EXPERT’S CORNER: Can health reform law mandate insurance?
Federal rulings won’t affect Massachusetts health reform, according to Sullivan
By Jim Fessenden
UMass Medical School Communications
Jean C. Sullivan |
Despite recent legal challenges to the Affordable Care Act, the final decision on the fate of the federal health reform law will eventually be made by the U.S. Supreme Court, according to health care reform expert Jean C. Sullivan, JD, director of the Center for Health Law and Economics and an instructor in family medicine & community health.
“There are now four federal district court decisions ruling on the constitutionality of the Patient Protection and Affordable Care Act, the federal health reform law commonly known as the Affordable Care Act,” said Sullivan, and two of the decisions are in conflict with the other two.
The rulings, according to Sullivan, hinge on the Commerce Clause in the U.S. Constitution, which gives Congress the power to regulate commerce between states, and may answer the question of whether the government can require people to purchase health insurance.
“A recent ruling in one of the federal district courts in Florida is the second one, along with a federal district court in Virginia, to interpret the Commerce Clause of the U.S. Constitution and find that the law’s insurance mandate is not a constitutional exercise of power under the Commerce Clause,” explained Sullivan. “At the same time, two other federal rulings, one by a federal district court in Michigan and the other, interestingly, by a different district court in Virginia, uphold the law as valid under the Commerce Clause of the Constitution.”
“So, it’s two for and two against,” said Sullivan. “In the end, the final decision on the fate of the federal health reform law will be made by the U.S. Supreme Court, once appeals make their way to that level.”
Because these legal challenges are based on the federal government’s power to regulate commerce between states, they don’t extend to Massachusetts’ own health reform, according to Sullivan. “Massachusetts’ health reform is a state law and affects only Massachusetts and its residents,” she said. “The Commerce Clause of the U.S. Constitution defines Congress’ power to regulate interstate commerce, which means it wouldn’t be relevant to a state law.”