Center et al v. Obama

FILED UNDER: Healthcare Policy, Law and the Courts, US Politics, , , , , , , , , , , ,
Doug Mataconis
About Doug Mataconis
Doug Mataconis held a B.A. in Political Science from Rutgers University and J.D. from George Mason University School of Law. He joined the staff of OTB in May 2010 and contributed a staggering 16,483 posts before his retirement in January 2020. He passed far too young in July 2021.


  1. Herb says:

    “However, in one way or another, it’s fairly clear that this case is head to the Supreme Court.”

    As if that will settle anything…..

  2. Brummagem Joe says:

    “However, in one way or another, it’s fairly clear that this case is head to the Supreme Court.”

    I look forward to the Supreme Court over turning the commerce clause. After all it has no ramifications outside this particular issue.

  3. Ben says:

    I agree that the government wins this argument based on precedent. And I agree that they’re not going to overturn it.

    However, all that being said, Wickard v. Filburn was one of the most infuriatingly BS cases I’ve ever read. It straight up pissed me off reading it back in Con Law.

  4. Zelsdorf Ragshaft III says:

    BS. If the SCOTUS does not reverse this keep your powder dry. The American people will not allow congress to force us to buy any F*cking thing. Only idiots thing the Consititution allows for this sort of BS. The commerce clause was never intended to extend to congress power which it limits in all areas.where it deals with what government at the federal level is authorized to do. Lawyers are the only people who find sh*t like this in the document. It does not take a law degree to understand the Constitution and it was not written to require that. It was written to be understood by any and all who read it. If this is not overturned, it will allow congress to dictate what cars we can buy based upon government interest in certain car companies. If you think this sh*t will stand, Doug, you are not paying attention to the Tea Party. Continue at your own peril for if conservatives have their way, we will need far fewer lawyers.

  5. mantis says:

    Psst, ZD3, the Constitution is a legal document written by lawyers.

    Btw, which cars have you been unable to buy due to government intrusion?

    Doug, did you notice Zelsdorf promising to kill you there at the end? Isn’t he adorable?

  6. JKB says:

    So the short version of the decision is – We exist, therefore, Congress can

    So the solution is political, i.e., scare Congress so bad they get their hands off our bodies. First through election, if not, then through tar and feathers, if not, anyone fluent in French want to translate the blueprints for the guillotine? It might come to that since their response is “Let them eat sugar free, gluten-free, partially hydrogenated fat-free, carob iced cake.

  7. An Interested Party says:

    Oh my, death threats, tarring and feathering…some deranged people are having a really hard time accepting this…if the GOP doesn’t take over the Congress next month and if the president does win a second term, these deranged people’s heads will surely explode…

  8. Brummagem Joe says:

    “Oh my, death threats, tarring and feathering…some deranged people are having a really hard time accepting this”

    Unfortunately, this is the mindset of a large part of the Republican base. Fascism does not lurk far below the surface.

  9. wr says:

    I sincerely hope their heads are all that will explode. But you’ve got maniacs like Zels openly making death threats, and his ilk are being spurred on by sociopaths like Angle. For the Tea Party, apparently patriotism means murdering your fellow Americans until everyone agrees with you. They seem to believe this is the definition of democracy.

  10. TMC says:

    I’m assuming ZRIII meant that conservatives would put lawyers out of work, not out of life.

    Remember that the path to fascism can approach from the left as well as the right, wr. Stalin was a sold-out fascist, not a communist. That’s why Stalin had Trotsky executed. Of course, he could have tried just telling him to ‘stop whining’ instead.



    This mandatory private middleman health care scam is corporate fascism, pure and simple. It doesn’t evolve overnight, hence the 60 plus years of slowly raising the temperature. We traded shock and awe for sneaky and awful – again.

  11. floyd says:

    I am deeply ashamed to see America end with such a pathetic whimper.
    What I fail to understand is how this “fopulation” can reconcile defending every form of perversion imaginable, while willingly denying basic liberties.
    How much more abuse shall free men patiently tolerate without recalling the principle of unalienable rights.

    It is in fact the left who threatens punishment for those who disagree, and will use the full force of the government to enforce their will, up to and including death to those who resist.

    Like, Winston Smith,all who resist are, by definition, “deranged”. That is afterall the new definition of democracy.

  12. to ‘interested party’ and ‘wr’:

    In the first three months of the Marxist mutt’s term enough weapons and ammunition were sold in this country to outfit the Chinese and Indian armies. It wasn’t bought for deer season.

    If my home, property or Liberty is endangered by refusing to participate in commie care “Liberal”(communist) heads will explode. “Liberal” season will begin and we must conduct a thorough one to fix this country. Before this is over many will understand that killing “Liberals” is a simple act of self defense. Nearly 20 years of dealing with the creatures has shown me that discussing anything with many of them is a waste of time. A few turn from their evil ways but many will have to be killed. That’s what war is.

    You creatures have three choices: learn to respect your neighbors’ Liberty, leave the country or die.

    For the shysters: Yes there were several lawyers involved in the founding, but they rarely compare to members of that ‘profession’ today. The modern shyster is part of the problem. We need to ban obvious communists/socialists/authoritarians from serving in the judicial system as well as holding any elected, hired or appointed government office.

    It can be done. It must be done.

    Don’t understand? Start here:


  13. floyd says:

    “the first trace of unorthodox thought immediately reveals itself as a jarring dissonance.” – Alan Bullock

    Thank you for the “jarring dissonance” and for the great link to the Quotes.
    While most Americans would not yet advocate the violence which you describe,It is clear that you have given voice to a mounting level of frustration felt by those who still value liberty and personal responsibility.