Commerce Clause, health insurance mandates, Affordable Care Act, ACA, Patient Protection and Affordable Care Act, collective action federalism, minimum coverage provision, Congress, constitutional limits
Opponents of the minimum coverage provision in the Affordable Care Act charge that if Congress can require most people to obtain health insurance or pay a certain amount of money, then Congress can impose whatever mandates it wishes—or, at least, whatever purchase mandates it wishes. This Essay refutes that claim by identifying four limits on the Commerce Clause that the minimum coverage provision honors. Congress may not use its commerce power: (1) to regulate noneconomic subject matter; (2) to impose a regulation that violates constitutional rights, including the right to bodily integrity; (3) to regulate at all, including by imposing a mandate, unless it reasonably believes that the regulation will ameliorate a significant collective action problem involving multiple states; or (4) to impose an economic mandate unless it reasonably believes that other regulatory means would be less effective or more coercive.
Neil S. Siegel, Four Constitutional Limits That the Minimum Coverage Provision Respects, 27 Constitutional Commentary 591-619 (2011)