Judge Strikes Down Universal Health Insurance Mandate: Death Knell for Obamacare?

The federal health care reform bill passed into law last year took a potentially lethal hit Monday when a district court ruling struck at one of its defining provisions. U.S. District Court judge for the Eastern District of Virginia Henry Hudson ruled that the requirement to buy health insurance by 2014 or pay a fine is unconstitutional. Two other judges have previously ruled that the universal care provision is constitutional. Thus, elevation through the appeals courts and possibly the U.S. Supreme Court is a virtual certainty.

The major case opposing mandatory health insurance coverage is still pending in the Northern District of Florida. In that case, 20 states came together to oppose the national health care keystone on constitutional grounds.

The requirement to buy insurance or pay has outraged conservatives, who view it as an unwarranted government intrusion into the lives of private citizens. The state of Virginia passed the Virginia Health Care Freedom Act, making it illegal to require Virginians to carry health insurance in the wake of the reform bill's enactment.

Thirty-seven other states likewise opposed the federal mandate; according to American Legislative Exchange Council, which drafted model legislation circulating among state legislatures, Louisiana, Missouri, Georgia, Arizona and Idaho have enacted provisions similar to Virginia's law. Arizona and Oklahoma went a step further and amended their constitutions to provide citizens a right not to buy health insurance. Legislation is pending after passage by one chamber in Tennessee, while a constitutional amendment passed one chamber in Alabama.

The governors of Oklahoma and Florida vetoed legislation passed in those states to override the federal health insurance mandate.

Hudson said in Monday's ruling that the federal insurance mandate represented an unprecedented expansion of federal power that cannot be supported by Congress' power to regulate interstate trade, according to the Washington Post.

"Neither the Supreme Court nor any federal circuit court of appeals has extended Commerce Clause powers to compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market," Hudson said in his opinion. "In doing so, enactment of the [individual mandate] exceeds the Commerce Clause powers vested in Congress under Article I [of the Constitution."

Universal coverage is the cornerstone on which national health care reform, often deemed Obamacare by critics, was built. Its other potential cornerstone, the public option, was demolished in the legislative process. If critics who already succeeded in upending a public health care option prevail in overturning the individual insurance mandate, the signature health care legislation of the Obama administration starts to look more like a patchwork of fixes than a landmark health reform program.