Fundamentally, the federal government has been making the same point since it began defending the coverage mandate: People will inevitably need healthcare, so forcing them to buy insurance is simply a matter of regulating how those services are paid for.
But the latest brief frames that argument in notably sharper terms than earlier filings.
“Because the need for health care is unpredictable, plaintiffs’ approach would require that individuals obtain insurance or else risk being left on the street after a car accident,” the government said. “Thus, under plaintiffs’ scheme, the penalty for failing to maintain minimum coverage — denial of treatment — would be far more draconian than the tax penalty that Congress enacted.”
The Justice Department appealed to the 11th U.S. Circuit Court of Appeals after a lower court ruled that the coverage mandate is unconstitutional. The judge sided with critics who argue that the federal government cannot force people to participate in a particular form of economic activity just because they are citizens.
In the Justice Department’s view, the mandate is constitutional because everyone will need healthcare at some point. So the insurance mandate regulates a purchasing decision.
The government specifically addressed questions — raised by both the states and the lower-court judge — over whether upholding the mandate would open the door to requiring people to buy vegetables, in the name of public health. Again, the brief argues that the insurance mandate regulates how people pay for a service, rather than requiring them to buy one.
“Health insurance is not designed to compel the purchase of health care services; instead, it ensures that the consumer will have the means to pay for health care services when they are needed,” the brief says.