[JURIST] A judge for the US District Court for the Middle District of Pennsylvania [official website] ruled [opinion, PDF] Tuesday that a provision of the Patient Protection and Affordable Care Act (PPACA) [HR 3590 text; JURIST backgrounder] requiring individuals to purchase health insurance is unconstitutional. The challenge was brought by a self-employed couple that would be subject to the minimum coverage provision, arguing that Congress’ Commerce Clause powers “do not comprehend the power to command individuals to engage in commerce in the first instance.” The government contends that the “uniqueness” of the health care market and insurance, in that they entail payment for services before services are rendered, justifies the provision. In its analysis, the court, recognizing the split in authority that currently exists on the issue of mandated insurance coverage, looked to two recent decisions that endorsed different sides of argument and noted that both concur on the point that “the Health Care Act has no equivalent in Commerce Clause jurisprudence.” This court also concluded that the provision had no equivalent and as a result, was unconstitutional. Judge Christopher Conner, writing for the court, addressed the novelty of the issue:

Moreover, the court has been unable to find any precedent, and the parties have been unable to direct the court to any precedent, that permits the expansion of the Commerce Clause authority to regulate individuals prior to their engagement in commercial activity on the basis of the unique nature of the market being regulated. This court is bound by the principles of stare decisis and must reasonably interpret, not create, law. This court’s interpretation of existing precedent, including Lopez and Morrison, leads the court to the conclusion that the Supreme Court would not construe the Commerce power to have such expansive reach. The extension of the Commerce Clause in the manner the government suggests is unsupported by precedent and therefore beyond the scope of this court’s proper function to grant.

The court also found the minimum coverage provision was closely tied to two other provisions of the PPACA—the guaranteed issue and preexisting condition health insurance reforms—which must then also be severed.

Given the split in decisions being handed down, the US Supreme Court [official website] is expected to weigh in next year. Last week, the US Court of Appeals for the Fourth Circuit [official website] dismissed two lawsuits [JURIST report] challenging the constitutionality of the PPACA. In Virginia v. Sebelius, the court held that Virginia lacked standing to sue and vacated the judgment of the district court [JURIST report], remanding the case with instructions to dismiss the suit for lack of subject-matter jurisdiction. In Liberty University v. Geithner, the court ruled that the suit was filed prematurely, also vacating the lower court ruling [JURIST report], which had declared the act constitutional. Although the Fourth Circuit dismissed the cases without deciding the issue of constitutionality, other federal courts have not hesitated to address it. Last month, the US Court of Appeals for the Eleventh Circuit [official website] struck down the individual mandate [JURIST report] as unconstitutional, creating a circuit split. The US Court of Appeals for the Sixth Circuit [official website] had upheld the law in June, and that ruling was appealed [JURIST reports] to the Supreme Court by the Thomas More Law Center (TMLC) [advocacy website].