Health care reform--what went wrong on the way to the courthouse.

摘要

Before health care reform was enacted, Democratic lawmakers and most legal scholars were confident of its constitutionality. Under long-established Supreme Court precedent, Congress would have authority, if it wanted, to enact a single-payer socialized insurance system, us- ing its powers to tax and spend "for the general welfare." Far short of such a system, the complex blend of regulation, subsidies, and an individual mandate included in the Affordable Care Act (ACA) is vastly more protective of insurance markets and individual freedoms. Congress has nearly unbridled authority to regulate products sold in or affecting interstate commerce, and health insurance is one such product. And given the economics of health insurance, a mandate to purchase insurance is integral to regulating how insurers design, price, and sell their products.