Penalizing a non-act is unconstitutional  It is unconstitutional to require individuals to buy private insurance, and penalize them for not doing so (that is, penalizing their non-act, their omission to purchase insurance). As David B. Rivkin Jr. and Lee A. Casey argue: “… Can Congress require every American to buy health insurance? In short, no. The Constitution assigns only limited, enumerated powers to Congress and none, including the power to regulate interstate commerce or to impose taxes, would support a federal mandate requiring anyone who is otherwise without health insurance to buy it.”(1)  The Congressional Budget Office believes “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.”(2) An individual mandate would have two features that, in combination, would make it unique. First, it imposes a duty on individuals due to them being members of society. Second, it requires the purchase of a specific service on pain of tax penalties if that product is not purchased. (2)  As noted by Sen. John Ensign, a Nevada Republican: "Anything we have ever done, somebody actually had to have an action before we could tax or regulate it."(3) As Robert A. Levy and Michael F. Cannon of the CATO Institute argue: “Congress' attempt to punish a non-act that harms no one is an intolerable affront to the Constitution, liberty, and personal autonomy. That shameful fact cannot be altered by calling it health-care reform.”(4) The individual healthcare insurance mandate would, for the first time, mean the government setting uo a monopoly or a cartel with which every citizen of the US would be compelled- by a statutory power- to do business. This destroys any pretence of individual market freedom, individuals would be required to contribute money out of each and every pay check they earned to either a government entity which would be staffed and/or controlled by political appointees or to a cartel made up of companies that would owe their continued existence on the cartel list to the acquiescence of political overseers. Either way, the reduction in individual autonomy and freedom over health care choices would be dramatically decreased and inevitably politicized. This has obvious worrying possibilities for corruption, the party in power would favour those who donate to the party.(5)  Enforcing the mandate may also intrude on Constitutional rights. Sherry Glied, Ph.D., Assistant Secretary for Planning and Evaluation at the U.S. Department of Health and Human Services has warned, “[d]eveloping a system to promptly identify and penalize scofflaws [people who flout the law] will take effort and ingenuity, particularly in our diverse and mobile country. It may require a degree of intrusiveness and bureaucracy that some will find unpalatable.”(6)This is likely to mean much more intrusive inspection, for example hospitals having to report to the government patients they have who don’t have health insursnce..(6) This is why a majority of the states, and numerous organizations and individual persons, have filed actions in federal court challenging the constitutionality of the individual mandate, and several courts have already struck it down on constitutional grounds.(7)  For all these reasons it is clear that for Congress to try to penalize a non-act is an unprecedented and unconstitutional power grab, and so the individual mandate is unconstitutional.