Third judge rules health reform constitutional

A federal judge for the District of Columbia on Tuesday evening ruled that Democrats' healthcare reform law is constitutional, bringing the total to three.

Two other judges — one in Virginia, the other in Florida — disagree and have ruled against the law. The issue is likely headed to the Supreme Court after an appeals court weighs in.

Opponents of the law argue that its individual mandate violates the Constitution's Commerce Clause because it seeks to regulate inactivity. But the Obama administration says the decision not to purchase insurance is a form of economic activity because everyone participates in the healthcare market; people who don't have insurance and can't pay out-of-pocket, the administration argues, merely pass on their costs to people who have coverage.

Judge Gladys Kessler, a Bill Clinton appointee, agreed.

"Because of this cost-shifting effect, the individual decision to forgo health insurance, when considered in the aggregate, leads to substantially higher insurance premiums for those other individuals who do obtain coverage," she wrote in her ruling. "According to Congress, the uncompensated costs of caring for the uninsured are passed on by healthcare providers to private insurers, which in turn pass on the cost to purchasers of health insurance."

The D.C. case was brought by five individual taxpayers who have all gone without insurance for many years.

The ruling was immediately applauded by the administration.

"We welcome this ruling, which marks the third time a court has reviewed the Affordable Care Act on the merits and upheld it as constitutional," Department of Justice spokeswoman Tracy Schmaler said in a statement. "This court found — as two others have previously — that the minimum-coverage provision of the statute was a reasonable measure for Congress to take in reforming our healthcare system. At the same time, trial courts in additional cases have dismissed numerous challenges to this law on jurisdictional and other grounds. The department will continue to vigorously defend this law in ongoing litigation."