Health Care and the Individual Mandate

If Court watchers are correct, it appears that the future of the individual mandate in the Affordable Care Act may hinge on whether the Court perceives that the mandate changes the relationship between the Government and the citizen in a “fundamental way.” What, then, is that relationship?

Many people seem to view the Federal Government as a conveyance in which the citizens ride. That is not the Constitutional view, however. In the Constitution the people have vested “legislative Powers . . . in a Congress of the United States” but each citizen is a part of this conveyance. This is the only constitutional relationship between the government and the people.

The question, then, becomes whether any member of the citizenry who decides or is unable to contribute to the general Welfare has a continuing right to demand that the rest of the citizenry should provide that citizen with healthcare? Has the citizen, by opting out of the collective functioning of the government, given up his right under the protection of the Constitution to a share in the general Welfare?

In the preamble to the Constitution the people established the Constitution as the primary vehicle for promoting the general welfare. Everyone agrees that the individual mandate is the only way to ensure that individual premiums from private insurance providers are universally affordable. To declare the individual mandate to be contrary to the Constitution would interfere with the constitutional duty of Congress to promote the general welfare.