In light of the recent ruling by a Florida federal court judge that the entire Affordable Care Act is invalid, Alaska Governor Sean Parnell has announced that he will not apply for federal grant aid to implement the health insurance exchanges under the law. Parnell stated that:

The Florida court’s declaratory judgment that the federal health care law is unconstitutional is the “law of the land” as it applies to Alaska, and we will not proceed down an unlawful course to implement it. . . . Supporters of government mandates in health care want Alaskans to conclude that if we don’t take the federal money that somehow we are not moving forward with health care initiatives in this state. That is false. The federal government’s “one size fits all” health care mandates may have ended with the Florida court decision, but we will continue working to reshape our health care system to fit the unique needs of Alaskans.

According to the press release, Alaska’s State Division of Insurance is exploring the possibility of developing a health insurance exchange that will run without federal funds. The same day Parnell issued this statement, the Obama Administration filed a motion (pdf) asking the judge in the Florida case to clarify that his declaratory judgment that the entire Affordable Care Act is unconstitutional does not relieve the parties of their rights and obligations under the new law while the case is being appealed. As argued in the motion, treating the judge’s decision as an immediate injunction would result in “significant disruption” to the provisions already in effect.

Meanwhile, on February 22, a federal judge in Washington, D.C. decided that the health care reform law is, indeed, valid law. In Mead, et al., v. Holder (pdf) U.S. District Judge Gladys Kessler dismissed a lawsuit charging that, among other counts, Congress lacked the constitutional authority to require individuals to purchase health insurance or pay a substantial penalty. Focusing – as have several other courts – on the scope of the Constitution’s Commerce Clause, Kessler found that case law has firmly established that “Congress may regulate an entire class of activities if, in the aggregate, that class has a substantial effect on interstate commerce, even if particular instances of the activity do not.”

Disagreeing with the plaintiffs in this case, Kessler determined that an individual’s decision to purchase or not to purchase health insurance is an “economic” one, and that in the aggregate, the decision to forgo health insurance substantially affects the national health care market. According to Kessler, “the individual mandate provision is an appropriate means which is rationally related to the achievement of Congress’s larger goal of reforming the national health insurance system,” and constitutes “a clear-cut example of ‘an essential part of a larger regulation of economic activity, in which the regulatory scheme could be undercut unless the intrastate activity were regulated.’” Therefore, Kessler concluded, Congress was acting within the bounds of its Commerce Clause power when it enacted the individual mandate provision of the Affordable Care Act. She also concluded that the mandate is valid under the Constitution’s Necessary and Proper Clause.

Kessler rejected, however, the contention that the imposition of a penalty should the individual forgo insurance is a valid exercise of Congress’s power under the General Welfare Clause. Agreeing with the Florida court on this issue, Judge Kessler claimed that the penalty does not constitute a tax, and therefore the Administration cannot rely on the General Welfare Clause – which enables Congress to impose taxes to promote the “common defense and general welfare” of the nation – for its justification.

Kessler also rejected the plaintiffs’ claim that the individual mandate violates the Religious Freedom Restoration Act (RFRA). The plaintiffs claimed that the minimum essential coverage requirement in the Affordable Care Act conflicts with their religious faith because, they contend, purchasing health insurance “implied that they doubted God’s ability to provide for their health.” In dismissing this claim, Kessler reasoned that the mandate does not place a place a substantial burden on the plaintiffs’ religious beliefs, and even assuming that it did, “it is the least restrictive means of serving a compelling governmental interest.”

In upholding the validity of the Affordable Care Act, Kessler acknowledged that 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.” Federal courts in Michigan and Virginia have similarly upheld the constitutionality of the Affordable Care Act. In contrast, a separate Virginia federal court in December 2010 – like that in Florida – declared the individual mandate unconstitutional. The Virginia judge in that case did not, however, find that the entire law was invalid. A handful of other courts have dismissed similar lawsuits on technical grounds.

This entry was written by Ilyse Schuman.

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