Judge Vinson's Health Care Smackdown: What's A Tea Party Without Tea Leaves?

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In his spare time, U.S. District Judge Roger Vinson, the author of Monday's sweeping ruling  gutting as "a bridge too far" the entirety of the Patient Protection and Affordable Care Act, apparently serves as the president of the board of directors of the American Camellia Society, an industrious group that evidently appreciates and nurtures a tiny, colorful corner of God's Green Earth. The camellia is known around the world not just as a plant that produces beautiful flowers -- it is the state flower of Alabama, for example -- but also as a plant that produces tea leaves. And what's a Tea Party, after all, without a healthy supply of tea leaves?

It cannot be a coincidence, then, that Judge Vinson, the Reagan appointee who has chosen reverence to the camellia as a hobby, would choose to compare (unfavorably, even) the Obama Administration's complicated (and increasingly endangered) effort to bring health insurance to 30 million Americans with the efforts of King George III and the British East India Company to tax the tea the colonials quoffed.

"It is difficult to imagine," Judge Vinson wrote in his 78-page ruling, "that a nation which began, at least in part, as the result of opposition to a British mandate giving the East India Company a monopoly and imposing a nominal tax on all tea sold in America would have set out to create a government with the power to force people to buy tea in the first place."

Tea Party analogy? Check. Head-scratching analysis? Check. Judge Vinson wrote:

"... the mere status of being without health insurance, in and of itself, has absolutely no impact whatsoever on interstate commerce (not 'slight,' 'trivial,' or 'indirect,' but no impact whatsoever) -- at least not any more so than the status of being without any particular good or service. If impact on interstate commerce were to be expressed and calculated mathematically, the status of being uninsured would necessarily be represented by zero. Of course, any other figure multiplied by zero is also zero. Consequently, the impact must be zero, and of no effect on interstate commerce.

The uninsured can only be said to have a substantial effect on interstate commerce in the manner as described by the defendants: (i) if they get sick or injured; (ii) if they are still uninsured at that specific point in time; (iii) if they seek medical care for that sickness or injury; (iv) if they are unable to pay for the medical care received; and (v) if they are unable or unwilling to make payment arrangements directly with the health care provider, or with assistance of family, friends, and charitable groups, and the costs are thereafter shifted to others."

Got that? The uninsured can only have a "substantial effect on interstate commerce" -- and thus be regulated by Congress -- if they are subject to the precise conditions which exist today all over the country, and which prompted the Act in the first place. The judge acknowledges this point, to his credit, saying that the Congress would of course have the power to regulate the millions of people who meet his five criteria above. But he then concludes: "But, to cast the net wide enough to reach everyone in the present, with the expectation that they will (or could) take those steps in the future, goes beyond the existing 'outer limits' of the Commerce Clause" (emphasis in original).

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Andrew Cohen is a contributing editor at The Atlantic. He is a legal analyst for 60 Minutes and CBS Radio News, a fellow at the Brennan Center for Justice, and Commentary Editor at The Marshall Project

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