The Constitution grants Congress the power to regulate conduct that substantially affects interstate commerce. As Congress found, the means of payment for services in the interstate health care market is economic activity that substantially affects interstate commerce. The requirement that participants in the health care market have insurance to pay for the services they consume is thus a quintessential exercise of the commerce power. The regulation furthers two principal economic goals. First, it prevents the substantial cost-shifting in the interstate health care services market that results from the practice of consuming health care without insurance. Second, it is key to the viability of the Act's regulatory requirement that insurers not deny coverage or charge higher premiums because of an individual's medical condition or history.

In February, Cuccinelli filed a writ of certiorari [JURIST report] with the US Supreme Court [official website] seeking an expedited appeal. Cuccinelli announced his intention to appeal directly to the Supreme Court [JURIST report] earlier in the month, citing the exceptionally far-reaching policy implications of the PPACA. There are currently 28 cases challenging the constitutionality of the PPACA. Federal courts in Washington, DC, Virginia and Michigan have upheld the law, while a federal court in Florida [JURIST reports] has also ruled the the individual mandate in unconstitutional, striking down the law in its entirety.