Federal Judge Rules 'Individual Mandate' Unconstitutional

In a decision that will likely come before the U.S. Supreme Court, a Virginia federal court judge has ruled that the government cannot require individuals to buy private health insurance, nor can it punish those who refuse to do so.

The ruling was already deemed "misguided" by at least one public health group and, while preliminary, physicians must be wondering what will happen to the influx of previously uninsured patients that were to walk through their doors in the coming years.

In a 44-page ruling, U.S. District Judge Henry E. Hudson sided with Virginia Attorney General Ken Cuccinelli (R) that Congress does not have the power to require every American to purchase private health insurance by the year 2014, a key provision of the Patient Protection and Affordable Care Act. The "individual mandate," as it is known, would have also punished individuals who did not purchase coverage with a fine.

Virginia is one of more than 20 states challenging the federal reform law, and the ruling is largely being viewed as a victory that could eventually topple additional parts of the landmark piece of legislation.

While the U.S. Justice Department argued that Congress was well in its power, under the Commerce Clause, to require individuals to purchase health coverage, Hudson argued that "despite the laudable intentions of Congress in enacting a comprehensive and transformative health care regime, the legislative process must still operate within constitutional bounds.

"Salutatory goals and creative drafting have never been sufficient to offset an absence of enumerated powers," he wrote. Translated for the common man: Even if you have the best intentions in mind, the law is the law.

Finding that the individual mandate had no "constitutionally viable exercise" attached to it, Hudson said it was "fatal" to the accompanying sanction to punish those who do not secure private insurance. "[The individual mandate] exceeds the constitutional boundaries of congressional power," he concluded.

Knowing the last word in the matter will likely come from the Supreme Court and not his bench, Hudson said that his ruling "is sufficient to stay the hand of the Executive Branch pending appellate review."

In one of the first statements following Hudson's ruling, the American Public Health Association, comprised of various stakeholders in public health, said it was "deeply disappointed" by the outcome.

"The Affordable Care Act for the first time would begin to fill the gaps of a once-broken health system by making insurance more affordable to obtain through federal subsidies," the group's executive director, Georges C. Benjamin, MD, FACP, FACEP, said in a statement. "Any effort that threatens or weakens the protections provided by the Affordable Care Act is misguided and would unduly put the future health of millions of Americans at perilous risk."

 Stay tuned to PhysiciansPractice.com for the latest reaction to today's ruling.