Is the individual mandate unconstitutional? Experts say no, but the far right keeps claiming the mandate goes beyond the power of Congress to regulate interstate commerce. The Senate health reform bill includes a section to make the case that the mandate is allowed, and cites the experience of Massachusetts to prove the point.
The Senate health reform bill (pdf) includes a 3-page preamble (section 1501, starting on page 320) of Congressional findings before the legal language setting up the individual mandate. The findings are essentially an advance brief to the Supreme Court in case a constitutional challenge is ever raised on the issue. The findings declare that health care is an economic activity that affects interstate commerce, and that the individual mandate furthers economic goals. The section includes the following:
(D) The requirement achieves near-universal coverage by building upon and strengthening the private employer-based health insurance system, which covers 176,000,000 Americans nationwide. In Massachusetts, a similar requirement has strengthened private employer based coverage: despite the economic downturn, the number of workers offered employer-based coverage has actually increased.
This is yet another, unexpected example of how Massachusetts health reform has paved the way for national reform.