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Federal Judge Rules Against Coverage Mandate In Health Overhaul

A federal judge in Virginia has ruled that the federal health overhaul overreached by mandating that practically everyone in the country be required to have health insurance.

In finding part of the health law unconstitutional, as Virginia Attorney General Ken Cuccinelli has claimed in a lawsuit filed in March, U.S. District Court Judge Henry Hudson ruled that the insurance mandate represents "an unchecked expansion of congressional power" that would ultimately "invite unbridled exercise of federal police powers." (Read the decision here.)

It's the first federal ruling to go against health overhaul. In October, a Michigan judge decided the insurance mandate was OK. A federal judge in Virginia's Western District late last month dismissed a lawsuit that claimed overhaul required funding of abortion services.

In a statement, the Justice Department expressed "disappointment" in the ruling, but added, "There is clear and well-established legal precedent that Congress acted within its constitutional authority in passing this law and we are confident that we will ultimately prevail."

Before overhaul became the law of the land, Virginia passed its own law that sought to exempt residents from the insurance mandate the federal law prescribes. As soon as the federal health law was enacted, Cuccinelli challenged it.

The feds have argued that for overhaul to succeed, just about everyone has to have insurance coverage. Those who don't get policies through work, the government or on their own would have to pay a penalty.

Opponents, including Cuccinelli, have argued the feds are stepping on the Constitution's handling of interstate commerce by enforcing a mandate. Specifically, shouldn't a person be free to make his or her own decision about insurance coverage?

The feds have maintained that's a false choice because everyone, at some point, becomes a consumer of health care services. Indeed, the feds have argued, deciding not to buy insurance coverage has a profound economic effect that crosses state lines. So, either way, you're already part of interstate commerce when it comes to health, and that means the government has the authority to regulate your behavior.

In shooting down that line of reason, Hudson wrote:

Of course, the same reasoning could apply to transportation, housing or nutritional decisions. This broad definition of the economic activity subject to congressional regulation lacks logical limitation and is unsupported by Commerce Clause jurisprudence.

The insurance mandate doesn't kick in until 2014, so there's plenty of time for appeals and litigation.

The outcome wasn't exactly a shock. During the summer Judge Hudson issued a 32-page opinion rejecting the Obama administration's plea to dismiss the proceeding brought by Virginia Attorney General Ken Cuccinelli.

At the time, Hudson's called Virginia's case "a narrowly-tailored facial challenged to the constitutionality" of the health law.

On Thursday oral arguments will begin in federal district court in Pensacola, Fla. So more legal fireworks on health care are pretty much guaranteed.

How would the mandate work? Here's a video from the Kaiser Family Foundation to explain.

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Scott Hensley edits stories about health, biomedical research and pharmaceuticals for NPR's Science desk. During the COVID-19 pandemic, he has led the desk's reporting on the development of vaccines against the coronavirus.