Sandra Day O'Connor College of Law, Arizona State University, AZ, USA.
J Law Med Ethics. 2011 Fall;39(3):394-400. doi: 10.1111/j.1748-720X.2011.00609.x.
Among multiple legal challenges to the Patient Protection and Affordable Care Act (PPACA) is the premise that PPACA's "individual mandate" (requiring all individuals to obtain health insurance by 2014 or face civil penalties) is inviolate of Congress' interstate commerce powers because Congress lacks the power to regulate commercial "inactivity." Several courts initially considering this argument have rejected it, but federal district courts in Virginia and Florida have concurred, leading to numerous appeals and prospective review of the United States Supreme Court. Despite creative arguments, the dispositive constitutional question is not whether Congress' interstate commerce power extends to commercial inactivity. Rather, it is whether Congress may regulate individual decisions with significant economic ramifications in the interests of protecting and promoting the public's health. This article offers a counter-interpretation of the scope of Congress' interstate commerce power to regulate in furtherance of the public's health.
在对《患者保护与平价医疗法案》（PPACA）提出的多项法律挑战中，有一个前提是，PPACA 的“个人强制参保令”（要求所有个人在 2014 年前获得医疗保险，否则将面临民事处罚）不受国会州际贸易权力的约束，因为国会缺乏监管商业“不活动”的权力。最初考虑这一论点的几家法院已驳回了这一论点，但弗吉尼亚州和佛罗里达州的联邦地区法院同意了这一论点，导致了许多上诉和美国最高法院的预期审查。尽管有创造性的论点，但决定性的宪法问题不是国会的州际贸易权力是否延伸到商业不活动。相反，问题是国会是否可以根据保护和促进公众健康的利益，对具有重大经济影响的个人决定进行监管。本文对国会州际贸易权力的范围进行了反向解释，以促进公众健康。
