May the Federal Government Require Private Individuals to Purchase Health Insurance?
To begin, it is clear that Congress may regulate health insurance under the commerce power. And it is clear that the federal government may tax individuals’ incomes in order to pay for and provide government health insurance. We do these things, in some measure, already. But now we are contemplating something quite different. In last week’s address to Congress, the President endorsed the notion of individual mandates for health insurance. As a matter of policy, mandates are controversial, but they make sense in light of the President’s proposed regulatory scheme.1 The question is, though, does the Constitution permit the federal government to directly impose upon its citizens duties of positive action, other than the duty to pay taxes, that are not imposed in connection with some benefit received from the government? Certainly state governments could impose such mandates. In 1905, the Supreme Court upheld compulsory vaccinations as a valid exercise of the states’ police powers.2 Possib
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