Obamacare Versus the U.S. Constitution

In a nation where Congress has already determined how much water your toilet tank can hold and whether you can purchase a 100-watt incandescent light bulb, the assertion of federal power is now so great and so unbounded that a case concerning the 2010 Patient Protection and Affordable Care Act (Obamacare), brought by 26 states will decide whether, in fact, there are any rights or powers left to the states.

What many Americans do not know is that the United States of America is composed of separate and sovereign republics, each with its own constitution. What has occurred, however, has been the erosion of states' rights and with that, the gradual distortion of the nation's central instrument of governance, the Constitution, to mean anything Congress wants it to say.

At the very heart of the Obamacare case the Supreme Court will hear Monday through Wednesday, March 26 through March 28, is the question of whether the federal government can coerce the states under the threat of withholding funds—in this case for Medicaid.

Obamacare vastly expands Medicaid, but it should also be noted that Medicaid has been expanded over the years without evoking this kind of organized resistance. Over a million Americans descended on Washington, D.C. on March 20, 2010 to demand that it not be passed. They were dismissed by the White House that bribed and pressured members of Congress who, it turns out, never even read the law before voting on it.

Created in 1965, Medicaid was intended to ensure that low-income individuals and families secure medical care. Obamacare represents that largest expansion in its history. As the largest federal-state funding program, in 2010 it represented some $401.4 billion. Predictions of what Obamacare will cost are over the moon.

At present, some 60 million Medicaid beneficiaries include one in four children, severely disabled people, many nursing home residents, and low-income pregnant women. Children's and trauma hospitals heavily rely on Medicaid funding. Under Obamacare, if ruled constitutional, more than 30 million more people are expected to gain health coverage through Medicaid.

The likelihood is that a federally administered health care system will destroy what is widely regarded as the best private sector health system in the world. It will put the government squarely between the physician and his patient, determining who receives treatment and the amount and cost of that treatment.

The issue of contention for many Constitutional scholars and others is Obamacare's demand that everyone either purchase a health insurance program or pay a fine for not doing so. Congress asserts this under the Commerce Clause, Article I, Section 8, Clause 3, that says it shall have the power "To regulate Commerce with foreign Nations, and among the several States, and with Indian Tribes."

The early Supreme Court led by the fourth Chief Justice John Marshall (serving from 1801 to 1835) broadly interpreted these powers, extending federal jurisdiction over a number of aspects of intrastate and interstate commerce. In more recent times, under Justice William Rehnquist, (serving 1986 to 2005) the Court restricted interpretation of the Clause to allow states more control over business conducted within its borders.

The tensions between the states and the central government have always been part of the life of the nation and the Civil War was the ultimate test of whether states can secede from the Union if they feel their rights are being trampled upon. Under the many progressive social justice programs instituted since the 1930s, federal programs have acquired the power to coerce states to do its bidding simply by threatening to withhold billions in funding.