Healthcare Reform in the United States Constitutional Equilibrium
5 Charlotte Law Review, 405-469 (2014)
66 Pages Posted: 29 Oct 2014 Last revised: 16 Feb 2016
Date Written: October 27, 2014
The paper presents and analyzes the key legal and philosophical issues that came up in National Federation of Independent Business v. Sebelius (“NFIB”). It discusses the individual mandate suggesting a legal and philosophical justification for it. It analyses the concept of interstate commerce and the interpretation of federalism as equilibrium of powers between the federal government and the states as a conception of the proper limits of the role of the state. It then presents the health care law as an evolution in the constitutional interpretation in the United States throughout its constitutional history. The case contributes to the evolution of the horizontal and vertical equilibrium of powers within the United States constitutional framework. The horizontal constitutional equilibrium on the federal level moves in favor of the legislative branch. At the same time the case redefines the powers of the federal state in the vertical equilibrium of the division of powers between the federal government and the states. Throughout United States’ constitutional history, the question of federalism has also been a question of the degree of accepting state intervention within civil society. In redefining this constitutional equilibrium among the horizontal and the vertical division of powers and by founding the individual mandate on the taxation powers of Congress, it remains consistent with a liberal conception of the role of the state, which does not engage in a wider redistributive policy. The philosophical foundation of the law on the basis of a free rider argument, although bringing about some redistribution, remains within the limits of a conception of free market liberalism.
Keywords: Affordable Care Act, U.S., Healthcare Reform, Philosophical Foundations, Comparison to Europe
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