Opinion ID: 2427342
Heading Depth: 1
Heading Rank: 2

Heading: Whether the Minimum Coverage Provision is a Valid Exercise of the Commerce Power under Lopez, Morrison, and Raich

Text: In applying this jurisprudence, our first duty is to determine the class of activities that the minimum coverage provision regulates. See, e.g., Perez v. United States, 402 U.S. 146, 153-54, 91 S.Ct. 1357, 28 L.Ed.2d 686 (1971) (directing courts to determine first whether the class of activities regulated by a statute is within the reach of Congress's power). There is debate over whether the provision regulates activity in the market of health insurance or in the market of health care. In the most literal, narrow sense, the provision might be said to regulate conduct in the health insurance market by requiring individuals to maintain a minimum level of coverage. However, Congress's intent and the broader statutory scheme may help to illuminate the class of activities that a provision regulates. See, e.g., Swift & Co. v. United States, 196 U.S. 375, 398, 25 S.Ct. 276, 49 L.Ed. 518 (1905) ([C]ommerce among the states is not a technical legal conception, but a practical one, drawn from the course of business.); United States v. Ambert, 561 F.3d 1202, 1212 (11th Cir.2009) (Congress did not focus on individual local registration as an end in itself, but rather as part of its goal to create a system to track and regulate the movement of sex offenders from one jurisdiction to another.). The Act considered as a whole makes clear that Congress was concerned that individuals maintain minimum coverage not as an end in itself, but because of the economic implications on the broader health care market. Virtually everyone participates in the market for health care delivery, and they finance these services by either purchasing an insurance policy or by self-insuring. Through the practice of self-insuring, individuals make an assessment of their own risk and to what extent they must set aside funds or arrange their affairs to compensate for probable future health care needs. [3] Thus, set against the Act's broader statutory scheme, the minimum coverage provision reveals itself as a regulation on the activity of participating in the national market for health care delivery, and specifically the activity of self-insuring for the cost of these services. Plaintiffs challenge the minimum coverage provision on its face as an unconstitutional exercise of congressional authority. They accept the class of activities that the provision purports to reach: participating in the national market for health care services without maintaining insurance that meets the minimum coverage requirement. Unlike the plaintiffs in Raich, they do not attempt to carve out a subset class of activities and to deny that their conduct has substantial effects on interstate commerce. Rather, like the plaintiffs in Lopez and Morrison, they claim that the entire class of activities that the provision attempts to reach is beyond Congress's power to regulate. [4] In this Circuit, [f]acial invalidation of a statute... is reserved only for when there are no set of circumstances in which the statute's application would be constitutional. United States v. Faasse, 265 F.3d 475, 487 n. 10 (6th Cir.2001) (en banc); see also United States v. Salerno, 481 U.S. 739, 745, 107 S.Ct. 2095, 95 L.Ed.2d 697 (1987). By regulating the practice of self-insuring for the cost of health care delivery, the minimum coverage provision is facially constitutional under the Commerce Clause for two independent reasons. First, the provision regulates economic activity that Congress had a rational basis to believe has substantial effects on interstate commerce. In addition, Congress had a rational basis to believe that the provision was essential to its larger economic scheme reforming the interstate markets in health care and health insurance.