A federal trial judge in Washington, D.C., Tuesday bluntly rejected the latest legal challenge to the Patient Protection and Affordable Care Act, ruling
that the "individual mandate" requirement in the new federal health care law was a legitimate exercise of congressional power to regulate the nation's health insurance initiatives.
U.S. District Judge Gladys Kessler
, a 1994 appointee of President Bill Clinton, declared that Congress had the authority under the Commerce Clause
of the Constitution to enact the contentious 2010 law
, which requires individuals to purchase health insurance starting in 2014. In rejecting an argument by the law's challengers, she said that an individual's decision not
to purchase health insurance was an active choice impacting the cost of health insurance for everyone else.
In her 64-page ruling, Kessler wrote: "Both the decision to purchase health insurance and its flip side -- the decision not to purchase health insurance -- therefore relate to the consumption of a commodity: a health insurance policy ... Because of the cost-shifting effect, the individual decision to forgo health insurance, when considered in the aggregate, leads to substantially higher insurance premiums for those other individuals who do obtain coverage."
Kessler then wrote: "To put it less analytically, and less charitably, those who choose -- and Plaintiffs have made such a deliberate choice -- not to purchase health insurance will benefit greatly when they become ill, as they surely will, from the free health care which must be provided by emergency rooms and hospitals to the sick and dying who show up on their doorstep. In short, those who choose not to purchase health insurance will ultimately get a 'free ride' on the backs of those Americans who have made responsible choices to provide for the illness we all must face at some point in our lives."
A jurist with extensive experience handling terror law cases, Kessler now becomes the third federal trial judge -- and the third Clinton appointee -- to declare the core of the Affordable Care Act constitutional after reviewing the merits of the legal claims against it. She joins U.S. District Judge Norman K. Moon in Virginia, who last December rejected a legal challenge to the new law by Liberty University, and U.S. District Judge George C. Steeh, who last October rejected another legal challenge in Michigan.
But two other federal trial judges -- both Republican appointees -- have declared the same provision of the Affordable Care Act unconstitutional. Last December, U.S. District Judge Henry Hudson, an appointee of President George W. Bush presiding in Virginia, struck down
the "individual mandate" provision in the new law as an improper attempt on the part of Congress to regulate what he called local and personal "inactivity." Last month, U.S. District Judge Roger Vinson, a 1983 appointee President Ronald Reagan sitting in senior status in Florida, went even further, tossing out
the entire new law as a violation of the Commerce Clause.
This lack of consensus at the trial court level -- and the likelihood of more disagreement in the months ahead at the federal appeals court level -- virtually guarantees that the United States Supreme Court eventually will have to broker the dispute. Kessler said as much in her ruling: "The controversy surrounding this legislation is significant, as is the public's interest in the substantive reforms contained in the Act. It is highly likely that a decision by the United States Supreme Court will be required to resolve the constitutional and statutory issues which have been raised."
The Justice Department issued a statement Tuesday in the wake of the ruling: "This court found -- as two others have previously -- that the minimum coverage provision of the statute was a reasonable measure for Congress to take in reforming our health care system. At the same time, trial courts in additional cases have dismissed numerous challenges to this law on jurisdictional and other grounds. The Department will continue to vigorously defend this law in ongoing litigation."