Michigan challenge to health care reform dismissed

A federal judge in Detroit dismissed a lawsuit challenging the health insurance mandate provision in the health care reform bill passed by Congress earlier this year. The suit was filed by the Thomas More Law Center, the Christian legal group based in Ann Arbor and founded by Domino’s founder Tom Monaghan, on behalf of themselves and three plaintiffs who object to being forced to purchase health insurance.

The suit sought an injunction declaring the act unconstitutional on several grounds, arguing that “the Health Care Reform Act violates states’ rights under the Tenth Amendment, the Free Exercise Clause, and the Fifth Amendment’s Equal Protection and Due Process Clauses.”

Judge George Steeh ruled that the authority to pass the health care reform act is found within the Interstate Commerce Clause of the Constitution. The plaintiffs had argued that the decision not to purchase health insurance is inaction rather than action and that it is unconstitutional to punish inaction. The court rejected that reasoning, noting that whether one has health insurance or not one is inevitably going to take part in the health care system:

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 cost- shifting 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….

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.

This is the first substantive ruling in one of several lawsuits filed against the health care reform bill but it signals the likely outcome in the other cases as well. You can read the full ruling here.