The Patient Protection and Affordable Care Act (“PPACA”), which became law on March 23, 2010, is an unprecedented and unconstitutional power grab by the federal government. The PPACA, referred to by some as “ObamaCare” or “Healthcare Reform,” takes effect in January 2014 and requires nearly every American to purchase acceptable insurance or face an annual penalty from the IRS, which increases every year the individual does not purchase health insurance. Several States have filed lawsuits challenging portions of the PPACA, specifically the individual mandate, as unconstitutional. We have filed amicus briefs in both the Virginia and Florida cases. We also represent four plaintiffs in D.C. Federal Court challenging the constitutionality of the law.
The PPACA is an unconstitutional individual mandate:
The PPACA is a forced mandate that penalizes Americans who choose not to participate. The ACLJ believes that the mandate is unconstitutional and that it will ultimately be overturned by the courts. It is unarguable that the U.S. Constitution established a federal government with limited powers. The federal government lacks the general police power afforded to the states and cannot act unless it can trace that action back to a constitutional grant of power. For Congress, these powers are located in Article I, Section 8, which includes the Commerce and Taxing and Spending Clauses. The PPACA includes extensive congressional findings citing the effects of health care on interstate commerce. Nevertheless, the ‘individual mandate’ reaches far beyond even the commerce power. As the Congressional Budget Office explained in the mid ‘90s: “A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States.” U.S. Cong. Budget Office, The Budgetary Treatment of an Individual Mandate to Buy Health Insurance, Aug. 1994. A direct result of the individual mandate’s inevitable impact upon a person’s finances and lifestyle is that he or she is compelled to adjust finances now, by setting aside money in order to pay the annual penalties. As a result, people will be unable to use or set aside their money for other purposes in the present, directly limiting their ability to plan for the future prudently.
The PPACA violates the Commerce Clause:
The Commerce Clause, found in Article I, Section 8, clause 3 of the United States Constitution, is broad, but not limitless. Congress may regulate activity which involves the “channels” or “instrumentalities” of interstate commerce or individuals or things therein. It may also regulate activity substantially related to or affecting interstate commerce. Lopez, 514 U.S. at 558-59 (emphasis added). It may even regulate intrastate activity necessary and proper to effectuate general regulation of interstate commerce. But, the individual mandate is not tied to any economic activity and, in fact, no voluntary activity at all. The mandate will compel nearly every American to act by purchasing insurance and then use this forced transaction as a basis to regulate their behavior. If the Commerce Clause were to allow Congress to force Americans to purchase a good or face punishment because they exist, then the idea of a government of limited powers is a nullity.
The PPACA violates the Taxing and Spending Clause of the U.S. Constitution:
Article I, Section 8, clause 1 of the United States Constitution, commonly referred to as the Taxing and Spending Clause, also fails to support the mandate. The individual insurance mandate is neither apportioned among the states according to census data, nor is it levied against any source of income. First, Article I, Section 2 of the Constitution requires “direct taxes be apportioned among the several states . . . according to their respective numbers.” In addition, Section 9 prohibits capitation or direct taxes “unless in proportion to the Census or Enumeration herein before directed to be taken.” The only exception to the apportionment of taxes is contained in the 16th Amendment and is limited to taxes on income.
If the mandate is characterized as a tax, it can only be seen as a direct tax on individuals or an excise tax. Black’s Law Dictionary defines “excise” as “A tax imposed on the manufacture, sale, or use of goods (such as a cigarette tax), or on an occupation or activity (such as a license tax or an attorney occupation fee).” Black’s Law Dictionary 585 (7th ed. 1999). As a direct tax, the mandate fails to pass constitutional muster. It also fails as an excise tax. By definition, excise taxes are placed on goods or things, such as licenses, not individuals as a condition of their existence. Ernest S. Christian & Betty Jo Christian, Is Obama’s Tax on Health Care Constitutional?, Investor's Business Daily, Sept. 26, 2009.
The PPACA regulates Americans merely because they exist:
No matter which of its powers Congress purports to rely upon, the ultimate question is whether Congress may regulate or tax a person simply for being? And, in order to preserve the American ideal within a federalist system of limited government, the answer must be no.
The PPACA was passed against the will of the people:
On Nov. 2, 2010, the American voters sent the Obama Administration a powerful message—rejecting the President’s agenda and signaling a need to repeal the health care law that most Americans oppose. The outcome of the election underscored the fact that most Americans do not support the PPACA, the government-run, pro-abortion health care law forced on the American people. Most Americans have said they want the PPACA repealed. Now, with a sweeping change in Congress, it’s time to do just that. We have started a nationwide petition campaign to demand that the new Congress repeal the Act. The PPACA was not the reform that America needs or deserves.
The PPACA and Abortion
President Obama’s insistence that “no federal dollars will be used to fund abortions” was a promise un-kept when the PPACA finally passed. His executive order was brokered in the eleventh hour before the bill was finally rushed through for a vote and did not guarantee that abortion would not become a mandatory health care “benefit” under the new health care law. We heard from more than 80,000 Americans calling on Congress to exclude abortion as a mandatory health benefit, yet the abortion funding issue was never resolved. Indeed, it could not have been without a specific exemption, an exemption that should have been included in the health care legislation. President Obama did nothing to alleviate the growing concern about turning health care into a government-run bureaucracy that will include an open door for transforming abortion into a mandatory health benefit. A specific exemption should have been included in the bill before it was passed to prohibit any mandate for abortion services in health care reform and to prohibit federal dollars from funding plans that include abortion services. And, without such an exemption, there’s now a green light in place for making abortion services a mandatory health benefit funded by federal tax dollars. This was an unacceptable act that the American people did not want and that should now be reversed by Congress. It was vital that any health care reform plan explicitly exclude abortion services from any national health care coverage mandate and that did not happen.
The ACLJ’s three-prong strategy to undo the PPACA
1 – Lawsuit: We’re engaging this issue in the federal courts. We’ve filed our own lawsuit challenging the constitutionality of the PPACA in the federal district court in Washington, D.C.
2- Filed Amicus Briefs: We’ve also filed amicus briefs supporting Virginia, Florida, and Michigan’s challenges as states to the federal law. Our amicus brief supporting Virginia’s legal challenge was filed on behalf of 28 members of Congress and more than 70,000 Americans. A federal judge recently heard arguments in that case and his decision declared the individual mandate unconstitutional. That is a significant victory. We have also filed an amicus brief, again representing members of Congress, backing the massive lawsuit spearheaded by Florida. We also just filed an amicus brief supporting a Michigan challenge to the PPACA and we’re urging a federal appeals court to overturn a lower court ruling and declare the individual mandate provision unconstitutional.
3- Nationwide Petition of Congress: With the significant political changes in Washington, we’re also demanding that the new Congress repeal this dangerous law. There’s growing political pressure to take action and that’s why we have launched a nationwide petition to demand legislative action as well.
There is a difference between a private hospital, even a not-for-profit, and a state, county, or city hospital. In a government hospital you have First Amendment rights that apply in this situation and in a private hospital you do not. However, here's what I suspect: there is probably a misunderstanding on the part of the hospital's administrator that if you were to pray with a patient as an employee, the hospital would somehow be violating the patient's rights or creating a problem. But there's nothing in federal law that prohibits you from praying with a patient who requests prayer and nothing that would get the employer in trouble because you prayed with the patient's permission. Now, the difficulty is this: because it is a private hospital, hospital employees can't mandate prayer with patients, but prayer can be allowed. And, if the hospital is offering holistic medical practices and healing hands organizations, then they should have no problem with your simply praying for a patient. Prayer is a common practice that is not illegal. We had a case involving prayer in a doctor's office that went to Federal Court. We were very successful in defending that. But again, I think you have a situation here where there's probably miscommunication or misunderstanding.